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2006-August
File Copy • ,Jefferson County Board of HeaCth .agenda • N1 mutes August 17, 2006 • JEFFERSON COUNTY BOARD OF HEALTH Thursday,August 17,2006 Main Conference Room Jefferson County Public Health 2:30—4:30 PM DRAFT AGENDA I. Approval of Agenda II. Approval of Minutes of July 20,2006 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. Board Recommendations: Green Business 2. Cyanobacteria & Vibriosis Update 3. JCPH Public Education & Outreach Plan • V. New Business 1. Joint Committee on Public Health Financing 2. Health Care Worker Vaccination—Time for a Mandate? 3. Jefferson County Point of Dispensing(POD) Exercise Report VI. Activity Update 1. Pandemic Influenza Community Forums VII. Agenda Planning VIII. Next Scheduled Meeting: September 21,2006 2:30 PM—4:30 PM Main Conference Room Jefferson County Public Health • DRAFT • JEFFERSON COUNTY BOARD OF HEALTH MINUTE S Thursday, July 20, 2006 Board Members: Staff Members: David Sullivan, Chairman—County Commissioner District#2 Jean Baldwin,Public Health Services Director Patrick M. Rodgers, Vice Chairman—County Commissioner Julia Danskin, Nursing Services Director District#3 Thomas Locke,MD,Health Officer Phil Johnson—County Commissioner District#1 Mike McNickle, Environmental Health&Natural Jill Buhler—Hospital Commissioner District#2 Resources Director Geoff Masci—Port Townsend City Council Sheila Westerman— Citien at Large (Ci ) Roberta Frissell—Citizen at Large(Couny) The meeting was called to order at 2:30 pm on July 20, 2006 by Chair David Sullivan in the conference room of the Jefferson County Public Health Department. All Board members were present with the exception of Commissioner Johnson, Member Frissell and Member Masci. All staff were present. • APPROVAL OF AGENDA Board Member Buhler moved to approve the agenda as written. Board Member Westerman seconded the motion,which carried by a unanimous vote. APPROVAL OF MINUTES Board Member Buhler moved to approve the minutes as written. Board Member Rodgers seconded the motion,which carried by a unanimous vote. PUBLIC COMMENTS Chair Sullivan called on the public for comments. A member of the community pointed out that his comment at the Board of Health meeting in June was not an accurate representation of his intent. He restated that the Jefferson County Code, as adopted by the Board of Commissioners on October 20, 2005, and as codified on the official website, does not show the amendments that were approved by the BOH on October 15, 2005. Another community member, who is a commercial clam farmer, expressed concern over the `threatened' area in Discovery Bay. He has reviewed DOH water quality numbers and • believes that there are many variables determining the levels of fecal coliform. He feels that it's too early in the process to know if water quality is being degraded and doesn't feel that it's necessary to form a Shellfish Protection Taxing District. West Nile Virus Newsletter, Summer 2006 Dr. Locke stated we are back in our monitoring mode for West Nile Virus (WNV). The virus made its appearance in Washington State last year. Mosquitoes that were positive for WNV were found in the Yakima area but there were no human or animal cases. There is speculation that northern states, like Maine, Washington and Alaska may not have the right kind of migration of bird/mosquito populations to effectively spread WNV throughout the state. Dr. Locke brought to the Boards attention a study about Culex Pipiens mosquito and how it changes its diet as the year progresses. The Culex Pipiens is the dominant WNV vector in the WA. The study found that the Culex have an appetite for birds earlier in the summer. When the birds leave late in summer,they switch over to humans. This may explain why we see human WNV cases peaking at the very end of summer. In response to a question about which birds are monitored for WNV infection, Dr. Locke pointed out that we focus on corvids rather than other bird types because the WNV fatality rate is higher in corvids. Thus if WNV is causing bird deaths, it is most likely to show up with increased corvid deaths. However, robins, condors, eagles and other birds can get WNV, it's just not as lethal. Board Correspondence Mike McNickle addressed the letter sent to Jefferson County Public Health by the Pacific Coast Shellfish Growers Association. The Association expressed their concern that the DOH, which does periodic water quality monitoring of commercial shellfish beds stated • that Discovery Bay had enough fecal coliform bacterial pollution to be listed as "threatened". Mike McNickle said we need to identify the sources of pollution and correct them, whether a result of failing septic systems or upland manure problems. He stated that these issues would be brought before the Board of County Commissioners in order to strategize and formulate a plan to avoid having the shellfish beds conditionally closed or closed. Mike explained DOH's system for testing. Samples are taken over time and a geometric mean is computed. It can take several years before improvements in water quality significantly alter this geometric mean. Dr. Locke stated that some of the measures Jefferson County is currently implementing have a beneficial impact on marine water quality. Making sure that On-Site Sewage systems are being appropriately maintained and that our illegal systems (which directly discharge into marine waters) are detected and stopped are ongoing environmental health priorities. Another factor that can cause high fecal coliform numbers is agricultural run- off from upstream farms. Mike McNickle and Dr. Locke met with City officials and discussed plans for monitoring Lords and City lakes for Cyanobacteria. Even though these lakes are low risk, monitoring is important because they are drinking water sources. The Kai Tai Lagoon and PT Golf Course pond are at risk for toxic algae but are off limits to the public-- posted and fenced and thus not an imminent public health threat. • • Cyanobacteria Update Mike McNickle handed out a monitoring table concerning various lakes in Jefferson County. Anderson Lake, Gibbs Lake and Lake Leland as well as other area waters are monitored weekly. The results from testing are now on JCPH website, www.jeffersoncountypublichealth.org. Mike McNickle pointed out that last week the species varied from Anabaena with anatoxin to microcystis with microcystin toxin to lyngbea wollei that can produce saxitoxin. Mike explained that saxitoxin is like the Red Tide toxin, a neurological toxin. Mike McNickle is working with the State Parks and they want to keep Lake Anderson closed until further notice. Anderson Lake is the hardest hit lake with algae blooms. Washington State Parks have agreed to finance a monitoring program at Anderson Lake from May— Sept. 2007, performing weekly monitoring and paid for a small percentage of 2006 monitoring. Mike McNickle reported that there is statewide interest and that toxic algae lakes are becoming an issue. DOH held a Toxic Algae Forum last week and brought together several counties to formulate a protocol and procedure to standardize plans. DOE said there would be grant funding available in 2007 for monitoring. Solid Waste Enforcement Update A power point presentation was presented by Mark Nelson, Environmental Health Specialist on Solid Waste. He pointed out the two basic approaches to Solid Waste was Enforcement and Education. Solid Waste education programs are offered to the • community in an effort to change behaviors and encourage community members to make better choices with regards to Solid Waste. Mark Nelson spoke briefly about two current education projects currently underway. One project involves Tami Pokorny, Environmental Health Specialist, who is working with the school districts trying to increase their participation in the recycling program. She is also our local videographer working on presentations for PTTV, showing the benefits of recycling vs. dumping. The other project involves Jasmine Fry, Environmental Health Specialist, who is working on awards programs with Green Business and EnviroStars. Mark explained enforcement efforts involving either Hazardous Waste or Solid Waste. Mark discussed the DOE complaint system called Environmental Report Tracking System (ERTS). Mark showed examples of current ERTS complaints and explained the necessary steps taken to follow up on a complaint and noted that Model Toxics Control Act sets a 90 day deadline for an initial investigation. Mark reported since the Solid Waste Ordinance was passed in October 2005 and the public has become aware of specific requirements of the ordinance, complaints have significantly increased. Mark Nelson stated 234 complaints have been filed since October 2005. From October- December 2005, 85 were received. In 2006 149 complaints were received with 89 closed to date. Each complaint averages 3-8 hours of work. It is estimated we have removed 20 tons of garbage and 100 vehicles, cited 10 illegal dumpers and written 21 citations to date, 3 of which were rescinded. • Chair Sullivan stated solid waste has been a major concern in this county for a long time • and the problem is finally being tackled. He thanked Mike McNickle and his EH staff for all of their efforts. Mike touched briefly on a coupon program grant for $30,000 he has applied for from the Department of Ecology through their off cycle grant application process. Mike explained how the grant worked. If you want to remove a junk car, JCPH would provide the recipient with a coupon that they would give to the tow truck driver. The driver would redeem the coupon through JCPH and get paid for 75%of the cost of moving the vehicle. Mike explained that we are also working with Ecology on a pharmaceutical disposal project regarding proper disposal of all non-controlled substances. Member Rodgers asked that the Board be kept up to date on the Coupon Program. Member Westerman mentioned that we needed to make sure that the Ordinance amendment was written to reflect exactly what was stated at the Board of Health meeting of October 2005. Mike said that he worked with County attorney David Alvarez and JCPH staff to look at the amendment. It was determined that amendments made to the draft ordinance by the BOH had been inadvertently omitted from the final document. This is known as a"scrivener's error". Since the Board of Health has already acted on the issue and that action is clearly recorded in the minutes and audio recordings of the meeting, we are allowed to correct the error in the solid waste code without further Board action. • NEW BUSINESS EnviroStars Award for Dentistry Northwest Mike McNickle informed the Board that Dentistry Northwest is being recognized by EnviroStars and have reached a 5 star rating. Board Chair Sullivan signed the award certificate on behalf of the Board of Health. Waste Reduction and Recycled Product Procurement Policy Mike presented a draft of the Waste Reduction Policy, which is part of the Green Business Program, for review and comment. This is the first effort to include the Jefferson County Public Health as a Green Business. Member Westerman pointed out the cost difference in recycled products. She feels that recycled products generally cost more. Member Westerman asked about what a "reasonable price" entailed. Jean Baldwin said that after all of our supplies were tracked through purchasing, Jefferson County Public Health already supported recycled product purchasing with the exception of those supplies that are purchased county wide. 2006-07 Tobacco Workplan Highlights Kellie Ragan gave an update on the work that is being done through the Tobacco Prevention Program. A Tobacco Advisory Board will be organized,which will further the prevention efforts in Jefferson County. The efforts will target the population with the • • greatest risk: 18-34 year olds, households with children, and those with less than a high school education. The Healthy Youth Survey will be a continuing effort. Compliance checks will continue. A new piece of the program will be focused on Employer Cessation Support. Jefferson Health Care is working towards a smoke-free campus. There will be continued monitoring and enforcement of the Clean Indoor Air Act as well as organizing a Secondhand Smoke Task Force. Kellie has also been doing some fact-finding around the Employee Assistance Programs (EAP) and has discovered there is very little information and support around cessation. EAP's refer people to either the American Lung Association or the Cancer Society. Kellie had the opportunity to shadow a client who is working at Harborview. At every patient visit, health care providers ask the question "do you smoke and are you interested in quitting." This question can be one of the most effective interventions. Proposed Board of Health Bylaws Changes Dr. Locke presented the first draft of the Bylaw changes for review. There were minor verbiage changes to coincide with the ordinance. Two new sections were added to the draft, Public Hearings and Appeals Hearings. He explained that the individual ordinances have appeals language but there are no protocols for public hearings. Dr. Locke explained that the Board could take action on this at any meeting but it takes 2/3 majority vote to change the Board's bylaws. Member Westerman suggested that this continue to appear on the agenda until there is • full attendance to take action on the proposed Bylaws changes. 2007 Budget Process Update Veronica Morris-Nakano spoke briefly about the 2007 budget. She told the Board that the 2007 Budget process has started. She said we are facing the normal challenges with the increase in wages and benefits and the increase in building rent. This year we will be submitting a budget appropriation requesting an increase in our General Fund to cover the bargaining members wage and benefit increase for the year 2006. The budget appropriation is essential for our carry over into 2007. This was also done in 2005. Veronica handed out a cost comparison of Information and Central Services costs for 2003-2007 showing the items that have been and continue to be a budget challenge. The increase in building rent was discussed at great length. Member Westerman expressed her concern over the methodology used in calculating the building rent and asked Veronica Morris-Nakano to inform the Director of Central Services that the BOH is interested in the basis of his rationale in calculating building rent. She pointed out when these costs increase the programs that are important to the community, which the BOH support and do their best to make sure continue, suffer . New Vaccines—Costs, Benefits, Controversies • Dr. Locke gave an overview of the new Human Papillomavirus (HPV) vaccine. He stated this is the first anti-cancer vaccine and it can have a huge impact on cervical cancer rates over time. Dr. Locke pointed out that the cost of the vaccine is $360 to immunize each child, which is more than all the other childhood vaccines combined. Agenda Planning—On-Site Sewage Code Revision Process The On-Site Sewage System state code is going to be adopted June 30, 2007 so we will start the process of revising our On-Site Sewage System code to match the state code. There will be a few issues being brought before the Board for direction, which include operation and maintenance. The PUD is eagerly waiting for us to take over the 0 & M program. Mike feels that it would be beneficial to take on the project as soon as possible. Member Westerman commented that approximately 1-2 years ago there was discussion about allowing the private sector to handle this. She would like to see us move in that direction. Chair Sullivan adjourned the meeting at 4:30 p.m. Next Board of Health meeting is August 17, 2006. JEFFERSON COUNTY BOARD OF HEALTH • David Sullivan, Chair Jill Buhler, Member Patrick M. Rodgers, Vice Chair Sheila Westerman, Member Excused Excused Roberta Frissell, Member Phil Johnson, Member Excused Geoff Masci, Member • • Jefferson County Board of HeaCth OldBusiness .agenda Item # 11�, 1 • Board Recommendations: Green Business .august 17, 2006 • • JEFFERSON COUNTY PUHEALTH SON OGS 615 Sheridan Street • Port Townsend • Washington • 98368 „ 360-385-9400 Fax 360-385-9401 • sif J N - www.jeffersoncountypublichealth.org August 10, 2006 PO Box 1220 Jefferson County Board of Health Port Townsend, WA 98368 Dear Board of Health Members: The Green Business program is proud to announce two more businesses have obtained certification; Circle & Square, and Pane d'Amore. Each of these businesses is going the extra mile to conserve water, energy and other resources. They are leaders in the community and each of them have developed unique ways to protect the environment while doing business. After signing the award, please return it to: • Jefferson County Public Health Solid Waste Management Program 615 Sheridan Street Port Townsend, WA 98368 Thank you for your continued support of the Green Business Program! Sincerely, / Jasmine Fry Environmental Health Specialist 0 COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES ALWAYS WORKING FOR A SAFER AND NATURAL RESOURCES 360-385-9400 HEALTHIER COMMUNITY 360-385-9444 74 4 Z w el AI ON • :,..,;-41-_ ,,,,,,-,-:-:::p-k?;.ac'--t- -,..--,--It-sc':::.I.,-o'::.t.v.:, ---- 7:410- , . _ -_--,,,:..,,-",-L'_:','?,'-2-- 0 U r7 •N0 cv 4'4'l'-'41'''''"-'' ' ' -'''',73;':-.41:;'e:''t.'14--' 4'!"*";*';':;''-4'. 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You are here: DOH Home » Environmental Health » Food Safety and Shellfish » Biotoxin Search Employees This information is also available toll free at 1-800-562-5632. (This information is only updated when conditions change) Conditions as of August 11, 2006 LAST CHANGE 8/9/2006 2:59:03 PM In Jefferson County, Oak Bay is closed to all species of shellfish. The following beaches are CLOSED to the recreational harvest of the species listed. All species means clams (including geoduck), oysters, mussels and other invertebrates such as the moon snail. Commercial shellfish harvesting may not be restricted, based on selected testing of shellfish lots. It is important to know the difference between butter clams and other species of clams. Butter clams have the ability to retain toxin for a very long time -up to a year or more. Areas may be closed for the sport harvest of butter clams when all other species are safe and open. The Department of Fish and Wildlife has pictures and descriptions of butter and other types of clams posted on their web site at http://www.wdfw.wa.govilishishelfish/beachreg/lclam.htm. • The Ocean beaches are closed to the sport harvest of all species of molluscan shellfish from April 1 to October 31 each year. The exception to this is razor clams on designated open beaches. All areas are closed for the sport harvest of scallops. The following closures do not apply to crab and shrimp. This bulletin only represents the Biotoxin Health Status of beaches. For additional pollution closures check the clickable maps. Please check the WDFW Web site for seasons and limits. Check Out The Beach Maps. County Area Species Clallam Seasonal closure of ocean beaches from Cape Flattery south to the All county line. Species Sequim Bay and Discovery Bay. Butter Clams Only The Strait of Juan de Fuca from Dungeness Spit westward to Cape All 0 Flattery. Species Grays Harbor Seasonal closure of ocean beaches. All http://www4.doh.wa.gov/gis/mogifs/biotoxin.htm 8/11/2006 Biotoxin.bio Page 2 of 3 I II Species • Island No Closures. No Closures Jefferson Discovery Bay and Kilisut Harbor. Butter Clams Only Seasonal closure of ocean beaches. All Species Oak Bay, Mystery Bay, Port Ludlow and Mats Mats Bay. All Species Hood Canal including Quilcene and Dabob Bays. Oysters Only King Three Tree Point south to the Pierce County line including Vashon All Island. Species Kitsap All of the eastern side of the county from Foulweather Bluff south to All the Pierce County line including Bainbridge Island, Liberty Bay, Species Sinclair Inlet, Agate Passage, Rich Passage, Yukon Harbor, Colvos Passage including Blake Island and Dyes Inlet. Hood Canal including Port Gamble. Oysters Only • Mason Hood Canal including Annas Bay, Oakland Bay, Skookum and Totten Oysters Inlets. Only Pacific Seasonal closure of ocean beaches. All Species Pierce Commencement Bay, Colvos Passage and the Narrows south to the All Narrows Bridge. Species San Juan No Closures. No Closures Skagit Fidalgo Bay, Sinclair and Cypress Islands. All Species Samish Bay. Oysters Only Snohomish Picnic Point south to the county line. Butter Clams Only Thurston Totten and Eld Inlets. Oysters Only Whatcom No Closures. No Closures S DOH Home I Access Washington I Privacy Notice IDisclaimer/Copyright information http://www4.doh.wa.gov/gis/mogifs/biotoxin.htm 8/11/2006 Oyster growing area closures expanded due to vibriosis outbreak- 8/03/06 - Washington State Dept of H... Page 1 of 2 gtwoo stye arentivoi iHeat , , ,,,, ,sc, ri,.. ,,,., .. .,,,,,, You are here: DOH Home » News Releases Home » 06-121 Search l Employees For immediate release: August 3, 2006 (06-121) Contacts: Tim Church, Communications Office 360-534-0068 Deanna Whitman, Communications Office 360-236-4022 Oyster growing area closures expanded due to vibriosis outbreak OLYMPIA—The Department of Health is closing more oyster growing areas due to a bacteria that is making people sick. The state now has 86 reported cases of vibriosis related to eating raw oysters. Most of the illnesses recently reported occurred before the Department of Health's latest commercial closures on July 24. The oyster harvest closure list now includes all recreational beaches and commercial growing areas in Hood Canal, Samish Bay, Oakland Bay, Mystery Bay, Skookum Inlet, Totten Inlet and Eld Inlet. "The closure of all of Hood Canal is precautionary due to the number of growing areas in the canal that have now been associated with these illnesses," said Nancy Napolilli, director of the department's Office of Food Safety and Shellfish. e dudepartment has expanded the recall to include these additional growing areas and is working closely with the stry to assure oysters from these growing areas are removed from the market. The best way people can avoid this illness is to not eat raw oysters for the time being. Vibriosis is not a problem with cooked oysters. The bacteria are killed when oysters are cooked to 145°F. There are still 77 growing areas in the state that are open and approved for shellfish harvest. Vibriosis is caused by a naturally occurring bacterium, Vibrio parahaemolyticus. Symptoms usually appear about 12 hours after eating infected shellfish but can begin within two hours or as late as 48 hours after consumption. The illness is usually mild to moderate and lasts for two to seven days; it can be life threatening to people with immune dysfunction or chronic liver disease. Unseasonably warm temperatures and afternoon low tides are thought to be major contributors to this outbreak. Areas that have been closed will be reopened when two consecutive oyster samples do not contain the strain of Vibrio parahaemolyticus. Updates on closures of recreational beaches and commercial growing areas (http://www.doh.wa.gov/) can be found on the agency's Web site, under "In the News." ### DOH Home I Access Washington I Privacy Notice I Disclaimer/CopyrightInformation i i i E ,;',;, Contact Information for the Department of Health http://www.doh.wa.gov/Publicat/2006_news/06-121.htm 8/11/2006 JCPH :: Working for a safer and healthier Jefferson I Lake Water Quality I Lake Water Quality Page 1 of 4 p 4„, t " s 4R A, ! HOME t HEALTH ENVIRONMENT I I INFORMATION NEWS ABOUT JCPH Home > Environment > Lake Water Quality Lake Water Quality Environmental Health works to monitor water quality at the various lakes in Jefferson County. t.j These readings are periodically updated as new tests are conducted the the results of the tests become available. Anderson Lake Lake Leland Beausite Lake Lower Putaansuu Creek Chinese Gardens Sandy Shore Crocker Lake Silent Lake Gibbs Lake Tarboo Lake Kah Tai Pond Teal Lake Upper Putaansuu Creek Anderson Lake • Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/5/2006 1,500,000 Anabaena 20 ppb 6/19/2006 Closed 6/26/2006 Closed 7/3/2006 27,000,000 75% Microcystis 5-10 ppb Closed until further notice. 7/10/2006 1,280,000 Lyngbya ocracea 7 ppb Closed until further notice. 7/17/2006 190,000 Lyngbya ocracea Closed until further notice. 7/24/2006 580,000 Lyngbya ocracea Closed until further notice. 7/31/2006 560,000 Saxitoxin 1 ppb Closed until further notice. Beausite Lake Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 10,100 Not Tested under regular observation 6/26/2006 under regular observation Chinese Gardens Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 3,600 Microcystis Not Tested 7/17/2006 Observed i http://www.jeffersoncountypublichealth.org/index.php?id=171,0,0,1,0,0 8/11/2006 JCPH :: Working for a safer and healthier Jefferson I Lake Water Quality I Lake Water Quality Page 2 of 4 • Crocker Lake Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 270,600 Gleotrichia No Toxins under regular observation 6/26/2006 Observed 7/12/2006 Observed 7/17/2006 Observed 7/19/2006 Observed 7/24/2006 Observed 7/31/2006 Observed Gibbs Lake Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/6/2006 21,400 Gleotrichia 6/12/2006 46,300 Aphanizomenon 6/19/2006 58,200 Aphanizomenon Not Tested Open 6/26/2006 33,300 Aphanizomenon Open 7/3/2006 46,000 57% fannie, OK for recreational contact 34% mike + others 7/10/2006 10,900 Microystis OK for recreational contact 7/17/2006 150,000 Aphanizomenon OK for recreational contact • 7/24/2006 103,000 Microystis OK for recreational contact 7/31/2006 103,000 Microystis No Toxins Ok for recreational contact Kah Tai Pond Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 3,600 Aphanizomenon Not Tested 6/26/2006 Observed 7/17/2006 Observed Lake Leland Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/6/2006 96,100 Aphanizomenon 6/12/2006 97,700 Aphanizomenon No Toxin 6/19/2006 220,000 Microcystis No Toxin Use Bottled Water for Drinking if using Lake Leland as potable water supply 6/26/2006 37,700 Aphanizomenon Use Bottled Water for Drinking if using Lake Leland as potable water 1111 supply 7/3/2006 31,900 Microcystis Ok for recreational contact http://www.j effersoncountypublichealth.org/index.php?id=171,0,0,1,0,0 8/11/2006 JLPH :: Working for a safer and healthier Jefferson l Lake Water Quality 1 Lake Water Quality Page 3 of 4 411 7/10/2006 24,200 Aphanizomenon Ok for recreational contact 7/17/2006 57,700 Microcystis Ok for recreational contact 7/24/2006 96,000 Anabaena-50% Ok for recreational Aphanizomenon- contact 50% 7/31/2006 20,000 Microcystis Ok for recreational contact Lower Putaansuu Creek Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/12/2006 900 Microcystis 7/17/2006 Observed Sandy Shore Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 44,500 Anabaena Not Tested 7/12/2006 Observed 7/19/2006 Observed 7/26/2006 Observed • 7/31/2006 Observed Silent Lake Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 20,500 Microsystis Not Tested 6/26/2006 Observed 7/12/2006 Observed 7/19/2006 Observed 7/26/2006 Observed 7/31/2006 Observed Tarbox Lake Sample Date Cell Count Algage ID Toxicity Result Recommendaton 6/19/2006 23,700 Anabaena Not Tested 7/19/2006 Observed 7/26/2006 Observed 7/31/2006 Observed • TealLake Sample Date Cell Count I Algage ID I Toxicity Result I Recommendaton http://www.jeffersoncountypublichealth.org/index.php?id=171,0,0,1,0,0 8/11/2006 JLPH :: Working for a safer and healthier Jefferson I News I Bacterial Outbreak in Shellfish Page 1 of 1 4111' "I* AC, • .�9 1464 ,., ✓, a3: A... 0 ... ® <...5. �.���.,..YY E,y^� yg�.,,54� -'shy _ i HOMEI I HEALTH E ENVIRONMENT INFORMATION NEWS ABOUT JCPH Home > News Bacterial contamination found in oysters can lead to illness Thorough cooking will kill bacteria and leave shellfish safe to eat Port Townsend, WA - A sporadic bacterial outbreak in Puget Sound has sickened several people across the state. The bacteria, Vibrio parahaemolyticus, are found primarily in oysters but can infect other shellfish as well. The Washington State Department of Health tests samples for the bacteria each year from May to October. The samples show sporadic bacterial contamination in shellfish throughout South Puget Sound, Hood Canal and Willapa Bay. Vibrio causes a variety of symptoms including diarrhea, abdominal cramps, nausea, vomiting, headache, fever, and chills. The symptoms usually appear about 12 hours after eating infected shellfish but can occur anywhere from 2 to 48 hours after consumption. The illness is usually mild to moderate and lasts for 2 to 7 days. Thorough cooking will kill the bacteria and leave the shellfish safe to eat. The risk comes from eating raw shellfish, especially oysters. "During warm weather months the risk of infection by SVibrio parahaemolyticus is increased and shellfish should be thoroughly cooked to prevent illness," said Richard Lillie, Vibrio Coordinator for the Office of Food Safety and Shellfish. "This also includes shellfish purchased at the supermarket." The agency will continue to monitor bacteria levels in oysters throughout the warm weather months. "While many people think it's great to slurp a fresh oyster, they can expose themselves to a variety of health risks," Lillie said. "Shellfish currently on the market should be safe to eat, provided that they have been kept refrigerated or iced after purchase and are thoroughly cooked to 145° F," Lillie said. The general public should look at notification of closure for marinas and recreational beaches by checking the department's Biotoxin web site or the biotoxin hotline at 1-800-562-5632. Harvesters should also look for and obey warning signs that have been posted at marinas and recreational beaches. Please call Neil Harrington if you have any questions about this press release at 360-385-9444. Back ....__..._._... Jefferson County Public Health 615 Sheridan Street-Port Townsend, WA 98368 360.385.9400 info@j.effersoncountypublicheaIth.org Jefferson County HomePafle Web Site by Lineangle Internet Solultions S http://www jeffersoncountypublichealth.org/index.php?id=5,243,0,0,1,0 8/11/2006 • Jefferson County Board-of 3-fealth OCdBusiness .Agenda Item # �V., 1 • Joint Committee on Public 3-realth financing August 17, 2006 • • July 17, 2006 The Honorable Shay Schual-Berke, Chair Joint Select Committee on Public Health Finance PO Box 40600 Olympia, WA 98504-0600 Dear Representative Schual-Berke: At the June 20, 2006 hearing of the Joint Select Committee on Public Health Finance, you asked the public health community to respond to the following question: "How much additional funding would the public health community be ready to spend in the first year or biennium?" Enclosed with this letter is a thoughtfully prepared response to that question. It includes a work plan that has all local health jurisdictions collaborating as a system to support rapid implementation of as well as recruitment for a large number of new positions. With this plan, we • are confident that we can responsibly expend a significant infusion of new dollars. Sherri McDonald, Rick Mockler, and John Wiesman from Thurston, Snohomish, and Clark counties, will be at the July 17, 2006 Committee hearing to present this plan and to answer any questions you and the Committee may have regarding the spending plan. Sincerely, Vicki Kirkpatrick Administrator Washington State Association of Local Public Health Officials Cc: Mary Selecky, Secretary of Health Joan Brewster, Department of Health Sherri McDonald, Director, Thurston County Public Health& Social Services Department Rick Mockler, Deputy Director, Snohomish Health District John Wiesman, Director, Clark County Public Health Local Public Health Officials • Joint Select Committee on Public Health Finance • Request for Information: Increase Spending for Public Health WSALPHO/DOH Response - July 17, 2006 Request At the June 20, 2006 meeting of the Joint Select Committee on Public Health Finance, the Committee asked for additional information about how the public health system would propose to spend additional funding in the first biennium. I. Response Overview The Washington State Association of Local Public Health Officials (WSALPHO) has met along with staff from the Department of Health(DOH) and determined that: • a minimum initial investment of$50 million of new funding the first year of the biennium can be responsibly appropriated and fully expended, and • a minimum $100 million investment the second year of the biennium can be responsibly appropriated and fully expended. • This initial investment will: • initiate implementation of the first of the three tierslof prioritized public health services in Year 1, • implement data and technology needs in Year 1, and • fully implement Tiers I and II in Year 2. To implement this plan, the public health system stands ready to work in advance of a budget decision from the legislature so we can be most responsive. In other words,we will assume the risk of starting work based on: • having heard that each committee member supports additional funding for public health and • believing that each party will put forward a good faith effort to work with their leadership in passing a budget that results in a substantial additional investment in this state's public health services. Finally, the underlying assumption is that all funding currently in the public health system from all sources (federal, state and local)would remain in the system. The current documented gap is $311 million per year. • 'Noted on pages 12 and 13 of the document,Creating a Stronger Public Health System presented to the Committee in May 2006. 2 • II. Strategy for Implementation Year 1 - Tier I (July 2007 - June 2008) Everyone understands that recruiting and hiring staff takes substantial time and effort. We are also very aware of the current nationwide nursing shortage. In hiring the staff needed to implement Tier I, we will assume a five month delay, on average, for all positions to be filled. This then allows for an initial investment in data and technology which can be quickly initiated. Using the $50 million Tier I figure, this translates to $20 million of data and technology investment and$30 million in public health services during the first year. PUBLIC HEALTH DATA AND TECHNOLOGY The initial $20 million investment for data and technology is proposed as follows. Table 1: Data and Technology Investment g � � c a. $2.5 Behavior Risk Factor Surveillance Purchase additional interviews for each System county to obtain health status and risk monitoring data at the county level and obtain public health system indicators. $3.5 Pubic Health Information Management Complete development of the PHIMS System(PHIMS) system to include all notifiable • conditions for disease reporting and investigation. $1.5 Emergency Response and Purchase an electronic system to register Communication and manage volunteers for deployment during public health emergencies. $3.0 Community Health Assessment Update current data systems (VISTA) with up-to-date death and illness data and upgrade the technology that supports this system. $2.0 Drinking Water database Complete statewide enhancement of drinking water database for more comprehensive data collection and analysis. $4.5 Special Population Surveys Collect data on populations of special interest(e.g.,pregnant and parenting women and school-age youth) at the county level. $2.0 Emergency Department data Begin data collection in hospital emergency departments to have more "real-time" data on health threats within communities (both immediate and chronic). • $1.0 Data Training Materials, classes, and software for data analysis (e.g., STATA, SAS, etc). $20.0 TOTAL Initial Investment 3 PUBLIC HEALTH SERVICES AND FTE • What follows are the service area FTE allocations to each local jurisdiction. It is worth noting that some jurisdictions will likely contract out portions of this work to community partners, so it is best to think of this as increasing the overall community capacity for public health services. Table 2: Year 1 Tier 1 Funding and FTEs-Communicable Disease 1 4..'01r Prdpottrthel Allocation of$8:04 - Resultrr illlllion to LHJs for ''!&'...1/1147-',40,' u 'it,; ,, 1 - g bl Full Suppo 3 � ,�'uF�d*eF�lealth�lttt'�sdtt[ctti, .. N ;�ik6 ,.,. tSi?. Vie., ,.., ,:�.$3.. a „ ,, . ,,. , ��i Adams County Health Dept. 17,300 0.27% $21,708 0.19 Asotin County Health Dist. 21,100 0.33% $26,532 0.24 Benton-Franklin Health Dist. 224,800 3.53% $283,812 2.53 Chelan-Douglas Health Dist. 105,800 1.66% $133,464 1.19 Clallam County Health Dept. 67,800 1.06% $85,224 0.76 Clark County Health Dept. 403,500 6.33% $508,932 4.54 Columbia County Health Dept. 4,100 0.06% $4,824 0.04 Cowlitz County Health Dept. 96,800 1.52% $122,208 1.09 Garfield County Health Dist. 2,400 0.04% $3,216 0.03 Grant County Health District 80,600 1.26% $101,304 0.90 Grays Harbor County Health Dept. 70,400 1.10% $88,440 0.79 • Island County Health Department 77,200 1.21% $97,284 0.87 Jefferson County Health Dept. 28,200 0.44% $35,376 0.32 Kitsap County Health Dist. 243,400 3.82% $307,128 2.74 Kittitas County Health Dept. 37,400 0.59% $47,436 0.42 Klickitat County Health Dept. 19,800 0.31% $24,924 0.22 Lewis County Health Dept. 72,900 1.14% $91,656 0.82 Lincoln County Health Dept. 10,200 0.16% $12,864 0.11 Mason County Health Dept. 53,100 0.83% $66,732 0.60 NE Tri-County Health Dist. 61,900 0.97% $77,988 0.70 Okanogan County Health Dist. 39,800 0.62% $49,848 0.45 Pacific County Health Dept. 21,500 0.34% $27,336 0.24 San Juan County Health Dept. 15,700 0.25% $20,100 0.18 Skagit County Health Dept. 113,100 1.77% $142,308 1.27 Skamania County Health Dept. 10,600_ 0.17% $13,668 0.12 Snohomish Health District 671,800 10.54% $847,416 7.57 Spokane Regional Health Dist. 443,800 6.96% $559,584 5.00 Tacoma-Pierce County Health Dept. 773,500 12.13% $975,252 8.71 Thurston County Health Dept. 231,100 3.62% $291,048 2.60 Wahkiakum County Health Dept. 3,900 0.06% $4,824 0.04 Walla Walla County Health Dept. 57,900 0.91% $73,164 0.65 Whatcom County Health Dept. 184,300 2.89% $232,356 2.07 Whtiman County Health Dept. 42,800 0.67% $53,868 0.48 Yakima County Health Dist. 231,800 3.64% $292,656 2.61 Public Health-Seattle&King County 1,835,300 28.79% $2,314,716 21.04 _TOTAL6,375,600 100.00% $8,039,196 72.15 e DOH Allocation $470,000 TOTAL ALLOCATION FOR CD $8,509,196 4 r • Table 3: Year 1 Tier 1 Funding and FTEs-Health Promotion topoi 1ottal ' A.oeatlon of �� t o $$47 i919n1; , t f s 8 0M zYe, r of�ol r ',4esctti[ig uhtt ,Heittf'du drttion .r; , � :'o1ii .P Isul on li �'f'orli lion 1,2 TEs Adams County Health Dept. 17,300 0.27% $25,569 0.23 Asotin County Health Dist. 21,100 0.33% $31,251 0.28 Benton-Franklin Health Dist. 224,800 3.53% $334,291 2.98 Chelan-Douglas Health Dist. 105,800 1.66% $157,202 1.40 Clallam County Health Dept. 67,800 1.06% $100,382 0.90 Clark County Health Dept. 403,500 6.33% $599,451 5.35 Columbia County Health Dept. 4,100 0.06% $5,682 0.05 Cowlitz County Health Dept. 96,800 1.52% $143,944 1.29 Garfield County Health Dist. 2,400 0.04% $3,788 0.03 Grant County Health District 80,600 1.26% $119,322 1.07 Grays Harbor County Health Dept. 70,400 1.10% $104,170 0.93 Island County Health Department 77,200 1.21% $114,587 1.02 Jefferson County Health Dept. 28,200 0.44% $41,668 0.37 Kitsap County Health Dist. 243,400 3.82% $361,754 3.23 Kittitas County Health Dept. 37,400 0.59% $55,873 0.50 Klickitat County Health Dept. 19,800 0.31% $29,357 0.26 Lewis County Health Dept. 72,900 1.14% $107,958 0.96 Lincoln County Health Dept. 10,200 0.16% $15,152 0.14 Mason County Health Dept. 53,100 0.83% $78,601 0.70 • NE Tri-County Health Dist. 61,900 0.97% $91,859 0.82 Okanogan County Health Dist. 39,800 0.62% $58,714 0.52 Pacific County Health Dept. 21,500 0.34% $32,198 0.29 San Juan County Health Dept. 15,700 0.25% $23,675 0.21 Skagit County Health Dept. 113,100 1.77% $167,619 1.50 Skamania County Health Dept. 10,600 0.17% $16,099 0.14 Snohomish Health District 671,800 10.54% $998,138 8.91 Spokane Regional Health Dist. 443,800 6.96% $659,112 5.88 Tacoma-Pierce County Health Dept. 773,500 12.13% $1,148,711 10.26 Thurston County Health Dept. 231,100 3.62% $342,814 3.06 Wahkiakum County Health Dept. 3,900 0.06% $5,682 0.05 Walla Walla County Health Dept. 57,900 0.91% $86,177 0.77 Whatcom County Health Dept. 184,300 2.89% $273,683 2.44 Whtiman County Health Dept. 42,800 0.67% $63,449 0.57 Yakima County Health Dist. 231,800 3.64% $344,708 3.08 Public Health-Seattle&King County 1,835,300 28.79% $2,726,413 24.79 TOTAL 6,375,600 99.99% $9,469,053 84.99 • 5 s Table 4: Year 1 Tier 1 Funding and FTEs Healthy Families • 3 A \ '"i�' � �.( cs i gar j © a '`,4071 N w, ubltc i ealth� ttsdre + t1 pulati( 1 O ' 1''ati . ,, 1tear ,°^ 5� � Adams County Health Dept. 17,300 0.27% $9,504 0.08 Asotin County Health Dist. 21,100 0.33% $11,616 0.10 Benton-Franklin Health Dist. 224,800 3.53% $124,256 1.11 Chelan-Douglas Health Dist. 105,800 1.66% $58,432 0.52 Clallam County Health Dept. 67,800 1.06% $37,312 0.33 Clark County Health Dept. 403,500 6.33% $222,816 1.99 Columbia County Health Dept. 4,100 0.06% $2,112 0.02 Cowlitz County Health Dept. 96,800 1.52% $53,504 0.48 Garfield County Health Dist. 2,400 0.04% $1,408 0.01 Grant County Health District 80,600 1.26% $44,352 0.40 Grays Harbor County Health Dept. 70,400 1.10% $38,720 0.35 Island County Health Department 77,200 1.21% $42,592 0.38 Jefferson County Health Dept. 28,200 0.44% $15,488 0.14 Kitsap County Health Dist. 243,400 3.82% $134,464 1.20 Kittitas County Health Dept. 37,400 0.59% $20,768 0.19 Klickitat County Health Dept. 19,800 0.31% $10,912 0.10 Lewis County Health Dept. 72,900 1.14% $40,128 0.36 Lincoln County Health Dept. 10,200 0.16% $5,632 0.05 Mason County Health Dept. 53,100 0.83% $29,216 0.26 NE Tri-County Health Dist. 61,900 0.97% $34,144 0.30 Okanogan County Health Dist. 39,800 0.62% $21,824 0.19 • Pacific County Health Dept. 21,500 0.34% $11,968 0.11 San Juan County Health Dept. 15,700 0.25% $8,800 0.08 Skagit County Health Dept. 113,100 1.77% $62,304 0.56 Skamania County Health Dept. 10,600 0.17% $5,984 0.05 Snohomish Health District 671,800 10.54% $371,008 3.31 Spokane Regional Health Dist. 443,800 6.96% $244,992 2.19 Tacoma-Pierce County Health Dept. 773,500 12.13% $426,976 3.81 Thurston County Health Dept. 231,100 3.62% $127,424 1.14 Wahkiakum County Health Dept. 3,900 0.06% $2,112 0.02 Walla Walla County Health Dept. 57,900 0.91% $32,032 0.29 Whatcom County Health Dept. 184,300 2.89% $101,728 0.91 Whtiman County Health Dept. 42,800 0.67% $23,584 0.21 . Yakima County Health Dist. 231,800 3.64% $128,128 1.14 Public Health-Seattle&King County 1,835,300 28.79% $1,013,408 9.21 TOTAL 6,375,600 99.99% $3,519,648 31.59 i • 6 • Table 5: Year 1 Tier 1 Funding and FTEs Health Information e � #�ropor#,ional Ldcal Alloeaf on of Tier ,, r r Healthy Percent of Information 7 ' '2064 OF . Tdta1 �F Funding `f1f2 Resulting 7/12 Public Health Jurisdiction Population.: 9 Poputatian. ;Year -; FTEs ,, Adams County Health Dept. 17,300 0.27% $11,880 0.11 Asotin County Health Dist. 21,100 0.33% $14,520 0.13 Benton-Franklin Health Dist. 224,800 3.53% $155,320 1.39 Chelan-Douglas Health Dist. 105,800 1.66% $73,040 0.65 Clallam County Health Dept. 67,800 1.06% $46,640 0.42 Clark County Health Dept. 403,500 6.33% $278,520 2.49 Columbia County Health Dept. 4,100 0.06% $2,640 0.02 Cowlitz County Health Dept. 96,800 1.52% $66,880 0.60 Garfield County Health Dist. 2,400 0.04% $1,760 0.02 Grant County Health District 80,600 1.26% $55,440 0.50 Grays Harbor County Health Dept. 70,400 1.10% $48,400 0.43 Island County Health Department 77,200 1.21% $53,240 0.48 Jefferson County Health Dept. 28,200 0.44% $19,360 0.17 Kitsap County Health Dist. 243,400 3.82% $168,080 1.50 Kittitas County Health Dept. 37,400 0.59% $25,960 0.23 Klickitat County Health Dept. 19,800 0.31% $13,640 0.12 Lewis County Health Dept. 72,900 1.14% $50,160 0.45 Lincoln County Health Dept. 10,200 0.16% $7,040 0.06 • Mason County Health Dept. 53,100 0.83% $36,520 0.33 NE Tri-County Health Dist. 61,900 0.97% $42,680 0.38 Okanogan County Health Dist. 39,800 0.62% $27,280 0.24 Pacific County Health Dept. 21,500 0.34% . $14,960 0.13 San Juan County Health Dept. 15,700 0.25% $11,000 0.10 Skagit County Health Dept. 113,100 1.77% $77,880 0.70 Skamania County Health Dept. 10,600 0.17% $7,480 0.07 Snohomish Health District 671,800 10.54% $463,760 4.14 Spokane Regional Health Dist. 443,800 6.96% $306,240 2,73 Tacoma-Pierce County Health Dept. 773,500 12.13% $533,720 4.77 Thurston County Health Dept. 231,100 3.62% $159,280 1.42 Wahkiakum County Health Dept. 3,900 0.06% $2,640 0.02 Walla Walla County Health Dept. 57,900 0.91% $40,040 0.36 Whatcom County Health Dept. 184,300 2.89% $127,160 1.14 Whtiman County Health Dept. 42,800 0.67% $29,480 0.26 Yakima County Health Dist. 231,800 3.64% $160,160 1.43 Public Health-Seattle&King County 1,835,300 28.79% $1,266,760 11.52 TOTAL 6,375,600 99.99% $4,399,560 39.49 DOH Allocation $380,000 TOTAL ALLOCATION $4,779,560 • 7 Table 6: Year 1 Tier 1 Funding and FTEs Environmental Health • * 0 4h Prtinal • NA, • •Ha , NH �� i A . rop000 a Adams County Health Dept. 17,300 0.27% $4,819 0.04 Asotin County Health Dist. 21,100 0.33% $5,890 0.05 Benton-Franklin Health Dist. 224,800 3.53% $63,002 0.56 Chelan-Douglas Health Dist. 105,800 1.66% $29,627 0.26 ' Clallam County Health Dept. 67,800 1.06% $18,919 0.17 Clark County Health Dept. 403,500 6.33% $112,976 1.01 Columbia County Health Dept. 4,100 0.06% $4,342 0.04 Cowlitz County Health Dept. 96,800 1.52% $27,129 0.24 Garfield County Health Dist. 2,400 0.04% $9,428 0.08 Grant County Health District 80,600 1.26% $22,488 0.20 Grays Harbor County Health Dept. 70,400 1.10% $19,632 0.18 Island County Health Department 77,200 1.21% $21,596 0.19 Jefferson County Health Dept. 28,200 0.44% $7,853 0.07 Kitsap County Health Dist. 243,400 3.82% $68,178 0.61 Kittitas County Health Dept. 37,400 0.59% $10,530 0.09 Klickitat County Health Dept. 19,800 0.31% $5,533 0.05 Lewis County Health Dept. 72,900 1.14% $20,346 0.18 Lincoln County Health Dept. 10,200 0.16% $2,856 0.03 Mason County Health Dept. 53,100 0.83% $14,814 0.13 NE Tri-County Health Dist. 61,900 0.97% $17,312 0.15 Okanogan County Health Dist. 39,800 0.62% $11,066 0.10 • Pacific County Health Dept. 21,500 0.34% $6,068 0.05 San Juan County Health Dept. 15,700 0.25% $4,462 0.04 Skagit County Health Dept. 113,100 1.77% $31,590 0.28 Skamania County Health Dept. 10,600 0.17% $3,034 0.03 Snohomish Health District 671,800 10.54% $188,115 1.68 Spokane Regional Health Dist. 443,800 6.96% $124,220 1.11 Tacoma-Pierce County Health Dept. 773,500 12.13% $216,493 1.93 Thurston County Health Dept. 231,100 3.62% $64,609 0.58 Wahkiakum County Health Dept. 3,900 0.06% $4,342 0.04 Walla Walla County Health Dept. 57,900 0.91% $16,241 0.15 Whatcom County Health Dept. 184,300 2.89% $51,580 0.46 Whtiman County Health Dept. 42,800 0.67% $11,958 0.11 Yakima County Health Dist. 231,800 3.64% $64,966 0.58 Public Health-Seattle&King $513,835 4.67 County 1,835,300 28.79% TOTAL 6,375,600 99.99% $1,799,848 16.15 DOH Allocation $750,000 TOTAL ALLOCATION $2,549,848 III 8 0 Table 7: Year 1 Tier 1 Funding Allocation and FTE Summary TOTAL FUNDING-CD,HP, TOTAL FTE CD HP, = m HF, HI,ESI HF,HI, EH Public Health Jurisdiction lamed on 7/12 Year " Based on 7112 Year Adams County Health Dept. $73,480 0.65 Asotin County Health Dist. $89,809 0.80 Benton-Franklin Health Dist. $960,681 8.57 Chelan-Douglas Health Dist. $451,765 4.02 Clallam County Health Dept. $288,477 2.58 Clark County Health Dept. $1,722,695 15.38 Columbia County Health Dept. $19,600 0.17 Cowlitz County Health Dept. $413,665 3.70 Garfield County Health Dist. $19,600 0.17 Grant County Health District $342,906 3.07 Grays Harbor County Health Dept. $299,362 2.68 Island County Health Department $329,299 2.94 Jefferson County Health Dept. $119,745 1.07 Kitsap County Health Dist. $1,039,604 9.28 Kittitas County Health Dept. $160,567 1.43 Klickitat County Health Dept. $84,366 0.75 Lewis County Health Dept. $310,248 2.77 Lincoln County Health Dept. $43,544 0.39 Mason County Health Dept. $225,883 2.02 NE Tri-County Health Dist. $263,983 2.35 • Okanogan County Health Dist. $168,732 1.50 Pacific County Health Dept. $92,530 0.82 San Juan County Health Dept. $68,037 0.61 Skagit County Health Dept. $481,701 4.31 Skamania County Health Dept. $46,265 0.41 Snohomish Health District $2,868,437 25.61 Spokane Regional Health Dist. $1,894,148 16.91 Tacoma-Pierce County Health Dept. $3,301,152 29.48 Thurston County Health Dept. $985,175 8.80 Wahkiakum County Health Dept. $19,600 0.17 Walla Walla County Health Dept. $247,654 2.22_ Whatcom County Health Dept. $786,507 7.02 Whtiman County Health Dept. $182,483 1.63 Yakima County Health Dist. $990,618 8.84 Public Health-Seattle&King County $7,835,132 71.23 TOTAL $27,227,305 243.87 DOH Allocation $1,600,000 TOTAL ALLOCATION $28,827,305 • 9 Year 2 - Full Implementation of Tiers I and II (July 2008 - June 2009) M Year 2 would continue implementation of Tier I services and add Tier IL Recruitment for Tier II personnel would occur in the second half of Year 1 to assure staffing at the beginning of Year 2. PUBLIC HEALTH SERVICES AND FTE - YEAR 2 Table 8: Year 2 Tier 1 and Tier II Funding Allocation and FTE Summary x ' �,. � -. . -...Resulting FTEs::.,.. to Support h Proportional Tiers 18,11 with Allocation of$100_M each LHJ. Percent cif with each LHJ receiving a r -:'_,:,- ,.._'.10,06:440,A103, ' T. t, re ei in a minimum n minimum of E ?:, . .one ion,FTE FTE ,,F1, IrC Heait�i uC staicti p.... � o h !.y , . .„ , ,,: , Adams County Health Dept. 17,300 0.27% $256,609 2.29 Asotin County Health District 21,100 0.33% $312,974 2.79 Benton-Franklin Health District 224,800 3.53% $3,334,433 29.77 Chelan-Douglas Health District 105,800 1.66% $1,569,320 14.01 Clallam County Health Dept. 67,800 1.06% $1,005,670 8.98 Clark County Health Dept. 403,500 6.33% $5,985,070 53.44 Columbia County Health Dist. 4,100 0.06% $112,000 1.00 Cowlitz County Health Dept. 96,800 1.52% $1,435,824 12.82 Garfield County Health Dist. 2,400 0.04% $112,000 1.00 Grant County Health Dist. 80,600 1.26% $1,195,531 10.67 _ Grays Harbor County Health Dept. 70,400 1.10% $1,044,235 9.32 Island County Health Dept. 77,200 1.21% $1,145,099 10.22 4 Jefferson County Health Dept. 28,200 0.44% $418,287 3.73 Kitsap County Health District 243,400 3.82% $3,610,325 32.24 Kittitas County Health Dept. 37,400 0.59% $554,750 4.95 Klickitat County Health Dept. 19,800 0.31% $293,691 2.62 Lewis County Health Dept. 72,900 1.14% $1,081,318 9.65 Lincoln County Health Dept. 10,200 0.16% $151,295 1.35 Mason County Health Dept. 53,100 0.83% $787,626 7.03 NE Tri-County Health District 61,900 0.97% $918,156 8.20 Okanogan County Health Dist. 39,800 0.62% $590,349 5.27 Pacific County Health Dept. 21,500 0.34% $318,907 2.85 San Juan County Health Dept. 15,700 0.25% $232,876 2.08 Skagit County Health Dept. 113,100 1.77% $1,677,600 14.98 Skamania County Health Dept. 10,600 0.17% $157,229 1.40 Snohomish Health Dist. 671,800 10.54% $9,964,734 88.97 Spokane Regional Health Dist. 443,800 6.96% $6,582,836 58.78 Tacoma-Pierce County Health Dept. 773,500 12.13% $11,473,239 102.44 Thurston County Health Dept. 231,100 3.62% $3,427,880 30.61 Wahkiakum County Health Dept. 3,900 0.06% $112,000 1.00 Walla Walla County Health Dept. 57,900 0.91% $858,824 7.67 Whatcom County Health Dept. 184,300 2.89% $2,733,701 24.41 Whitman County Health Dept. 42,800 0.67% $634,848 5.67 Yakima County Health Dist. 231,800 3.64% $3,438,263 30.70 Public Health-Seattle&King County 1,835,300 28.79% $27,222,799 247.00 _TOTAL 6,375,600 100.00% $94,750,296 849.92 ill DOH Allocation of$100 M. _ $5,250,000 Total LHJ Allocation of$100 M $94,750,296 TOTAL $100,000,296 10 • III. Work Plan This work will be initiated prior to the legislature adopting its next biennium budget. As mentioned earlier, this is based upon the understanding that: • each committee member supports additional public health funding and • a good faith effort will be made by each Committee member to work with their party's leadership and membership to deliver additional funding to the public health system. In doing so, the public health system stands ready to implement and deliver on these necessary services. WSALPHO will form implementation support work groups for "Washington Responds for Safer &Healthier Communities". The intent is to share across jurisdictions materials and the burden of work to minimize duplication of effort and assure rapid start up. TIER 1 "WASHINGTON RESPONDS" WORK PLAN Table 9: Work Plan for Successful Im i lementation of Tier I Ft:l ve Kt. ar �� aa yam.` �' CrtlY6; 21- 7, n YY a Jan 2007 WSALPHO/DOH Work groups to include: Implementation Work • Hiring support Groups • Contracting support • • Personnel recruitment campaign • IT Implementation • Training and orientation of new staff Jan 2007 Performance Measure In keeping with current practice, DOH in collaboration —Dec Development with WSALPHO, the state Board of Health, and the 2007 University of Washington will develop performance measures for the funded areas. Feb 2007 Hiring Support—Job Sample/model job descriptions are collected and prepared Descriptions for each of the positions needed to fill Tier 1 positions. This will assist locals in having job descriptions ready. It will also assist any local governments needing to create new job classifications. Feb - Recruitment Campaign A state, regional, and national recruitment campaign is April developed to recruit a strong public health work force and 2007 to prepare for a surge of needed personnel. This will include a one-stop web site where a job seeker can go and get common information and be linked to local jurisdictions. March Hiring and Contracting Each local jurisdiction maps out its human resource 2007 Planning process for hiring and training multiple public health positions. 411 Each local jurisdiction maps out it contractingprocess p ocess for any contracts it might want to implement to carry out the 11 public health work. March- Hiring Administration Any local jurisdiction needing to add job classifications April complete the necessary steps. 2007 April - Hiring Administration Prepare all local human resources paperwork (job May announcements, etc) for recruiting initial positions. 2007 March- IT Implementation Information Technology work group meets to develop May Planning plans for implementing the data and technology work. 2007 This group will be an oversight group and will make use of any existing IT groups to develop implementation plans and do the implementing. May Recruitment Campaign Implement local, regional, and national recruitment plan. 2007 June Recruitment Post positions. 2007 June 1 - Recruitment Hold multi jurisdiction public health recruitment fairs 15, 2007 around the state (e.g.,Bellingham, Bremerton, Seattle, Spokane, Vancouver, Yakima). Concentrate recruitment fairs on positions with know shortages, such as nurses. July 1, Recruitment Begin hiring. 2007 July— Implement Services Tier I positions begin work Nov 2006 TIER 2 "WASHINGTON RESPONDS" WORKPLAN Table 10: Work Plan for Successful Im,lementation of Tier I Sept 2007 Hiring Support—Job Sample/model job descriptions are collected and prepared Descriptions for each of the positions needed to fill Tier 2 positions. This will assist locals in having job descriptions ready. It will also assist any local governments needing to create new job classifications. Sept- Recruitment Campaign State, regional, and national recruitment campaign is Dec 2007 developed for recruiting a strong public health work force and to prepare for a surge of needed personnel for Tier II. October Hiring Administration Any local jurisdiction needing to add job classifications 2007 completes the necessary steps. Nov- Hiring Administration Prepare all local human resources paperwork(job Dec 2007 announcements, etc) for recruiting Tier II positions. Jan- Recruitment Campaign Implement local, regional, and national recruitment plan March for Tier II. 2008 Jan- Recruitment Post positions and begin recruitment/hiring for July 2008. March 12 • rR.3": ., /� `S` F ', .ter ° '�� '`Zw'4 AA'," fid,, 9/M_ Ke ..i . Det. 1 2008 Jan - Recruitment Hold multi jurisdiction public health recruitment fairs March around the state (e.g., Bellingham, Bremerton, Seattle, 2008 Spokane, Vancouver, Yakima) for Tier II positions. Concentrate recruitment fairs on positions with know shortages, such as nurses. July 1 Implement Services Tier II positions begin work. 2008 IV. Prior Success in Rapid Implementation Washington State's public health system has a track record of appropriately expending significant funding increases in a relatively short period of time. We are prepared to do so again. A few examples of past success include: ■ Significant federal funding for bioterrorism in the first two years, totaling approximately $25 million. • In the late 1980's the Legislature appropriated a significant amount of money to address the emerging HIV/AIDS epidemic, an increase of approximately $13 million in the first full biennium. • ■ Tobacco settlement funding for tobacco control and prevention spent throughout the state, totaled $15.8 million in the first two years. V. Public Health's Commitment and Leadership You can be assured whether the new funding is $50/$100 million per year or more, the public health community will quickly have a system in place to ensure all dollars can be appropriately and effectively spent to achieve the goals articulated in the document Creating a Stronger Public Health System. • 13 8/9/06 Key messages for Commissioners and Legislators about the History and Process of the Joint Select Committee on Public Health Financing • The Joint Select Committee on Public Health Financing was created by the Legislature in 2005 through passage of HCR 4410. The bi-partisan Committee has been meeting regularly to thoroughly study public health in Washington. This Spring, the Committee asked public health officials the following questions: o What important public health needs are you unable to meet today? o What would it cost to meet them? Priorities? o How would these actions improve the public's health and how would we know they were effective? • Public health officials from across the State were involved this spring in identifying and prioritizing the gaps in services. The costing methodology previously developed through the PH Finance Committee was used to assign costs to the gaps (S-K and DoH used slightly different methodologies, but the results were comparable). The total gap identified was approximately$307 million per year across the PH system. At the behest of the Committee, the top priorities were ranked in 3 dollar-based tiers; $50 million, $100 million, and$200 million • • After careful study, the bipartisan 4410 committee concluded that: o There are genuine gaps in Washington's Public Health system o The system has deteriorated in recent years, due in part to uncertain funding that has not kept pace with inflation and population increases. o The State of Washington should provide dedicated public health funding increases,targeted at specific public health gaps. o Responsibility and funding for public health should continue to be a partnership between state and local government. • New funding would enable local health departments to: o More rapidly detect and control disease threats o Attack the root causes of our major health and hospital care costs -- preventable chronic disease like diabetes and heart disease. o Adding capacity to help low income, first time parents raise healthy children ready to learn o Better identify, track, and control emerging human health threats from animals (e.g.,bird flu, West,Nile Virus, monkey pox, SARS, etc) o Enhance data systems for disease tracking and for better program accountability, efficiency and effectiveness. • All local health jurisdictions would receive funding. $50 million in the first year of the biennium and$100 million in the second will reverse the trend of a deteriorating public health system. • A • _ _ _ JOINT SELECT COMMITTEE ON PUBLIC HEALTH FINANCING: DRAFT FINDINGS 1. What is the role of Washington's public health system? • Investments in public health have improved well-being, saved lives, and saved money through its focus on disease prevention and health promotion. Promoting healthy, prevention-based behaviors and providing a safe environment have been at the core of public health's work. In addition to increasing the quality and number of healthy years of the population, these measures have been demonstrated to be cost-effective strategies that save money that would otherwise be spent later on health care services. • By their nature, public health services are provided on a continual basis in injury theand publicillness, man of the activities health system are in a constant state of activation in order to monitor and e public safeguard community health conditions. • Public health services in Washington are provided through a decentralized system involving 35 different local health jurisdictions that receive local, state and federal support. Public health is one of state and local government's earliest functions in Washington. Counties have traditionally provided much of services and have been governed by local health boards. • The benefit of establishing priorities at the local level has come at the expense of uniformity in the statewide public health system. Washington's public health system has traditionally allowed local governments to establish priorities for public health activities in accordance with their views of their constituents' needs. While such a system promotes local control, there has been a resultant loss of uniformity in the types of public health services that are offered across the various jurisdictions statewide. • f • Washington State's 1993 health services act directed that a Public Health Improvement Plan be developed for Washington State, along with Joint Select Comm. on Public Health Finance 1 Revised per Chair instructions—7/13/2006 D D standards for local health jurisdiction performance. While these activities have been accomplished, no performance quality or outcome measures exist currently. In its twelve years of existence, the PHIP has established uniform standards that local health jurisdictions must strive to meet in performing the duties associated with certain public health activities. While these standards provide some accountability, no data is currently available to allow policymakers to evaluate the quality of services being provided or whether current dollars are being spent efficiently or effectively. • As the needs of Washington's residents have changed over time, the responsibilities of the public health system have also changed. Emphasis in earlier parts of the twentieth century focused on the control and treatment of communicable diseases such as tuberculosis. Later, additional functions were added as traditional functions appeared to yield some successes. 2. What are the emerging developments in public health? transportation has required that local public health • • Increased efficiency in p q officials be aware of health risks from all parts of the world. Washington's geographic location and economy have made it a hub for international activity which brings people and goods into the state every day. This activity has increased the potential risk that its citizens could be exposed to public health hazards once considered foreign. The recent SARS outbreak in China that migrated to Toronto is an example of such a threat. • Recent disasters, both local and global, have raised concerns about including public health systems as a component of emergency preparedness efforts. Emergency preparedness planning may benefit from several capabilities of the public health system, including its ability to identify diseases; coordinate the responses of health care personnel and facilities; and distribute medicines and medical equipment. • Certain conditions thought to have been controlled have reemerged. The reappearance of tuberculosis and other diseases after they were believed to have been contained has in recent years added to the demands on public health. • Joint Select Comm. on Public Health Finance 2 Revised per Chair instructions—7/13/2006 ID A - • The public health system has coordinated links to health care for those with unmet needs. The lack of access to certain health care services has meant in a number of places that public health resources have been spent coordinating care services for individuals with unmet needs. • Public health approaches have been applied to reduce the prevalence and the health effects of certain chronic conditions that have been increasing in the population. Public health may be used to change unhealthy behaviors, as evidenced by tobacco cessation efforts, using prevention-based strategies to deter the onset of the conditions caused by these behaviors. • Home visits from public health nurses have helped to promote healthy practices and habits in families. Some evidence suggests that home visits from public health nurses to at-risk, • first-time mothers can produce social and health benefits for both the mothers and their children. • The current fee-based structure for funding certain environmental health activities is not practicable for meeting the cost of addressing other environmental health hazards. While fees are used to cover the cost to conduct environmental health activities directly related to the human activity being conducted, they are not a practicable means to fund all threats that the environment poses to public health. These threats come from the natural environment, such as West Nile Virus, the human "built" environment, such as mold or lead in schools, or a combination of the two, such as failures in on-site sewage systems. • Through the Public Health Improvement Plan process, the public health system in Washington recognizes a need to complement the current process measures for assessing public health service delivery with performance measures. The Public Health Improvement Plan process has resulted in statewide process measures that local health jurisdictions use to evaluate the effectiveness of the services that they provide. As standardized data become available, • Joint Select Comm. on Public Health Finance 3 Revised per Chair instructions—7/13/2006 D A FEL-r] Washington's public health system would logically next develop and implement performance measures that evaluate the actual public health outcomes. 3. What is the public health funding structure and trends? • State and local governments spent about $590 million on public health services in Fiscal Year 2004. About half of this spending was by the state Department of Health (DoH) on statewide activities, and the other half occurred locally, by the 35 local health jurisdictions (LHJs). FY 2004 Public Health Spending Dollars in Millions Direct DoH • Spending $248 $265 0 DoH Contracted to Locals Local Spending, not from DoH $75 • State and local governments use five principal strategies to prevent disease and promote health. At the state level, almost two-thirds of spending is in the broad category of health promotion. This reflects inclusion in that category of federal funding for the Women, Infant, and Children (WIC) nutrition program, childhood immunizations, and a variety of disease-specific federal categorical grants. Local health department spending is directed more equally across the full range of public health strategies. S Joint Select Comm. on Public Health Finance 4 Revised per Chair instructions—7/13/2006 D State Health Local Health Statewide Department* Departments* Total "c1E73.Mr$744°'4ZfiV.Vaikc4 1414:417' fe $ . Promoting Healthy Lives (includes chronic disease prevention, and support to $172 $85 $257 high-risk families and pregnant women) Using Health Information to Guide Decisions $12 $25 $37 Administration $32 $25 $57 �. ... * $75 million of federal and state funds contracted by the state DoH are shown as a local health department expenditure. Totals do not include $23 million of fee-supported DoH health professional and facility regulatory activities. • Public Health spending is a very small share of total health care spending. • The federal Department of Health and Human Services estimates that a total of $32.25 billion was expended on personal health care in Washington in 2004. That is over 50 times the amount expended that year by Washington's state and local public health departments. • Public Health in Washington is financed by a complex, and often confusing, variety of sources. These include: -4 federal grants — some ongoing, and some for short-term demonstration purposes only—for specific functions such as WIC, childhood immunizations, AIDS treatment and prevention, emergency preparedness, water quality, family planning, and a range of disease-specific conditions; annual state appropriations from General Fund-State (GF-S) and Health Services Account taxes, and from the state's tobacco lawsuit settlement; —> appropriations from local tax sources by county governments and, in some cases and to a more limited extent, cities; and i Joint Select Comm. on Public Health Finance 5 Revised per Chair instructions—7/13/2006 D D - --> fees charged for state and local regulatory activities in areas such as food handler permits, restaurant inspections, septic system inspections, and issuance of birth and death certificates. 100% 90% 80% 13% 70% 31% 23i' 60% 26% 50% 21% 40% 30% 20% 10% 0% DoH LHJs Total D Federal o State o Local Taxes m User Fees • There is little dedicated state or local revenue source for public health. In 1993, the Legislature dedicated 2.95% of the Motor Vehicle Excise Tax • (MVET) to local public health, but this was repealed in 2000 following passage of Initiative 695. At one time, county governments were obligated to spend 21.5 cents per$1,000 of local assessed valuation on tuberculosis control and public health, but this statutory restriction on use of local property tax revenues was repealed in 1977. Currently, a small portion of cigarette taxes and tobacco settlement funds are dedicated to tobacco prevention and control programs. • State and local public health experts report that the need for additional funding is particularly critical at the local health jurisdiction level. For the past five years, these experts have been engaged in an intensive and comprehensive effort to define the services that need to be delivered by a fully functional local health department, and to quantify what it should cost to deliver those services. Based upon a rigorous review and refinement of that work conducted at the Joint Select Committee's request, these experts concluded that total local-level spending would need to almost double from the 2004 level in order to assure fully adequate level of public health services for Washington state residents: • Joint Select Comm.on Public Health Finance 6 Revised per Chair instructions —7/13/2006 • oLi Estimated Spending Needed To Assure a Functional Local Public Health System (Dollars in Millions) Estimated Unment %Increase LHJ Spending Spending Funding Needed to Fill In FY 04* Needed "Gap" Gap ° , si Promoting Healthy Lives(includes chronic disease prevention,and support to $92 $188 $96 104% high-risk families and pregnant women) M' Using Health Information to Guide Decisions $27 $64 $37 135% ° a ol TOTAL $323 $638 $315 97% *Administration and support costs, at approximately 8%of total, are allocated across direct service • functions proportional to the cost of those functions. • Spending on Washington's public health system increased by 18% during 1998 —2004, after controlling for inflation and population growth. State department-level spending increased by 20% per resident. Local department-level spending increased by 16% per resident though, as discussed later, this statewide average masks significant variation among individual local health departments, with some seeing an increase in total spending, and others not. However, similar increases in the near future are uncertain. • Over 70% of the 1998-2004 spending growth was due to increased federal funding. Washington's public health system has become increasingly reliant upon federal financial support. -� federal funding for public health is discretionary and has been reduced in many areas. -* federal grants almost always carry "categorical" restrictions which require that they be used only for specific purposes such as WIC, bio-terrorism, • AIDS, or demonstration projects. As a result, these federal funds often Joint Select Comm. on Public Health Finance 7 Revised per Chair instructions—7/13/2006 D _ - can't be used for activities state and local health officials judge to be of equal or greater importance to assuring the public's health. • Approximately 13% of the 1998-2004 growth in public health spending per resident was due to fee increases, which increased 15% faster than inflation during this period at both the state and local levels. The capacity to address gaps in current public health services through additional fee increases is limited, since: -3 The benefit of certain kinds of public health activities accrue to the public at large and over long periods of time, and cannot be linked directly to any one fee payment. These include activities such as working with infected people and their contacts to stop the spread of communicable disease; educating the public to prevent accidents and the development of chronic diseases; testing air, water, soil, and dead animals for the presence of health hazards; and analyzing data to identify community health risks, disease patterns, and effective intervention strategies. Increasing fees in existing fee programs to too high a level -for example, for septic system permits, or for immunizations -may discourage • compliance, resulting in greater health risks for the general public. In addition, fees that are out of proportion to the benefits received invite judicial scrutiny-the courts have interpreted such financing mechanisms to be taxes, irrespective of the nomenclature. -* Shifting staff from fee-supported activities to respond to public health emergencies such as disease outbreaks results in reduced revenues at the very time additional resources are needed most. • The remaining 17% of the increase in state and local public health spending between 1998 and 2004 was due to two ongoing, but static, infusions of new state funds: --4 $24 million to "backfill" approximately 90% of what local health departments received from the MVET prior to its 1999 repeal. This appropriation has not been increased for inflation since 2003. -> $26 million per year for tobacco-use prevention and cessation activities. Approximately half of this expenditure has been funded from $100 million that was set-aside for that purpose from the first payments the state received under the national tobacco lawsuit settlement. That set-aside will • Joint Select Comm. on Public Health Finance 8 Revised per Chair instructions—7/13/2006 ID • be depleted by 2009. The balance is a portion of the cigarette tax increase levied in 2001 by Initiative 773. After controlling for these two one-time infusions and inflation, state funding per resident actually decreased by about 25% between 1998 and 2004. • On a statewide basis, local tax spending on public health decreased slightly between 1998 and 2004, after controlling for population growth and inflation. However, as shown below and on the next page, there is considerable local variation. Local tax support for public health in Seattle-King County remained stable at about $21 per resident throughout this period. In the 34 other local health jurisdictions, it averaged less than half that much per resident, and decreased by about 27% after controlling for inflation. Public Health Spending per Resident From Local Tax Sources (Inflation-Adjusted to 2004) • $25.00 $22.29 $21.28 $21.26 $20.00 - Seattle- $15.00 King County $10.00 - $11.75 $5.00 - Other — $8.70 $8.02 $8.56 34 LHJs $0.00 FY 95 FY 98 FY 01 FY 04 • These decreases in county tax support seem likely to continue, if: -a There are continued increases in criminal just costs, which have grown from an average of 62% of county general fund revenues in 1998, to an average of 66% in 2004. -> Initiative 747 is upheld. 1-747 has limited growth in property tax revenues to 1% per year since 2001, unless a higher level is approved by • referendum. Joint Select Comm. on Public Health Finance 9 Revised per Chair instructions—7/13/2006 in 2004, San Juan County spent 37% of its general fund revenues on law and criminal justice services; Wahkiakum spent 53%, and Whatcom County 54%. By contrast, law and criminal justice services comprised 61% of King County's general fund revenues; 66% of Pierce County's; and 67% of Grant's. -> differing levels of demand on the local public health system, particularly in areas with large concentrations of low-income and immigrant populations. • These differences in local taxing capacity, local spending capacity, and perceived local needs limit the extent to which local-options taxes can be relied upon to assure availability of a basic level of local public health services statewide. 4. What are the priorities of the public health community for additional investment in public health today? • The public health community has undertaken a thoughtful and deliberative process to establish its priorities for potential additional investment in the public health system. • Public health experts from around the state were convened in special workshops to develop priorities for additional investment in the public health system and to estimate the staffing support needed. Priorities were grouped into three levels of investment. In selecting priorities and estimating costs, the community focused on needs believed to exist statewide and utilized other criteria to guide their decision-making. The recommendations allow for an even distribution of new resources to serve all communities. • The public health community's priorities for additional investment in the public health system reflect both existing and emerging needs of the system. The public health community believes the greatest unmet needs to be workers and information tools that would help to stop the spread of communicable disease, reduce the growing impact of chronic disease, and help support at-risk families and teens to avoid problems. In addition, the community believes that protecting food, water and air are basic responsibilities that cannot be neglected, and that helping people get the critical health services they need will help them lead healthier lives. • Joint Select Comm. on Public Health Finance 11 Revised per Chair instructions—7/13/2006 D 0 11 • • The priorities of the public health community for additional investment in the public health system, as documented in "Creating a Stronger Public Health System" presented to committee members at the May 25, 2006 meeting, is a reasonable template that the committee may rely upon in considering and formulating its own recommendations for future investment in the system. The public health community's priorities document sets out issues, needs, and proposed actions that have been thoughtfully considered. The expertise and input from the community in its prioritization process means that the product is of significant import and value. • • Joint Select Comm. on Public Health Finance 12 Revised per Chair instructions—7/13/2006 • Jefferson County Board of Health New Business Agenda Item # 17., 2 • Health Care ANorker 'Vaccination - Time for a Mandate ? .august 17, 2006 • WASHINGTON STATE MEDICAL ASSOCIATION HOUSE OF DELEGATES SResolution: A-2 (A-06) Subject: Mandatory Healthcare Worker Vaccination Introduced by: Thomas H. Locke,MD, Delegate Washington Public Health Officers Society Referred to: Reference Committee A 1 WHEREAS, influenza is the sixth leading cause of death among adults in the United 2 States, killing an average of 36,000 Americans annually, and being associated with 1 in 20 3 deaths in those 65 years of age or older; and 4 5 WHEREAS, influenza kills as many or more Americans each year than breast cancer 6 (40,000), and three times as many as HIV/AIDS (14,000) and the estimated annual direct cost 7 of influenza infection in the United States is estimated to be between 3 and 5 billion dollars; 8 and 9 10 WHEREAS, influenza infection is transmitted in occupational settings by both 11 asymptomatic and symptomatic health care workers. Complications of nosocomial influenza 12 are particularly burdensome on the elderly, the immunocompromised, critically-ill patients, 13 and young children — the very populations congregated in hospitals and medical clinics. • 14 Influenza infection in these populations can often result in severe, prolonged, devastating 15 illness, death, increased length of stay, and added costs; and 16 17 WHEREAS, recent studies have shown that healthy working adults who receive 18 influenza vaccination have 25% fewer upper respiratory infections, 44% fewer doctor visits, 19 and 43% fewer sick days off, saving an average of$47 per person annually. A previous study 20 revealed that among three different cohorts of 25,000 adults each studied over 3 years, 21 influenza vaccination reduced pneumonia and influenza hospitalizations by 48-57%, all acute 22 and chronic respiratory conditions by 27-39%, and all cause mortality by 39-54%. This 23 resulted in a direct savings per year averaging$117 per person immunized; and 24 25 WHEREAS, a Scottish study comparing mortality rates between long-term care 26 hospitals that offered influenza vaccination to health care workers, where 51% were 27 vaccinated, and hospitals that did not, where only 5% were vaccinated, demonstrated a nearly 28 40% reduction in all-cause mortality among the patients cared for by the health care workers 29 in the hospitals with higher levels of health care worker influenza vaccination; and 30 31 WHEREAS, influenza vaccination for health care workers is recommended by 32 National Quality Forum, a voluntary consensus health care standard-setting organization in the 33 US, the Healthcare Infection Control Practices Advisory Committee (HICPAC), and the 34 Advisory Committee on Immunization Practices(ACIP); and 35 36 WHEREAS, vaccination requirements have been used successfully to increase 111/ 37 immunization rates in school-aged children and health care workers. Childhood immunization 38 rates vastly improved in the US, often exceeding 90-95%, once mandatory school-entry 39 immunization requirements were put into place. In health care settings, mandating hepatitis B 40 vaccination and rubella vaccination has also been successful in achieving nearly universal Resolution A-2-Page 2 1 immunization of health employees against these pathogens. Similarly, health care worker 2 requirements for measles, mumps, varicella, and annual screening for tuberculosis, have • 3 worked and result in improved patient safety; and 4 5 WHEREAS, the response to voluntary influenza vaccination recommendations for 6 health care workers has been dismal—only 36% of US health care workers received influenza 7 vaccination in 2002. Even among health care centers utilizing highly organized and 8 aggressive campaigns to promote immunization of health care workers, 30-50% remain 9 unvaccinated; and 10 11 WHEREAS, after more than two decades of voluntary trial and error programs, the 12 time has come to take the next step in addressing this public health challenge by requiring 13 influenza immunization of all health care workers; THEREFORE BE IT 14 15 RESOLVED, that the WSMA support a statewide mandate by the State Board of 16 Health requiring all health care workers with direct patient care responsibilities to show proof 17 of annual influenza vaccination or appropriate documentation of a medical contraindication, 18 religious exemption, or signed declination listing their reason for refusing immunization 19 vaccination. (New HOD Policy. Directive To Take Action) Reference: Poland GA, Tosh P, Jacobson RM. Requiring influenza vaccination for health care workers: seven truths we must accept.Vaccine. 2005 Mar 18;23(17-18):2251-5. • HOUSE ACTION: ADOPTED ADOPTED AS AMENDED • FILED REFERRED NOT ADOPTED • Jefferson County Board-of Health � Media Report -august 17, 2006 • Jefferson County Health and Human Services JULY — AUGUST 2006 NEWS ARTICLES 1. "Second-hand smoke dangers told in report",Peninsula Daily News, 7/10/06 2. "Sporadic outbreak urges caution: don't eat raw oysters",PT Leader, 7/19/06 3. "Call 211 for social services",PT Leader, 7/19/06 4. "Lake swimming holes are open",PT Leader, 7/19/06 5. "Discovery Bay fouled,group says", Peninsula Daily News, 7/20/06 6. "New Worries over Anderson Lake bacteria",Peninsula Daily News, 7/21/06 7. "Discovery Bay tax district for water quality?",Peninsula Daily News, 7/21/06 8. "Tips on Underage Drinking",Walker Mtn.News,July 2006 • 9. "Anderson's bloom is growing",Peninsula Daily News, 7/25/06 10. "Study reveals solid-waste habits,trends,Peninsula Daily News, 7/30/06 11. "Plan for school immunizations",PT Leader, 8/2/06 12. "Going Green: Restaurant, Co-op set example"(2 pages),PT Leader, 8/2/06 13. "Bacteria restricts oyster harvest",PT Leader, 8/2/06 14. "Swimming pool is a vital city-county-schools issue"Perspective by Len Mandelbaum, PT Leader, 8/2/06 15. "Health official urges firms to 'go green',Peninsula Daily News, 8/8/06 16. "Meth remains top drug in Jefferson",Peninsula Daily News, 8/6/06 17. "Health officials will test poultry at county fairs",Peninsula Daily News, 8/6/06 18. "Chickenpox is a required vaccine for some grade levels",PT Leader, 8/9/06 • 0 Briefly . . . . 7 ,i,-..i; „..(4 `4 YID .t7Y 1,f Y : r. q that i earlylhalflot'iillibn t RR ; .� ' amoling4inerit n ard°Still, { eLl 'rdgu`larl xposed4O)sebdncll Vi 3: r`T hand smoke !load ortt'f's '"told in ep0� e t -Forladditionalinformatior about tobacco prevention;'ani �` ;, ` ' control`activities,in East Jef� 'o'Oton in . �S ND 1• .� ferson County;Ftontact�Ragan �Aboutone m�ee'Jeffersom:_, 360-385-9446;�orch¢k�onf•+ ��� Coup, teelives with at least-One srn o er�'a county {' ; www jeffeisoncounty' ) -31:'C report saypL, `',, :r< . publichea52th org,J,J1. .e.(1c,r!. An4l,the..rePort by Kellie '' .sn ,Air;. n; '`fin -- • - _� .. a�se�nent Coordrna-. tors,for cauntyntnronrnental th '�u4. ' i ,.i i ,,. • a t of Jefferson '' ty 3-tb'19-year-olds egort being exposed to sec, and-hand smoke m a room or( - rcle: x. I /if/2 _06 ,V) She cited US.Surgeon Geri Richard.H,,carmona;in a. oT,; ;., issued last month,.who': :• • tad there is no risk-free level f / 4o# "posure to second-hand - Carmona said on-smokers'' 7 /I -. to secondhand smoke• at • ''e or work increase their tr ri4LoLdeveloping heart disease by 25 to 30 percent and lung cane by 20.to 30 percent. • ` '(Phe Carmona-report added S Wednesday,July 19,2006•B 3 sporadic o urges • raw oysters on t eat cauton . d ie, A sporadic Shas outbreakkensamples lles the bacterih tests symptoms a each abdominal cramps,nausea,vom-ng Vibrio cvent oordinator natorss,"said Rfor the Ochard ffice in Puget Sound has sickened samp several people across the state. year from May to October. The iting,headache, fever and chills., l , of Food Safety f"Shellfish and deShe Shellfish. the The bacteria, Vibrio parahae- samples show sporadic bacte- The symptoms usuallyappear molyticus, are found primarily rial contamination in shellfish about 12 hours after eating market should be safe to eat, throughout South Puget Sound., infected shellfish but can occur provided that they s hellfish as well. Hoysters but can infect otherhave ebeen Hood Canal and Willapa Bay anywhere from two to 48 hours kept refrigerated or iced after s The Washington State Vibrio causes a variety of oroughly iiss usually mild to moderate and cooked to 145° F,"he said.. lasts for two to seven days. The general public should Thorough cooking will kill look at notification of closure the bacteria and leave the shell- for marinas and recreational fish safe to eat. The risk comes beaches by checking the depart- from eating raw shellfish, espe- ment's biotoxin website at www. cially oysters. doh.wa.gov/ehp/sf/biotoxin. "During warm weather htm or hotline at 800-562-5632. / months the risk of infection Harvesters should also look for by Vibrio parahaemolyticus is and obey warning signs that increased, and shellfish should have been posted at marinas and be thoroughlycooked to pre- recreational beaches. • TT: • • • • • Port Townsend&Jefferson County Leader Call 211 s •ocia services New toll-free helpline starting in September People dial 911 for life-threatening number to call when seeking counseling or The UGN board has not yet voted on emergencies. other special assistance,and trained opera- a specific contribution, but it's going to Starting in September,people here can tors can quickly intervene and get callers be about'$9,000 a year," said Peden. The dial 211 for quick access to human health properly connected. Jefferson Board of County Commissioners and counseling services. "211 is a great access for people to call has also expressed project support. United Good Neighbors of Jefferson to find help in social and health services, The Clallam-Jefferson-Kitsap call County is partnering with United Good and it will alleviate 911 calls," said Bob center — located at the Kitsap Mental Way of Clallam and Kitsap counties to cre- Peden, UGN director. "The 211 opera- Health facility— is being certified by the ate a 211 call center for the North Olympic tors will be trained to help [and can, for Association of Information and Referral Peninsula. example] get someone who wants to talk Systems and is connected only to genuine The 211 system has been undergo- about sexual assault directly to the specific public and nonprofit agencies. ing development since 1997 and is now agency." The system is being activated used nationwide by 165 million people. Other examplesof211 assistance:seniors this September; the exact date will be The toll-free system serves two central .with questions from their homes, requests announced later. A 211 call center for purposes: It relieves pressure from the for home-health care, and people seeking Pierce, King and Snohomish counties has 911 emergency system by giving people a help for drug and alcohol addictions. been activated. • • • r 1111 N make swimmingholes are o No serious algae problems outside of Anderson Lake A heatwaveis coming this Mike McNickle, county envi- in Tacoma to determine what ue to monitor Anderson Lake week.Temperatures are expect- ronmental health director, said species of algae are present, throughout the summer. "We ed to soar past 75 degrees on lakes are being monitored in what concentration they are are hopeful that this ongoing Thursday and reach the mid- closely during the coming hot present, and whether the algae bloom will dissipate soon, 80s by the weekend, so many spell,'when the intense sun- are producing toxin: said McNickle. "But until and people might be seeking a cool light could encourage the type . The lab reported late July 14 unless we can be assured that lake for a swim. of algae blooms that closed that another species of algae, the toxins are out of the lake Good news: All Jefferson Anderson Lake. McNickle had Lyngbia wollei, are present in through our monitoring efforts, County lakes and recreational previously expressed concern Anderson Lake and are pro- we will continue to advise parks except Anderson Lake about people swimming in ducing a toxin known as saxi- [Washington] State Parks offi- State Park — still afflicted Lake Leland. toxin, which is similar to that cials to keep the lake closed to with toxic algae growth — are Jefferson County Public produced by paralytic shellfish recreational contact." open for swimming. Anderson Health has been monitoring poisoning, otherwise known as Jefferson County Public Lake Park remains closed to Anderson Lake since late May, red tide. alLuse. Health maintains an updated when two dogs died after drink- These toxins are very pow- database of lake monitoring Popular fresh-water swim- ing from that lake. The depart- erful and can cause neurologi- information on its website. ming holes such as Gibbs ment has been collecting and cal problems in animals and Click on Lake Water Quality Lake, Lake Leland and Sandy submitting water quality/algae humans. at Shore Lake are open. However, samples from the lake to a lab Public. Health will contin- health.o geffersoncountypublic • t - • • • DiscoveryBayfouled, group says y Action includin � � � � � �' � LY, .. ..„. .,„...,,„, g , s Fav , ,r �S.�y '� aye. u'<y tlt+�� ��� Env . , $ ����'Abd{ ES^W ,� v-� y + 4 >, `v ,t-.z-. ..; • bans, urged to e� fi�,, .� + , „�..4 a . protect shellfish n i i �'r ����r, BY JEFF CHEW PENINSULA DAILY NEWS 4 + �4�L Y.X,it Y T J t DISCOVERY BAY —North maw. I a¢. igtr� -k..z Americas largest shellfish ' ,,...,,;:i,:...,,,-.., -.=„,-. { 3;;j} T +t r x v z association is urging Jefferson ,f ,,r k e F .., County environmental health 0 41+t-. I ' '�.#trf�ta �� -� a..: x� 'gk �, y.. f a yy�M t� ,01444 ew s '�, �f� 7°fs.F Y„ . officials to take immediate „, � ,� s+� �'.�;��' �+ steps to protect shellfish '` i ` ��x ✓� r " .,., +Fs.'—.. .-,.;,'''�-i°.3-, .ins ..i�* -k,, threatened byDiscoveryBayw� `s �. waters contaminated with ris- # to 1` 't" �'� ei �"� L s. s nt-,, `4.. ua, .x.x +v ,,a. rt., e v yam ing levels of fecal-coliform bac l tl `atl a x + p' �� � � 4 '"+� ' feria. t 6M:fag_ ,, : 072.~r�, 'S u4, �,,., Robin Downeyexecutive '' �� "� "" director of the Pacific Coast , . a ry * ,:'EW ' f k '....-..n..... 74:::?: . t... Shellfish Growers Association, ' , x Y` -�` , '� &h��, t�'iv"tC$�a;,a!�t"aa""#w 'f5cc�."� r�''sy µ' •r'. raised both water quality and ,, t s ;;I`-.:., ! xk ""''°` � +' " economic issues that could ,,# s f �,., s ( , p. re \ rr t •' n yQ ? ave irxtq + i ?5x4'f# ' y'-•,v a 4 :,'•".- .044?..e+m` result should part or all of theta 1 �� �w. '•'•" *x �M4 r dM 4 �'�'Z ^�'RF } i , {.%'d "M.\"'^' #-';'X 3 F E"k.. ' .—„ ,..,.,'. bay be closed to shellfish h th r.,`�: 1 "t�,s °.) w 4. a.�.- r z ,e-,-. :7,.;-...‘„tr. vests. i''.•;;- .,.-'1'� ..••. ."ii.t,q :.tea "4 J }`4,7.rq°.F a 4,0,.... •,, e,,.„, "� "7 z# q Further downgrades could s nv , r a.r ..fg l ; t z ... ,,. result in closing a portion of JEFF CrrEW,Pti r s ti vuLr he,,,, the bay,state and county offi- State and county officials are monitoring an Increase in fecal coliform pollution in cials said. southwest Discovery Bay. A shellfishing group said the development threatens shellfish beds. Multistate interests tional marketing and research. . closed because they are corn- where several state water-qual- The Pacific Coast Shellfish Recent state Department of mercial beds.” ity tests this year have turned Growers Association represents Health water-quality tests have Bob Woolrich,growing-areas up evidence of elevated fecal the local,state and federal placed a southwest portion bf - manager for state Department coliform levels. • interests of oyster,clam,mus Discovery Bay on the"threat- of Health's shellfish program, Findings led to the state mus- sel,scallop and geoduck grow- ened"list because of down- said Snow Creek—'which downgrade in water quality in ers in Washington,Oregon, grades in water quality. flows into Discovery Ba — California,Alaska and Hawaii. "Threatened is just one step may be at least Y the area between the northern part of the: edge of the community's corn- The association is,involved away from conditionally closed source of the fecalcoliform pol- mercial center to near in everything from environ- or closed,"said Mike McNiclde, lution,. condo- mental protection,shellfish Jefferson Countyenvironmen- miniums, Wt's time-share"We're talking about the miniums, Woolrich said. safety health issues and tech- tal health director .. :_ .,_:,.Yc17+':6glithern,end,ofDiscovery_ TURN TO BAY/A7 nological advances to interna- "We don't want it to be Bay on the west side,"he said; Bay: Shellfishro p tectlon district CONTINUED FROM Al Downey was unavailable for closures." Fecal coliform bacteria can Wth further comment on Wednes- The source of the bacteria reheoonithe ch said of the hast originate from aging or failing day icneeds to be identified, 30 samples,which are collected septic systems and animal Basally,their telling us to McNickle and Woolrich said. every other month in 17 water s do something, McNickle said A shellfish protection dis- sampling stations around Dis- "The [state health] depart- he would discuss the Discovery trict would allow the county covery Bay. mentwater quality monitor- Bay shellfish contamination commissioners to seek funding ing indicates elevated fecal col- threat with county Board of to locate contamination Sixteen of the 17 stations, iform at levels that could lead Health officials who are meet- sources and take steps to con- he said, "are showing excellent to a downgrade in growing jog today, trol it,said McNickle. results." t area status if the source of this The board includes all three "We don't have the staff and He said his department contamination is not found Jefferson County commission- money"he said. would look at samples near the and remedied," Downey wrote ers, Phil Johnson,David Sulli- "We're already monitoring end of the year to determine van and Pat Rodgers. the lakes,which we don't have whether a closure is necessary. 1 in a letter this month to Tami Pokorny, county o nvironmen- "The law allows us to pro- staff and money for." "What we are seeing are taiN. Hny,th natural resources tett shellfish with a shellfish The county is monitoring some inconsistent occasionally protection district and that's three of 10 lakes in the county poor water results and that e • staffer. "I look forward to learnin what we're going to talk the after Anderson Lake was won't meet the approved stan- g county commissioners about," closed because of high levels of what action Jefferson County McNickle said. g dard, which is the highest plans to take to protect local "You're talking abut eco- cyanobacteria, also known as standard for growing shell- shellfish resources." nomic vitality with shellfish blue-green algae blooms. fish." Cyanobacteria is deadly in Anderson Lake and has killed Port Townsend/Jefferson County Edi- two domestic dogs and some for Jeff Chew can be reached at 364385- wildlife,said McNickle. 2335 or jef/chew@ peninsuladailynews.corn. • • New worries over Anderson Lake: Muskrats Lake bacteria CONTINUED FROM Al tions. BY JEFF CHEW The 70-acre lake—the cen- The latest cyanobacteria PENINSULA"DAILY NEws terpiece of Anderson Lake count in Anderson Lake co m- State Park near Chimacum— pares to 27 million cells per PORT TOWNSEND— was closed June 4 after two milliliter, according to With warm weather conditions dogs drank its waters and died McNickle. combined with naturally during a blue-green algae Lake Leland cleared recurring elements, Anderson bloom. Since then, dead muskrats Jefferson County health Lake has become a prime haven for deadly cyano- have been found around the officials have cleared Lake bacteria. lake, said McNickle, whose Leland for safe recreational the heat wave, we're department has been water- use after a week in which offi- "Withsampling lakes Anderson, cials warned lake residents really going to have to be care- Leland and Gibbs,and visually and fishermen to avoid contact ful," said county Environmen- monitoring seven other county with the water. tal Health Director Mike lakes for algae blooms. Leland, a 100-acre lake, is McNickle, addressing the north of Quilcene. county Board of Health on Dangerously high • Levels of cyanobacteria Thursday. Anderson Lake's toxic cells known as microcystic cyanobacteria levels remain have fallen dramatically in Temperature rising dangerously high, said Lake Leland water tests of samples taken two weeks ago, McNickle, and the popular He referred to temperatures park remains closed to the said McNickle. public until further notice. expected to rise this weekend, Lake sampling results from mixing with naturally recur- Other lakes around Jeffer- county and Port Townsend ring nitrogen and phosphorous son County remain clear of lakes will be posted on the Jef- cyanobacteria, which appear ferson County Public Health that makes for fertile algae in so-called blue-green algae Web site under a lake water blooms around the lake. Those blooms contain blooms,said McNickle. quality link. 0 cyanobacteria. Higher than ever, the The site: www.jefferson• Several different toxins cyanobacteria level in the 70- countypublichealth.org. acre Anderson Lake was Clallam County environ- have run the cycle in the lake, tested at 1.3 million cells per mental health officials say some more deadly than strych- " milliliter, said McNickle, they have not discovered ele- nine, adding that the lake is now vated cyanobacteria levels in "Toxins in the lake are corn- testing extremely high for sax- lakes in that county peting with each other, so otoxins. hopefully they will kill each Saxotoxins are similar to what causes paralytic shellfishPort Townsend/Jefferson County Editor other off," McNickle said. poisoning in saltwater loca- Jeff Chew can be reached at 380-3854335 or jeffchew@peninsuladailynews.com. TURN TO LAKE/A8 N --0� �� 7- 1 • • .. DiscoveryBay • x district for water q uali • ' Health Board • hears views in AS FRIDAY,JULY 21,2006(J) wake of fouling BY CHEW Bay• ` Lar e flag' PENINSULNINSUL A DAILY NEWS • g PORT TOWNSEND — Keeping Discovery Bay's water quality safe CONTINUED FROM Al clam beds ended when live- for shellfish is of major concern to "It's about as high.as you aboard boats long moored in one longtime shellfish farmer. nearby waters left the area. But settingupa shellfish protec- can get,"county Environmen- Broders said he believes tion taxing district is another mat- tal Health DirectoraeMike abundant shorebirds and ter. McNickle said after Thurs- otters in Discovery Bay could "We don't want those beaches day's county Board of Health the source of fecal coliform closed,but we don't feel the need for meeting. This is more than a red bacteria in the water. a shellfish taxing district," Richard "The septic systems Broders told the Jefferson County Dflagc sJe Baldwin.BHealth ettin u , and Board of Health on Thursday. Director Jean refl Broders. upgrades," said Broders' family has owned and "This is a large flag." "It's not like it used to be." operated Broders Seafood Co., with Further downgrades Jefferson County Health • clam beds along the west and east shores of Discovery Bay, since the Officer Tom Locke said county Further downgrades could health officials had been suc- 1940s. result in closing the southwest cessful in stemming septic sys- portion of the bay, McNickle tern pollution in Discovery Broders expressed surprise at the said. Bay,saying there were cases of Pacific Coast Shellfish Growers Association's letter to county envi- Bob Woolrich, growing- septic systems "with straight ronmental health officials urging a areas manager for state pipes into the bay." taxing district. Health's shellfish program, His company is not a member of said Snow Creek,which flows Shellfish protection the association, which represents into Discovery Bay, might be larger local, state and federal inter- at least part of the source of Locke warned that the state ests of oyster, clam, mussel, scallop the fecal coliform pollution. could require shellfish protec- and geoduck growers from Alaska, "We're talking about the Hon if water quality further Washington, Oregon, California and very southern end of Discov- declined in the bay. Hawaii. ery Bay, on the west side," he "It's mandatory if it gets to a certain point," he told the said, where several state Protect shellfish water-quality tests this year Board of Health. have turned up elevated fecal County Commissioner Robin Downey,executive director coliform levels. David Sullivan, D-Cape of North America's largest shellfish The findings led to the state George, voiced support for a association, urged in the letter to downgrade in water quality in shellfish protection district, take immediate steps to protect the area between the northern saying he believes the pollu- shellfish threatened by bay waters edge of the Discovery Bay tion source is Snow Creek. contaminated with rising levels of highway commercial center to Said McNickle: "We need to fecal-coliform bacteria. a spot near Trendwest time- Downey raised economic issues share condominiums, Wool- do some proactive work there that could result should part or all of rich said. to,identify the source." the bay be closed to shellfish har- Broders said his company Health Board member vests. owned shellfish beds on both Sheila Westerman said it Broders said some of his com- sides of the Trendwest condos appears the state Health pany's clam beds are within the along the bay's' western Department "wants us to do shores,along parts of the bay's something immediately." eastern shores and the shore- "They do," McNickle most southwesterly section where line in Lower Hadlock, responded. the state Department of Health's between the boat ramp and shellfish office has found water sam- Skunk Island. Port Townsend/3effersonCoun Bacteria pollution four Jeff Chew can be reached at 3635}38.5-2335• ples with fecal coliform bacteria counts of 1,600 per millimeter. years ago in Lower Hadlock's orjeflchew®peninsuladailynews.com. TURN TO BAY/A8 1biid7 -A.1--o • nz, 'c O a) a) 0 .y O cd N R 8 Y _sC c O c s C O 00 ca. y vJ 0 a v ° E > •c* o s E Op 0 a q Na x .5 U "y V\ c 2 0 4) c � tea " ia b o a x 5 v a o o E .a E� o f U ao U C� o on. Ems- cid v=, C a . 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" ' EVAN CAELPENINSULA NEVN; • , Dane Fickeisen, a specialist with Jefferson County Evironmental Health,fills bottles of water at AndersonAILY Lake to look for toxic blue-green algae Monday. • Anderson 's bloom is g Heat wave causing toxic A toxicology report showed safe levels of blue-green algae, that microsystis.was producing said Mike McNickle,Jefferson a level of anatoxins at 20 parts County environmental health algae to multiply in lake per billion. director. Health OrganizatioAccording to n any Worlde otabeforeewe e scaln open thel some elake,Y BY EVAN CAEL edge, supposedly from drink- more than 1 part per billion McNickle said. • PENINSULA D.•uLv News ing the toxic water. should close the lake. As for the other lakes in Jef- CHIMACUM—It's become June 5 Closure Health ferson County, McNickle said Dana Fickeisen's routine this New form of toxin Environmental summer. The state park, located off But more recently,test sam employees are inspecting lakes em lee Every Monday, she kneels Anderson Lake Road about a pies taken from the lake July such as Gibbs and Leland visu- at Anderson Lake's edge to fill mile west of Chimacum, was 10 show the a new form of ally for blue-green algae small bottles with samples of closed June 5 after two dogs toxin taking over. blooms. water that will be tested for were killed from ingesting the A high concentration of lyn- "We're monitoring them the toxic blue-green algae that water and one nearly died gbya wollei have been produc- closely because of the hot forced the state park's closure after going into a seizure but ing saxatoxin levels at between weather,"he said. in early June. was able to be saved. 5 and 10 parts der billion'.---, • ;>4o discoveries of the.offend- With the recent'heat wave Cyanobacteria some Saxitoxin is a neurotokin" 'ing algae have been found•to on the North Olympic Penin- times referred to as blue-green affectingthe nervous system. Clallem County lakes,officials' sula and throughout the state, algae — is present in most "We've had toxin soup," have said. Fickeisen, a specialist with bodies of water and usually said Fickeisen. Jefferson County Environ- causes no problems for In order for Anderson Lake mental Health, fears that humans or animals. to be reopened,two samples inprter van Caeolrcan be reamed at algae blooms in the lake could But when the right condi- consecutive weeks must show @peninsuladailynews.com. evan.caei be growing. tions align — the water is • "The hot weather has made calm, relatively warm and it bloom,"said Fickeisen of the overly rich in phosphates and poisonous algae. nitrogen, common chemicals "It's all over,everywhere." in lawn fertilizers — it can On Monday morning, a bloom into high concentra- sheen of the algae could been tions. seen stretching over much of Initially, test results in the 70-acre lake surface. June showed that the lake had She said some wildlife,such at high concentration of ana- as mice and muskrats, have toxins, one toxic form of been found dead at the lake's cyanobacteria. «t t4i1 aa7��. t ate:/ !�il!���ti �' y ?2,-- .E,_...):8—,-., g) C.0+� , / zm !!i ____________r /p/'y- nz „,,it,,.. � R • 1l lii y' '! « aha - m m � ,,, .a �” + f Y �f 3�t 1t�1 C >l3C ❑^ 4• • fG � Qm w y o.b7y +--' o c a , so E y- 4. pE -e.'a-,D4 4, 0 : CaoiPp. , t3 C '� - M . z w � G tido'^ c�"".n�mcE u ,, s.,„� a ' d �, .ASI ,I O/ '00 0 Z rn.' 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E• p > a , 4 2 1:,,.,. . .,,, .. li .t,.. p ,,:: 1 , . g... at,11.4 ; ›, ,°- a ° i)::-.-• ..0 1.. 0 ;"2 .s ,, or, s y A� O 1 S � . r. -,cc a. 0 C 4a N 40 - J C x L.: _O SCC^ Ua . r,'.' C > wma)^ 4).n _ o-0w°,TjLCC ao >;v - '� Cl) o , afi �i33ET4° 3o a,.oo'-w -3Eg�,4: • Plan for school • immunizations The new school year is still a ease, and a tetanus booster is few weeks away, but it is never recommended. A new tetanus too early to think about updat- vaccine for adolescents that also ing your child's immunizations. protects against whooping cough Jefferson County Public Health has recently been made avail- reminds parents that students able through the State-Supplied should be immunized before the Vaccine Program. Sixth-grade first day of school. To avoid the students should have already full waiting rooms and long lines received all other vaccines seen later in August, parents required for kindergarten entry. are advised to take children to For students in grades 10 their medical provider or Public through 12,the hepatitis B series Health clinics soon for necessary and a tetanus booster are rec- vaccinations. This year there is ommended but not required. a new vaccine requirement in Any students who have not Washington for kindergarten and had chickenpox disease could sixth-grade students. receive the vaccine, but it is Kindergarten students are required for only kindergarten required to have four doses of and sixth grade. • DTaP and three doses of polio, Childhood immunizations are with. the last doses after the available at many local physi- fourth birthday; three doses of cians' clinics; call your provider hepatitis B; two doses of MIvIR; for an appointment. Jefferson and one dose of chickenpox vac- County Public Health holds cine if they have not already had walk-in immunization clinics chickenpox disease. every Tuesday and Thursday, 1- Sixth-grade students are 4 p.m. at 615 Sheridan St., Port required to have one dose of Townsend. For more informa- chickenpox vaccine if they have tion call your medical provider not already had chickenpox dis- or Public Health at 385-9400. E' z -o‘„ Goi \� green 11., , , .....„4„;..,;,,..„,1,,,,„:,..„,,,..r, r-.4 , -.-:- ,r,...... ,:,,,,,:;,,3 ,. ;.p'(' ,• t • p • de 4• ' ' 7 4' U.', t� ..y t .J 4t • rCi r. J' ' i' .. m r* 3 - t is k .. j I E ,k II) ,, e`t ./4. 14;;:.r .;, ` / P ' ji./..,t.:%,,4..•.1 ._ d ' vF � : t r ,�° ttI '1.e. / :\ !" 1n � a !+ , I .1 4q:$fi , •-:..41044-0,'.iiii - . . , • , , .i, , ',,, ..•:,,,,;!,,N 4 1., , ; - ,:;,,,,t : , ,,,,, fottt, rif etr 3 4 t - .� � F� �' , i • yam. { t t et. "'...,'ivi!.V•• a.,r .... ..;;,. ..'. -IN +1 • �► ; r.. ' f i ' \ t ' ' l .� .3 , ..h ; .v .,f1 asY_ j j rt ♦ � ?li P +u,i, s' r a f a s ‘ol • :. —,,?}.1;;;:',:;;;;,." f 'Guar r m �, .nt.T+?'�7y'+`,'". .....wr. 111 _�.. .-�v.:�I� " +r yaue, ,:i.,/, ',..,,,,;..i.,;,,,,S � F • rr. }r` ! , 4 '3�e.,+ y y K,. ' �. wM:; 1 ,' ,,,,,,,,;;_r '-� u Jasmine Fry of Jefferson County Environmental Health listens as Port Townsend Food Co-opdManager Brendon/ describes Jetted for use by local organic farmers, �� > nv° ' - 7 1: how or9en1c food waste a cot. Photos by Xasia Dlerzgo Restaurant,_Coop set example By Karla Plerxga pe Leader Staff Writer " `Its a f eel-good Anew• program recently launched by Jefferson County's environmen- thing for the Con— z y tai health department is designed to ,1 ` o- ' encourage day-to-day business prat- Burner, knowing that tices that help the environment. P L Green Business, coordinated by they're buying a �_ i r Fry, is a way to help busi- } product or service ' �° _ ''t�r'1 :?rl Jasminesidentify ways they can reduce t _','"'zit""" ` t t .: waste,$y doing a site visit and talking that's handled with k ` ,. �s ;fit with the owner of the business, Fry '` i s t �`^1 looks for ways the business can use the earth in s M '• mind " k less water, less paper, less packaging :u ;,y' 7--- x and less electricity,for example. Jasmine Fry zr � E ' .. ,AL `K ` (� The program was patteme. after program :- ..,1 . coordinator m�4 ; r�" ' vC4•:. .. EnviroStars, a King County program Jefferson County Green Business wu k 0 also implemented in Jefferson County, 0.1 I which provides businesses with incen- plans to develop a directory for con- a E* • tives and recognition for reducing hoz- sumers to help them make choices t f �a 1.. .pk ,d u ; r ued ardour waste and also helps consumers about where they will spend their identify firms that are environmentally money. A Green Business windows conscious. decal is also a way to spot businesses I,t. + "It's kind of a sister program to that have been certified. 4 EnviroStars," she said. "But it has So far, Fry has talked with nine r u : tf ''� more to do with how you run the local businesses,and four have earned y �r�; � as � , s'► office side of things." their "green" certification, includ- f �' Yg , �� The program was launched with a ing Belltower Art; Silverwater Café, yup � l grant of$30,000 from the Washington Annapurna Center for Self-Healing , Department of Ecology ,r `` and $10,000 and Monsoon, a downtown Port • from Jefferson County. ,� a & d Townsend retail store that is also seek- c 3 Raising the profile of companies ing Fair Trade certification. s ' that are mindful of the environment The first to be certified was Wild <...�y : I could be good for the bottom line,she Coho restaurant_ in uptown Port - said. Reducing waste can also reduce Townsend. Open since 2000, the res- I c • costs and help a company attract new taurant has been ' �` I cc, customers. run in an environ- Chef Jay Payne breaks mentally conscious way from the start, eggs Into a bucket In the kitchen at the Wild Coho restaurant In Fry is working on Bertin local said owner Jay Payne. Port Townsend.The restaurant is one of the first Jefferson Coum y businesses certified as g y "green" and "Green Business"certification through a new program or ani t businesses to achieve See GREEN,Page 1 Public Health. 9 aed by Jefferson County t3 max i *! r°s . ii.4 "reit,' s t� q, a / u C 'O U l ei 3 S F �n ,�'�� � d� ,:',),;,,',;1....;,' i f �'L /5 O � j r, d -.11,4,.1,'''' A '11.1,1 a .{Fly .f i. '; s `' .,�s '� .� t, O fri Vi �4;3 • . J� {� jj ' p'e'a� F �`-k .1• 's�s e moi ;-',":,,,".%1',A",, A 1 U 00 4 �� �r � rte � + �' ,� � ,� ra 3 +s si '�'r i` t i•b a t 1�� R � f d� �" k' A V ° CA .. Y x� � ¢' friiin o 0 ora 3 .. qfl )-',13.,:- f J f . fiy` - g U 1� o;,4 4"i � � x� f�� ,�„ $F '-:',..,Nil--.7...,," 1, �§�� �w, i.:''''''-' . i� '.a � §J'°,a�Y '''':::e.,'.',1','":" I �"�-,. 3 � .G �n b X �. gs f , �, • v y q ..,!. iif t; ,,,,,..'-' 'it\:,,,..,:? ,..-', , *,,,,,-,:.: A g ' t i. I f'�..N 4), E t' \ .s• ' '-,' tEg. t . Gr--n` &�i°'.e' -;i1..).3.., ', y O�1 "' .�f? U .,V+ two),0 f it's ¢ r �.< I I .. H Ny .0 N 0 U �s� �� I zc am'''sl,"'', r O U y 7 J �7 ,. . .„..„ .•,..., do, - ) , ''� 0 ?fig Qa 2 8 • .s _. 8 , a�w. ..' a °a vn..�. b- Mga j ,� Al.: i v,yn "� V ° it ° 00 1, , .,ve.„, ..4.1.. ... } fP N o oy 83 �, � c • ›./ ''I —' - ' '''' 111';:;— ' CD l i- 4. cial) o5 qc. o po $ o tey •'y fla 0a' va ° yaoornr 1s o ia °' 71..‘ 'na;+d C ao „, 3 ° a'! oo< "grew . [ Ta' av U aAo8.� bra ce m48 ° .h) ° d . Ea o d ro?� ° cu+ a$A...� 4 ., ai o sel% ' 000 = °Ob�QdcR 7. 3 a-• a. �,,,,,,,,,,:,:,,4).,,,,,,...:7,:,,,,e a ' p e o 8 ,.s4 a 2. o` .ae aP � o ° $ P,' 1:1 � : Uboo ° °� i o,0 :;:133 nsov .b •.S c A •' O' b �ra Uy . La ~ [ o r.. _ t d ° °i `� + 9. vn rn o g ;1 • NOnNN ; �H C ¢ ' UofTf ° Ni0 o wg v v ° " CO � ' � 8 c�ao y UU ❑ a . V � O $ +QF' .5 N ° �UU .8•B , p 9.�b 'D '4 avao 4 bOa' o 8yT1U • U o � ° 'Da O [ oaSioA ^.a o a „' tibA1 •., O � h U 5b n„ ,, N ti , . ,gco ° 3 � n a �S wrn e C ,.� G g b c wo ~ aN vO0.° °3 v ar„ _ °2 o v ° a 8° 4'1), ve Bacteria restricts oyster harvest Washington State Department vest of oysters has been closed oyster harvesting until further possible and within four hours of Health reports that as of from the Mason County line notice." of harvest. the week ending July 28, 60 north to Tala Point. This clo- • Thoroughly cook all shell- Washington residents have sure includes all public access Shellfish harvesting tips fish. been confirmed to have con- beaches along Hood Canal. The The Department of Health The Department of Health tracted vibriosis from consum- closure was based on high levels offers the followingtips to sum- additionally reminds consum- ing improperly cooked or raw of the vibriosis-causing organ- mer harvesters of shellfish in ers that store-bought shellfish oysters harvested from Hood ism from oyster tissue samples, Washington state: must be refrigerated and han- Canal. and a number of human vibrio- • Always check the pollution died properly to prevent ill- Vibriosis is an intestinal ill- sis cases associated with eating and biotoxin status of the beach ness. ness caused by naturally occur- raw oysters from southern Hood before you harvest. The Food Safety and ring bacteria known as Vibrio Canal. • Harvest as soon as possible Shellfish Program website, parahaemolyticus. Most of the "The best way to protect after the tide goes out. www.doh.wa.gov/ehp/sf/ cases have been reported during your family is to cook all shell- •Do not harvest shellfish that default.htm, has general infor- the month of July. Additional fish thoroughly," said Mike have been exposed to direct sun- mation about recreational and cases connected to Washington McNickle, Jefferson County light for more than four hours. commercial shellfish harvest oysters are being report- Environmental Health director. •Refrigerate or ice as soon as and food safety. ed in other states! Typically, "But due to the high number of Washington sees about 20 cases illnesses caused by vibrio from a year. oysters recreationally harvested Due to this increased report in Hood Canal, it is prudent to illness, the recreational har- close the beaches to recreational 7.1`• • • • Wednesday,August 2,2006•C 13 • Perspective Swimming pool is a vital city-county-schools issue By Len Mandelbaum Port Townsend Our only public swimming pool sits,uncomfortably,in the shade of other pricey civic architectural projects: City Hall restoration, the skate park and the tidewater viewing area. Appearances notwithstanding, the pool is the most important near-term issue for the community,not merely because of the public need but for the possibility of reversing the civic lethargy that attends the question. The following policy considerations are not contested: • Swimming is a major health aid. Families benefit from children learn- ing to swim, the disabled exercise in a minimum-risk environment, others mitigate arthritis and back problems,while there are the aerobic benefits for anyone and fun for most. •Fast Jefferson County has one pool in operation.It is old,feeble and staffed by good folks who tend to leave in order to find jobs that pay their bills. • • Sequim, in comparison, has an Olympic-size pool in great shape that actually draws people from this area—at some personal and public(environ- ment,roads)cost. •The county has,inexcusably,pulled out of the pool operating partnership with the city and school district.The school district is considering sale of the Mountain View Elementary School campus that houses the pool.As a result, the city has stalled on both long-range planning and meeting some immediate needs.While the status of Mountain View is a good reason to be deliberative about long-range investment,the city is obviously the"partner"that needs to take action on short-range problems. Some suggestions: • Deal with the short-range issues immediately in order to guarantee reasonable use of the facility and to encourage the swimming community to participate as partners for the long-haul changes that are necessary.Offer the school district$1 for an option to make a first offer to buy should the district decide to sell the property.The minimal fiscal consideration is due to the fact that the district and city have a mutual interest in preserving the pool.(If the city cannot find the$1,even within the remains of the pool bond issue it has trammeled upon,I will put the buck in escrow for the purpose.) • Enlist effective spokespersons from the swimming communities, the healthcare community,parents and businesses,and form an effective Green Wave Task Force to consider and assess these options for each of the partner governing units. • Should the school district seek a buyer for Mountain View?Are there sufficient uses(i.e.,police station)of the facility to justify purchase?What discount for making a pool available to the school district? •Would a regional city-county park district be the best vehicle for funding and management,a city-YMCA team,or both? •Particularly if a city-county alliance develops,what about public land other than Mountain View(i.e.,Memorial Field)for the combined use facility? 11110 •In the meantime,raise salaries and provide appropriate incentives so that stafk turnover,is mitigated and pool hpurs are expanded,to,meet increased derilarld. :.;. (p,r. •Make it clear as policy that the swimming program is a priority item on the city agenda and should be so with the other"partners." • Work with the medical community, parents and swimming groups to educate the public as to the benefits of swimming. IP. i i■. 4.) t, , ,4,t,,,4, , 4'`, • ),70„.. 0 a) ,,„ , . ,,. . L �.,,, `. .. ._ .. ¢ _, ‘ T 3,.. „,.., Saoro� b�-� °• N 1 Green • bc� a,so� ,Qro WwW . BusinessJ. O ,:i--,c5, g a a . o ° CONTINUED FROM Al Other ways are to perform �o N -. E . 2=; ° > -- .2 And finally, the business regular maintenance on heat to o u= a 3 '..c - ' H must set annual goals to ing, ventilation and air condi-' U x c ° improve its level of environ- tioning systems and demon-, gE y w -E =•"> mental practices. strate a 15 percent reduction` >, c 2,y c 2, ro w o Once these steps are coin- of energy use. O - o Q.y o 1 P o a .31 pleted, the business receives a Also, water reduction is a 41' n.Ume: Q..9.2 �c Eo o s a) r o o sticker to place on the front method. �� E-- ,i ,F-,' > door to inform consumers that Or, a business can come up y =E-y•° = it uses environmentally with its own creative ways to � > friendly practices, which can lessen its environmental) ro - 3 ro w o T, c•• attract consumers, Fry said. impact. 3 c- m ° She also said the businesses 2 22 2 .... 0 °y c al th4t are a part of the program Already certified NE ° 3 c o a) v) will be listed on Environmen- tal Some of the businesses ° ti ' a " [ tai Health's Web site. c ro 11.o i already certified in the pro- log! .o° -.5.7.- o N [ Its free advertising," Fry gram are Annapurna Center II MN •� 2 E — N• 5. said. y° 8 S o G ro o for Self-Healing, Bell Tower Nimiu O' °a1 w .�, ,c,N - m „ Art, The Food Co-op, Mon- 0. z �. o C.E w•- 0 b Reducing costs soon, Silverwater Cafe and y LO al L'. _ o She said with less solid The Wild Coho. • (i) 2) E o e z " o 6' : •0 5 waste through recycling, Fry said this is her last cp 2.� y a.o ° y „ = [ = reducing and reusing, costs week with the Jefferson •o " -E-, y o F iu are reduced to dispose County Environmental Health. °= P roID' 2 t3 70 � 0 o garbage. Division. A new employee of, ,ip .0 .,, >. 0 The Green Business Pro- the department, Mark Heike,, laiL-( •5 F c ; gram is not to be confused will take over. ctQ� u v�° y with another incentive pro- Fry said she believes the; ,- ->-‘9-"'a5'o y 0 gram through the county's Green Business Program will) o a y o, Environmental Health stay in Jefferson County and by c.. 0 .E ro o p,,..7.' Department called Envi- will have an impact on the; MOM 0 CCS c.q aro on a' y roStars, Frysaid. �+ o o ..o aenvironment. w-c�+'U.- "' o EnviroStars is focused " • (13 Qr U y 4-o-2 c more on the responsible dis- posal of hazardous waste, we can start to do as a culture CCS e o ?,a. ,,, ,9 while Green Business Pro- t) that will start to add up," said' "' a [ c c v gram simply tries to reduce Fry. c/) ,� o waste, she said.II MIMI For more information, eon- 4.) F 6' a.° x 1 Some of the techniques that tact Jefferson County Envi- 2-2 IC '> ; o cn b would allow a business to ronmental Health Depart- o E 3 o apply for the program are to ment at 360-385-9444 or visit 0 O o demonstrate a 25 percent the department's Web site at In 2 a diversion of annual waste gen- jeffersoncountypublichealth.org.. ••--i ^� y y eration by implementing a A [ 2 source reduction measure and . '� purchasing a recycled content Reporter Evan Cael can be reached' IIIIC -o o at 360-385-2335 or evan.cael@ Q� i CO product. peninsuladailynews.com. ' 0 r Men V Q � 2 t~ CU ,L) • 3 ar ° 13) y,, � a m c E. - nLJ 7a 5 E+ W m ro 1)pJ ���� 0 r z a C In U U of 0.x1a U 6 �°0t ' M "'F4 ,,,-,,72,-'7'5.&: D Q' s c' 8-,':!-•"d g ti (' ° � ,- 0 o -, a'a e r E 1 D C''?' �•G D W ti M d 1 hS (�gsti w w ° � r I °0 F . x° R a °-o C/7 CD1 ports ' aEd „ �-° - . � �.,. CONTINUED FROM"A1 particular is not as affected by §:A cte ° o lY'9 .c 5 m ag g d aft 5 u' I ;1 \O = They are now kept behind meth as other parts of Jeffer- 00 0-•,-.x °: ° 8.'"m° %"m g-o:r-� '' No pharmacy counters and buyers son,such as the Tri-Area,Brin- 8-5-2,,c.'5.. C 5 0 5'o R° �2 8 O non and Quilcene ° 5 ° , el G_ 0, INN must sign their names when ° ` y purchasing the medications. But the Key City has its own 5 FO X r a �,c Also,Miller said high quality drug problems. w a n meth is being imported from Marijuana and alcohol, o ° in d ` ?.d o° m w o away Dalzell said, are the topdrugs d ° 5 0p °0 ` o d c 5 ` a (D 3 Mexico that is takingthe g o 5' ° o m R 7 need for what he called small, in Port Townsend. d d a0 7 00 0 personal"Beavis and Butt-head About four years ago,Dalzell labs"to exist. started Drug Court, which is a c5o c f 2 3 W In past years, Jefferson therapeutic approach to dealing 11 (3.1--,.G c�c�� S tp co . T 47''' -',et". ,, ci) County raided about six meth with the county drug problem, 0-'rd rb % 3 a; e" labs per year,but now only one as opposed to simple punish- -' ° m o F ° 50 ^ 0 o �� k '. .` or two are discovered and ment. � �, .4.6 ,..e.‘: = d �. t9 —A r closed down. When a nonviolent drug o ,, o d o a�.f�< i : felony is committed, charges g d ° 3 " `� k pis Meth dealing are deferred and the individual w F `N° Q'.e rn Tz • t ' EEtti-a A gq N A c aredw d still paramount issues inthe rious ste $ mogram. 8 ;5 ° Miller said meth dealersusu- The person must appear c g- o g K ° a„ ^ N '�" once a week in court, attend o 0 o H c ^� ally sell small amounts— 16th drug treatment, make a call y � tb z 4 s of an ounce quantities for about every morning by 9 a.m. to see .,.-3 d `o "`s+°' , $80 each — to support their C7 $ °c 5 a O habits. if a urine examination is Ly d •00 e Many people, once addicted required for that day, and pur- ° p r : to the drug, begin to sell meth sue either a general equiva- a �� o zeil' ° ‘; NC and get others addicted to it lency degree, or GED,the high m 2 Q,Q, ,.,"-° x a3 Miller said. school diploma, or a college "That's how it spreads like a degree' 3 « t •:\ ,,,k•.,_ \ k , C:li cancer,"he said. Plus, the individual must ^ , i� He recalls one woman about hold down a job and pay resti- a -I . ,. ,. a 4.t two years ago who had her chil- tution if the offense was a prop- �•S 4 'i ct 1,`* . i .'i erty crime. p f2.,:,,....:'....-,....„1-3..m.,1::-.41. dren taken away by social o , lMalt workers because of her meth It takes away the original F addiction. reasons people got into drugs in to 2 i I' `' 'r• , ` ' When that happened, the the first place,"Dalzell said. ® i t st st *' ' woman reported that she was ,',' Ott Currently there are about 20 N�+ ' ` '«' relieved because- her children people in Drug Court. /9 t « "' � ,� x °v ` l would annoy her and get in the Since its inception,about 75 ., g• .." _ , way while she was trying to people have been admitted, ^ - rr t y ' ' �` take the drug. with 10 A \ F f i1'y'° ' people graduating. a "When you've got something "The point is to make the o , ' � `' that will cut the bond between people aware of the damage 0."m «;'` ` 'a r ,'. a mother and child, it's got to they've done to themselves and be a pretty strong addiction," the community, and give them C.a :` '°., Miller said. the tools to restore that dam- ^ 1. 5., �` Jefferson County Prosecut- age,"Dalzell said. �'L e ing Attorney Juelie Dalzell But she added that it's i'o t ' "-- tom agrees that meth within the extremely important to prose- ...2 1. county as well as the nation is a cute people if they don't comply `° i (I) ,. large problem. with the program because with- e t C Across the nation, 76 per- out the threat of prosecution, �d n YcQ.A A ; „,,-0,1,,,,L”` cent of the caseload of prosecut- .people will not take it seriously. A ° `, " ,v a "' a ,,,,„,4 ing attorneys is methampheta- "I really like Drug Court," g � .° cn mine,"Dalzell said. said Dalzell. "People get made s ?ytt� 'ti ,°,L MIP "These people start making whole again." rt *•.0..2.4:',,;-.:,*�'' serious mistakes. Their brains e ire gone; their souls are gon ,7.,..„....,.,,,,,..,..„...,04,‘' �� � � Reporter Evan Cael can be reached at oecause of this drug." 360-385-2335 a: �s, *� ;a She said Port Townsend in °r at evan.cael® 3 '"° :: , v;« - peninsuladailynews:com, wm°° � 4 "'�• 7 O • • ,-•,..°" -4 • X P z o -- • PENINSULA DAILY NEWS Peninsula Health 'officials �viil test poultry at county PENINSULA DAILY NEWS according to the World Health free of a variety of animal dis- State health personnel will Organization. eases. visit the Jefferson County and Still, the virus appears not "We can also spend some visit m County fairs to test to have made the "jump" to a time educating the general strain that can spread from public about bird flu, even chickens and other birds for human to human. those who interact with live bird, flu virus in an effort to protect flocks and reassure State personnel are visiting chickens only at these kinds of fair visitors. county fairs across Washing- special events." This is the first year such ton this month and next. Backyard bird enthusiasts inspections have taken place. Birds from so many flocks should report signs of unusual The Jefferson.County Fair illness among birds - sneez- is this week, Friday through "Because birds from so ing,coughing,nasal discharge, Sunday. many different flocks come diarrhea, listlessness and sud- The. Clallam fair is next together at our fairs, these den death — to the state vet- • week,Aug. 17-20. events are great disease sur- erinarian's office or their local Although the inspectors veillance opportunities," said veterinarian. will be checking for avian Dr. Leonard Eldridge, Wash- If H5N1 is ever found in influenza, known as H5N1, ington state veterinarian. Washington poultry, the agri- they stress that it has yet to be "While the probability that culture department will found in North America. we will find the H5N1 virus is destroy the infected flock,pre- In Asia and the Middle extremely low, we will make vent the spread of the disease East,at least 134 people work- this an opportunity to share and limit the economic dam- ing in close quarters with information with bird owners age to the poultry:industry, infected birds have died, about how to keep their!locks Eldridge said. CP2s l\C 1?--6-0 • • 0 - Wednesday,August 9,2006 B 3 Chikpo x vaccine for s rade levels The new school year is still a with the last doses after the through 12,the hepatitis B series few weeks away, but it is never fourth birthday; three doses of and a tetanus booster are rec- too early to think about updat- hepatitis B; two doses of MMR; ommended but not required. ing your child's immunizations. and one dose of chickenpox vac- Any students who have not Jefferson County Public Health cine if they have not already had had chickenpox disease could reminds parents that students chickenpox disease. receive the vaccine, but it is should be immunized before the Sixth-grade students are required for only kindergarten first day of school. To avoid the required to have one dose of and sixth grade. full waiting rooms and long lines chickenpox vaccine if they have Childhood immunizations are seen later in August, parents not already had chickenpox dis- available at many local physi- are advised to take children to ease, and a tetanus booster is cians'clinics; call your provider their medical provider or Public recommended. A new tetanus for an appointment. Jefferson Health clinics soon for necessary vaccine for adolescents that also County Public Health holds vaccinations. protects against whooping cough walk-in immunization clinics This year there is a new vac- has recently been made avail- every Tuesday and Thursday, 1- cine requirement in Washington able through the State-Supplied 4 p.m. at 615 Sheridan St., Port 0 for kindergarten and sixth-grade Vaccine Program. Sixth-grade Townsend. For more informa- students. students should have already tion call your medical provider Kindergarten students are received all other vaccines or Public Health at 385-9400. • required to have four doses of required for kindergarten entry: DTaP.and three doses of polio, For students in grades 10 7" te,452(24,--- • • • . .: • ..._q __10 • IP . . • Jefferson County Public Health POD Set-up Drill After Action Report August 17, 2006 Executive Summary On July 13, 2006,Jefferson Counties Public Health carried out a local POD set-up drill using the SNS Plan and signage provided by DOH. Community partners were invited to observe the basic clinic flow, discuss the SNS Plan and provide feedback. Chapter 1: Exercise Overview Exercise Name:Jefferson Counties Public Health POD Set-up Drill Duration: 3.5 hours Exercise Date:July 13,2006 Sponsors: State Agencies: Washington State Department of Health (DOH) Federal Agencies: U.S. Department of Health & Human Services (HHS), Centers for Disease Control and Prevention(CDC), Type of Exercise: Drill Funding Source: CDC Cooperative Agreement U90/CCU017010-03-3 administered via DOH Consolidated Contract C13035 Program: Public Health Emergency Preparedness and Response (PHEPR). Focus:Response. Classification:Unclassified(U). Scenario: Biological release or threat(C) Location:Jefferson County Participating Organizations: • Washington State Department of Health (DOH) • Jefferson County Public Health(JCPH) • Kitsap County Health District(KCHD) • Jefferson County Department of Emergency Management • Jefferson County Sheriff's Department • Port Townsend Police Department • East Jefferson fire and Rescue Number of Participants): • Players: Jefferson-9 • Observers: • Jefferson-Fire-2, DEM-2, Law Enforcement-2 Kitsap - 2 Washington State DOH-1 1 Jefferson County Public Health After Action Report-July 13,2006 Pod Set-up Drill • Controllers/evaluators: • Jefferson-1 Exercise Overview: This drill was designed to provide training for the JCPH staff in setting up the POD according to the SNS Plan and setting up the signs provided by DOH.The drill was also intended to train the staff on the basic clinic flow design laid out in the SNS Plan. Community partners were invited for an orientation to the POD design. Exercise Evaluation: This drill was evaluated by collecting feedback from the players and the observers. Chapter 2: Exercise Goals and Objectives Goals and Objectives: 1. Train JCHP staff on POD Plan and set-up. 2. Practice assembly and placement of sign holders and signs supplied by DOH. 3. Test the SNS Plan's gymnasium setup and clinic flow in the Art Building at the Jefferson County Fair grounds. 4. Expose SNS process to community partners: DEM, Law Enforcement, Fire/EMS, • Hospital. Chapter 3: Exercise Events Synopsis Transported supplies,set up POD and signage for stations. Evaluated facility's appropriateness for clinic. Oriented community partners to clinic. Broke down clinic,packed up supplies. Evaluated second possible building. Chapter 4: Analysis of Mission Outcomes Goals and Objectives: 1. Train JCHP staff on POD Plan and set-up. Nine staff members were trained on POD Plan and set up. 2. Practice assembly and placement of sign holders and signs supplied by DOH. Sign set up practiced and best placement of signs determined. Additional needed supplied were identified: zip ties, duct tape, clothesline rope, red surveyor tape. The discovery was made that • the medium size metal stanchion sign holders have not been sent by DOH. 2 Updated: 8/17/2006 Jefferson County Public Health After Action Report-July 13,2006 Pod Set-up Drill • 3. Test the SNS Plan's gymnasium set up and clinic flow in the Art Building at the Jefferson County Fair grounds. The Art Building was determined to be in adequate for the POD. It is too small to allow enough room for lines and the bathrooms are in the back,not easily accessed by those standing in line. 4. Expose SNS process to community partners:DEM,Law Enforcement,Fire/EMS,Hospital Representatives from DEM, Law Enforcement, Fire/EMS were oriented to the Local, State and Federal SNS process. Conclusions Alternate larger location is needed. Volunteers will be needed to run the clinic. Signage is adequate but some sign holding hardware is still needed form DOH and additional supplies are needed. A question arose regarding prescribing authority and medical oversight of dispensing nurses. • • Updated:8/17/2006 3 0 t ocg v O a) 0 No0 00 1 0 ° .E GJ N t O co g N N g o x j g p. 1 V -6 A ;§ .c) o 1 Rh ,� ; w ii . v 3 v j kci) .-. 3E 0 w �, °' a ° 0 74 c`l ,., U 4, CS c n c n x ,-, (� o. I • _, n o o w -• 0 :4 d O o RI g �+ Cn I '" 4•a O 1 i a! 'E.5 E •; e i Ot ao uvO Qv . 'A' • a..,CZ a.• ,C v m o °'E , w2 ' 4.. uTi ' o CU p . H Cl5 vO ° 'Cvm � E x 'd a), 5 2 ° .� � t. Ozem . s-,uO ¢ U ° -0ESU v P.-, gIm , Z0.40 U Q.o u vs O 0 41 ap ,Th U v �° •E o = 'LS m .5 8 0 ] o o ° to N 4 o �, ti o �+ r0 ' 0 a) o 0 ` I ca (n ° cn w "" '-. . i bA co O pw R•, v F+ 0,4 bACO 0 W[ bpU • C.Ni1-_, i..4 � I i '3 •I- - o * 1_1'• cQ,N m > 2 y O . DI v n al y DI m Lcu I) 1....1 w-+ W F.-, .S] *•4 W 14 F-. W F-, 0 I.., 04 O w 4 . Spring 2006 1. • a'81) 1 #xarsnucrxarory Region 2 aEAL T for the Peninsulas lc ea Be Wise and Immunize—Yourselves! As Health Care Workers (HCW) we owe it to ourselves,our families and our patients to stay healthy.We have a responsibility to our patients to know our immune status. We need to protect them from any hazards that our lack of immunity to infectious disease might pose to their health. Health Care Garden Variety The CDC Advisory Committee on 7 Vaccine Workers Adults Immunization Practices (ACIP) -_ . strongly recommends that all Health Hepatitis B 3 doses at 0, 1-2 If risk factors present Care Workers be vaccinated against apart 4 months the diseases listed here. MMR 2 doses,4 weeks 1-2 doses,4 weeks MMR You should know your status - apart apart for measles,mumps and rubella. If ;; P 1 , Varicella 2 doses,4 weeks 2 doses,4 weeks you haven't had these diseases or apart apart don't know your history, get I t k" .„ .,,,,..4. Influenza 1 dose annually 1 dose annually immunized. Find out your status with a blood draw (antibody titer) i`, Tetanus/ Booster every 10 Booster every 10 J ' diphtheria/ years years Measles and mumps are highly - -- , Tdap contagious and can have serious # S \:a Meningococcal Microbiologists If risk factors present complications. Rubella infection in pregnancy can cause birth defects. ; For information on children's immunization go to https://fortress.wa.gov/doh/cpir/iweb/main.jsp and scroll You would not want to be down to"Valuable Links". responsible for infecting anyone! Varicella The rationale for Tetanus updates should be a immunization is the same as for routine part of all patient exams. MMR—protection against the spread of the infection to Jane Kurata,Immuniza _ Td with susceptible children and adults, tion Coordinator with 4Ma Pertussis,a new Jefferson County Public especially those with a higher risk Health,receives a TdaP Tdap is recom- vaccine, should be for complications. vaccine from CD Nurse, considered for Lisa McKenzie. mended by ACIP for Hepatitis B When you work in a all people working health care personnel health care facility and there is as soon as feasible. with children. increased risk of exposure to blood or bodily fluids a post vaccine anti- Health Care Workers: Who Are You? body test is recommended to assure you are a vaccine"responder". Influenza Everyone should have a You are: Who work in: yearly vaccine for seasonal flu. You Physicians Hospitals need to stay well to be productive Nurses Health departments and to avoid spreading flu to your EMS Responders Private offices and clinics Medical&Dental professionals Nursing homes patients,co-workers and especially Medical&Dental students Schools to those who have increased risk of Lab technicians Laboratories 0 complications. Volunteers&Administrative staff EMS The Region 2 Public Health Emergency&Preparedness Program(PHEPR)endeavors,through this newsletter,to keep you,our health care providers in Clallam, Jefferson,and Kitsap Counties,informed about Public Health issues that affect you and the patients you serve.If you have questions,comments or need more information about items in this newsletter,please contact the editor,Ruth Westergaard,by phone(360)337-5752,FAX(360)475-9344,email wester®health.co. kitsap.wa.us or at 345 Sixth Street,Suite 300,Bremerton,WA 9833'7.Spring 2006 edition published 5/15/06. Spring 2006-Page 2 Region 2 Sys • Communicable Disease �� `�e�`° `��� Surveillance Data o,�4,1- t�eoxJ o'°' a �.. Ao e suMarch 2006 , , Ca�x,„ �eQx �et•`�\Se Qe,Js �� Lr11 o�sc• Kitsap Current Quarter(Jan-Mar) 1 5 6 1 0 0 23 1 163 13 2005 Cases 6 21 28 11 0 1 48 6 608 76 2004 Cases 4 14 24 11 3 2 8 2 672 70 *Incidence Rate per 100,000 resi- 2.1 7.3 10.8 4.6 ** ** 11.7 1.7 266.7 30.4 dents (2004-05) National Goal(cases per 100,000) 1.0 13.2 N/A 13.2 N/A 13.2 13.2 1.0 170.0 19.0 Jefferson Current Quarter(Jan-Mar) 0 0 0 0 0 0 1 0 9 1 2005 Cases 0 2 9 7 0 0 4 1 57 2 2004 Cases 0 2 2 2 0 0 19 0 37 3 *Incidence Rate per 100,000 resi- 0.0 ** 20.1 16.5 0.0 0.0 42.1 ** 172.2 9.2 dents (2004-05) _ National Goal(cases per 100,000) 1.0 13.2 N/A 13.2 N/A 13.2 13.2 1.0 170.0 19.0 Clallam Current Quarter(Jan-Mart 1 1 2 2 1 0 0 0 28 3 2005 Cases 1 2 7 4 3 ** 2 0 135 18 2004 Cases 0 5 2 8 0 0 2 0 151 8 el *Incidence Rate per 100,000 resi- ** 5.3 6.8 9.0 ** ** ** 0.0 215.5 19.6 dents (2004-051 _ National Goal(cases per 100,000) 1.0 13.2 N/A 13.2 N/A 13.2 13.2 1.0 170.0 19.0 *2004 population:Kitsap (239,500),Jefferson (27,000),Clallam (65,900) *2005 population: Kitsap (240,400),Jefferson (27,600),Clallam (66,800) **Incidence rates not calculated for<5 cases. Data source: Public Health Issues Management System(PHIMS);Washington State Department of Health Monthly Morbidity Data Region 2 Public Health Kitsap County Health District 345 Sixth Street,Suite 300 Bremerton,WA 98337 Your Community Liaisons Need respiratory etiquette kits? a Need information? Need???? g'. We've given out over 400 respiratory etiquette kits. 14144,, So, if you haven't called yet for a I<it, call now. ,-- They're FREE! _, Coming Soon to a Public Health :�A 't • binder near you-Immunization Updates Public Health Community Liaisons at(360) 337-5752 or (360) 337-5254. r* rd H �d 5- �d H, X1 oo � o `° CD Cp � I �- ai ara � vN O o CD'CD CDD -OL C5a *• Q ed A - CA p °.11 O prcl - CD . `' O sv 7d 'TJ - cn IQ C'n cn ¢ 1 o H CD � 0o m Q- rt'10 's1 ,SCD an ed O < 0 0 p p vii O Q Cl7 N .. cn cp O . - � " " p. 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