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HomeMy WebLinkAbout2006- September File Copy • Jefferson County Board of 3leaCth Agenda Minutes • September 21, 2006 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, September 21, 2006 Main Conference Room Jefferson County Public Health 2:30 PM—4:30 PM DRAFTAGENDA I. Approval of Agenda II. Approval of Minutes of August 17,2006 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. First Confirmed Human West Nile Case in Washington 2. Beneficial Use of Biosolids in Jefferson County 3. Migratory Bird Testing Results 4. Washington Smoking Rate Drops V. New Business • 1. Initiative 901: Jefferson County Responds 2. 2007 Performance Measures 3. State Association of Local Boards of Health Proposal 4. Report to City of Port Townsend VI. Activity Update 1. Co-Occurring Disorder Integrated Treatment Training October 2,2006 VII. Agenda Planning VIII. Next Scheduled Meeting: October 19, 2006 2:30 PM—4:30 PM Main Conference Room Jefferson County Public Health • 4 • FFERSON COUNTY BOARD OF HEALTH 4Ap I TE M NU S %%*1 Thursday, August 17, 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 Dans kin,Nursing Programs 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 Wlesterman—Citizen at Large(City) Roberta Frissell—Citizen at Large (County) Meeting was called to order at 2:35 pm on August 17, 2006 by Vice Chair Rodgers in the conference room of Jefferson County Public Health. All Board members were present with the exception of Chair Sullivan and Member Masci. All staff members were present with the exception of Mike McNickle. There was a quorum present. APPROVAL OF AGENDA • Vice Chair Rodgers moved to approve the agenda with one change, adding Allan Sartin to the agenda. Board Member Buhler seconded the motion,which carried by a unanimous vote. APPROVAL OF MINUTES Board Member Westerman moved to approve the minutes as written. Board Member Johnson seconded the motion,which carried by a unanimous vote. PUBLIC COMMENTS No Public Comments OLD BUSINESS Information Services & Facility charges to the Health Department There was a discussion regarding budgeting for health department facilities and the process for calculating rent. Allan Sartin explained that the procedure is based on budget numbers and actual costs for the facilities. Numbers are separated out by buildings using a work order system to track the work that is done for each building and then charged accordingly. Under Jefferson County's system, 2007 Budget figures charged to Jefferson County Public Health are based on actual expenses incurred in 2005. Board Recommendations: Green Business • Jean Baldwin explained the differences between EnviroStars and Green Business. EnviroStars is only for businesses that handle hazardous waste, which includes usage, disposal and the storage of hazardous wastes. When the business meets the specified requirements,the business becomes an EnviroStar and is recognized with an award that is posted in their facility. An EnviroStars Award was presented to Dockside Cleaners, Jefferson County's first Dry Cleaner to become an EnviroStar. Green Business is for businesses that do not handle hazardous wastes but are doing things to reduce waste, save energy, reduce water use, increase recycling, and decrease cost of deliveries. This program recognizes a business that has met those requirements. Board Members recommended that the awards be signed by the Chairman. Green Business Awards were presented to Belltower Art, Circle& Square, Food Coop, Lehani's, Monsoon, Pan d'Amore, Silverwater, The Annapurna, and Wild Coho. Cyanobacteria& Vibriosis Update Neil Harrington explained the most recent results from the water samples taken from area lakes to monitor for cyanobacteria. Anderson, Gibbs and Leland are the three lakes being sampled on a weekly basis. Results are posted weekly on the Public Health website. Lake Leland, at present, is stable. Gibbs Lake has high numbers of cyanobacteria but there has been no toxin detected. No action is needed for non-toxin producing cyanobacteria strains. Anderson Lake continues to show high levels of toxin producing bacteria and will remain closed until further notice. Other lakes in the county continue to be checked every week. • Dr. Locke described a Vibriosis outbreak that is occurring,primarily in the Hood Canal area. Vibriosis is caused by a naturally occurring marine bacteria that rises to high levels in warm weather. It can cause severe gastrointestinal symptoms and can be life threatening in the immunocompromised. There has been an increase in vibriosis cases this year of 5 times the normal state rate. Lisa McKenzie, Communicable Disease Program Coordinator explained in detail that the two local cases of disease due to oyster contamination were visitors to the area. We have no local residents reported with the illness. We are in an ongoing surveillance mode, keeping restaurants informed and advising them to only serve cooked oysters at this time. Neil explained the State was in the process of closing beaches along the canal. The Health Department sent out a press release stating that the Hood Canal is closed for recreational harvest of oysters. In addition, signs were posted along the beaches from the entrance of the Hood Canal and south to Triton Cove. JCPH Public Education & Outreach Plan Jean Baldwin spoke about JCPH's efforts to communicate with the general public by updating the website in a timely manner, sending out newsletters and focusing on health education& information. Tami Pokorny coordinates the PTTV show"The Many Faces of Public Health". DVDs are available of each of the previous shows. Examples of a newsletter for the WRIA 16 Planning Unit was shown. Tami is also speaking at the farmers market about educational strategies used to promote recycling. • • NEW BUSINESS Joint Committee on Public Health Financing HB4410, enacted by the Washington State Legislature in 2005, established a joint legislative committee to study public health funding needs. The committee's draft recommendations were reviewed. A final report is expected in November and will be brought back to the Board for review. Health Care Worker Vaccination—Time for a Mandate? Dr. Locke discussed a resolution to be considered at the Washington State Medical Association's annual meeting in mid-September that calls for a statewide Health Care worker influenza mandate. Jefferson County Public Health Preparedness Point of Dispensing(POD) Exercise Lisa McKenzie gave a brief report regarding the strategic National Stock Pile program for emergency preparedness, which is a national program that provides medical supplies for an outbreak or emergency. Counties are required to have a plan to set up a clinic to vaccinate or dispense antibiotics. JCPH conducted a test on July 13th All the local partners were invited to attend. Activity Update/Agenda Planning It was suggested the letter Dr. Locke wrote regarding child immunizations,which was published in the Port Townsend Leader in 2005 be run again for 2006. • Local onsite regulations are being drafted to be compliant with the state law that takes effect in July of 2007. Completion is expected by November and Board of Health hearings will take place in December 2006. Pandemic Influenza Community Forums Julia Danskin informed the Board that we have started small community group forums. Betty Dunaway with Kitsap County did a presentation to the emergency preparedness community groups. She is also working with the mill and will be going to Port Ludlow and other smaller communities in the area. There is a larger presentation planned partnering with the Bremerton/Kitsap Health organization. Meeting adjourned at 4:15 pm. Next Board of Health meeting is September 21, 2006. JEFFERSON COUNTY BOARD OF HEALTH Phil Johnson, Member Jill Buhler, Member Patrick M. Rodgers, Vice Chair Sheila Westerman, Member • Roberta Frissell, Member • Board of Health Old Business .agenda Items # 1 � First Confirmed Human "West Nile Case in 1NA September 21, 2006 • , • W,,,,,er Health as!in,ton Matte flkpartm�ent of News Release ,. For immediate release: September 13, 2006 (06-143) Contacts: Jeff Smith, Communications Office 360-236-4072 Deanna Mill, Communications Office 360-236-4022 Pierce County man is state's first confirmed case of West Nile virus infection OLYMPIA—A Pierce County man in his forties is confirmed as the state's first human infection with West Nile virus. Blood tests at the state Public Health Laboratories were positive, so samples were sent to the Centers for Disease Control and Prevention (CDC), which confirmed the positive result today. The man did not travel out of the state during the likely time he was bitten by an infected mosquito; he developed mild symptoms—a rash and fever—in July, sought medical attention in August, and has recovered. The disease is not spread person to person so he is not a threat to public health. • "Most people who are infected with West Nile virus don't ever get sick or have symptoms, yet it can be a very serious disease for a small number of people, especially those older than 50 years of age," said Dr. Jo Hofmann, State Epidemiologist for Communicable Disease. "Avoiding mosquito bites is the best prevention. With our first in-state infection, it's vital to take the simple precautions that can help protect you from West Nile infection." People can avoid mosquito bites by staying indoors around dawn and dusk when mosquitoes are most active; making sure that door and window screens are in good working condition; and using a mosquito repellent when outdoors in areas where mosquitoes are active. Always follow label instructions when using mosquito repellents. It's also important to reduce mosquito habitat around the home. Turning over old buckets or cans, emptying water from old tires, and frequently changing water in birdbaths, pet dishes and water troughs helps eliminate the small puddles of water in which many mosquito species breed. West Nile infection can cause encephalitis (inflammation of the brain) or meningitis • (inflammation of the lining of the spinal cord and brain). People over age 50 have the highest risk for serious illness. —More— WNV-suspected human case in WA September 13, 2006 Page 2 • West Nile virus is primarily a bird disease. Mosquitoes become infected by feeding on infected birds, and then pass the virus to uninfected birds, humans, horses or other hosts. Crows, ravens, magpies and jays are especially susceptible to dying from the virus. The Department of Health is monitoring for the presence of West Nile virus by tracking mosquito samples, horses, and dead birds. So far in 2006, there has been one horse infection acquired in our state out of 28 tested; there have been no positive mosquito samples (912 tested), or dead birds (273 tested). The Department of Health West Nile virus information line 1-866-78-VIRUS (1-866-788-4787) and the agency's West Nile virus Web site (www.doh.wa.gov/WNV) are excellent resources for anyone who wants to learn more. The Department of Health is working with local health partners as well as other state agencies, including the Departments of Agriculture, Ecology, and Fish and Wildlife on West Nile virus monitoring, planning, control and prevention. . ### Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. • Board of 3-CeaCth Old Business .Agenda Item # IV., 2 Beneficial Ilse of Bioso lids In Jefferson County • September 21, 2006 • • JEFFERSON COUNTY PUBLIC HEALTH BENIFICIAL USE OF BIOSOLIDS IN JEFFERSON COUNTY Mission: Always working for a safer and healthier Jefferson County Objective: To recycle biosolids in a beneficial way, while protecting public and environmental health. Rationale: The purpose of this statement is to educate the public on the use of biosolids in Jefferson County. Issue: What are biosolids and how are they handled in Jefferson County? Biosolids are the semisolid, nutrient-rich, organic material resulting from the wastewater treatment process. Wastewater treatment has made our water safer for recreation and seafood harvesting. Thirty years ago, thousands of American cities dumped their raw sewage directly into the nation's rivers, lakes, and bays. Now, federal and local regulations require all wastewater to be treated before being discharged back into the environment. When wastewater reaches a • treatment plant, the sewage goes through physical, chemical and biological processes which scrubs most of the nutrients out of the water and biologically converts it into solids which are filtered out and removed. If properly treated, the water discharged from the treatment plant is clean and poses little risk to human or environmental health. The remaining biosolids can then be employed for other uses. Jefferson County does not regulate the use of biosolids in the county. In Washington State, all biosolids are permitted and overseen by the Department of Ecology. In the eyes of the State, biosolids are considered to be a valuable resource. This fact is enshrined in Washington State Law which states "to the maximum extent possible, ensure that municipal sewage sludge is reused as a beneficial commodity and is managed in a manner that minimizes risk to public health and environment" (Chapter 70.96J.005 RCW). State rules (WAC 173- 308-080) define beneficial use as "the application of biosolids to the land for the purposes of improving soil characteristics including tilth, fertility, and stability, and enhancing the growth of vegetation consistent with protecting human health and the environment." Currently, biosolids in Jefferson County are being disposed of in two beneficial ways. The biosolids from the Port Townsend Wastewater Treatment Facility are used to produce compost at the Port Townsend Compost Facility. The biosolids • are mixed with chipped yard waste and placed in aerated static piles. The biological composting process increases the internal temperature of these piles to over 131° F for at least three days. The composting process therefore kills • pathogens in the biosolids by "cooking" them. The compost is tested on a regular basis to ensure that it does not exceed acceptable levels of contaminants. Once the compost has finished the composting process, it is sold to the public as a soil amendment. Jefferson County Public Health permits the compost facility as a solid waste facility but does not regulate the biosolids used in the compost. Biosolids from the Port Ludlow Wastewater Treatment Facility, along with biosolids from Port Gamble and the City of Bainbridge Island, are used as a fertilizer on the Pope Resources tree farm south of Highway 104. The tree farm has been specifically sited to minimize the possibility of the land application affecting the surrounding areas. Soils, topography and groundwater of the application area have all been analyzed to ensure that the application of biosolids to the forest will not contaminate surface water or flow off the site. The biosolids are trucked to the site and sprayed on the land at or below a maximum calculated agronomic application rate. This rate has been calculated so the forest is not overloaded with nutrients. The biosolids are sampled on a regular basis for heavy metals and fecal coliform bacteria. Access to the application site is restricted to the public by gates on the roadways and numerous "No Trespassing" signs are posted around the perimeter of the area. Washington State law gives the Department of Ecology sole jurisdiction to manage land application of biosolids; therefore Jefferson County Public Health does not permit, regulate or monitor this site. According to the Department of Ecology, there have been no known violations of the permit conditions at this site. If done properly, recycling biosolids can be good for the environment. Organic matter and nutrients have been recycled for centuries to improve soil fertility and productivity. When properly applied and managed, biosolids can provide essential plant nutrients, improve soil structure and tilth, add organic matter, enhance moisture retention, and reduce soil erosion. This document was written with help from the Department of Ecology website(www.ecy.wa.gov)and the U.S.Environmental Protection Agency website(www.epa.gov). • Svt _ru &' ' meg,+'t rxe V � vav Jefferson County Staff and Residents Exchange Information about Solid Waste and Recycling Every day, about 114,000 pounds of garbage hit the deck at Jefferson County transfer stations— enough to fill the courthouse clock tower from the basement to the rooftop twice a week. Where does it all go?Annually,we ship nearly 42 MILLION pounds of solid waste(trash and garbage) over 300 miles by truck and train to eastern Washington for permanent disposal at Roosevelt Regional Landfill. The cost: $1,037,777.86 in 2005. The county generates funds to process solid waste through tipping fees—the price we pay at the scale shack or for curbside garbage service. Currently 47% of the tipping fees collected are spent on landfill disposal whereas 7% is spent to support the recycling program. . Last winter and spring, 324 Jefferson County residents assessed their solid waste and recycling habits in a survey developed by the Environmental Health Department. The survey was intended as an educational tool and to gather information about residents' recycling preferences and use of solid waste and recycling facilities. Because the survey was non-statistical in nature,the accuracy of the results will not be evaluated. The survey was distributed by the Solid Waste Advisory Committee and county staff. The majority of responses were from individuals between the ages of 40 and 60 and from people who have lived in Jefferson County ten years or more. Fifty-eight percent live in Port Townsend. Fifty-four percent are female. The survey mentioned resources to aid recycling such as the Jefferson County Freecycle website— a Yahoo®group(http://groups.yahoo.com/group/JeffersonCoFreecycle). The site is used to connect people and(free)things. The survey also alerted participants to services that they may not have known existed.For example,curbside recycling pickup is available to rural residents(at a cost of$7.64/month). Eighty-seven percent of survey respondents reported that they recycle at least a portion of their solid waste. In fact,Jefferson County residents in partnership with the Jefferson County Recycle Center, diverted almost seven million pounds of useable materials from the landfill last year. "We're always looking for a new and better way of doing things," said operations manager Matt Hall. "For example we've recently begun accepting most#2 plastics and green glass. We've also increased the frequency of service runs to satellite drop sites." The survey asked whether additional materials should be added to the recycling program and if residents would bear the cost of recycling them. Plastic bags and demolition/construction waste • had the highest combined scores of the items not currently accepted by the Recycle Center. Sixty percent of residents indicated that the existing drop site locations meet their needs.A few people requested that the Recycle Center be open Sundays and longer hours on Saturdays. Of the 155 respondents who have unwanted electronics at home 138 people intend to donate or sell the items themselves,or to recycle them at the Jefferson County Recycle Center next door to the P.T. Transfer Station on Jacob Miller Road(385-7678)at a cost of$0.35 per pound. Only 17 planned to dispose of their unwanted televisions,computers,or peripherals as garbage. The survey identified two local businesses that refurbish computers and provide them to low-income residents at little or no cost: Ty's Computers and Conklin Photography,both in Port Townsend. Computers and televisions contain lead and other hazardous materials that can be recycled into new products.More than half of surveyed individuals were aware that cellular telephones also contain significant amounts of lead. Cellular phones can be disposed of at no charge at the Recycle Center and at the Household Hazardous Waste Facility(HHW)at 10th Street in Port Townsend(379-6911). Seventy percent of respondents were unaware that the HHW accepts compact fluorescent lamps, which contain mercury, from county residents at no charge. Like lead,mercury does not decompose and its increasing presence in the environment,and in our diets through the consumption of fish,has serious consequences for the health of unborn babies and young children in particular. Almost 60%of survey respondents were aware that the HEW accepts unwanted pesticides and fertilizers at no charge to county residents.Only 13%of residents said that they apply these chemicals on an annual basis;the rest use them rarely or only when problems arise. A 16 pound bag of"weed and feed"may cost just$10.00($0.63 per pound). So why not buy a little extra just in case?The reason: collecting,processing, and shipping a random assortment of these • "flammable toxins"along with other hazardous chemicals for permanent disposal is expensive.In 2005,the HHW took in 3025 pounds of unwanted garden chemicals.Almost a thousand pounds of useable product were given away via the reuse shelves at the EHW. The remaining ton of garden chemicals was shipped to one of four incineration facilities(in faraway UT,NE,OH or AR)and burned at a cost of$1.62 per pound! At$1227 per ton, it costs 1926%more for the county to responsibly dispose of hazardous wastes than it does to dispose of garbage. Still,this is peanuts compared to the cost of environmental clean-ups where hazardous materials are handled recklessly. So look for alternatives to hazardous chemicals, including garden chemicals. Buy and use as little as possible only when necessary! In 2005,the City of Port Townsend's Biosolid Facility accepted approximately 6,850 tons of unwanted vegetation from residents and developers. Some of this material consists of native plants from forests that provided valuable environmental services such as water filtration and sufficient groundwater recharge to supply wells for drinking water. These forests are frequently replaced by lawns with thick, shallow root mats that slow water infiltration and cause surface water runoff problems(stormwater)that affect salmon and shellfish habitats. Jefferson is the only county in Washington that accepts yard waste and land clearing debris at no charge. Forty percent of survey respondents favor a user fee to pay for storage and chipping of this material. Expenses are currently paid for by all City of Port Townsend utility rate payers. "The amount of yard waste we're receiving is more than the facility is designed to handle.Home composting of yard waste is encouraged to alleviate the amount of materials coming to the facility. Grass clippings and small woody fibers are a good way to add carbon to a nitrogen . dominated(food waste)compost process,"said John Merchant,City of Port Townsend operations • manager for street, sewer and stormwater. Although most(62%)survey respondents reported that they are composting food waste using homemade bins,the survey did not ask residents whether they also compost yard waste. Last October,the county approved new solid waste regulations that are intended to protect the public and environment from the effects of improper waste disposal practices (http://jeffersoncountypublichealth.org/pdf/Solid_Waste_Regulations.pdf). Only eighteen percent of survey respondents said that they were aware of these new laws. Mark Nelson, environmental health specialist commented that, "It's important for individuals and families to take personal responsibility for managing their own garbage."Otherwise, county resources are expended to resolve conflicts, often between neighbors, and to conduct enforcement activities. Sixty-five percent of individuals indicated that they were"satisfied"with the solid waste program in Jefferson County overall. Twenty percent were"not satisfied"and twenty-two percent were "very satisfied." The bottom line is still: REDUCE, Reuse and recycle. The three Rs help minimize pollution, loss of habitat, and energy consumption. They support the environmental services that vegetation and soils provide, such as water storage and filtration,as well as the benefits to people and wildlife from open spaces ...and a more peaceful world. Garbage is increasingly a luxury! Perhaps we shouldn't just ship it all away... For more information visit www.co.jefferson.wa.us and click on"Solid Waste"or contact Tami Pokorny, environmental health specialist,at tpokorny@cojefferson.wa.us or(360)379-4498. • • • Board of Health OCd Business .agenda Item # n7., 3 • Nligratory Bird westing Results September 21, 2006 • .elease No. 0326.06 Page Ews RELEASE ■� N .Jatiod Slates Occettoton101A0001000 • Olko 01-Dorrununicatiom 1400 Washington.DC 202501300 • �( X ? 40223 • ,oc. ' news u independence SW Release No. 0326.06 Contact: Angela Harless, USDA(202) 720-4623 F. Quimby/J. Moody, DOI(202) 208-6416 DOI, USDA, STATE PARTNERS TEST MORE THAN 13,000 WILD MIGRATORY BIRDS IN ALASKA No Highly Pathogenic H5N1 Avian Influenza Detected WASHINGTON and BARROW, AK, Aug. 29, 2006-Agriculture Secretary Mike Johanns and Interior Secretary Dirk Kempthome today announced that their departments and the State of Alaska have tested more than 13,000 wild migratory birds for highly pathogenic avian influenza(HPAI)H5N1 in Alaska. No HPAI H5N1-a virus that has killed wild birds, commercial poultry and more than 140 people in Asia, Europe and Africa-has been detected in any of the Alaska samples. •, "Guided by the national wild bird surveillance and early detection plan, our collaborative efforts have comprehensively sampled and tested high-priority species throughout Alaska," said Secretary Kempthorne, who this week is visiting a sampling camp near Barrow, Alaska. "Although no high-path H5N1 virus has yet been detected,we must remain vigilant and thorough in this important detection and early warning program. I'd also like to recognize the cooperation of Alaska subsistence hunters, of citizens who have reported dead birds, and of the Alaska public in general, who have made great efforts to become informed on this issue and thus are valuable partners in state and federal efforts." "Close collaboration with our federal, state, and local partners is essential to the success of our national wild bird monitoring strategy," said Secretary Johanns. "This plan is one of many tools we use to control the spread of highly pathogenic forms of the avian influenza virus. The U.S. Department of Agriculture (USDA) also works on the international front, as well as at our borders and within them to ensure the highest levels of protection and early detection capabilities are in place." The national wild bird surveillance and early detection plan is part of President Bush's National Strategy for Pandemic Influenza. The President allocated$29 million in his fiscal year 2006 avian influenza supplemental funding package for implementation of the wild bird monitoring plan. The U.S. Department of Interior(DOI), USDA, the State of Alaska, and the University of Alaska have been involved with sampling wild birds in Alaska since April 2006. The sampling program includes a goal to sample and test 75,000 to 100,000 migratory birds across the United States this year. So far DOI(including the U.S. Fish and Wildlife Service and the U.S. Geological Survey) ihtml:file://D:\boh%20packet\Clallam\September2006\Release%20No %200326 06.mht 9/14/ .elease No. 0326.06 Page has tested more than 11,000 samples and USDA has tested more than 2,000 samples-for a total of more than 13,000. Of those tested by DOI, approximately 113 have tested positive for some form of avian influenza. This is to be expected since there are 144 subtypes of"bird flu," • most of which pose no threat to domestic poultry or humans and do not produce noticeable symptoms in wild birds. Of the 113 samples, all tested negative for the highly pathogenic 1-15N1 virus. The Alaska samples were taken from 26 "target species." Because of their migratory patterns and habitats, these species were determined to be most likely to have encountered highly pathogenic H5N1 before arriving in Alaska. Sample numbers (USDA data have not yet been added) are now being entered into a database called the HPAI Early Detection Data System (HEDDS), which is available at http://wildlifedisease.nbii.gov/ai/to agencies, organizations, and policymakers involved in avian influenza monitoring and response to share information on sample collection sites,bird species sampled, and test results. Within the auspices of national wild bird surveillance and early detection plan, the USDA and DOI are working with Alaska, the other 49 states, as well as the U.S. Pacific Territories and Freely Associated States to collect 75,000 to 100,000 wild bird samples along with 50,000 environmental samples of wild bird droppings across the United States in 2006. USDA and DOI collaborated with the Association of Fish and Wildlife Agencies, and the Pacific, Central, Mississippi, and Atlantic Flyway Councils to develop the plan, formally known as An Early Detection System for H5N1 Highly Pathogenic Avian Influenza in Wild Migratory Birds -- U.S. Interagency Strategic Plan." As birds from Alaska and Canada begin their southerly migration from these breeding grounds, state, federal and university biologists in the lower 48 states and Hawaii have begun • capturing and sampling various species under an expanded wild bird surveillance program for all national migratory bird flyways and states. This intensified migratory bird surveillance is carried out through cooperative agreements and projects with the states and Pacific Islands. The funding level for each state is based on species-specific wild bird migratory patterns, historic disease prevalence, habitat availability and other biological and physical criteria. USDA and the states have completed cooperative agreements, with USDA providing nearly$4 million for state agencies to sample specific species of migratory birds at appropriate sites under plans coordinated through the four national flyway councils. DOI's U.S. Fish and Wildlife Service has finalized cooperative agreements with Hawaii, California, Idaho, Montana, Nevada, Oregon, Utah, and Washington. Thus far, these states and other cooperators have received $1.9 million from the U.S. Fish and Wildlife Service to implement monitoring strategies in each state's surveillance plan. Migratory birds are only one possible pathway for introducing HPAI H5N1 into North America. Other potential routes include international travel, and both legal and illegal commerce in poultry, poultry products, wildlife and wildlife products. Federal and state governments also have bolstered efforts to monitor these other potential pathways for introducing the virus into North America. For more information about USDA's and DOI's avian influenza efforts, go to www.usda.gov/birdflu and www.doi.gov/issues/avianflu. For information about the U.S. Government's efforts and guidance related to human pandemic preparedness, go to http://www.pandemicflu.gov/. • ihtml:file://D:\boh%20packet\Clallam\September2006\Release%20No %200326 06.mht 9/1 4/2n • Board of Health Odd Business .agenda Item #n7., 4 • Washington Smoking Rate Droys September 21, 2006 • • CHRISTINE O. GREGOIRE _ Governor Cyt<asy�v STATE OF WASHINGTON OFFICE OF THE GOVERNOR P.O. Box 40002 •Olympia, Washington 98504-0002•(360)902-4111 For Release: Immediate Contact: Governor's Communications Office Date: Wednesday,August 30,2006 Phone: 360-902-4136 Department of Health, Tim Church 360-236-4077 Governor Gregoire Announces Washington Smoking Rate Drops to 5th Lowest in Nation 205,000 fewer adult smokers since state began Tobacco Prevention and Control Program SEATTLE—Governor Chris Gregoire today announced that the adult smoking rate in Washington has dropped to 17.8 percent, which is the fifth lowest smoking rate in the country. Adult smoking in Washington has dropped by 21 percent since the state began its comprehensive • Tobacco Prevention and Control Program in 2000, far outpacing the national rate of decline. "I am proud that Washington has become a national leader in the battle against tobacco use,"said Governor Gregoire. "It has taken a lot of hard work and the consistent decline in adult smoking rates shows that the hard work is paying off. Washingtonians will live longer, healthier lives because they have quit smoking." At a press conference today in Seattle, Secretary of Health Mary Selecky announced that the adult smoking rate in Washington declined from 22.4 percent in 1999 to 17.8 percent in 2005, moving the state up in rank from 20th to fifth place in the nation. The drop translates to about 205,000 fewer smokers in Washington—equal to filling Safeco Field four times. The decline in smoking will save the state $1.8 billion in future health care costs. "We're helping smokers put out their cigarettes for the last time and that means a healthier Washington,"said Secretary Selecky. "Our rates are falling at a remarkable pace and our statewide cessation programs, including the Tobacco Quit Line and our work with health care providers, are making a real difference in people's lives." The Washington Tobacco Quit Line is a key element of the state's adult tobacco prevention and control work. More than 80,000 Washington residents have called the toll-free quit line (www.quitline.com) at 1-877-270-STOP (in Spanish, 1-877-2NO-FUME) for free counseling, a personalized quit plan, local quitting resources and free quit kits. • "There are now many more former smokers in our state than current smokers," said Dr. W. Hugh Maloney,president-elect of the Washington State Medical Association. "To build on this momentum, doctors,nurses and health care workers should identify patients who smoke and guide them to proven quitting resources like the Tobacco Quit Line." • The state has trained thousands of physicians and other health care workers on how to help their patients quit smoking and has implemented several campaigns to make those most at-risk aware of cessation resources. While Washington has made significant headway in lowering smoking rates,there is still work to do. The tobacco industry spends more than$184 million each year in our state to hook smokers. About 45 youth start smoking each day and about 8,000 people in our state die every year from tobacco-related diseases. Media materials(http://www.quitline.com/pressroom.php) are available online. ### Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. • • • Board of 3-CeaCth Wow Business .agenda Item # T., 1 Initiative goi: 0 Jefferson County Responds September 21, 2006 • • Background Initiative 901 (I-901): I-901: Back 9 Jefferson Co',inty—Respon s • Purpose:To protect citizens of the State of Washington,including workers,from the risks Jefferson County Board of Health Presentation of second-hand smoke. September 21,2006 Kellie Ragan,M.A. ■ November 2005 Tobacco Prevention Program Coordinator —Passed by voter majority in all Washington counties —Passed by 63%voter majority in Jefferson County and Washington State Public Health:Always working for a Safer and Healthier Community Public Health:Always working for a Safer and Healthier Community I-901: Complaints To Date I-901: Background (continued) (Jefferson County) • December 2005-The amended Clean • All complaints logged by Tobacco Indoor Air Act(RCW 70.160) became Prevention Program staff effective. • Complaints received to date: 39 —Number of businesses identified:21 • February 2006-Jefferson County -Number of businesses in Port Townsend: 17 Board of Health passed Ordinance -Number of businesses with Food Permits: 15 2006-04-0216-06 -Number of businesses that have received multiple complaints:9 Public Health:Always working for a Safer and Healthier Community : Public Health:Always working for a Safer and Healthier Community I-901: Complaint Types (Jefferson County) 1-901• JCPH Response • Smoking on deck under owner control:12 • Commitment to protect the citizens of • Smoking at sidewalk table/bench under owner control: 12 I. Jefferson County, including workers, • Smoking inside public place:7 from the risks of second-hand smoke. i■ Smoking within 25'of doors/windows/ventilation:3 • Inadequate Signage:2 j■ Business Owner/employee smoking directly outside place of business:2 '■ Private residence(apartment complex)complaint: 1 Public Health:Always working for a Safer and Healthier Community Public Health:Always working for a Safer and Healthier Community • 1 4` • I-901: JCPH Response (continued) I-901: JCPH Response (continued) ■ Phone complaints and/or spot checks by JCPH • I-901 collaboration--JCPH Tobacco staff serve as catalyst for contact with businesses. Prevention and Food Safety Programs: - Educational Packets sent:17 —Food Establishments Inspected:35 I - Official Notices sent or hand-delivered:8 p —Site Visits:3 —Establishments with observed compliance: 35 i - No action taken:11 — Citations Issued:0 — Food Permits Suspended:0 — Food Permits Revoked:0 —Variance Applications Reviewed:1 —Variance Applications Denied:1 I Public Health:Always working for a Safer and Healthier Community Public Health:Always working for a Safer and Healthier Community 1 I-901: JCPH Response (continued) 'I-901: JCPH Response (continued) ■ Enforcement: • Education and Outreach: -Violation occurs when a complaint registered by —Notification to businesses that complaints are a person to Jefferson County Public Health has • being received been witnessed or observed by JCPH staff.Only —Educational materials and signage provided observed noncompliance will be considered an enforceable violation under these regulations —Technical Assistance visits (See Ordinance:Definitions 04-0216-06.060). Public Health:Always working for a Safer and Healthier Community Public Health:Always working for a Safer and Healthier Community I !JCPH: Tobacco Prevention and I-901: JCPH Next Steps Control Activity Highlights • Education process continues to promote • Tobacco Advisory Committee compliance with I-901 —Review Jefferson County Tobacco Strategic Plan; • Official Notices/Technical Assistance visits update as applicable based on registered complaints • Secondhand Smoke(SHS)Task Force -Charged with development of local plan to • Actions of last resort: reduce 5H5 exposure —Citations • Cessation Efforts —Food Permit suspension —Technical assistance available to employers to —Food Permit revocation support cessation efforts among employees Public Health:Always working for a Safer and Healthier Community Public Health:Always working for a Safer and Healthier Community S 2 • Jefferson County Public Health Questions??? Contact Information: Kellie Ragan 360-385-9446 kragan@co.jefferson.wa.us Public Health:Always working for a Safer and Healthier Community • • 3 y • In November 2005, Washington voters FEZ' G� • passed Initiative 901 (I-901),as an �O �� • amendment to the Washington Clean Indoor F., _ �' Air Act. I-901's stated puIA rpose rpose is to protect 1 r the citizens of the State of Washington from 4 k '"" F � the effects of second-hand smoke. Consistent with this goal, I-901 expanded the non- \,.... `�SHI1�Cs� smoking provisions of the Clean Indoor Air • Act. For instance, restaurants, bars, bowling Office of alleys, and skating rinks must now completely 4,44,7 prohibit smoking. Attorney General Rob McKenna k This document is intended primarily to provide guidance on I-901 to state agencies and officials. The answers set forth below provide general guidance and analysis of the • provisions of I-901, as they relate to frequently asked questions. Many questions regarding the • interpretation of I-901 can best be addressed in the context of specific facts and circumstances. l: 4 State agencies should continue to address �� 410,41 specific questions to the Assistant Attorneys General assigned to their agency or program. 0 ',4,4p14),veg,,, s '''‘'''"ftliete tb, Local governmental entities should consult '",,e' ''1,','*-14, their attorneys with questions about the interpretation or implementation of I-901 or the other provisions of the Clean Indoor Air :1414(11'•`-'‘‘. '2"-PEArt,,:?-eft:144164Pi.407,-.•‘tir Act. Although the Attorney General's Office can provide general guidance on the likely interpretation of I-901, the initiative gives enforcement authority to locality, n enforcement and local health departments. Private citizens and private entities should make decisions about their own responsibilities :14,404.-,:wet,„frovt,4 on the basis of guidance and direction from these local authorities. A guide for State It iS important to remember that I-901' Agencies and1. ` irided`an existing law; while certain provisions of the Clean Indoor Air Act were Employees amended or repealed, other provisions '14,4remained the same. This document does not f� provide a complete analysis of the Clean March 2006 �y , Indoor Air Act as it existed before the • ,, .,,, A .,„^4 fsti.'ez,,,,e54 passage of I-901. It focuses on ways that I-901 " changed the Clean Indoor Air Act. General Questions about 1-901 What is the Stated Purpose of I-901? 3.Inclusive but not Limited List of Public Places: To protect the citizens of the State of Washington,includ- Public places include,but are not limited to:schools, ing workers, from the risks of second-hand smoke. elevators,public conveyances or transportation facilities, museums,concert halls,theaters,auditoriums,exhibition halls,indoor sports arenas,hospitals,nursing homes, health care facilities or clinics,enclosed financial What does I-901do? institutions,educational facilities,ticket areas,public I-901 imposes prohibitions against smoking in all hearing facilities,state legislative chambers and "Public Places"and"Places of Employment"and requires immediately adjacent hallways,public restrooms, those who own and control such places to take certain steps libraries,restaurants,waiting areas, lobbies,bars,taverns, to ensure compliance. bowling alleys,skating rinks,casinos,reception areas, I-901: and no less than seventy-five percent of the sleeping 1.Prohibits any person from smoking in a public place or quarters within a hotel or motel that are rented to guests. place of employment. 4.Exclusions:"Public place"does not include: 2.Requires owners,lessees,or other persons in charge of a)A private residence unless the private residence is a public place or place of employment to: used to provide licensed child care, foster care,adult a)Prohibit smoking in those places. care,or other similar social service care on b)Post signs prohibiting smoking"as appropriate" the premises. under the initiative. For retail stores and retail b)Private facilities which are only occasionally open to service establishments,signs must be posted at the public,except upon occasions when the facility each entrance and prominently throughout the is actually open to the public. establishment. I-901 did not change signage c)Up to twenty-five percent of the sleeping quarters in requirements for facilities that were required to be a hotel or motel rented to guests. non-smoking prior to the passage of I-901. What is a Place of Employment? Can a Place be Both a Public Place and a 1.General Definition: any area, Place of Employment? a)under the control of a public or private employer, Yes. Restaurants,retail stores,hospitals,buses,schools, b)which employees are required to pass through and many state facilities are examples of buildings and during the course of employment, including,but not vehicles that are both public places and places of employ- limited to,entrances and exits to the place ment because they are open to the public,and people work of employment. in them. 2.Presumptively Reasonable Minimum Distance: "Place of employment"also includes a reasonable minimum distance of"twenty-five feet from entrances, What is a Public Place? exits,windows that open,and ventilation intakes that 1. General Definition: That portion of serve an enclosed area where smoking is prohibited." a)any building or vehicle, 3.Inclusive but not Limited List of Places of Employment: b)used by and open to the public(regardless of Work areas;restrooms;conference and classrooms;break ownership or fee for admission). rooms and cafeterias;and other common areas. (I-901 did not change this basic definition of a public 4.Exclusions:"Place of Employment"does not include: place. The initiative did add additional locations to the a)A private residence, definition of public place and removed certain b)A home-based business,unless used to provide exceptions to the definition.) licensed child care,foster care,adult care,or other 2.Presumptively Reasonable Minimum Distance: "Public similar social services on the premises. place"also includes an area twenty-five feet from entrances,exits,windows that open,and ventilation intakes that serve an enclosed area where smoking is prohibited. -2- r 41, • Are Persons or Entities in Charge t;TPublic What Responsibility does a Regulatory Places or Places of Employment Required to Agency have to Report Violations of the Remove Ashtrays that are Located Within Law to the Agencies Responsible for Twenty-five Feet of the Entrance or Exit? ' Enforcing the Law? No,the initiative does not have a requirement related I-901 does not require state regulatory agencies to to ashtrays. However,the law does place responsibility report non-compliance with the Clean Indoor Air Act to law on owners,lessees and employers to prohibit smoking. If enforcement or the local health department. However,many smokers congregate around the entrance to a building,it entities regulated by the state are required to comply with all may be prudent to remove the ashtray. state and federal laws. Consequently,some state regulatory agencies will have an obligation to monitor compliance with the smoking prohibitions to the same extent they monitor compliance with other state and federal laws. Some state What are the Requirements for Placing agencies may require inspectors to report observed No-Smoking Signs? violations of state law to local law enforcement for Signs must be placed at each entrance to a building. appropriate action. Signs also must be placed in prominent places throughout retail stores and retail service establishments. These signage requirements were in existence prior to the passage of I-901, but I-901 has increased the number of facilities that are sub- Can a Regulatory Agency Revoke a License ject to the requirement. for Failure to Comply with I-901? Local jurisdictions have the authority to adopt regulations conditioning licensure on compliance with I-901. Some Mathe Owner or Person in Charge of a local jurisdictions currently have ordinances that allow busi- ness and occupation licenses to be conditioned on compli- • Public Place or Place of Employment Ipose ance with a broad range of regulations relating to health and Additional Restrictions on Smoking? safety;these ordinances may encompass smoking restric- In general,yes. Owners and employers may choose to tions. As referenced above, certain state issued licenses or impose additional restrictions on smoking on their premises permits may be conditioned on compliance with all ap- or smoking by employees. In some instances,however, plicable state and federal laws. In such cases,violation of employees may have rights under employment agreements the provisions of I-901 may result in state regulatory action or collective bargaining agreements limiting the employer's affecting the license or permit. right to impose restrictions greater than those required by I-901. Can local law enforcement or local health departments enforce additional restrictions imposed by owners or employers? If an employer or owner chooses to impose restrictions that are greater than the restrictions in 1-901, local law enforcement and local health department officials may not enforce those greater restrictions under the authority of 1-901. However, law enforcement may have authority to enforce these additional restrictions under laws relating to trespass or other subject areas. Still other laws may contain additional restrictions on smoking in certain facilities or certain types of businesses.These laws are enforceable by, *tate and local officials. 3 Questions Specifically Related III How does RCW 70.160 Apply to Businesses to Public Places pp sinesses What is a Building? on Tribal Lands and to Businesses Owned The term"building,"is not defined in I-901. State agen- and Operated by Tribal Members? cies and local entities should consult counsel about specific In Washington,all lands within Indian reservations,as fact patterns to determine whether a structure is included in well as off-reservation trust homesteads,allotments,and"in the scope of I-901. A structure,enclosed by four walls and lieu"fishing sites,are referred to as"Indian country."1 a roof,with entrance and egress through doors and windows The question of how the Clean Indoor Air Act(includ- would generally,though not exclusively,be considered a ing the provisions of I-901)applies in Indian country and "building." I-901 specifically includes transportation facili- ties,to tribal businesses is complex and somewhat fact specific. tickat areas,and waiting areas within the definition of a public There are,however,some general jurisdictional rules that place. will provide some guidance. Note that in addition to determining whether a structure is a building,and consequently a public place, it is also neces- sary to consider whether the structure is a place 1-18 U.S.C.§1151 provides: "Except as otherwise provided in sections of employment. 1154 and 1156 of this title[relating to liquor],the term `Indian country", as used in this chapter,means(a)all land within the limits of any Indian reservation under the jurisdiction of the United States Government, notwithstanding the issuance of any patent,and, including rights-of-way Is a Bus Shelter a Public Place? running through the reservation,(b)all dependent Indian communities within the borders of the United States whether within the original or A"waiting area"is included within the definition of pub- subsequently acquired territory thereof and whether within or without lic place.This may indicate an intention to prohibit smoking the limits of a state,and(c)all Indian allotments,the Indian titles to in places such as bus shelters where persons must congre- which have not been extinguished,including rights-of-way running gate in order to avail themselves of governmental services. through the same." In addition,the bus itself meets the definitions of both a • •Within Indian country,state law generally does not apply to tribal public place,and a place of employment,and consequently, businesses or tribal members unless Congress expressly allows it. while at the stop,the twenty-five foot minimum distances There is no express congressional authorization to apply the maya 1 prohibitions and requirements imposed by 1-901(or the Clean Indoor PP Y Air Act)to tribes or tribal members. Consequently,the prohibitions and requirements in 1-901 do not apply to tribes,tribal businesses,or tribal members in Indian country Is an Outdoor Sporting Arena a •State law generally does apply to non-tribal members and non-tribal cc' businesses operating or acting within Indian country unless it's clear l�[I bIIC Place"? that Congress intends to preempt such state law. There is no express Because I-901 includes indoor sports arenas within the congressional intention to preempt the applicability of the Clean definition of"public place,"but does not mention outdoor Indoor Air Act or 1-901 to non-tribal members within Indian country arenas,it is likely that an outdoor arena was not considered Consequently,except where congressional intention to preempt is « found to be implied(see discussion below),1-901 does apply to non- to be the type of building"that is a public place. Note tribal members(both as individuals patronizing a non-tribal business however,that an outdoor arena will often be a place of err- and as the owners or"persons in charge"of public places or places of ployment,subject to the restrictions of I-901. employment)within Indian country •If state law affects a "transaction"with a Tribe or its members,courts will conduct a `particularized inquiry"to determine whether application of the state law to the non-tribal member(s)is preempted. Is a Parking Garage a Public Place? In conducting a "particularized inquiry"the court will explore the Yes,if it is used by and open to the public(regardless of balance of state,tribal,and federal interests to determine whether ownership or fee for admission).An open parking lot would Congress implicitly intended to preempt the application of state law to non-tribal members when engaged in such a "transaction"with a Tribe not fall within the definition of"building"but a covered or tribal members. Application of this "particularized inquiry" structure with limited entrances and exits is likely to be balancing test is fact-speck and case-by-case,and the outcome is considered to be a building,regardless of whether it has full unpredictable. For this reason, it is djcult to say with certainty,but walls,half walls,or railings. In addition,a parking garage reasonably likely,that a court would find that 1-901 does not prohibit smoking by non-tribal members when patronizing tribally-owned may be a place of employment even if it is not a businesses within Indian country where smoking is permitted public place. III -4- S What does "Used by and Open to,the May an Employer Provide a Smoking Public" Mean? Shelter that Complies with the Provisions The phrase"used by and open to the public,"qualifies of 1_901 what buildings or vehicles are"public places." In.that con- text,the phrase should be given its usual and ordinarymean- Yes, under some conditions. Outdoor structures provided for employee smokers such as gazebos or lean-tos may not ing. Most publicly owned buildings are"used by and open be subject to regulation provided the shelters are outside to the public."Those that are not(such as secure facilities) the twenty-five foot buffer. However, employees cannot be will probably be"places of employment,"and thereby still required to enter an area where smoking is occurring. The subject to I-901 and the Clean Indoor Air Act. In addition, employer,owner, lessor, or state agency in control of the most state owned facilities are subject to Executive Order premises should: 88-06. Privately owned buildings and vehicles are"used byand • Identify the smoking area clearly with signs. Make sure that no employee is required to enter the open to the public"when the public is explicitly or implic- outdoor smoking shelter while someone is smoking there. itly authorized or invited to enter or use the building or ve- • Conduct cleaning and maintenance work in the hide,regardless of whether a fee is charged for admission. designated smoking shelter when smokers are not present. Privately owned facilities will also often be"places •Meet all applicable laws such as building codes,fire of employment." codes,and land use regulations. Questions Specifically Related Must an Employer Provide a Smoking to Places of Employment ShEmyees? • No,elter unlessfor there isploal contractual requirement that requires the employer to make provision for smokers. Can an Employer Allow Smoking in the Break Room, Cafeteria, Outdoor Picnic Tables shared by all Employees, or other Is Smoking Permitted in Personal Vehicles Common Areas? Parked on State Grounds? In general,no. Although an employee might not be required to use the break room or cafeteria,I-901 expressly Yes, if it is in an outdoor parking lot and the vehicle is five feet or more from any entrance,or exit, includes these parts of a workplace within the definition of a parked twenty place of employment(where smoking is prohibited). How- window that opens, or ventilation intake of an enclosed, ever,an employer could choose to provide some other shel- nonsmoking area. ter for smoking employees as long as it met the twenty-five foot buffer area requirement and other employees are not required to pass through the area in order to leave or enter What is the Effect of 1-901 on Existing the building. Collective Bargaining Agreements? Bargaining units have been notified that the state intends to implement 1-901. No union has requested to bargain over the implementation of 1-901. kt 41111 5 4 k i e • Are Employees who Work in Public Areas Is an Employer Allowed to Have a such as Streets, Highways, Public Parks or Designated "Smoking Room"? the Grounds of a Building Prohibited from Answer for private employers: Smoking? Are other Persons Prohibited Yes,but only under extremely limited circumstances. For from Smoking in those Areas because they most employment settings it will not be feasible. are Places of Employment? Under I-901,a"place of employment"is defined to The entire area of a public street or park is not"under the include a reasonable minimum distance from places where control of"the state or local entity generally charged with smoking is prohibited. The law presumes that the reason- maintenance or oversight of the area in the same way that able minimum distance is twenty-five feet. If a doorway a place of employment is generally under the control of an separates the designated smoking room from a hallway owner or supervisor. However,in keeping with the intent where smoking is prohibited,then all areas,including the of I-901,employers should take reasonable measures to designated smoking room,that are within twenty-five feet ensure that employees required to perform maintenance or of the doorway must be smoke free. That is,the no smok- operational work in outdoor public areas are not exposed to ing area would extend twenty-five feet into the designated second-hand smoke. smoking room. Given the size of most rooms,this require- ment will prevent most employers from offering a desig- nated smoking room. Does 1-901 Prohibit Smoking in a "Private I-901 allows owners,operators,managers,or employers Enclosed Workplace?" to present clear and convincing evidence to the local health The Washington Clean Indoor Air Act has governed department that,due to the unique characteristics of the smoking in public places, including many workplaces,since building,twenty-five feet is not needed to prevent smoke 1985. One provision in the 1985 law allows employers to from infiltrating the non-smoking area of the facility. If • have a"private enclosed workplace"inside an office work the local health department agrees with the evidence pre- environment. Even though this provision was not repealed sented,it has authority to decrease the size of the required by I-901,it must now be interpreted in conjunction with new reasonable minimum distance,which in turn,may increase requirements added by I-901. the possibility that a designated smoking room would be •A"private enclosed workplace"cannot be a"public feasible. Local health departments are developing criteria to place",i.e.,within that part of a building or vehicle"used use when considering such requests. by or open to the public,"including the presumptive Answer for State Agencies: twenty-five foot buffer from doors,windows and Designated smoking rooms are probably not permissible ventilation intakes. in buildings that house state agencies. In addition to the re- •A"private enclosed workplace"can not be a"place of quirements that apply to private employers,an indoor smok- employment,"i.e.,an area"which[other]employees are ing room is generally prohibited for state agencies subject to required to pass through during the course of Executive Order EO 88-06. employment,"including,work areas,common areas,and the twenty-five foot buffer from doors,windows and ventilation intakes of enclosed nonsmoking areas. Is it Permissible for an Agency to Have a •A"private enclosed workplace"cannot be in a place where smoking is otherwise prohibited. Prior to Policy that Allows Smoking by Employees enactment of I-901 workplace smoking in state facilities, in their Personally Assigned State Vehicles buildings and vehicles had already been significantly when No other Persons Are Riding curtailed by Executive Order 88-06 and by regulations with Them? adopted by the Department of Labor and Industry Yes. Under the circumstances described above,the state restricting smoking in the office work environment. WAC vehicle permanently assigned to an individual employee for 296-800-240;WAC 296-800-24005;WAC 296-800- state business would qualify as a"private enclosed work- 24010. To the extent the restrictions in I-901 are greater place." However,smoking with others in the vehicle would 40 than these regulations,the provisions of 1-901 must violate both state policy and I-901. An agency may choose be followed. -6- � r e - V, Questions Specifically Related • to Private Facilities to prohibit smoking in all state owned vehicles,including What is a Private Facility? those that are personally assigned to employees. See Execu- I-901 does not define private facility. In the context of tive Order EO 88-06. I-901,it is best defined as a facility that is not a"public place"or a"place of employment." A private facility may occasionally be open to the public,but smoking is prohib- How does the Prohibition on Sotokingint ited when the public is present.Questions about whether "any Area under the Control of a Public is r a particular facility is"private"or"public"are highly fact specific. Charging an entry fee to a facility probably is not Private Employer Which Employees s are Required to Pass Through durin the the determining factor,because I-901 specifically includes places which charge admission fees within the definition of Course of Employment" apply to lite public places. A decision maker likely would look to such Grounds of a Facility?' factors as membership criteria,the purpose of the organiza- The place of employment provisions of I-901are limited tion,and membership fees that exceed the costs of food, to areas under the control of the employer through which ` drinks and entertainment. employees have to pass during the course of employment. The definition of"place of employment"also prohibits smoking within twenty-five feet from the entrances and exits of an enclosed area where smoking is prohibited. Is a Private Facility a Place of Employment? 1-901 does not exclude private facilities from the defini- The various parts of the Initiative indicate that an em- tion of place of employment.Therefore,the drafters of I-901 ployer should prohibit smoking along any pathways within may have intended private facilities which have employees its grounds that employees must use to get into the building to be subject to the restrictions on smoking, at least while and must prohibit smoking within twenty-five feet of all employees are present. This would be consistent with I- • entrances and exits and ventilation intakes. Thus,a place of 901's stated intent—to protect workers from the effects of employment includes enclosed garages and walkways that second-hand smoke. employees must pass through in order to get to their work- place. It also extends to outside areas that employees must pass through as they enter or leave a building. Depending Are an organizati0n's Members Considered on the configuration of the building and grounds,an em- to be Employees? ployer would not necessarily be required to prohibit smok I-901 does not define"employee"and decisions about ing in an open parking lot on the grounds of the facility. whether an individual is an employee of an organization These restrictions would be consistent with the expressed depend on the facts and circumstances of each situation. In intent of I-901—to prevent exposure to second-hand smoke. deciding whether an employment relationship exists,a deci- sion maker is likely to weigh a number of factors including the relationship between the employer and the individual Can the Presumption that a T went °4tive foot prior to passage of I-901,the parties'understanding of Perimeter Around a Building is the Least their relationship,the amount of supervision the employer Possible Distance t0 Prevent ttkexercises over the individual's performance of responsibili- incursion be Rebutted? ties,the number of hours the individual spends on the job, and the amount and nature of compensation received by the The law presumes that the reasonable minimum distance individual. A member of a private organization who works from entrances,exits,windows and ventilation units is for compensation of any kind,including tips,would likely twenty-five feet. As provided in I-901, § 6,this presumption be considered an employee.However,an organization might can be rebutted by owners,operators,managers,employers not become an employer merely because it has elected or others who own or control a place of employment. The industrial insurance coverage for volunteers or because it applicant must provide clear and convincing evidence to the compensates volunteers for out-of-pocket expenses incurred local health department that smoke infiltration will not incur and that the public health and safety will be protected by a in the course of performing services for the organization. •distance of less than twenty-five feet. Local health depart- ments are developing criteria to use when considering such requests. 'z Questions Specifically Related to Private Residences , Does 1-901 Restrict Smoking in Do the Signage Requirements Apply to a Private Residences? Private Residence Used to Provide No, with one exception. Private residences are excluded Licensed Care? from the definitions of public place and place of employ- Yes,because the signage requirements apply to all entities ment, unless the residence is being used to provide licensed regulated by I-901. child care, foster care,adult care,or other similar social services. Is Smoking in a Private Residence If a Private Residence is used to Provide Prohibited Twenty-four hours per day Even Licensed Care to Children or Adults, are the if the Residence is only used to Provide Care Providers Prohibited from Smoking in Licensed Care to Children or Adults for a their Own Homes? Certain Number of Hours each Day? The law prohibits smoking in a private residence if it is Yes. Smoking is prohibited if the private residence is used to provide licensed child care, foster care, adult care,or used to provide licensed care to children or adults. The law another similar social service. The care providers will not does not indicate whether the smoking ban applies twenty- be able to smoke in their own homes unless 1)the area in four hours a day or whether smoking is only prohibited which they smoke is twenty-five feet from entrances,exits, when the home is actually being used to provide care. and ventilation intakes leading to the part of the home that is used to provide care,or 2)the individual can convince its local health department to reduce the presumed reasonable If an Individual is Receiving Care in minimum distance,to a distance less than twenty-five feet. Someone else's Private Residence would that be Prohibited from Smoking in •Individual the Caregiver's Home? Yes. If the private residence is being used to provide licensed adult care(or similar social service care),it falls within the definition of place of employment, and smoking is prohibited. �-38Y Gp, Office of Attorney General - «,. , Rob McKenna 1125 Washington Street SE III ! 4 Olympia,WA 98504-0100 't'it --.- -Cr' 360-753-6200 RSIiI1.:Cs www.atg.wa.gov 0 - JEFFERSON COUNTY PUBLIC HEALTH 4,,g 615 Sheridan Street • Port Townsend •Washington • 98368 www.jeffersoncountypublichealth.org 0 August 25, 2006 SUBJECT: Clean Indoor Air Act (RCW 70.160)/Initiative 901 Compliance Dear Jefferson County Food Establishment Owner, We the undersigned members of the Jefferson County Board of Health are writing to remind all owners and managers of Jefferson County Food Establishments of their obligations under Washington State's newly amended Clean Indoor Air Act. When a 63% majority of Washington state and Jefferson County voters approved Initiative 901 in November of 2005, the law was changed to prohibit all indoor smoking in public places and places of employment. In January of this year, the Jefferson County Board of Health passed an ordinance that establishes detailed enforcement procedures for these new legal requirements. Repeated violations of the county ordinance may result in fines, court appearances, food establishment permit suspension or, in extreme cases, permit revocation. We acknowledge that changes enacted by voters by adoption of 1-901 have a major impact on food service establishments that previously allowed smoking by patrons. We also know that fewer than 1 in 5 Jefferson County residents are current smokers, that stobacco-related illness is the Nation's leading cause of preventable death, and that environmental tobacco smoke ("second hand smoke") is a significant risk factor for heart disease, lung disease, and cancer. Jefferson County Public Health is responding to potential violations of the Clean Indoor Air Act on a complaint-driven basis. If your establishment is being contacted, it is because a complaint has been filed. If, after careful investigation, it is determined that smoking is being allowed within a prohibited indoor area or within 25 feet of a window, door, or air intake, we are empowered to take enforcement action to protect the health of the public. Maintaining a smoke free environment for your workers and customers not only makes sense from a public health perspective, it is a legal responsibility. We strongly encourage you to take a proactive approach in assuring compliance with these laws. This may include firm reminders to patrons, visible signage, and strictly enforcing non- smoking requirements in outdoor seating areas (within 25 feet of doors or windows). IPCOMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES `�, VS'vt�`ltil� NATURAL RESOURCES MAIN: 0385 94000 HEALTHIER COMMUNITY MAIN:360-385-9444 FAX:360- FAX:360-385-9401 Page 2 of 2 Food Service Establishments-RCW 70.160 August 25, 2006 1111 While these measures may seem burdensome, failure to comply with the law carries significant penalties —fines start at $513.00. Food service establishment owners can face suspension or revocation of their operating license as a result of repeated violations of the law. And worst of all is the failure to protect workers and customers from the very real dangers of environmental tobacco smoke. Thank you for your cooperation in this matter. Sincerely, Jefferson County Board of Health • Background Information: Initiative 901(1-901) passed by voter majority throughout Washington State and became law on December 8, 2005. 1-901 amended the Washington State Clean Indoor Air Act(RCW 70.160)and now prohibits smoking in all public place and within 25 feet of doors, windows that open and ventilation intakes. Local Health Departments are charged with enforcement of RCW 70.160. To view RCW 70.160 or Jefferson County Ordinance 2006-04-0216-06 visit: http://www.jeffersoncountyoublichealth.orq/index.pho?tobacco • • Board of 3-feaCth Netiv Business .agenda Item # `V., 2 • 2007 Performance pleasures September 21, 2006 • Jefferson County Public Health — Planned Performance Measures 2007 ADMINISTRATION • GOALS FOR FY 2007: ADMINISTRATION I. Assure accurate and timely fiscal reports. 2. Assure technical support in assessing the basic health needs of Jefferson County communities. 3. Assure administrative, technical and financial support for all Jefferson County Public Health (JCPH) contractual agreements. 4. Provide administrative, technical and financial support to Interlocal agencies that contract for fiscal services with JCPH. 5. Assure accurate and timely technical and clerical support to each division within JCPH serving the residents of Jefferson County. 6. Provide certified birth and death certificates to the community with accurate and timely information of births and deaths. OBJECTIVES FOR FY 2007: 1. Seek sustainable funding to update and maintain the priorities identified through the assessment of Healthy Jefferson. 2. Provide administrative and financial support to meet required reporting, invoicing, and tracking of contractual agreements with Federal & State agencies, Interlocal/Departmental agreements and MOU's held by JCPH. 3. As fiscal agent, provide administrative and financial support to meet quarterly reports and contractual agreements as required by Federal & State agencies for all agreements held by agencies that contract with JCPH. 4. Conquer the continuing challenges of the new financial system, GEMS, by attending all • available training and utilizing the knowledge of other county employees. 5. Provide supervision, training, assistance and evaluation of the systems that provide the business service support to the various Public Health services provided to the residents of Jefferson County. 6. Assess the needs of the financial team to determine whether the current staff level is sufficient. 7. 100% of requests for birth and death certificates will be processed within 3 working days. PERFORMANCE INDICATORS: 2005 2006 2007 Projected Projected Health of Jefferson County will update priorities Prevention Update& Data Steering and indicators of Jefferson County citizens principles maintain Committee completed priorities review local data Number of federal, state, intergovernmental, and 63 67 69 interdepartmental grants currently active Number of professional service contracts, 185 188 MOU's, and other agreements currently active Average number of invoices processed per 91 145 180 month Number of birth and death certificates issued by Births—421 JCHHS Deaths— 1,286 • SUMMARY OF KEY FUNDING/SERVICE ISSUES: Funding for public health services continues to be unstable and categorical. Impractical deliverables and reporting requirements have impacted current funding that has supported our services for many years. Non competitive funding 1 of 2 sources have changed to becoming competitive, which leaves certain services vulnerable. A challenge the administration division will face in 2006-2007 is workload. The challenges with the new financial system (GEMS), and the reporting and billing requirements for grants and contracts, have impacted the administration division with a heavier workload. In 2004, due to budget cuts, administration . reduced FTE's by approximately 1.5. The workload and accuracy continues to be monitored. The need for the administration division to return to the former FTE staffing level is apparent, however, due to the current budget forecast this is not possible at this time. • • 2 of 2 • ADMINISTRATION DIVISION 2007 REVENUE SOURCES Interfund Chg. For General Fund Service$211,197 evenue$195,818 38.36% 35.57% Misc. Revenue, Beg. Fund Balance Contributions$3,118 $34,640 0 0.57% Taxes$57,571 6.29 0 Fee for Service 10.46% $10,000 State Grants$38,228 1.82% 6.94% ■Beg. Fund Balance$34,640 ❑Taxes$57,571 ❑State Grants$38,228 ■Fee for Service$10,000 ❑Misc. Revenue, Contributions$3,118 IN Interfund Chg. For Service$211,197 ■General Fund Revenue$195,818 • ADMINISTRATION DIVISION 2007 EXPENSE CATEGORIES Wages&Benefits $382,332 70.87% Tool&Equipment $2,500 0.46% Supplies$2,200 0.41% Interfund Payment for Professional Services Svcs$550 $57,571 0.10% Communication$350 10.67% Insurance$52,145 0.06% Interfund Rents& 9.67% Advertising$350 Leases$36,240 Miscellaneous$2,945 Travel $2,300 0.06% 6.72% 0.55% 0.43% 0 Wages&Benefits$382,332 ■Supplies$2,200 0Tool&Equipment$2,500 0 Professional Services$57,571 II $350 0Advertising$350 • El Travel $2,300 ❑Insurance$52,145 ■Miscellaneous$2,945 ■Interfund Rents&Leases$36,240 ❑Interfund Payment for Svcs$550 Jefferson County Public Health— Planned Performance Measures 2007 DRINKING WATER • MISSION: The mission of the Drinking Water Program is to assure that the residents and visitors to Jefferson County have access to the best quality drinking water that is reasonably available in order to minimize the threat of waterborne disease. GOALS FOR FY 2007: 1. Become a delegated County for Group B public water systems. 2. Assure that all new wells are constructed in accordance with requirements established by the Washington Department of Ecology. 3. Provide technical assistance when requested so that individual water supplies are safe. 4. Limit public exposure to water systems with known deficiencies. 5. Integrate water adequacy review information with Natural Resource water quality database OBJECTIVES FOR FY 2007: 1. Inspect at least 50%of all new wells constructed and 90%of all wells being de- commissioned. 2. Maintain high rates of compliance with state well drilling regulations. 3. Review all building permits and project applications to assure that potable water supplies meet basic public health standards as well comply with state statutory and regulatory requirements. 4. Provide technical guidance to any residents requesting assistance with their individual or • small water systems to deliver safe drinking water. 5. Establish appropriate policies for alternative water supply systems. 6. Continue contracting with DOH for public water supply projects as long as adequate funding is provided. PERFORMANCE INDICATORS: 2003 2004 2005 2006 2007 Number of well applications received&reviewed, includes 157 165 170 170 185 carry forward from previous years(USR's) Number of new wells start notification(drilled) 84 88 90 90 90 Number of wells abandoned 31 33 20 20 20 Number of applications with no well drilled(carry forward) 42 44 40 40 40 Number of new wells inspected(start notification received) 63 66 60 60 60 Percent of new wells(starts) inspected 75% 75% 66% 66% 66% Number of abandoned wells inspected 31 33 20 20 20 Percent abandoned well inspected 100% 100% 100% 100% 100% SUMMARY OF KEY FUNDING/SERVICE ISSUES: Increased tracking will be done within existing databases such as permit plan and the food • service database. Databases, including the water quality database, will be updated as necessary to add new fields to track performance indicators. 1 OF 2 LINKS TO COUNTY STRATEGIC OBJECTIVES: • Protecting and Enhancing Natural Resources. • Addressing locally identified and defined public health problems. • Operating within a business plan based on sustainable resources, measured performance, • and outstanding customer service. i • 20F2 Jefferson County Public Health — Planned Performance Measures 2007 FOOD SAFETY S MISSION: The mission of the Food Safety Program is to minimize the risk of the spread of disease from improperly prepared, stored or served foods handled in commercial settings. GOALS FOR FY 2007: 1. Provide classroom food safety instruction for all food service workers. 2. Assure minimum sanitary standards are observed in all food service establishments. 3. Provide basic food safety information to the general public. 4. Proctor ServSafe exams to food service establishment managers. 5. Establish technology enhancements to further educational outreach efforts. OBJECTIVES FOR FY 2007: 1. Offer food safety training at a frequency and in locations convenient to food service workers. 2. Review all new food service establishments for compliance with state and county requirements. 3. Inspect all food service establishments at a frequency adequate to assure compliance with state and local regulatory requirements. 4. Offer educational materials and technical assistance to non-regulated community groups and organizations where requested. • PERFORMANCE INDICATORS: 2003 2004 2005 2006 2007 Number of food workers trained 1,306 1,500 1,044 1,100 1,100 Number of food worker classes at Health 62 60 52 52 52 Department Number of food worker classes at other 29 30 20 25 30 locations Number of food establishment permits 248 260 265 270 275 Number of required inspections completed 300 300 352 352 355 Number of inspected establishments that 20 20 33 70 70 required repeat inspections due to critical violations. Number of establishments receiving 48 50 41 30 35 Outstanding Achievement Awards Number of temporary food service permits 75 78 75 80 90 Number of complaints received and 22 30 25 35 30 resolved 4110 1 OF 2 SUMMARY OF KEY FUNDING/SERVICE ISSUES: Food Safety Program activities are funded solely through permit fees. 411 LINKS TO COUNTY STRATEGIC OBJECTIVES: • Addressing locally identified and defined public health problems. • Operating within a business plan based on sustainable resources, measured performance, and outstanding customer service. • • 2 OF 2 Jefferson County Public Health — Planned Performance Measures 2007 ON SITE SEWAGE PROGRAMS (OSS) • MISSION: The mission of the Onsite Sewage Program is to minimize the threat of surface and ground water contamination from failing or improperly designed, installed or maintained onsite sewage systems. GOALS FOR FY 2007: 1. Educate homeowners, builders,real estate personnel,banks, installers, designers and onsite system maintenance personnel in the proper operation and maintenance of onsite sewage systems. 2. Assure a high quality-monitoring program. 3. Implement and enforce state and local rules and regulations governing the installation and use of onsite sewage systems. 4. Investigate action requests and complaints in a timely manner to reduce the threat of human contact with untreated wastewater. 5. Complete all state funded grant activities on-time and on-budget. 6. Assure high quality customer service. OBJECTIVES FOR FY 2007: 1. Develop written informational materials for public distribution and conduct workshops for community groups addressing onsite sewage system operation and maintenance. 2. Provide training to community groups to increase awareness of regulatory requirements for onsite sewage systems. 3. Review monitoring and inspection reports and provide timely follow up. 4. Utilize existing data systems to track action requests and complaints. 5. Develop and implement a system for routinely surveying customer service. 6. Assure that site inspections in response to permit applications are conducted within 14 days of receipt of application. • 1 OF 2 PERFORMANCE INDICATORS: 2004 2005 2006 2007 Number of systems repaired/upgraded not associated 16 25 25 40 • with a violation or building application. Percent of existing systems receiving regular 3rd party 25% 22% 22% 25% monitoring. Percent of system failures less than 5 years in use 1.5% 1.5% 1.5% 1.5% Number of complaints received 40 40 40 40 Percent of complaints requiring enforcement action. 25 20 20 30 Number of septic permit applications 156* 350* 350* _ 375* Number of permits<14 days to initial inspection 73 185 185 10 Number of permits>14 days to initial inspection 35 40 40 0 Percent of permits issued with clock stoppers that 59% 35% 35% 0% delay processing time Average days to process permits 19 15 15 10 Percent of permits applications pending 8.6% 6.0% 6.0% 4.0% Number of evaluations of existing system(EES) 136 280 280 300 Percent of EES resulting in required significant 25% 25% 25% 25% maintenance or repair. Percent of failures/major maintenance 3.6% 2% 2% 1% Number of educational workshops 4 9 9 15 Number of workshop participants 56 180 180 220 * Number of applications does not equal approved permits • SUMMARY OF KEY FUNDING/SERVICE ISSUES: Tracking will be done with existing data systems to evaluate effectiveness of monitoring programs. With the completion of the DOE non-point source pollution grant, ongoing O&M activities will need to be funded through permit and inspections fees. Implementation will focus on coordination with the PUD to set up systems for scheduling and tracking inspection activities and conducting community outreach to increase awareness of the new requirements. LINKS TO COUNTY STRATEGIC OBJECTIVES: • Protecting and Enhancing Natural Resources. • Addressing locally identified and defined public health problems. • Operating within a business plan based on sustainable resources, measured performance, and outstanding customer service. • 2 OF 2 • ENVIRONMENTAL HEALTH DIVISION 2007 REVENUE SOURCES Fee for Service $386,250 40.33% Intergovernmental $70,882 Interfund Chg. For 7.40% - Service$43,383 4.53% General Fund Revenue$82,688 State Grants Federal Grants 8.63% $289,993 $24,838 Beg. Fund Balance 30.28% $29,653 2.59% 6.23% 0 Beg. Fund Balance$29,653 0 Federal Grants$24,838 O State Grants$289,993 0 Intergovernmental $70,882 0 Fee for Service$386,250 0 Interfund Chg. For Service$43,383 ■General Fund Revenue$82,688 • ENVIRONMENTAL HEALTH DIVISION 2007 EXPENSE CATEGORIES Wages& Benefits $602,803 65.99% Interfund Payment tx : s ` Svcs$89,214 £ Supplies$7,418 9.77% 0.81% Tool &Equipment $8,000 0.88% Interfund Rents& Leases$74,893 Professional Services 8.20% Advertising $1,300 $106,500 Miscellaneous$8,780 ° 11.66% 0.96% Communication 0.14/o Travel $10,560 $3,978 1.16% 0.44% 0 Wages& Benefits$602,803 0 Supplies$7,418 • OTool&Equipment$8,000 0 Professional Services$106,500 ■Communication$3,978 OAdvertising $1,300 IN Travel $10,560 ■Miscellaneous$8,780 ■Interfund Rents&Leases$74,893 0 Interfund Payment for Svcs$89,214 Jefferson County Public Health — Planned Performance Measurers 2007 FAMILY SUPPORT • BUDGET/PROGRAM: Community Health: Family Support Programs Maternal Child Health(MCH) including newborn follow-up, Child Birth education and Breast Feeding Support, Maternity Support Services (MSS)/Infant Case Management, Best Beginnings/Nurse-Family Partnership (NFP), Children with Special Health Care Needs (CSHCN), Women Infants and Children (WIC), and the Child Protective Services (CPS) Contract Programs: Alternative Response System (ARS), Early Intervention Program(EIP), and Passport. MISSION: The purpose of the Family Support Programs is to provide health and parenting education, skill building, support, and referrals to community resources to pregnant women and families with children. Services also include voluntary home visits to prenatal,post partum families, and families at risk of Child Protective Services involvement. These services are provided so county babies are born with the best opportunity to grow and thrive, the impact of health problems are minimized, and children receive the care and nurturing they need to become functional adults. GOALS FOR FY 2007: 1. Maintain the current number of clients served through the Family Nurse Partnership Program (Best Beginnings) for Jefferson County residents. 2. Monitor Nurse Family Partnership Program replication by tracking data on program fidelity. 3. To assess the percentage of pregnant and parenting women receiving Jefferson County Public Health(JCPH) Family Support services, in which depression is an issue. • 4. Continue to provide breastfeeding education and support so that all county mothers can provide their children with the physical and emotional benefits of breastfeeding. 5. Prevent nutritional related problems for pregnant women and children under five in Jefferson County. 6. Identify children with special health care needs in Jefferson County and assist families with health and development interventions and referrals as needed. 7. Provide services and information in Jefferson County aimed at preventing Child Abuse and Neglect. 8. Increase awareness and support of the Family Support Program mission through community presentation on the relationship of adverse childhood experiences and adult health problems. OBJECTIVES FOR FY 2007: 1. Support the Nurse-Family Partnership PHN's maintaining caseload intensity by providing opportunities for ongoing support and education both within JCPH and limited travel for other offerings such as the Washington State Consortium for Nurse-Family Partnership. 2. Send client data monthly to Nurse-Family Partnership program head office for assessment and evaluation. 3. Depression screening and education will be offered to all pregnant and parenting women who are participating in JCPH programs and appropriate referrals will be made for those who have a positive screen. 4. Through universal screening of newborns and their families identify those who may need referral to breastfeeding tea party or lactation consultation telephone, office or home-visits. Ongoing 111 collaboration with Jefferson Health Care staff for lactation support will help ensure all families receive the services they need. New Collaboration with Kitsap County Health District Bringing Baby Home program and Harrison Hospital in Silverdale to increase Jefferson County resident's newborn referrals from Harrison Hospital. 1 OF 2 5. Provide WIC nutrition education and support to all eligible county women and children. 6. Provide developmental and health screening through JCPH programs including community outreach to providers and the schools to identify children with special health and development needs and assist families in getting further evaluation and intervention services. • 7. Awareness and assessment of risk for child abuse and neglect is an integral component of all Family Support Service Programs. Referrals to CPS/DCFS will be made as appropriate and services will be provided to families at risk or involved in CA/N through the ARS and EIP contracts. 8. Continuing Best Practice Nurse family Partnership (NFP)program to prevent Adverse Childhood experiences in at risk families to reduce youth and adult tobacco, drug and alcohol use. See Felitti Study. PERFORMANCE INDICATORS: 2006 2006 2007 Planned Projected Planned 1. Number of depression screenings completed 70 70 70 2. Number of newborn screened 120 120 90 3. Number of Home and Office visits provided for NFP, 1500 1300 1300 MSS,MCM, MCH and Breastfeeding consultation 4. Yearly report from Family-Nurse Partnership ** ** ** 5. Total number of women infants and children served by 900 850 870 WIC in Jefferson County(from CIMS report) 6. Number of children with special health care needs 60 60 60 receiving Public Health Nurse intervention through JCI-IHS. 7. Number of families served through CPS/DSHS contract. 20 20 20 ** Report yearly SUMMARY OF KEY FUNDING/SERVICE ISSUES: • Jefferson County Health report published in May 2003 confirmed what the staff in the Family Support Programs has observed in their work in the community: `families with young children are very vulnerable'. Multiple factors contribute to this status: poverty, mental illness, substance abuse, and family abuse/violence. For many families these challenges have been transmitted across generations and now the newborns are vulnerable to these risk factors. Over the years of providing services through programs such as MSS/MCM, WIC, and for the last 6 years,Nurse-Family Partnership, staff has worked to increase knowledge and skills in a committed effort to prevent and reduce the effects of these conditions. We are now able to effectively serve clients and families who previously were resistant, or too entrenched in complex psychosocial problems to accept services. Working effectively with these families requires a high degree of skill and support. These families, with multi-generational challenges, respond best to consistent, intensive services delivered over a long period of time. JCPH Family Support Programs were unable to start the Program Assessment project in 2006 due to lack of funding and staffing in Assessment. JCPH Family Support Programs hopes to start the Assessment Project in 2007 with Assessment staff and possible electronic data collection. This will increase our knowledge of this specific population and demonstrate that the positive outcomes shown in the national program are also being achieved in Jefferson County. Additional Medicaid Administrative Match funding was used to maintain the level of services in Family Support Programs in 2006. In 2007 JCPH is looking for an increase in funding from the County Liquor Excise Tax revenue and Medicaid Administrative Match funds to cover the cost of maintaining a current level of service to families in the community and Nurse Family Partnership, Best practice, intensive • home visiting intervention program for families at risk. July 25, 2006 2 OF 2 Jefferson County Public Health — Planned Performance Measurers 2007 POPULATION & PREVENTION BUDGET/PROGRAM: Population & Prevention Programs Raising Healthy Community Grant (HC), Tobacco (TP/C), School Health(S/H), Childcare health and Safety(CC), Peer-In(PI), Oral Health(OH), and Drug and Alcohol prevention(DA) MISSION: The purpose of the Population& Prevention Programs is to provide health education and public health interventions to county residents in order to promote a healthier community, prevent disease and unintentional injury, improve the quality of life and reduce disparities in health. GOALS FOR FY 2007: 1. Improve identified social and health indicators for school-age youth(S/H) 2. Improve overall health of Jefferson County residents.(TP/C) 3. Enhance the quality of child care provided in Jefferson County(CC) 4. Enhance the overall health& safety of Jefferson County children (PI) and(OH) 5. Support Healthy Youth Coalition functioning(HC) 6. Reduce favorable attitudes toward problem behavior within the youth and adult communities. (DA) 7. Delay age of initiation of problem behavior. (DA) 8. Reduce adverse childhood experience as measures by reduced CPS referrals (DA) • OBJECTIVES FOR FY 2007: 1. Maintain delivery of school in-service/trainings, student health screenings, student health consults, student health care referrals (S/H) 2. Provide tobacco specific education and resources to employers to support employee cessation (TP/C) 3. Maintain child care provider consultation re: health, immunizations, safety and child development(CC) 4. Peer educators will provide school health classes to middle&high school students (PI); health education classes will be provided to elementary, middle&high school students; and increase Oral Health prevention interventions. 5. Maintain number of Healthy Youth Coalition meetings annually 6. Increase the perception of risk for youth regarding alcohol and marijuana use, especially for 6th, 8th, and 10th grade students.(DA) 7. Increase access to adults with healthy beliefs and clear standards for 4th through 6th grade students in Jefferson county.(DA) 8. Provide Early Intervention services to at risk families to prevent adverse childhood experiences. (DA) See Felitti study showing how adults who had reported greater than 2 Adverse Childhood Experiences had increased health problems including tobacco, drug and alcohol use. See Family Support services program performance measures. • 1 of 2 PERFORMANCE INDICATORS: 2006 2006 200aft Planned Projected Plan . Number of student health screenings 1550 1600 1500 Number of employers receiving tobacco specific technical assistance (TP/C) * 5 5 Number of Peer-In educational presentations 50 50 50 Number of school health classes 240 170 200 Number of phone calls to WA State Tobacco Quit line from Jefferson Co. 60 75 75 Number of Healthy Youth Coalition Meetings 8 8 8 Number of classroom presentation/interventions (Drug and Alcohol 140 120 140 preventions) Number of students served in the class room presentations 200 390 350 • new for 2006-2007 SUMMARY OF KEY FUNDING/SERVICE ISSUES: Jefferson County Public Health(JCPH)delivers programs that promote healthier communities and individuals. Focusing public funds on prevention programs have proven to be cost effective. JCPH hopes to find funding in 2007 to continue to collect Assessment data to assist in deteruiiiiing community needs and prioritize services (substance abuse, domestic violence and child abuse and neglect). The Juvenile Justice Grant, Healthy Communities grant was renewed 2006 for another 3 years with in-kind services providing intervention and prevention programs to identified children in vulnerable families. These services include work in the schools and supporting Big Brother/Big Sister program. Besides the Healthy Communities grant, the above programs provide universal prevention programs available to all in the community. State prevention health services monies come with extensive evaluation components. • Tobacco and Healthy Communities funding have community specific goals and measures that must be met to maintain funding. School funding is based on State School Nurse corp. funds and contracts with school districts which should remain the same in 2007. Decreasing enrollment may decrease the number of classroom presentation and the number of students served. Drug and Alcohol prevention services continues to work with Community Health programs providing integrated prevention services. Prevention funds are utilized primarily through the school based, proved effective, Best Practice Programs. These funds allow prevention specialist to reach the vast majority of middle school students. UGN chose to reduce requested funding for Peer-in in 2007 from $10,000 to $2,000. At the time of writing 2007 Performance Measures JCPH is unsure how it will continue the program at the 2006 level of service and will be considering other funding sources. Healthy Child Care Washington, a Dept. of Health Contract to provide Public Health Nurse Consultation to Child Care providers, funding in 2007 is cut in half from $24,000 to $11,450. This will be a reduction on staff hours of 14 a week to 7 a week. Trainings and consultation services provided to Child Care providers will be cut in half with these reductions. July 24, 2006 • 2 of 2 Jefferson County Public Health — Planned Performance Measures 2007 TARGETED COMMUNITY HEALTH BUDGET/PROGRAM: Targeted Community Health Services Family Planning, Breast and Cervical Health Program, and Foot Care MISSION: The purpose of Targeted Community Health Services is to provide outreach, access, health education, and support treatment to specific populations in Jefferson County in order to improve the health of the community. Specific program purposes are: • Family Planning: to provide reproductive health, clinics, outreach and education for Jefferson County residents in order to promote health and well-being and reduce unintended pregnancies. • Breast and Cervical Health Program: provide public education and health screening services to women age 40-64 with low incomes and no or limited health insurance in order to assure early detection and treatment of breast and cervical cancer. • Foot Care: provide foot care and health outreach to Jefferson County seniors to prevent health complications. • GOALS FOR FY 2007: 1. Insure access to breast and cervical health exams to women age 40 to 65 years old. 2. Decrease unintended pregnancy rates in Jefferson County(measure)/Assure Family Planning Services are provided in every community 3. Support seniors' independence by maintaining their mobility • OBJECTIVES FOR FY 2007: 1. Track Family Planning usage patterns and produce annual report 2. Maintain breast and cervical health program in Jefferson County 3. Emergency contraception to be provided under standing orders, 5 days per week, and expand community education and clinical services 4. Maintain the current level of community foot care and continue expanding into home care PERFORMANCE INDICATORS: 2006 2006 2007 Planned Projection Planned Number of unduplicated clients served in Family Planning 1600 1300 1400 Number of adolescents under 19 served in Family Planning 330 300 310 Number of Breast& Cervical screening exams 90 100 100 Number of foot care contacts 2400 2400 _ 2400 SUMMARY OF KEY FUNDING/SERVICE ISSUES: Preventing unintended pregnancies is a local, state, and national Public Health Goal. Jefferson County Public Health(JCPH)provides the only Family Planning program in east Jefferson County. Family Planning is considered a Critical Health Service by the State Board of Health. In 2006 Family Planning Clinic management was restructured to use a team approach to creating efficiencies, increasing fee revenue and increasing clients. At the same time the Take Charge Medical Assistance program that pays for most of the Family Planning Clients services is being changed and Medical Assistance fee for services will be reduced. By working to increase clients and health insurance revenue, and allocating more County Funds to Family Planning JCPH hopes to maintain the Critical Health Services of Family Planning in Jefferson County. The Breast and Cervical Health Program addresses the need for Cancer screening and early treatment to decrease deaths from breast and cervical cancer in Jefferson County. 1 of With a slight increase in funding from Washington State in 2007 we hope to increase Breast and Cervical Health exams to a few more clients. Jefferson County has a high percent of over age 85 citizens. JCPH Foot Care Program helps this population maintain independence and mobility in a rural community. The Foot Care program continues to provide needed services to the Senior population in Jefferson County. July 25, 2006 • • 2 of 2 Jefferson County Public Health — Planned Performance Measures 2007 . COMMUNICABLE DISEASE BUDGET/PROGRAM: Community Health Communicable Disease TB, Communicable Diseases, Immunization, Travelers Immunization, Sexually Transmitted Disease, HIV, Syringe Exchange Program. MISSION: Communicable Disease The purpose of the Communicable Disease Health program is to protect Jefferson County residents from serious communicable diseases by providing disease surveillance, investigation and reporting, along with education, screening,treatment and immunization services. The program interacts with community members, medical providers, the Washington State Department of Health and other agencies while working toward this purpose. GOALS FOR 2007 1. Maintain the low rates of active TB in Jefferson County(TB) 2. Timely investigation of reportable conditions (CD) 3. Support universal access to State supplied vaccines for all children(Imm) 4. Continue to support immunization registry in Jefferson County,promoting use by all immunization providers (Imm) 5. Assess childhood immunization rates for children served by Primary Care Clinics receiving State supplied vaccines 6. The Family Planning and STD clinics will assist in controlling Chlamydia transmission in Jefferson County(STD) 7. Providers will be informed about current communicable disease trends and new communicable disease control recommendations 8. HIV testing and counseling clinic resources are focused on persons at risk for HIV infection(HIV) 9. Case management services will assist HIV positive clients in accessing priority services, medical/dental, mental health, substance abuse treatment, and preventing homelessness. 10. Prevent the spread of blood borne communicable diseases among injecting drug users and their partners (SEP) 11. Annual report to BOH for CD, TB, Immunization Programs, STD 12. Develop bioterrorism response capacity OBJECTIVES (INTERVENTIONS) FOR 2007 1. Encourage appropriate screening&treatment for latent TB infection(TB) 2. Develop &update protocols for investigation of reportable conditions (CD) using the new electronic reporting systems, Public Health Issue Management System (PHIMS) and Public Health Reporting of Electronic Data(PHRED). 3. Maintain an efficient system for supplying State supplied vaccine and vaccine recommendation up-dates to private Health Care Providers in Jefferson County (Imm), including training for, and transitioning to, direct shipment of vaccines from manufacturer to clinic through new Washington State VMBIP program. 4. Continue to provide private Health Care Providers support and updates on the Child • Profile Immunization Registry 5. Perform an assessment of childhood immunization rates, using AFFIX software, every other year, for each clinic receiving State supplied vaccines 1 OF 3 6. Clients seen in Family Planning and STD clinics who are at higher risk for Chlamydia (age criteria)will be screened for Chlamydia(STD) 7. Provide updates, outreach and training to providers about local, state and national • communicable disease outbreaks and disease control recommendations 8. 75%of clients who receive HIV testing will be high risk(HIV) 9. Case management services will continue to provide services that assist HIV positive clients in accessing priority services, medical/dental, mental health, substance abuse treatment, and preventing homelessness. 10. Promote utilization of syringe exchange program services (SEP) 11. Develop and update regional bioterrorism plan, coordinating with regional bioterrorism partners, local emergency response agencies and Jefferson Healthcare PERFORMANCE INDICATORS 2006 2006 2007 Planned Projected Planned (TB)Number of clients started on preventive therapy for latent 3 3 3 TB infection (CD)Number of communicable disease reports confirmed, 85 90 90 interventions applied and processed for reporting to the state (Imm)Number of doses of publicly funded vaccine, 3,500 3,500 3,500 administered by private health care providers and Public Health clinics, supplied and monitored through Public Heath's immunization program Number of providers trained in VMBIP vaccine ordering and 5 5 5 receiving system (Imm)Number of providers participating in the Child Profile 5 5 5 • immunization registry (Imm)Number of Jefferson County children<6 with 1 or more 85% 78% 80% immunization in Child Profile system (Imm) Number of Jefferson County children<6 with 2 or more New New 68% immunization in Child Profile system 2007 2007 (Imm) Number of clinic site visits to assess childhood 2 2 2 immunization rates,using AFFIX software (STD) Percent of at risk FP and STD clinic clients at risk for 100% 100% 100% Chlamydia screened(age criteria 14 -24).Number of clients in New New 375 risk group screened for Chlamydia,Ahlers report. 2007 2007 (HIV)Number of persons counseled and tested for HIV 80 80 80 infection (HIV) Percent of persons counseled and tested for HIV infection 75% 75% 75% that were in high-risk category (HIV) Number of face-to-face encounters between case manager New New 45/200 and client. Number of collateral encounters with client's 2007 2007 representative or other encounters per quarter. (SEP)Number of clinics 100 100 100 (SEP)Number of visits to SEP 50 50 50 (SEP)Number of syringes exchanged 15,000 15,000 15,000 (BT) Develop and update bioterrorism response plan 1 1 1 II 20F3 • SUMMARY OF KEY FUNDING/SERVICE ISSUES: These programs address locally identified and defined local public health problems. Communicable disease prevention is a locally funded program since the county milage was returned from the state to counties for TB control. Immunization funds from the state have been primarily in the form of vaccine. County funded Services provide a professional staff that prevent, identify and respond to disease outbreaks. Substantial staff time is spent on responding to public requests for information about communicable diseases and screening for reportable illnesses in the process. HIV services are funded from the state and federal government to provide basic communicable disease prevention, HIV positive client case management, testing and counseling to high-risk community members, and focused high-risk interventions. Funds are highly programmatic and based on federal case numbers, which may not represent Jefferson County epidemic profile. Volatile program funding is based on formulas re-negotiated with Region VI AIDSNET every year. Starting in 2002 federal funding was received for developing the capacity for bioterrorism response. This response capacity is being developed in coordination with our Region 2 Public Health Emergency Preparedness and Response (PHEPR)partners Kitsap and Clallam Counties, our local emergency response agencies, Jefferson Healthcare and other health care providers. For 2007 this project involves continuing to complete and expand the appendices and procedures that go with the basic Local Health Department Emergency Response Plan that was first drafted in • 2003. This involves continuing to update the basic plan, continuing to develop and update a Strategic National Stockpile plan, and completing a Pandemic Flu plan. We do not expect any increases funding in 2007. However, increased funding would allow for increased Communicable Disease surveillance, outreach, and resource development with the Health Care Providers in the community. Decreased funding would result in scaling back on services. The Board of Health would be involved in deciding which services would be impacted. 7/14/2006 • 3 OF 3 • COMMUNITY HEALTH DIVISION 2007 REVENUE SOURCES Federal Grants State Grants $512,743 $226,748 29.35% 12.98% Intergovernmental -- $118,204 IOW6.77% Beg. Fund Balance Fee for Service $400,750 $146,293 General Fund Misc. Revenue, 22.94%4% 8.37% Revenue$337,067 Contributions$5,000 19.30% 0.29% 0 Beg. Fund Balance$146,293 0 Federal Grants$512,743 0 State Grants$226,748 0 Intergovernmental $118,204 O Fee for Service$400,750 0 Misc. Revenue, Contributions$5,000 ■General Fund Revenue$337,067 • COMMUNITY HEALTH DIVISION 2007 EXPENSE CATEGORIES Wages& Benefits $1,119,955 Supplies$193,692 65.27% pp 11.29% Tool &Equipment $1,200 , 0.07% Professional Services $144,815 Interfund Payment for 8.44% y Communication Svcs$84,694 $1,800 4.94% Travel$14,531 0.10% Interfund Rents& iscellaneous 0ing Advertissing Leases$126,589 $24,475 $4,200 0.24% 7.38% 1.43% 0 Wages&Benefits$1,119,955 ■Supplies$193,692 • 0 Tool&Equipment$1,200 ❑Communication $1,800 ❑Professional Services$144,815 OTravel $14,531 ■Miscellaneous$24,475 ®Interfund Rents&Leases$126,589 ❑Interfund Payment for Svcs$84,694 Jefferson County Public Health—Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES • Individual Employment The mission of the Developmental Disabilities Individual Employment Program is to assure that citizens with developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive participation in community life. GOALS FOR FY 2007: 1. A choice of vocational providers to select from within the informed choice process,in order to provide work opportunities, placement and follow-up services necessary to help persons with developmental disabilities obtain and continue integrated employment in the community,in business,or industry. 2. To assure that each individual shall have a Pathway to Employment plan or Person Centered planning/profile delineating individual skills,which reflects the goals needed to pursue or maintain gainful employment.Each individual shall receive supports needed to implement the plan. 3. To provide support to the employee's supervisors and/or peer workers to enable them to support the person on the job,on the job training,and modification of the work site. OBJECTIVES FOR FY 2007: 1. Client choice and control will be increased by supporting active participation in the development of the choice process between vendors. 2. The Pathway to Employment plan or Person Centered planning/profile delineating individual skills shall support the individual to experience vocational assessments at community sites. 3. These Vocational Providers will base services on a Pathways to Employment plan or Person Centered planning/profile that includes vocational match and individual goals,outcomes and personal preferences. A document that shows this procedure was implemented will be included in the vocational file. 4. WISE will provide technical assistance,training and broad job development with our local Employment Vendors. The outcome • will be to establish new Supported Employment positions within the Jefferson County area while educating the community, providers,school personnel and parents on transition issues,disability awareness and the value of employment. 2002 2003 2004 2005 2006 2007 PERFORMANCE Actual Actual Actual Actual Projection Projection INDICATORS: Number of persons in 15 14 11 11 14 11-18 Individual Employment that Individuals Individuals Individuals Individuals Individuals Individuals have been served,are currently being served and/or we are planning to serve. Average Wage per Hour $6.81 $7.12 $7.22 $7.44 $7.40 7.45 Average Monthly Hours 44 31 40 37 42 42 Average Monthly Wage $302.00 $224.00 $289.00 $273.36 $310.00 $320.00 Total Hours Worked 5,187 3,050 4,627 4,290 4,482 4,500 Total Gross Wages $35,338 $21,775 $32,997 $31,919.93 $32,000 33,000 Total County Funding $47,669 $32,880 $43,107 $31,618 $33,000 34,000 SUMMARY OF KEY FUNDING/SERVICE ISSUES: An ongoing issue in Jefferson County for people with Developmental Disabilities is the need for more integrated employment opportunities in order to bring up their economic reach. This statement leads the Developmental Disabilities Individual Supported Program to support the Jefferson County 2007 Budget Strategic Objective to address locally identified and defined local public health • issues. This will in turn assist the Jefferson County 2007 Budget Goal to target and support the service needs of a growing community, in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities with sustainable industries in consideration of integrated employment and a balanced economy for citizens with developmental disabilities. 1 of 11 The opportunity for people with disabilities to obtain gainful employment continues to be an essential priority for a number of reasons: The Division of Developmental Disabilities new"Working Age Adult"Policy mandates that all people with a developmental disability between the ages of 21-65 must have a written Pathway to Employment which reflects the goals needed to pursue or maintain gainful employment in the community. • Society grants status to those with"spending power",along with the fact that expendable income allows additional personae choice. • Employment brings benefits to individuals in terms of opportunities to build relationships and to be seen as a contributing member of society. • Meaningful wages in conjunction with social security benefits are essential to maintaining independence. • For young adults,employment can be a form of family support/respite,allowing family members to have independence. It is in the best interest of Jefferson County,and society in general,that all people deserve to have the choice,opportunity and support to achieve an inclusive and productive participation in community life. • • 2 of 11 Jefferson County Public Health — Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES Pre-Vocational Program • MISSION:The mission of the Developmental Disabilities Pre-Vocational Program is to assure that citizens with developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive participation in community life. GOALS FOR FY 2007: 1. To provide training and short-term employment in businesses organized and designed primarily to provide employment to persons with severe disabilities. 2. To assure that each individual shall have a"Pathways to Employment"plan,which reflects the goals needed to pursue or maintain gainful employment in the community. Each individual shall receive supports needed to implement the plan. 3. Training will be arranged in order to teach clients concepts such as attendance,task completion,problem solving and safety. OBJECTIVES FOR FY 2007: 1. Specialized Industry will base instruction on the goals established in a Pathways to Employment plan or Person Centered planning/profile delineating individual skills to provide training and support in social,communication,self-care,and job skills such as attendance,task completion,problem solving and safety. 2. The"Pathways to Employment"plan shall support the individual to experience at least three vocational assessments at community sites. Participation in community employment assessment sites will assist staff to evaluate client vocational skills, and give clients the opportunity to make informed choices about future employment options that are essential to the person's success in the workplace. PERFORMANCE 2002 2003 2004 2005 2006 2007 INDICATORS: Actual Actual Actual Projection Projection Projection Number of persons in Pre- 16 9 9 10 7-9 7-9 • Vocational that have been served, Individuals Individuals Individuals Individuals Individuals Individuals are currently being served and/or we are planning to serve. Average Wage per Hour $2.70 $2.62 $2.94 $3.82 $4.00 $4.50 Average Monthly Hours 60 69 69 75 79 75 Average Monthly Wage $162.00 181.00 $203.00 $264.13 $237.00 257.00 Total Hours worked 9,357 6,717 7,277 7,325 7,400 7500 Total Gross Wages $25,283.00 $17,589.00 $21,359.00 $27,997.62 $28,200.00 29,400.00 Total County Funding $37,535.00 $26,859 $28,793.00 $28,932.99 $29,947.00 28,000.00 SUMMARY OF KEY FUNDING/SERVICE ISSUES: The Developmental Disabilities Pre-Vocational Program supports the Jefferson County 2007 Strategic Budget Objective to address locally identified and defined local public health issues. This will in turn assist the Jefferson County 2007 Budget to target and support the service needs of a growing community,in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities with sustainable industries in consideration of integrated employment and a balanced economy for citizens with developmental disabilities. The opportunity for people with disabilities to obtain gainful employment continues to be an essential priority for a number of reasons:The Division of Developmental Disabilities new"Working Age Adult"Policy mandates that all people with a developmental disability between the ages of 21-65 must have a written Pathway to Employment which reflects the goals needed to pursue or maintain gainful employment in the community. • Society grants status to those with"spending power",along with the fact that expendable income allows additional personal choice. • Employment brings benefits to individuals in terms of opportunities to build relationships and to be seen as a contributing member of society. • • Meaningful wages in conjunction with social security benefits are essential to maintaining independence. • For young adults,employment can be a form of family support/respite,allowing family members to have independence. It is in the best interest of Jefferson County,and society in general,that all people deserve to have the choice,opportunity and support to achieve an inclusive and productive participation in community life. 3 of 11 Jefferson County Public Health— Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES Group Supported Employment MISSION: The mission of the Developmental Disabilities Group Supported Employment Program is to assure that citizens with • developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive live in community life. GOALS FOR FY 2007: 1. Group Supported Employment Program is supervised employment and training in regular business and industry settings for groups of no more than eight(8)workers with disabilities. (Typical program examples include enclaves,mobile crews,and other business-based programs employing small groups of workers with disabilities in an integrated community employment setting.) 2. To assure that each individual shall have a"Pathways to Employment"plan,which reflects the goals needed to pursue gainful employment in the community.Each individual shall receive supports needed to implement the plan. OBJECTIVES FOR FY 2007: 1. Group Employment will base instruction on the goals established in a Pathways to Employment plan or Person Centered planning/profile delineating individual skills to provide training and support in social,communication,self-care,and job skills,(such as attendance,task completion,problem solving and safety)that are essential to the person's success in the workplace. 2. The"Pathways to Employment"plan shall support the individual to experience at least three vocational assessments at community sites. Participation in community employment assessment sites will assist staff to evaluate client vocational skills,and give clients the opportunity to make informed choices about future employment options that are essential to the person's success in the workplace. PERFORMANCE INDICATORS: 2003 2004 2005 2006 2007 Actual Actual Actual Projection Projection Number of persons in Group that have 6 6 7 4-6 4-6 been served,are currently being served Individuals Individuals Individuals Individuals Individuals • and/or we are planning to serve. Average Wage per Hour $2.79 $3.78 $4.74 $4.90 $5.50 Average Monthly Hours 65 57 55 65 50 Average Monthly Wage $182.00 $214.00 $231.00 $253.50 325.00 Total Hours worked 3,910 4,084 3,323 4,700 3400 Total Gross Wages $10,910 $15,430 $15,749.55 $18,330 18,550 Total County Funding $14,639 $18,533 $16,309.90 $18,053 17,000 SUMMARY OF KEY FUNDING/SERVICE ISSUES: The Developmental Disabilities Group Supported Program supports the Jefferson County 2007 Strategic Budget Objective to address locally identified and defined local public health issues. This will in turn assist the Jefferson County 2007 Budget Goal to target and support the service needs of a growing community, in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities with sustainable industries in consideration of integrated employment and a balanced economy for citizens with developmental disabilities. The opportunity for people with disabilities to obtain gainful employment continues to be an essential priority for a number of reasons:The Division of Developmental Disabilities new"Working Age Adult"Policy mandates that all people with a developmental disability between the ages of 21-65 must have a written Pathway to Employment which reflects the goals needed to pursue or maintain gainful employment in the community. • Society grants status to those with"spending power",along with the fact that expendable income allows additional personal choice. • Employment brings benefits to individuals in terms of opportunities to build relationships and to be seen as a contributing member of society. • Meaningful wages in conjunction with social security benefits are essential to maintaining independence. • For young adults,employment can be a form of family support/respite,allowing family members to have independence. It is in the best interest of Jefferson County,and society in general,that all people deserve to have the choice,opportunity and Suppill to achieve an inclusive and productive participation in community life. 4 of 11 Jefferson County Public Health—Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES • Community Access Programs MISSION: The mission of the Developmental Disabilities Community Access Program is to assure that citizens with developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive participation in community life. GOALS FOR FY 2007: 1. To provide services that assist people with disabilities to gain access to community activities in which people without disabilities also participate. 2. Community Access will base instruction on the goals established in a Person Centered Future planning/profile delineating individual skills to provide training and support in social,communication,self-care,and volunteer/job skills that are essential to the person's success. OBJECTIVES FOR FY 2007: 1. Increase the numbers of opportunities to contribute to the community through voting,civic groups,and other clubs etc. Progress will be documented in the client's files,i.e.Person Centered Future planning/profile. 2. To increase opportunities for contribution through volunteer experiences,with the staff person working in the background as a consultant,in order for community relationships to develop. YEKrlwi boos lvv4 Zuv5 zuuo 2007 INDICATORS: Actual Actual Actual Actual Projection Projection Number of persons in Community 12 Ind 12 Ind 10 Ind 8-10 hid 6-8 hid 6-8 Ind Access that have been served,are currently being served and/or we are planning to serve. Average Days of Service 4 days per 4.6 days 5.6 days 6 days per 6 days per 4-6 days • client per client per client client client per client Average Hours of Services 11.8 hours 13.1 hours 13.2 hours 14 hours 14 hours 20 hours per client per client per client per client per client per client SUMMARY OF KEY FUNDING/SERVICE ISSUES: The Developmental Disabilities Group Community Access Program supports the Jefferson County 2007 Strategic Budget Objective to address locally identified and defined local public health issues. This will in turn assist the Jefferson County 2007 Budget Goal to target and support the service needs of a growing community, in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities. Community Access is a service that requires identifying people and opportunities in the community who may be resources,friends or guides themselves. It also necessitates knowing when to get out of the way,and letting people experience success and failure within the guidelines of health and safety. Community Access staff roles continue to evolve to one of consultant or guide to the individual rather than only as accompanied staff. It is in the best interest of Jefferson County,and society in general,that all people deserve to have the choice,opportunity and support to achieve an inclusive and productive participation in community life. • 5 of 11 Jefferson County Public Health— Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES Child Development Programs • MISSION: The mission of the Developmental Disabilities Child Development Program is to assure that children with developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive participation in community life. GOALS FOR FY 2007: 1. Support and work with Early Intervention Services Providers to continue to participate as one funding source for specialized therapeutic and/or educational services for eligible infants and toddlers and their families from birth through the child's third birthday or enrollment in public school in Jefferson County. 2. Support schools to become a participating Early Intervention Services Provider since not all school districts in Jefferson County are serving children,Birth to 3. Schools are necessary partners to ensure early intervention resources are available in each area of the Jefferson County. This means school funds cannot be accessed for many children/families living outside of serving school districts'boundaries. OBJECTIVES FOR FY 2007: 1. Continue to develop a Countywide Birth-to-Three system,(with an emphasis on getting all Jefferson County School Districts to participate),in order to access as many funding sources as possible with an emphasis on a comprehensive regional cooperation,knowledge,and communication between all Birth-to-Three providers in Jefferson County. rL'nrvnlvlAM.L Lwt LUVJ Lt1Ozi LUt73 1,OO6 2007 INDICATORS: Actual Actual Actual Actual Projection Projection Number of persons in Child 7 11 13 15-17 15-17 11-25 Development that have been Individuals Individuals Individuals Individuals Individuals Individuals served,are currently being served and/or we are planning to serve. Total Number of Units of Service 99 213 241 275 275 350 SUMMARY OF KEY FUNDING/SERVICE ISSUES: The Developmental Disabilities Child Development Program supports Jefferson County 2007 Strategic Budget Objective to address locally identified and defined local public health issues. This will in turn assist the Jefferson County 2007 Budget Goal to target and support the service needs of a growing community,in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities through the development and maintenance of birth to three early intervention services that are specialized,therapeutic and educational. An issue of concern is that a significant portion of the incidence of children born with developmental disabilities can be attributed to preventable circumstances,such as substance abuse during pregnancy,inadequate prenatal heath care and nutrition,teenage pregnancy,and environmental toxins. In addition,the severity of disability and developmental delay can often be mitigated through early intervention services with children and families living"at risk". There is increased public understanding of the importance of early intervention services to occur as early as possible to maximize full potential for each child. Thus,there is increased emphasis placed on fmding and serving the children. However,there has been only minimal Washington State funding added since the Washington Infant Toddler Early Intervention Program(ITEIP),an entitlement, for all eligible infants,toddlers and their families program began in 1994. The funding is not enough to fully fund evaluations, assessments,development of Individualized Family Service Plans(IFSP's)or comprehensive early intervention services for all children and their families,statewide.Funding no longer matches the needs and the increased number of children and families served. Evaluations and assessments are expensive and often take up much of the funding that is needed for services and direct therapies. School districts that do serve children,birth to three,are unevenly distributed throughout the State and this is reflected in Jefferson County where not all school districts in our County are serving children,birth to 3. This means state school funds cannot be accessed for many children/families living outside of serving School Districts. Beginning in 2009 all School Districts in Washington State will be mandated to participate in Birth to Three Programs as a funding partner. School Districts are necessary partners to ensure early intervention resources are available in each area of Jefferson County,so we encourage the goal of supporting and educating all Jefferson County School Districts to participate, in order to access as many funding sources as possible with an emphasis on a comprehensive regional Birth to Three System. It is in the best interest of Jefferson County,and society in general,that high priority is given to prevention and early intervention ill strategies. 6 of 11 Jefferson County Public Health — Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES • Individual & Family Assistance Programs MISSION: The mission of the Developmental Disabilities Individual&Family Assistance Program is to assure that citizens with developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive participation in community life and to support the Parent-to-Parent Program to provide emotional support and information to families of children with special needs and/or disabilities. GOALS FOR FY 2007: 1. Projects to provide supports with more control and flexibility to families and persons with developmental disabilities and connections to natural and informal community supports. In order to enhance their ability to make informed choices and develop attitudes of Self-Determination in order to meet life's challenges. 2. To provide information,education,emotional support and referrals to families of children and professionals who work with these families. 3. To promote parent and professional partnerships and relationships in Jefferson County. OBJECTIVES FOR FY 2007: 1. To gather and/or prepare and distribute materials to the Jefferson County community about resources and services available through DDD and other local,state and national agencies or programs. 2. To coordinate program activities with Early Intervention Programs,the Interagency Coordinating Council,(ICC)and Family Resource Coordinators(FRC)in Jefferson County. 3. To recruit,train and supervise the development of volunteer"Helping Parents." 4. To involve parents in health and education related planning,conferences,policy development and leadership training. PERFORMANCE INDICATORS: 2003 2004 2005 2006 2007 Number of persons in Individual and Actual Actual Projection Projection Projection Family Assistance that have been served, 3-10 3-6 4-6 8-12 8-20 • are currently being served and/or we are Individuals Individuals Individuals Individuals Individuals planning to serve. SUMMARY OF KEY FUNDING/SERVICE ISSUES: The Developmental Disabilities Individual and Family Assistance Program supports the Jefferson County 2007 Strategic Budget Objective to address locally identified and defined local public health issues. The Developmental Disabilities Individual and Family Assistance Program supports the Jefferson County 2007 Budget Goal to target and support the service needs of a growing community,in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities by improving the quality of life as part of the statewide Parent-to- Parent Program, dedicated to supporting families through a volunteer parent peer by offering emotional support and information about disabilities and community resources to parents who are just learning about or seeking new information about their child's disability,illness or chronic health condition and for county citizens through programs that emphasize attitudes of self-determined ability in order to make informed choices in an integrated arena. Through implementation of the National Parent-to-Parent model;utilizing trained veteran parents of children with disabilities,called "Helping Parents",they provide one to one emotional support and information to new or referred parents who have a child with similar needs. Parent-to-Parent Programs achieve optimal success when a strong parent professional partnership exists. Professional partners contribute administrative and organizational support,as well as professional oversight of the program,which serves to enhance the credibility and long-term stability of the parent's efforts. Efforts of the parents drive the program because it is a service for parents,delivered by parents with a paid coordinator at the helm. The added compliment of a community Advisory Board ensures that the program has broad based community input and involvement. In recognition of the important grassroots history of this program and the values inherent in being community based,Parent-to-Parent programs are all independent,community-based programs. The 32 community based programs formally affiliate together as a statewide organization under the auspices of Washington State Parent-to-Parent Programs,with a central statewide coordinating office maintained at the ARC of Washington State. It is in the best interest of Jefferson County,and society in general,that high priority is given to prevention and early intervention and to self-determination strategies. • 7 of 11 Jefferson County Public Health — Planned Performance Measures 2007 DEVELOPMENTAL DISABILITIES . Community Information & Education MISSION:The mission of the Developmental Disabilities Community Information&Education Program is to assure that citizens with developmental disabilities in Jefferson County have the choice,opportunity and support to achieve inclusive and productive participation in community life. GOALS FOR FY 2007: 1. Costs incurred by the program for activities to inform and/or educate the general public about developmental Disabilities and related services. 2. To promote activities aimed at promoting public awareness and involvement,community consultation,capacity Building and organizational activities. OBJECTIVES FOR FY 2007: 1. Provide at least two training sessions on Self-Determination Inclusion Training/Concepts,(i.e.:"Reaching My Own Greatness" and"Mixed Voices"training), focusing on the following target groups: • DDD case managers • Service Providers-(Targeting at least two Staff from Employment and Two Staff from Residential) • Parents • DD Board Members 2. County staff will initiate the Jefferson County Developmental Disabilities Providers Support Group in order to maintain strong working relationships,staff support and open lines of communication with staff and clients. Support a biweekly Caregiver Support Group for Staff and or Families who support People with Developmental Disabilities under the guidance of certified Counselor. Skills to be taught how to avoid burnout,deal with stress and how to support people with challenging behavior. • 3. Develop and implement a community/education awareness campaign that values and appreciates the diversity that results from full participation of people with disabilities in community life. 4. Support collaborative outreach efforts with local agencies including the ICC,the ARC, DSHS and Special Education/School Systems to identify individuals who could benefit from DD services in Jefferson County. Estimates of need suggest that there are unidentified individuals who could benefit from services. In particular,children birth-to- three,school age children,seniors,and persons residing outside of Port Townsend. 5. Provide opportunities for broader community input and involvement in DD services by educating and informing the community with publicity about issues through the media,community forums,workshops,(i.e.:computer trainings),vendor surveys and a dedicated spot/time for public comment at every Board meeting. 6. Support our local People First chapter to continue monthly meetings with the existing Jefferson People First chapter to: • Broaden membership through outreach efforts aimed at future members • Provide training and/or individualized mentoring in self-determination,self-advocacy,and other skills as requested by the Chapter • Develop a media/public education plan.(Pass on People First Educational videos to the Officers and/or Advisor.) • Support members to partake in generic Jefferson County housing and transportation programs • Promoting"Reaching my own Greatness"and"Mixed Voices"Workshops • Support the People First Community Team Builder to build community capacity,awareness and involvement while informing and/or educating the general public about developmental disabilities and related services. • Support People First (on an annual basis) to sponsor the surveying of participants, their families and/or their support networks and employers regarding customer satisfaction. People First will design the Customer/Client survey forms. • 8 of 11 7. Support another Person with a Disability to become a participating member of the DD Advisory Board 8. WISE will review all Jefferson County High School Transition Programs with the County Coordinator in order to locate and fill gaps,while establishing successful communication and working relationships with Schools,Parents,DDD,Employment • Vendors,the County and DVR. 9. WISE will create a Transition Planning Packet/Life Portfolio and set up an informational training session for parents and school personnel,in order to teach them about guardianships,wills,trusts,school navigation,residential,employment and transition options and what to expect in the adult system. 10. Work towards an effective Jefferson County Transition Plan with its number one goal being effective school to work transitions for all students with Developmental Disabilities. 11. Support a local Advocacy position as another choice to create a Pathway to Employment plan or Person Centered planning/profile delineating individual skills for individuals with Developmental Disabilities,which reflects the goals,needed to pursue or maintain gainful employment. 12. Endorse an Advocacy Program that creates the attitudes of Self-Determination in order to enhance the individual's ability to make informed choices while realizing their full potential while aiding in the development of shared responsibility. 13. Support a local Parent Coalition that will bring information and support to parents of children and adults with disabilities in Jefferson County in local quarterly meetings. Promote a Parent Advocacy Network that creates a mentoring network across age groups while teaching parents to advocate and contribute effectively to a changing system,as well as learning to interpret the school system,the community and its agencies. 14. Support the local ARC to create a local Representative Payee Program will assist individuals to fulfill their financial obligations by managing and budgeting their funds, to provide a Counseling Program will provide individual, family and/or group counseling to support improvements in the quality of lives, with the hope to help people experience maximum opportunity for self-actualization and integration,and to have a Family Caregiver Workshop will focus on Guardianships,Wills,Trusts,Transition Issues and/or Individual Educational Plan Advocacy. 15. comprehensiveProgram Conduct onsite Evaluations;i.e.:Contractual Outcome Attainment Issues,Program Planning and • Evaluation Issues,Health Safety and Regulatory Oversight Compliance Issues,Individual Rights Issues. Other impressions and systems may be reviewed in an adjunct manner. Results of these Program Evaluations will be fmished in a summary and/or data format and presented to the Jefferson County Advisory Board. 16. WISE will help the DD Coordinator to develop the Community Planning Process, the Advisory Board Retreat and create the Jefferson County Developmental Disabilities Comprehensive Plan. 17. WISE will work with the DD Coordinator to develop Presentations to the Jefferson County Community and DD Board on the subject of: Working Age Adult Policy,Service Trends/Innovations in the System and the County/Board's perceived roles in the future. 18. WISE will train community providers on the Discovery Process and/or Pathways to Employment and will work with individuals on his Person-Centered Plan or Pathway. Vendors will be involved through mentoring. 19. WISE will work with the DD Coordinator to provide workshops/trainings for local employment vendors and school personnel on job development,marketing,training,coaching skills and service trends. pFRFl1RMANCI'TNilif'A'MR C• /MA /OM /Mc NUM hnm Actual Actual Actual Projection Projection Number of persons in Community 3-100 3-100 3-100 3-100 3-100 Information that have been served,are Individuals Individuals Individuals Individuals Individuals currently being served and/or we are planning to serve. • 9 of 11 • SUMMARY OF KEY FUNDING/SERVICE ISSUES: The Developmental Disabilities Community Information&Education Program supports the Jefferson County 2007 Strategic Budget Objective to address locally identified and defined local public health issues. The Developmental Disabilities Community Information&Education Program supports the Jefferson County 2007 Budget Goal to target and support the service needs of a 4111 growing community, in order to maximize the use of limited resources,programs and services that must be strategic, effective, innovative and efficient in their delivery while targeting community priorities by improving the quality of life for county citizens through alternative ways to deliver programs that will improve services within available resources and by ensuring that citizens with developmental disabilities have access to integrated services we can maintain and improve the quality of their lives. The Parent Coalition,the ARC of Jefferson County,the Advocacy Program,WISE and the People First group will promote self- determined attitudes in order to provide people with disabilities and families of individuals with developmental disabilities access to generic Community services: community health care,prevention,intervention,mental health services,housing,transportation and transition services. A guiding principal that has evolved from choice and personal empowerment is known as Self-Determination. Sparked by the Americans with Disabilities Act(ADA), Self-Determination is putting an emphasis on increased consumer control. An issue of concern around Self-Determination is the challenge it brings to families and people with disabilities to become better consumers of services and accept a greater role in the process. Individuals with disabilities and their families need to have the opportunity to make informed decisions about life goals in order to have an impact on the purchase of services. It is in the best interest of Jefferson County,and society in general,that all people deserve to have the choice,opportunity and support to achieve an inclusive and productive participation in community life. To provide support for individuals with developmental disabilities and their families in order to enhance their ability to make informed choices and to realize they're full potential. It is in the best interest of Jefferson County,and society in general,that all people deserve to have the choice,opportunity and support to achieve an inclusive and productive participation in community life. • • 10 of 11 • DEVELOPMENTAL DISABILITIES DIVISION 2007 REVENUE SOURCES State Grants $294,399 88.12% Misc. Revenue, Contributions$50 0.01% Taxes$37,308 General Fund 11.17% Beg. Fund Balance Revenue$2,166 $162 0.65% 0.05% II Beg. Fund Balance$162 II Taxes$37,308 0 State Grants$294,399 ■Misc. Revenue, Contributions$50 DGeneral Fund Revenue$2,166 III DEVELOPMENTAL DISABILITIES DIVISION 2007 EXPENSE CATEGORIES Professional Services $234,243 70.11% Communication$300 0.09% Advertising $1,500 0.45% Travel$1,300 Supplies°$550 Wages& Benefits 0.39% 0.16/o Miscellaneous$7,344 $55,627 Interfund Rents& 2.20% 16.65% Leases$4,150 Interfund Payment for Svcs$29,071 1.24% 8.70% 0 Wages&Benefits$55,627 II Supplies$550 II O Professional Services$234,243 0 Communication$300 ■Advertising $1,500 ■Travel$1,300 ■Miscellaneous$7,344 0 Interfund Rents&Leases$4,150 0 Interfund Payment for Svcs$29,071 Department of Natural Resources — Planned Performance Measures 2007 SURFACE WATER QUALITY PROGRAM MISSION: Monitor and respond to threats to water quality for protection of human health and fish habitat by using available local, state and federal funding effectively and efficiently. GOALS FOR FY 2007 1. Implement a lake monitoring program to protect the public from the threats of toxic blue green algae and bacterial contamination. 2. Ensure healthy beach water quality at heavily used saltwater beaches. 3. Begin to use awarded state funds to improve water quality in Chimacum Creek. 4. Monitor actions to assure that goals for each project are being met. OBJECTIVES FOR FY 2007 1. Develop and implement a detailed written lake monitoring program including exploring long term funding options. 2. Monitor swimming beaches on a weekly basis during the swimming season. 3. In partnership with the Jefferson County Conservation District and North Olympic Salmon Coalition complete the tasks outline in the scope of work for the first year of the Chimacum Creek Centennial Clean Water Grant. • PERFORMANCE INDICATORS: 2006 2004 2005 2007 Lakes Monitored 0 0 9 9 Swimming Beaches Monitored 0 0 0 2 JCPH funded water quality stations on 0 0 0 40 Chimacum Creek Percentage of program budget represented by 0 0 0 6% state and federal funds SUMMARY OF KEY FUNDING/SERVICE ISSUES: This program implements the following objectives for the 2007 Budget: • Protecting and enhancing natural resources. • Protecting human health and welfare. • Operating within a business plan based on sustainable resources, measured performance, and outstanding customer service. 1 Department of Natural Resources — Planned Performance Measures 2007 WATER QUALITY/HABITAT ENHANCEMENT & PROTECTION MISSION: Protect and restore high quality habitat for fish and wildlife using available local, state and federal funding most effectively and efficiently. GOALS FOR FY 2007 1. Implement priorities for habitat acquisition and restoration based on recently completed studies. 2. Obtain state and federal funds to leverage local funds for habitat preservation and enhancement. 3. Obtain state funds to improve water quality in Chimacum Creek. 4. Monitor actions to assure that goals for each project are being met. OBJECTIVES FOR FY 2007 1. Use Eastern Jefferson County refugia study and the WRIA 16 and WRIA 17 Limiting Factors Analysis as the basis for determining priorities for protection, enhancement and restoration of habitat in eastern Jefferson County. 2. Obtain non-local revenue to leverage available local funding such as the Conservation Futures tax and Secure Rural Schools Title III funding to preserve and protect the most potential high quality habitat. • PERFORMANCE INDICATORS: 2006 2004 2005 2007 Complete technical habitat assessments for fish 1 1 1 1 and wildlife Acres of restored or protected sensitive habitat 7 10 15 10 Percentage of program budget represented by 34% 56% 37% *19% state and federal funds *First year separated Surface Water Quality and Water Quality/Habitat Enhancement&Protection Programs SUMMARY OF KEY FUNDING/SERVICE ISSUES: This program implements the following objectives for the 2007 Budget: • Protecting and enhancing natural resources. • Operating within a business plan based on sustainable resources, measured performance, and outstanding customer service. • 1 of 1 • NATURAL RESOURCES DIVISION 2007 REVENUE SOURCES Interfund Chg. For Service$236,451 41.79% General Fund Revenue$157,199 State Grants$120,500 21.30% 27.78% Federal Grants Beg. Fund Balance $13,000 $38,696 2.30% 6.84% ❑Beg. Fund Balance$38,696 0 Federal Grants$13,000 ■State Grants$120,500 ❑Interfund Chg. For Service$236,451 ■General Fund Revenue$157,199 • NATURAL RESOURCES DIVISION 2007 EXPENSE CATEGORIES Supplies$512 0.10% Professional Services Wages &Benefits $276,650 52.21% $136,424 25.74% ix 4 *1540340, • ication$1,500 Interfund Payment for 0.28% Svcs$32,863 6.20% Miscellaneous$50,960 9.61% Interfund Rents& Leases$25,634 Travel$2,450 �.� Insurance 17 9E2 n zmo/ O Wages&Benefits$136,424 •Supplies$512 ❑Professional Services$276,650 ❑Communication$1,500 • ❑Travel$2,450 0 Insurance$2,962 ■Miscellaneous$50,960 ❑Interfund Rents& Leases$25,634 •Interfund Payment for Svcs$32,863 • Board of Health Wow Business .agenda Item #`V., 3 • State Association of Local-Boards of 3fealth Proposal September 21, 2006 • a L • Healtr King County Julia Patterson August 18, 2006 METROPOLITAN KING COUNTY COUNCIL District Five Roberta Frissel Jefferson County Board of Health 615 Sheridan St Port Townsend WA 98368 Dear Ms. Frissel, As a member of a local Board of Health, you are well aware of the health challenges facing not only your region, but other areas around the state. Declining revenues, increasing demands, growing diversity of programs and clients, and rising trends in accountability and outcomes have all contributed to struggling public health departments and districts, as well as declining health outcomes for health issues like obesity, diabetes and heart disease. I have recently been in contact with the Health Administrator from Yakima County, Dennis Klukan, and have received information from him and from the National Association of Local Boards of Health (NALBOH) on potentially forming a Washington State Association of Local Boards of Health. State Associations of Local Boards of Health (SALBOHs) can serve as a convener and an advocate for all Boards of Health. For many years, Public health has not been given the attention and resources needed to provide services and improve programs. Even though King County is large and well-staffed, our health department lacks a strong voice in Olympia. In order to improve health statewide, Boards of Health, as spokespersons for their health department or district, should have the opportunity to have their voice heard by the legislature, the Governor, and the Department of Health. By forming a SALBOH, we can work in concert to have a strong, unified voice when influencing policy and working with decision-makers. • King County Courthouse,516 Third Avenue,Room 1200,Seattle,WA 98104-3272 (206)296-1005 TTY/TDD(206)296-1024 FAX(206)296-1050 email:julia.patterson@metrokc.gov www.metrokc.gov/patterson Other benefits of a SALBOH are: coordination and information sharing on emerging disease preparedness, best practice exchange with regard • to code and regulation changes, shared Board of Health member resources, training and leadership, and statewide conferences for networking and information exchange. I have enclosed information about SALBOHs, but I write solely to gauge interest of other Board of Health members. If it is clear that there is widespread receptiveness, we can engage further, in concert with our health departments and districts, in a collaborative conversation about how best to proceed. I appreciate the work you do for the public's health; and hope to hear your input about forming a SALBOH. Please contact me via email: Julia.Patterson@MetroKC.Gov or telephone: 206.296.1005. Sincerely, Julia Patterson King County Councilmember King County Board of Health Chair • • What Have SALBOHs Done? The activities and projects of a SALBOH will vary depending upon the needs, opportunities,and resources within each state. While one major focus is education and training of board of health members, SALBOHs have also have been instrumental in the initiation, development, and collaboration of other projects that advance that state's commitment to public health. Each of the following has been accomplished by one or more of the SALBOHs. Education and Training • Published a guide of responsibilities for new board of health members • Developed a complete training manual for board of health members • Established a website for board of health training resources • Provided training by workshops and distance learning • Convene annual statewide conference for board of health members • Organize regional conference within a state • Established a leadership institute for board of health members • Piloted an accreditation program for board and local public health agency • Establish monthly board of health conference calls among board of health presidents Collaboration and Partnerships • Participation in bioterrorism training exercises • • Guided formation of an organization of public health associations to attract grants • Worked with state and Centers for Disease Control and Prevention(CDC)to deliver Governance Performance Standards workshops to all boards • Participated in grant survey to assess perceived training needs of board members • Participate in annual statewide joint meeting with other public health associations • Participated in developing accreditation standards • Participated in activities to reorganize local public health Initiatives and Advisory • Promoted initiatives for smoke-free cities and states • Initiated regulation of body art(tattoos,etc.,) • Advocated for retention of local board regulatory authority • Work with legislators and participate in legislative hearings • Hired a lobbyist to represent joint association • Contracted with other public health association to provide administrative services • Promoted credentialing of public health administrators and emergency response coordinators • Served as "Friend of the Court" on public health issues Association of Local Boards of Health of Idaho Association of District Boards of Georgia Health J. Fred Agel,President Carolyn Meline,President 3643 Doroco Dr.,NE 655 10th Avenue r Atlanta,GA 30340 Pocatello,ID 83201 • Ph: (770)939-4320 Fax: Ph: (208)233-3211 Fax: (208)234-7169 `> Jage131035@aol.com cmeline@corr.state.id.us Illinois Association of Boards of Health Massachusetts Association of Health Boards Jan Allen,President Marcia Benes,MS,Executive Director 123 Lake Hickory Circle 56 Taunton Street Belleville, IL 62223 Plainville,MA 02762 Ph: (618)277-1535 Fax: Ph: (508)643-0234 Fax: (508) 643-0234 Janalien703@aol.com bens@mahb.org Michigan Association for Local Public Association of North Carolina Boards of Health Health Mark Bertler,Executive Director Lorraine Salois-Deane,President PO Box 13276 3420 Ridge Road Lansing,MI 48901 Durham,NC 27705-5538 Ph: (517)485-0660 Fax: (517)485-6412 Ph: (919)403-8182 Fax: (919) 966-0478 mbertler@malph.org lsalois-deane@nc.rr.com New Jersey Local Boards of Health Public Health Association of Nebraska Association Pat Lopez,Executive Director Paul Roman,President 4521 Hill Drive PO Box 101 Lincoln,NE 68510 Shrewsbury,NJ 07702 II Ph: (402)489-5090 Fax: (402)483-0570 Ph: (732) 842-7850 Fax: (732)933-9595 jpnic75@aol.com paulroman@mail.com Ohio Association of Boards of Health Utah Association of Local Boards of Health Beth Adamson,Executive Director Kathy Froerer,Executive Director 576 High Street 726 North 1890 West Worthington, OH 43085 Provo,UT 84601 Ph: (614)436-4431 Fax: (614)436-4451 Ph: 801-377-1264 Fax: 801-374-3082 aimltd@tcssoftware.com kfroerer@utah.gov Wisconsin Association of Local Health Departments & Boards Sharon Hampson, Co-President,Boards of Health 2510 Cass Street LaCrosse, WI 54601 Ph: (608) 785-2022 Fax: (608)785-9846(call ) sharonkgh@charter.net • Updated 712012C r • Board of Hearth New Business .agenda Item #17., 4 • Report to City of Port Townsend September 21, 249196 • Ar°` JEFFERSON COUNTY PUBLIC HEALTH rF ',' 615 Sheridan Street • Port Townsend •Washington • 98368 • www.jeffersoncountypublichealth.org September 15,2006 David Timmons, City Manager City of Port Townsend 250 Madison Street Port Townsend,WA 98368 Subject: Port Townsend Liquor Excise Tax(PTLET) Dear David: As you know, Jefferson County Public Health (JCPH)has contracted directly with the City to provide substance abuse prevention programs in Port Townsend.These are part of the Regional Support City- County contract. Enclosed you will find a summary of 2006 service delivery,2007 service plan,and service description. JCPH submitted a 2007 Prevention Budget including$34,921 from the City of Port Townsend.This amount was derived by using the current formula outlined in the Regional Service Agreement for the allocation of the PTLET. The PTLET annual contribution is the only money the City of Port Townsend contributes to public health. JCPH is the only provider of public health services to Port Townsend citizens.JCPH has the infrastructure in place to assess community needs,plan effective interventions, influence services and evaluate prevention programs.All programs within JCPH have extensive reporting requirements and are part of national,state, local and regional service plan&delivery of services. PTLET funds are used by two specific programs within the array of services offered everywhere in the • county, Project Alert and Big Brothers Big Sisters. Both services have been rigorously researched and are nationally recognized Best Practices for school aged children.They fill a documented need derived from local community health assessment data. A snapshot of services received by Port Townsend youth and families from September 2005 through June 2006: • Project Alert served 199 Blue Heron students during 64 sessions • Big Brothers Big Sisters provided 1672 mentoring hours through 796 mentoring contacts. As you may recall, PTLET funds are included in the required match of the 5-Year Federal Drug Free Community grant.Year 5,which supports Big Brothers Big Sisters and the Healthy Youth Coalition,begins October 1,2006. The core mission of Jefferson County Public Health is prevention. Prevention,simply stated, keeps bad things from happening to individuals,which in turn contributes to overall community health. We look forward to ongoing collaboration in 2007 with the City of Port Townsend. Please notify me if there is a conflict of the 2007 budget assumption of$34,921. Thank you for attention to this very important matter. Sincerely, Jean Baldwin N Director, Jefferson County Public Health cc: Jefferson County Board of Health Mark Welch, Mayor City of Port Townsend John Fischbach,Jefferson County Administrator • COMMUNITY HEALTH DEVELOPMENTAL DISABILITIES PUBLIC HEALTH ENVIRONMENTAL HEALTH ALWAYS WORKING FOR A SAFER AND NATURAL RESOURCES MAIN: 0854000MAIN:360-385-9444 FAX:360-385-9401 HEALTHIER COMMUNITY FAX:360-385-9401 JEFFERSON COUNTY PUBLIC HEALTH • Prevention Program Narratives PREVENTION COORDINATION& ACTIVITIES The Substance Abuse Prevention Program has provided prevention services to Jefferson County residents for over a decade with the mission to prevent the onset of chemical use and abuse among youth. School and curriculum-based programs are used to target students at risk by developing alcohol, tobacco and other drug related programs. The program offers various projects that target students using a social resistance approach to promote social and decision making skills in order for the student to learn how to say no to alcohol,tobacco and other drugs. Current substance abuse prevention services include the Best Practice programs Project Alert, Smart Leaders, and Youth Yellow Pages (YYP). Project Alert is a school-based, social resistance approach to drug abuse prevention. The curriculum specifically targets cigarettes, alcohol, and marijuana use and involves parents and families. Smart Leaders is a curriculum- based program that uses role-playing, group activities, and discussion to promote social and decision making skills in racially diverse 14 to 17-year-olds. As participants advance in the program, they are involved in educational discussions on alcohol, tobacco, and other drugs and have the opportunity to recruit other youth for the program and assist with sessions offered to younger boys and girls. Youth Yellow Pages is designed to help youth and parents make informed choices. It lists facts, services, resources and activities for youth, young adults and families. Listings include: alcohol poisoning, depression, overdose, religious organizations and • many more. Program Outcomes include enabling students to develop reasons not to use drugs, assist students to identify pressures, help students learn to refuse external and internal pressures by developing skills, provide counter pro-drug messages, help students recognize the benefits of resistance, create drug-free peer leaders, and provide a comprehensive resource guide for youth, young adults, and families with children. The primary expense in Prevention Coordination and Activities is in wages and benefits. Revenue sources include a federal grant and contributions from the City and County. The federal portion requires a 10%match which is covered by the City and County contribution. NURSE FAMILY PARTNERSHIP Nurse-Family Partnership (NFP) is an evidence based nurse home visiting program that improves the health, well-being, and self-sufficiency of low-income first time parents and their children. NFP nurses work with their families to achieve three important goals: • Improve pregnancy outcomes by helping women engage in good preventative health practices including accessing prenatal care, improving their nutrition, and reducing/quitting use of tobacco, alcohol, and illegal substances. • Improve child health and development by helping parents provide responsible, nurturing, and competent care. • • Improve economic self-sufficiency of the family by helping parents develop a vision and a plan for their own future, including planning pregnancies, education and job skills and employment. PREVENTION PROGRAM NARRATIVES 1 of 3 Nurse-Family Partnership is the most rigorously tested program of its kind. Randomized controlled trials were conducted in 3 sites in three different states. Consistent program effects • include: • Improved prenatal health • Fewer childhood injuries • Fewer subsequent pregnancies • Increased intervals between births • Increased maternal employment • Improved school readiness At age 15, the children from the first trial were found to have: • 48% reduction in child abuse/neglect • 59%reduction in juvenile arrests After 15 years, the mothers were found to have: • 61% fewer arrests • 98% fewer days in jail Nurse-Family partnership ranked highest in terms of cost return among early intervention/prevention programs according to the Washington State Institute for Public Policy. They estimate the benefit per dollar of cost to be $2.88. In 1998, the RAND Corporation determined that the savings were attributable to: • An increase in tax revenues from increased employment • • A decrease in government assistance such as food stamps and welfare • A decrease in other expenses such as emergency room visits, special education, and homeless shelters • A decrease in criminal justice system involvement. A 2005 RAND study concluded that the economic returns were even greater when the programs are effectively targeted. The return for each dollar invested in NFP was $5.70 for the higher-risk families. JCPH nurses have been implementing the Nurse Family Partnership program since 1999. We participate in ongoing data collection through the NFP national office in an effort to ensure a quality program with fidelity to the research model and to better understand our local community. Our first 5 years of data analysis shows that we are both targeting and effectively serving the higher risk families in Jefferson County. As an example, our data shows that: • 59% of Jefferson county NFP enrolled pregnant women have experienced physical or emotional abuse as compared to 29% of NFP pregnant women nationwide. • 26% of Jefferson County NFP enrolled pregnant women are experiencing mental illness as compared to 5%of NFP pregnant women nationwide. Our goal is to make this research proven, Best Practices program available to every eligible • family in Jefferson County. PREVENTION PROGRAM NARRATIVES 2 of 3 HEALTHY COMMUNITIES - BBBS • Big Brothers Big Sisters of America(BBBSA) has been providing adult support and friendship to youth for nearly a century. A report in 1991 demonstrates that through BBBSA's network of nearly 500 agencies across the country, more than 70,000 youth and adults were supervised in one-to-one relationships. Service delivery is by volunteers who interact regularly with a youth in a one-to-one relationship. Agencies use a case management approach, following through on each case from initial inquiry through closure. The case manager screens applicants, makes and supervises the matches, and closes the matches when eligibility requirements are no longer met or either party decides they can no longer participate fully in the relationship. BBBSA distinguishes itself from other mentoring programs via rigorous published standards and required procedures including orientation for all volunteers, volunteer screening, youth assessments, matches, and supervision. Orientation is required for all volunteers. Screening volunteers and youth assessments consists of a written application, background checks, extensive interviews, and home assessments. Each screening and assessment is designed to screen out those who may inflict psychological or physical harm, lack the capacity to form a caring bond with the child, or are unlikely to honor their time commitments. They also help the caseworker learn about the child in order to make the best possible match and also to secure parental permission. Supervision is accomplished via an initial contact with the parent, youth, and volunteer within two weeks of the match. There are monthly telephone contacts with the volunteer, parent and/or youth during the first year and quarterly contacts with all parties during the duration of the match. An evaluation of the BBBSA program has been conducted to assess children who participated in BBBSA compared to their non-participating peers. The evaluations showed decreased drug and alcohol use, better academic behavior and attitudes, and improved relationships with their parents or guardians and peers. The national average cost of making and supporting a match relationship is $1,000 per year. The program is funded by local, federal, and non-federal match dollars, consisting of Liquor Excise Tax from the City, Office of Juvenile Justice, and in-kind contributions provided by the Healthy Youth Coalition, BBBS, and OESD. BBBS of Seattle manages and supervises the overall program and will seek further funding. • PREVENTION PROGRAM NARRATIVES 3 of 3 • JEFFERSON COUNTY PUBLIC HEALTH Prevention Program - Prevention Coordination & Activities PREVENTION COORDINATION & ACTIVITIES 2006 Program Expense Budget 4,843 9,901 8.47% 17.31° ` ❑Wages & Benefits •Professional Services ❑Other Operating Costs ❑Interfund Payments 42,464 74.23% • PREVENTION COORDINATION & ACTIVITIES 2006 Program Revenue Budget 0 Federal Grants 3,366 5.86% ■State Grants 21,340 37.16% ;mom ❑Intergovernmental Grants CITY 32,715 56.97% 0 Charges for Services •County Contribution • • JEFFERSON COUNTY PUBLIC HEALTH Prevention Program - Maternal Support Services/Nurse Family Partnership MATERNAL SUPPORT SVCS - NURSE FAMILY PARTNERSHIP 2006 Program Expense Budget 15,419 5,072 7.86% 2.59% 5,460 ❑Wages & Benefits 2.78% Professional Services ❑Other Operating Costs ❑Interfund Payments 170,225 86.77% • MATERNAL SUPPORT SVCS - NURSE FAMILY PARTNERSHIP 2006 Program Revenue Budget 33,184 0 Federal Grants 16.92% 65,661 M State Grants 33.47% 16,881 8.61% ❑Intergovernmental Grants --,-.011111111111111111 (MVET) 0 Charges for Services 80,450 41.01% ■County Contribution • • JEFFERSON COUNTY PUBLIC HEALTH Prevention Program - Healthy Communities/Big Brothers Big Sisters HEALTHY COMMUNITIES - BIG BROTHERS BIG SISTERS 2006 Program Expense Budget 2,227 1,107 11,829 2.23% 1.11% 11.84% 0 Wages & Benefits ■Professional Services ❑Other Operating Costs 0 Interfund Payments 84,760 84.83% • HEALTHY COMMUNITIES - BIG BROTHERS BIG SISTERS 2006 Program Revenue Budget 7,000 0 Federal Grants 7.00% ■State Grants 0 Intergovernmental Grants 4A* (City) 0 Charges for Services 92,930 93.00% ■County Contribution • Board of 3CeaCth .activity Update .Agenda Item # rVI., 1 Co-Ocurring Disorder • Integrated treatment draining - October 2, 2006 September 21, 2006 • 'aaakaia`ava'aa,aaWaSt•.,_ a co 0 1 tij a .5 0 cn U 1 Ce O N En •fry N C C 03 4 x a� -o F"—i w a icill Z s. o -'4Z-yi, ,t,-.,- -0 ,„‘L' 0 k) -.:44- 4.44,41.0 C N C lek g ____ 1 '0 2 a:t --- ,,, , , .41 ,,,, , , _ _ _ x) al ..., _go ,,„„rm .4),:_,, ,. 1 f z ..0 ''''' an SILlik H MS 2 la: 2 ' ---''.'t2aC.,/L.-a"-.. 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O a, n 00 ,. n R . p �y o H me o = n y. n m a. o n r.4) i n yw y� rni o t1. pi o ¢' n yrs n + "q a . ] g ? �n-y .s n 04 n ? n n ›. n c n• 0 , �' 'x n w ' N H QK1. 2_, n `/ n x o n hOy 0 a n - 9 5 5 n a. a �. „ me g o . • a. 2 o ;, u11I- QC/DFe ri;Iril� 0Aiep ct9gOmv, ogia' ' t ry O F„ nf ' w 0 IyDa W ��tt, .,¢� �i, ` 21 n P b ? ? f2D PL E- r E- • w 0 ry "pe P-."CI O n ,' N 0 ? `nC a-. A.. 5 r • Board of Health Media Report • September 21, 2006 • • Jefferson County Health and Human Services August 2006 — September 2006 NEWS ARTICLES 1. "Anderson Lake may be closed through season", PDN, 8/22/06 2. "All of Puget fouled by red tide outbreak",PDN, 8/25/06 3. "Shellfish danger worsens", PDN, 8/25/06 4. "Report dead wild birds", PT Leader, 8/30/06 5. "Red tide closes Discovery Bay beaches to shellfish harvesting",PT Leader, 8/30/06 6. "State smoking rates drop after ban takes effect", PDN, 8/31/06 7. "Good defense against flu: washing hands", PDN, 9/6/06 • 8. "2-1-1 hot line for human services set", PDN, 9/12/06 9. "Smoking crackdown angers some local business owners",PT Leader, 9/6/06 10. "Anderson Lake might make a short return", PDN, 9/8/06 11. "Smoking crackdown angers local business owners", PT Leader, 9/6/06 12. "Wash you hands—September is National Food Safety Month",PT Leader,9/13/06 • • Anderson may bclosed throughseason Labor Day restart- McNickle said it's possible An- now unlikely, i, Berson Lake could "3n be closed for the •• 4 rest of the season. " � The ark nor- says health official p mally closes on BY EVAN GAEL Oct. 1 and PENINSULA DAILY NEWS • �y,` reopens April 20. ��' The most CHIMACUM — With the lake McNickle recent test results still showing toxic algae, Jefferson were taken Aug. 7 County Environmental Health offs- and show a cials are doubtful that Anderson microsystis count of three parts per Lake State Park will reopen to the billion. public by Labor Day. Microsystis is one of the three Environmental Health Director types of poisonous algae that have Mike McNickle said he was hopeful been present in Anderson Lake since • the park would be open by Labor late May, when two dogs died from Day weekend, Sept. 1-4. drinking the lake water. "We need two weeks of clean Another dog nearly died but was results in a row to open the park saved after going into convulsions. again, and I don't think we're going The World Health Organization recommends a body of water be to make it [by Labor Day]," said McNickle. closed to the public if it has levels of "But, if we're clean this week and toxins greater than one part per bil- lion, McNickle has said. clean next week, we might be able to open it." TURN TO LAKE/A6 Lake: Weather CONTINUED FROM Al Generally, cooler weather, Algae blooms occur natu- rainfall and reduced sunshine rally in Anderson Lake and will lead to reductions in algae other lakes in the region, but blooms and toxin levels, said they can become deadly to ani- McNickle. There are no other lakes in mals and possibly humans Jefferson or Clallam counties with the effects of a certain with toxic algae blooms. level of phosphorous and sun- Two Jefferson lakes — light, McNickle said. Gibbs and Leland— are being At one point during the tested regularly. Several oth' summer—in June—the lake ers believed to be at risk are had a toxicity level at 20 parts being checked visually to • per billion. A sample taken July 31 ensure algae is not forming. showed no toxins. Reporter Evan Cael can be "Then it bounced right • back with some toxins," said reached at 360-385-2335 or McNickle. evan.cael@peninsuladailynews.com. i All of Puget fouled by red tide outbreak Yl� • �1 , { .... l', 5.u. .et: Toxins .,, , THE ASSOCIATED PRESS OLYMPIA—The worst red tide in years : ,'` CONTINUED FROM Al "I'm concerned if people has shut down shellfish beds in much of Scientists saytoxic organ- ignore these warnings, we Puget Sound and prompted serious public ':« g could wind up with people health worries, state officials said $TIics called Alexandrium, um, with illness, if not worse," Cox Expanded beach closures have not ; ' ch produce powerful neu- said reached the heart of Washington state's Itoxins that cause paralytic Paralytic shellfish poison- ellfish poisoning in humans,large farmed shellfish industry, and the AY:.:. in can be fatal, but the last are resent in very high levels. g state said commercial shellfish on the mar- p �' g deaths in Washington state ket have been tested and should be safe to The organisms are present were in 1942. eat. 1n blooms of`algae that thrive The latest serious illnesses But industry officials worried that more In, warm, calm summer were in 2000, when several bad news could further damage businesses t:I.vileather. people were sickened — some already reeling from a separate bacterial . 'The state closes shellfish- even paralyzed — after eating outbreak. ,"growing areas when measure-. contaminated shellfish near III The state Health Department said r�ments of the toxins reach 80 Wednesday that the newest round of beach t"'tr•h• Gig Harbor, Cox said. crograms. Cooking does not eliminate closures means virtually the entire shore- „<'.`..But many areas are show- the toxins, and people should line from Everett south to just north of iiig levels of 1,000 micrograms be extremely careful when Olympia is off-limits for shellfish harvest- ' :or.more, with mussels at Port harvesting shellfish on public in The eastern Kitsap Peninsula also has 'Ludlow containing nearly or private tidelands, officials been affected, along with areas near Port ;10,000 micrograms. said. Gamble, Port Ludlow and along the Strait 2:';,` of Juan de Fuca, said Frank Cox, a Health Department marine biotoxin coordinator. "I don't think we've ever had anything . quite to this scale,” Cox said Wednesday. TURN TO PUGET/A8 `PbN) 8- as-acc, • • : • ` xF'. ti August25-2.6, 2,006 } • Shellfish danger • _ _ _ C ) "- - ° tom-, o c Uj o.� O. .'"' cT, ., _ +'�' .� � m W C ° O. z =.tea 0. m worAlct sens w � �� ~��� � � ��Y ° �0.5 a)ci' L � sans f F.' ° � 00o ate' +' " t y "A% Report wild it s People who see dead wild deceased shorebirds and water- birds can report their observa- fowl such as ducks, geese and • tions on a new, toll-free tele- swans are the birds most likely phone line established by the to be tested. Washington Department of While wild bird die-offs Fish and Wildlife. occur naturally each year, the Most dead bird reports can be department plans to investi- submitted by calling 800-606- gate large or unusual events, 8768. The exceptions are dead Mansfield said. crows, ravens, magpies and Wild birds are known to jays, which should be reported carry various strains of avian to local city or county health influenza, often without seri- departments that are tracking ous health effects. However, those species for potential West one strain, known as Highly Nile virus cases. Pathogenic Avian Influenza Callers to the Fish & H5N1 (HPAI H5N1),has sick- Wildlife reporting line will be ened and killed birds in Asia asked to leave their name,tele- and parts of Europe. About phone number, the date and 200 people also have con- time of the call, the number of tracted the disease after close dead birds they are reporting, contact with infected birds. • the specific location of the The HPAI H5N1 strain has not birds and—if known—the spe- been found in North American cies of bird and approximately wild birds, although surveil • - how long the birds have been lance testing for the virus is dead. under way nationwide. The new reporting line Meanwhile, as a standard is part of Fish & Wildlife's safety precaution for protec- surveillance effort for avian tion from various diseases car- influenza, also known as "bird ried by wildlife, people should flu." not handle dead wild birds "Since avian influenza with bare hands or transport • has been found elsewhere in them. Those who choose to waterfowl and shorebird spe- bury or dispose of dead birds cies, those are the birds we that are not needed for dis- will follow most closely," said ease testing are advised to Dr. Kristin Mansfield, Fish & wear rubber gloves or use a Wildlife veterinarian. "On the long-handled shovel, and to other hand, a bird that died clean their hands and tools because it flew into a window with soap and water or alcohol ,or was hit,by,a car.wp14,not ..Wipes,afterward. ,, warrant disease•testing. "Just.-as •people. routinely Reports will be reviewed ,• carry certain•viruses such as tegeact--- by wildlife experts, who will the common cold, wild ani- respond as needed. The bird mals routinely carry various • a),_ 3o ,-Uk • species and the apparent cir- diseases,"said Mansfield."It's cumstances of its death will simply common sense to avoid • determine whether a dead bird touching wild animals with is tested for avian influen- bare hands and to wash hands za, said Mansfield. Recently and tools after handling." Wednesday,August 30,2006•B 3 ded tide closes Discovery Bay beaches to shellfish harvesting Because of high concentrations of marine "Consumption of shellfish with these fish contaminated with the naturally occur- »otoxins that cause paralytic shellfish poi- concentrations of PSP biotoxin can easily ring marine algae that contain toxins that are zoning,beaches in the Discovery Bay area are be lethal," said Neil Harrington, environ- harmful to humans. Symptoms of PSP can :losed to the recreational harvest of shellfish. mental specialist with the Jefferson County appear within minutes or hours and usually According to the Washington State Department of Environmental Health. "No begins with tingling lips and tongue moving )epartment of Health, the closure area dinner of steamed clams is worth the risk of to the hands and feet followed by difficulty )oundaries are from north of Cape George, serious illness or death." breathing, and potentially death. Anyone south to include all of Discovery Bay and Warning signs have been posted at high- experiencing these symptoms should contact iorthwest to approximately one mile west of use beaches warning people not to col- a healthcare provider.For extreme reactions, diamond Point in Clallam County. lect shellfish from these areas. The closure call 911. Port Ludlow and Oak Bay also remain includes clams, oysters, mussels, scallops Despite the term "red tide," the algae :losed to shellfish harvesting. PSP-causing and other species of molluscan shellfish. that contain the toxins cannot be seen and biotoxins have been detected at concentra- Crab is not included in the closure, but the must be detected through laboratory test- ions of 60 to 120 times the threshold for clo- "crab butter" should be discarded, and only ing. Recreational shellfish harvesters should lure from samples collected at Port Ludlow the meat should be eaten. check the Department of Health website Marina and South Indian Island County Park. Commercially harvested shellfish are at www.doh.wa.gov/ehp/sf/biotoxin.htm or Marine biotoxins are not destroyed by sampled separately, and products on the call the biotoxin hotline at 800-562-5632 cooking or freezing and can be life-threaten- market should be safe to eat. before harvesting shellfish anywhere in ing. People can become ill from eating shell- Washington. • • i • 1 t • • State smoking rates drop after • ban takes effect By Jot CASEY PENINSULA DAILY NEWS Where there's SEATTLE — Adults are 'clearing the air around Wash- no smoke ington, including in the North Olympic Peninsula, much to THE DROP IN smok- the glee of health officials. ing among adults in Fewer people are puffing Washington state trans- tobacco fumes into the air,state lates to: Health Secretary Mary Selecky ■205,000 fewer smok- said at a press conference ers—equivalent to filling Wednesday in Seattle. Safeco Field four times Washington's rate of ■65,000 fewer smok- tobacco-addicted people ing youths • dropped to 17.8 percent in ■$1.8 billion in health 2005, the fifth lowest among care costs the 50 states,she said. ■A 21 percent drop The latest figure compares since the state's Tobacco to a smoking rate of 22.4 per- Prevention and Control cent in 1999,when Washington efforts started in 2000. ranked 20th in the nation. Among the top 10 no Fewer smokers here smoking states,Washing- ton ranks behind Utah, In Clallam County, the California,Connecticut, smoking rate among adults and Hawaii. dropped from 20.1 percent in It stands ahead of • 2003 to 17.6 percent in 2005, Kansas,Idaho,New Jer• • said Florence Bucierka,human say,Massachusetts and services planner. Oregon • In Jefferson County,compo- "There are now many rable figures were 19.8 and 13 more former smokers in percent, said Kellie Ragan, our state than current Tobacco Prevention and Con• smokers,"said Dr.W. trol program director. Hugh Maloney,president- Because only about 200 Jef- elect of the Washington ferson County households were State Medical Associa- measured in the state's random tion. III telephone survey,the difference Peninsula Daily might not be statistically signif- News icant,Ragan cautioned. Nevertheless, Bucierka was ' happy with her county's perfor- to give up the habit. mance. A survey of new.mothers in "I think in Clallam County Clallam County showed that 24 part of what has made the dif• percent smoke, Locke said. In ference is the tobacco work that Jefferson County,the rate is 18 Rachel Anderson has done," percent. • Bucierka said. Bucierka said heaping taxes She referred to the county's on the price of cigarettes also Tobacco Prevention and Con- encourages smokers to quit. trol Program specialist. Impact of 901 unclear Bucierka also credited county commissioners'support However, officials weren't TDd of the program that has certain of the impact that Ini- included a no-smoking zone tiative 901 has made.The new around the courthouse in Port law banned indoor smoking in Angeles and limited smoking places of employment that zones at the Clallam County include bars and restaurants. g_6(,-o, fair. "I have not seen anything Clallam County buys space that's really measured that," in Peninsula Daily News to Locke said. "It's probably too advertise the state's toll-free early to tell." Quit Line — 877-270-STOP The law has made a minor (7867) in English, 877- dent in the bars'business,how- 2NOFUME (877-266-3863) in ever,about 2 percent,he said. Spanish, 877-777-6534 for "They do lose customers but hearing-impaired people, or then they gain customers," www.Quitline.com.. Locke said."They lose smokers The Quit Line offers free and then they gain non-smok- • counseling, a personalized ers." smoking-cessation plan, local The stop-smoking battle is resources and free quit kits. far from over, though, anti- One index of the county's smoking activists said. success, Bucierka said, is that The tobacco industry spent Clallam enjoys the highest per- more than $184 million last centage of Quit Line callers in year to promote smoking in the state. Washington, according to the Dr. Tom Locke, health offi- state Department of Health, cer for the North Olympic and most of the advertising tar- • Peninsula,said,"We've made a geted people 18 to 29 years old. huge investment in trying to About 45 youths start smok- reduce the rates of smoking. ing each day, according to the "The majority of the tobacco health department, and about settlement money has actually 8,000 people in Washington die gone into health-related areas, each year from tobacco-related including tobacco cessation." illnesses. Anti-smoking efforts concen- trate on preventing young peo- Reporter Jim Casey can be reached at ple from starting to smoke and 350-417.3538 or by e-mail at on convincing pregnant women pm.casey®Perunuuladailynews com • .. .., , . . .. 41.,X.,' ,.,..---rm-k.' t:e.' ,-' vo...' • ', ' . . .:;'....;‘...',:•;-.1...'-i,'S.'174'4. , • .----g-Alr,.!'?..L'•'..,,,-,1;,":";„.„-,N-ft..',',.. .. '-'7.-,::::;iL,;-,-:,.,.=;:,...-:. ,;••=4,4$5.i..,,..%'14,-.-,.. 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From "Cover Your Cough" posters distributed to county schools to hand sanitizers for businesses and residents, Public Health and other health-care services are gearing up to protect against flu. Flu: Hand sanitizers reduce illness CONTINUED FROM Al blunt the effects should a pan- Nursing Director Julia Dan pared," said Danskin. Theyfear that the H5N1 demic develop. skin said she has received dis Flu vaccine is expected to The Clallam County Health penser bags of hand sanitizer be plentiful this flu season and virus, commonly called bird or and Human Services Depart for use around Public Health Danskin said vaccines will also avian flu, could mutate into a ment has received an $18,000 and other public facilities. be encouraged for children as disease as deadly to humans as grant to help prevent flu. Already, staffers at Jeffer- well as seniors, who are con the 1918 influenza that killed son Healthcare hospital and sidered higher risks fdr flu. millions around the world. Hand sanitizers health-care clinics around the Jefferson Healthcare hospi- Humans can catch the dis In Jefferson County, hand county are using hand sani tai is expected to sponsor flu ease from handling infected sanitizers can be found on titer from dispensers. shot clinics,she said. poultry. desks around the Public "It can help cut down on The county Public Health World health officials say Health offices. employee absenteeism during program is in conjunction with H5N1 eventually will "make They may also end up on the flu season," said McKen- similar efforts in Clallam and the jump — mutate — to a those of employees at Jeffer tie. Kitsap oounties, as part of the strain that humans can spread son County Courthouse, County health officials will state's Region 2 Public Health to humans, and experts expect should they want them. also focus on education in the Emergency and Preparedness it to spread around the world. Where the sanitizer dis coming months. Program. Preventative measures in pensers are distributed is yet "We are planning to do Jefferson and Clallam coup- to be decided. McKenzie, said. some flu forums this fall to Jefferson County Editor leew ties are intended to reduce all While dispensers are still educate businesses and the can be reached at 360-385-2335 orme-mail cases of flu — and perhaps on the way, Public Health community on ways to be pre jeN.chew'peninsuiadadynews.com. - t04 o ~ m m o ^ to y oro L ' ° m3C0 3 .a- ywT:',4 o ° 76 33 E.4 y cC i4 .9A1 d w '' ''' y2T ' ''� o 0 '-a' . onyx �, r ° O , -.3-'4'd c .' m y . l0�'- ° CateooEgo 'bv � btia E C s-, y Q'-. .0-CO ° a, QZ O . 0 ; :,,,, ,,, ,,.„ ,,....-0. (*...,,,, ..a . N04 ,,,, w - $. 5„4• , , 7.744) � -,,,,44...0,46' ,"��' � � a7 m w C ^C k w b °� • +' 'b y�.0 T. O 3 q " O a) C .0 m-' ,„:.. T6 � . �}+ a*ao . c pop ,i,.w 0 0 o a' 3 y r.. yi ! ; j- i 3 c vmctl of t'' i > a� c > g aC T 2 d - 4 V. 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Leader Staff Writer a1 F see tri Since it took effect in December 2005, the `-•i"'" 4a' � !F-• e kz 1::•'-':=7;';.1r-'‘'''',.. !• " •V Washington State Clean Indoor Air Act seemed to be i L;Et ll 1 T, : ..lis-v,..#'1-;';';;%"-t1 ' working out pretty well for Lynn Hamlin LeMaster . :` 1 - and her husband,Bill-or so they thought. I l 1'f ;1 r; • E � ...4,i4.7111,17.12';',. �t` � Late last month the LeMasters,who own Lehani's : : • r Deli and Coffee House on Taylor Street in down- ''ll , ? to R., is fl t...,: ; ' r ,Af � ' �°:s ` �i..,.. town Port Townsend,received a letter from Jefferson ... ,`4.1 ,'t �t t, t i. Ili + 'r s''yi- 1. sJ,r�«. ' �' ' County Public Health officials indicating they had 9 v"i s I' + ;r4 ` received calls complaining about people smoking in ra aa� ,>, 1,i s t z�sa t w. :> . • s ` SIM` tit front of their business. [ `~ ' 'r r{ 1`4 6 1 t.S x .,rx. �a r';:. i. 'rr !r 1 s t 'r ! 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PENINSULA DAILY NEWS "If there is an opportunity to open up the park prior to Nov. 1,we will do PORT tOWNSEND — Anderson that." • Lake, closed due to toxic bacteria, If the lake reopens,notice would be could reopen briefly before it closes publicized,he said. for the winter if the bacteria disap- pears before Nov L County won't test until May The popular trout-fishing lake near Port Hadlock and Chimacum Jefferson County Environmental was closed June 5 after toxic bacteria Health officials said they are through killed two dogs and sickened another. testing Anderson Lake for the toxin It will remain closed until the until May. • bloom of bacteria, known as blue The county is now leaving any green algae,subsides. decision about the lake to state parks Anderson Lake routinely is closed• officials. for the offseason starting Nov 1 until The lake still has bacteria levels May. dangerous for both people and ani- • Should the bloom of toxin, known mals, said Mike McNickle, Jefferson as blue green algae,subside before the County environmental health director. lake normally closes Nov 1,there is a TURN TO LAKE/A8 • • o _ r 0 co i4! 9] db' itph 0 ,„, oQ0-, ou z O "a � 9 Zwo m gx (,Nt. 7 a 05.0eo `_•-' Ox O dry "�"0 N0 n"a ......"NNC g (~ oN ,,O gv w 00 ro cN, A ° N co m m o c < "o "▪ c+ Et a "oo o ° t xgg�. c m 5 ° x 0 e•0) .00 7ao-x00 � ° fD co m w fD co . ::3, jai , f<D't7 W N o"7 N 90 G.".(D•.{ 0 N QG .o co cD e,+. ..� co cory. 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D ^cD (7 V �a — g . � , oco Fro, ° '1 t Q. co ti oNO gmn C"'e•° .2 a 00, D� o 0 o I;' N U ^„,O fcD 5 03 ,5, m N $ O O 0-g, ;4 CDD < a 0 o 0 o n o x N , g o 6, 3 _ g ao . • N amc.g•• o 3 o` (.. 1'. (D .� CM c o C 0-N,g.*, " "b O 0 - . ., o % w ,y E Cao O1. m co . <<" G. The Port Townsend Leader OnLine 1 Smoking crackdown angers local business owners Page 1 of 3 Pitl1T GI 0 t 411 .„ k 4 ,,. ,.,, - Ac,).", ' r"'" '4, t f �9 Crt 4fhe I..E& 1` *) Wednesday,September 06,2006 Smoking crackdown angers local business owners By Blythe Lawrence, Leader Staff Writer Wednesday,September 06,2006 Since it took effect in December 9 2005 the Washington State Clean Smoking violation complaints listed Indoor Air Act seemed to be working Complaints or violations compiled by Y out pretty well for Lynn Hamlin- Jefferson County Public Health from I ' � LeMaster and her husband, Bill -or December 2005 through August 2006. t � - "46 so they thought. The complaints are listed in the order in r R, which they were received by the county. vt.VLate last month the LeMasters, who The county does not provide the names '�$ ' own Lehani's Deli and Coffee House of those who made the complaints. ��>1 c' ' on Taylor Street in downtown Port p Townsend, received a letter from0 Business: Carl's Building Supply, Port �, Jefferson CountyPublic Health Hadlock P"f4, ii: " �� officials indicating they had received44' ‘".. Violation: Employee smoking in business 4 f 4 calls complaining about people ( 5 i',1;.., smoking in front of their business. Number of incidents: 1 i':f Washington's Clean Indoor Air Act, �` RKY. & 4 ' p # N Business: 1012 Coffee House, Port 4 �� which went into effect late last year, prohibits smoking within 25 feet of Townsend 4 t74 the doors and windows of public Violation: No"No Smoking"signs, complaint of smoking at tables outside facilities.A letter from Public Health store z is a business's first step toward losing its food license. Number of incidents: 2 After Washington voters approved Business: Aldrich's Market, Portathe 1-901 smoking ban, individual Townsend t: 'AOP:ii iii,,,'i f,',...:,,,,':14;;;;f4..1,;:::;.;1.",1: -- counties were charged with coming Violation: No"No Smoking"signs T \ up with their own ways of enforcing Number of incidents: 1 ` the new law. Unlike other counties, Jefferson County Public Health has Business:A-Z Photo, Port Townsend ,� not set up sting operations to crack Violation: Owner smoking directly F s down on businesses that might be in outside business � , �„ �� violation of the ban, said Public Number of incidents: 1 Lighting up within 25 feet of the Health spokesman Mike McNickle. doors, windows or air intake of a As the agency's Environmental Business: Computer Telephone Store. Health director, McNickle helped PortTownsend public establishment has been develop Public Health's enforcement •banned in Washington since voters guidelines. Violation: Smoking in front of passed I-901 in 2005. But local establishment business owners say many visitors to What the agency has done is Number of incidents: 1 Port Townsend, such as out-of--state respond to complaints made against , tourists, are unaware of the law.t_ the businesses by people who Business: Lehani's Deli and Coffee http://www.ptleader.com/print.asp?ArticleID=15853&SectionlD=21&SubSectionID=21 9/8/2006 The Port Townsend Leader OnLine I Smoking crackdown angers local business owners Page 2 of 3 Photo by Blythe Lawrence witness smokers in violation of the House. Port Townsend ban. A single complaint can be Violation: Employee smoking outside, enough to generate a letter like the one received by the LeMasters. After four complaint of smoking outside, Public letters, the business's food-service license is suspended until owners Health official witnessed smoking successfully appeal the action or demonstrate that they have rectified the outside of business . problem. After the fifth letter, the license can be revoked. Number of incidents: 3 Business owners say the threat of losing their food licenses puts the onus of enforcing the smoking ban -whether inside or outside their businesses-on Business: Uptown Pub and Grill, Port them. Townsend Violation: Smoking on back porch Anonymous complaints Number of incidents: 2 Lynn Hamlin-LeMaster said she called Public Health and asked who had Business: Highway 20 Roadhouse, Port lodged the complaints. Some of the calls were anonymous, she was told. The Townsend rest were confidential. Violation: Employee smoking in business "What I don't like is I have to enforce it and it's based on anonymous calls," Number of incidents: 2 Hamlin-LeMaster said. "They're taking that phone call as absolute proof that it's happening. They're not verifying it at all." Business: Sirens, Port Townsend Violation: Patrons and employees Punishing a business based on anonymous phone calls makes Steve smoking on deck, evidence of smoking Wilmart, owner of Quimper Sound, uneasy as well. on deck Number of incidents: 4 Wilmart said he doesn't have a problem with enforcing the law. But he doesn't like the idea of being penalized based on an anonymous phone call. Business: Quilcene Liquor Store, "My big concern is that can be used in a vindictive fashion," he said. "If the Quilcene expectation is that we have to enforce it,we cannot be penalized without Violation: Employer smoking in business having recourse. If they cannot give us any details, there is little we can do to Number of incidents: 1 rectify the situation." Kellie Ragan, coordinator for Jefferson County's tobacco prevention and Business: Water Street Brewery, Port • control program, said people who call to complain about smoking in front of Townsend public buildings are often reluctant to give their names. Violation: Complaints of smoking on deck "If there's a complaint, we'll send a letter out," she said. Number of incidents: 3 But McNickle said Public Health does not respond to anonymous complaints. Business: The Geoduck, Brinnon Violation: Complaint of smoking on deck "Our regulations are very specific," McNickle said. "We don't just take Number of incidents: 1 anonymous complaints and act on them as an enforcement tool." complaintBbut before a third letter-and a$513 fine- is issued, a Violation:usiness: HadlockaHouse,m Port Hadlock After the third Complaint of smoking on deck Health Department worker will go to the business and talk with the owner Number of incidents: 1 about how to rectify the problem. McNickle and Ragan both emphasized that Public Health does not mean to Business: San Juan Commons, Port go after small businesses. Townsend Violation: Complaint of smoke infiltrating "This isn't about picking on small businesses; it's about supporting the health hallway and neighboring apartment and wellness of everyone," Ragan said. "The reason this law passed is to Number of incidents: 1 protect workers and the general public from the dangers of second-hand smoke." Business: Discovery View Apartments, Port Townsend In August, the department received a complaint that people had been Violation: Smoking outside kitchen smoking in front of its own building on Sheridan Street. during meal prep Number of violations: 1 "We of course will enforce upon ourselves," McNickle said. "We will assure • that smoking within 25 feet of the doors doesn't occur." Violations and complaints A list obtained from Public Health showed that since 1-901 went into effect, the department has recorded 27 "violations" http://www.ptleader.com/print.asp?ArticlelD=1 85 3&SectionlD=21&SubSectionlD=21 9/8/2006 The Port Townsend Leader OnLine I Smoking crackdown angers local business owners Page 3 of 3 ranging from no"No Smoking" signs at Aldrich's Market and the 1012 Coffee House to "evidence of smoking on the deck" at Sirens. 6 The extensive waterfront deck at Sirens does extend far enough away from the door to allow some patrons to smoke outside and still comply with the law, McNickle said. Public Health has been working with the restaurant's owner to make the area compliant, he said. Health Department records show that 11 of the 27 violations are "complaints"about smokers not following the 25-foot rule. The list did not say how many complaints were made anonymously. Lehani's Deli and Coffee House appears on the list three times. On Dec. 21, 2005, a violation about an "employee smoking outside"was recorded. On Aug. 16, a complaint of people smoking at the tables outside the store was recorded, and on Aug. 21, a Jefferson County Public Health official witnessed smoking at the tables outside the store during a site visit. The letter the LeMasters received from Public Health was dated Aug. 23. Preventing smoke from coming indoors, whether it comes from an individual lighting up inside the establishment or filtering through open windows and doors, is the responsibility of the business owner, McNickle said. But he said that responsibility for outdoor smoking, even within 25 feet of a building, belongs to the smoker. If the business has posted "No Smoking"signs on its outdoor tables and chairs, it is considered to have done everything it can to prevent people from smoking there, and the responsibility shifts from the business owner to the person who is violating the law. The LeMasters are confident smoke hasn't been drifting inside their café. But even though no smoke is coming inside, the letter from Public Health makes it seem as though they are responsible for anything that happens outside as well, Hamlin- LeMaster said. The morning after she received the letter, she posted laminated signs to each of the chairs and tables outside Lehani's. McNickle said business owners whose patrons ignore the "No Smoking"signs should call the police. *Port Townsend police Sergeant Ed Green said he has spoken with people smoking in front of public places but hasn't written anyone up for smoking since the ban took effect. "The Health Department has been keeping us out of it as much as possible," Green said. Hamlin-LeMaster said once or twice a week she has to remind a customer enjoying a cigarette on one of the metal chairs that he/she can't smoke so close to the building. The encounters haven't always been pleasant. Once, a person lifted a chair in a threatening manner, and Hamlin- LeMaster said she thought he was going to throw it at her. Another time the smoker inquired sarcastically whether he should go smoke in the middle of the street. "Besides hiring an employee to sit[outside], I just don't know how to control it," she said. Related Links Content©2006 Port Townsend Publishing Company,Inc. Software©1998-2006 lop!Software,All Rights Reserved IP http://www.ptleader.com/print.asp?ArticlelD=15853&SectionID=21&SubSectionID=21 9/8/2006 • oWednesday,September 13,2006•B 7 Wash your handsSeptember • , • is National Food SafetyMonth September marks the 12th Use separate cutting boards ham, sausage, 160°; steaks, food on the kitchen counter; use annual National Food Safety —one for raw meat, poultry and roasts and chops (beef, veal and the refrigerator, cold water or Education Month. Its goals are seafood, and another one for all lamb): medium rare 145°,medi- a microwave. (Note: If using a to reinforce food safety educa- other foods.Wash cutting boards urn 160°,well done 170°. microwave, make sure to finish tion training among restaurant after each use. the cooking process immediately and foodservice workers and to Never place cooked food on Chill: Refrigerate promptly after it is defrosted.) educate the public to handle and a plate that previously held raw' Refrigerate or freeze perish- prepare food properly at home, meat,poultry or seafood. ables,prepared food and leftovers Storing& serving leftovers where food safety is equally Clean up raw meat spills within two hours. Discard food or carry-out important, whether cooking immediately so cooked foods that has been left out at room Take home and immediately from scratch or serving take-out and foods that won't be cooked temperature for more than two refrigerate any foods leftover meals and restaurant leftovers. do not get contaminated. hours.If in doubt,throw it out. from a restaurant meal. Most food-related illness can be Hot foodshould be cooled as Label leftovers with the date prevented by following proper Cook: Cook to proper quickly as possible. Slice large and eat or freeze within three food handling and preparation temperatures cuts of meat into 4-inch pieces days. Check the refrigerator once procedures. Cook food to the proper ' and distribute soups and stews a week and discard old leftovers. internal temperature; check for into small containers. Reheat leftovers to a minimum 4111Clean: Wash hands and doneness with an instant-read Never defrost (or marinate) of 165°and stir to heat evenly. surfaces often thermometer. Wash hands for at least 20 To keep bacteria from grow- . seconds with warm water and ing, do not allow food to be in • soap, and dry thoroughly with the danger zone (from 41° to a paper towel before handling 140°)for longer than two hours. food and always after handling When using a microwave for raw meat,poultry or seafood. • cooking, cover the food,stir and Do not handle food when ill rotate. When finished, let stand or if you have cuts or sores on for two minutes to distribute the your hands. heat,then stir again. Wash cutting boards and The U.S. Department of knives before and after preparing Agriculture recommends the raw meat,poultry or seafood. following temperatures for cooking: poultry (chicken, tur- - Lae_ke4,- 1 Separate: Don't cross- key — ground or whole pieces) contaminate 165°; eggs, 160°; seafood (fish,. Store raw meat, poultry and shellfish), 160°;ground products I`( � --C seafood on the bottom shelf of (hamburger, lamb, pork, veal), the refrigerator to prevent juices 160°; pork chops, roasts, ribs, from dripping on other foods. medium 160°, well done 170°; • 0 A. 1 '` 0 • West Nile Virus Newsletter ` Zoonotic Disease Program, Washington State Department of Health September 21, 2006 Volume 4, Issue 10 Purpose West Nile virus activity in the northwest, 2006 To keep our partners and other interested entities informed ait West Nile virus(WNV)NV) �� E) No Activity Detected EMI WNV Activity Detected In This Issue AI. �� m `rami Pierce Countyman is �R# state's firstVVNV Activii AL WNV case , ,.�j1' Source: WNV found in threeAlligr • L I/IRhO Idaho Department of Health&Welfare Wel Web site,September 20,2006. more Yakima horsesFL—'—i 11101111111 Oregon Department of Human Services t ! 'I Web site,September 19,2006. Dead bird from Yakima (^ Washington State Department of County tests positive ‘111 Health Web site,September 20,2006. I l via Residents of Southwest WA encourage to prevent mosquito bites WNV positive in the northwest • Mosquito group wants Washington: 1 human, 4 horses, 1 bird wider net Idaho: 779 humans, 319 horses, 114 birds, mosquito pools detected in 6 counties Oregon: 47 humans, 23 horses, 15 birds, 23 mosquito pools National, regional, and state surveillance update Pierce County man is state's first confirmed WNV case Previous Issue Washington Department of Health, News Release, September 13, 2006 Idaho's Ada County OLYMPIA - A Pierce County man in his forties is confirmed as the state's first spraying results are in human infection with West Nile virus. Blood tests at the state Public Health California's West Nile Laboratories were positive, so samples were sent to the Centers for Disease warning system Control and Prevention (CDC), which confirmed the positive result today. The Journal articles from man did not travel out of the state during the likely time he was bitten by an Vector-Borne and infected mosquito; he developed mild symptoms — a rash and fever — in July, Zoonotic Diseases sought medical attention in August, and has recovered. The disease is not spread Crows slow to bounce person to person so he is not a threat to public health. back from WNV "Most people who are infected with West Nile virus don't ever get sick or have Guidance for states symptoms, it can be a very doing bird surveillance yet serious disease for a small number of people, for WNV and/or H5N1 especially those older than 50 years of age," said Dr. Jo Hofmann, State Epidemiologist for Communicable Disease. "Avoiding mosquito bites is the best View the September 7, prevention. With our first in-state infection, it's vital to take the simple precautions 2006 WNV Newsletter that can help protect you from West Nile infection." • Continue this news release at http://www.doh.wa.gov/Publicat/2006 news/06- 143.htm and read the Tacoma-Pierce County Health Department's news release at http://www.tpchd.org/news.php?id=170. p Web Resources WNV found in three more Yakima County horses Washington State Department of Agriculture, News Release, September 14, 2006 Washington State Department of Health OLYMPIA - West Nile virus has been confirmed in three additional horses in 1111 www.doh.wa.govlwnv Yakima County. None of the animals had been vaccinated against the disease. Centers for Disease Control and Prevention "The best way to protect a horse from West Nile infection is vaccination," said www.cdc.gov/ncidod/dvbid/ westnile State Veterinarian Leonard Eldridge. US Geological Survey ArboNET maps Read this news release at http://agr.wa.gov/News/2006/06-39.htm. diseasemaps.usgs.gov Washington State University Cooperative Dead bird from Yakima County tests positive for WNV Extension Washington Department of Health, News Release, September 20, 2006 www.wnv.wsu.edu �+ OLYMPIA - A magpie from Yakima County Washington State t "79 =�,sr �' , , has tested positive for West Nile virus. Four Department of � �, . Agriculture # horses in Yakima County have tested positive www.agr.wa.gov/FoodAnim }+ );7":;,11 {¢ al/AnimalHealth/Diseases/ 4 ' � � _ ' for West Nile infection this season, and the westNilevirus/detault.htmfirst human case acquired in this state — a ' •►x ,� „ � €' Pierce County man in his 40s — was , A,, 'Y,L.' ::, confirmed last week. Northwest Links Idaho Department of According to the Washington State Department of Health, the magpie was Health&Welfare collected last week near Union Gap and sent to the Washington Animal Disease www.westnile.idaho.gov Diagnostic Laboratory at Washington State University for testing. It's the first Oregon Department of West Nile virus-positive dead bird in our state this season. • Human Services httq://egov.oreoon.00v/DHS /oh/acdldiseases/wnile/sure "Testing for West Nile virus in mosquitoes, horses and dead birds helps show ev.shtml where the disease is active," said Dorothy Tibbetts, director of the agency's British Columbia Center zoonotic disease program. "These tests show West Nile is active in parts of eastern for Disease Control Washington. We put a lot of effort into monitoring and tracking the disease in our httq://www.bccdc.org/conten t.ghp?item=183 state because we know people are concerned. The best protection against West Nile infection is to avoid mosquito bites." Subscribe, The magpie was collected and submitted by the Yakima Health District as part of Submit Articles, the state Department of Health monitoring program. Many local and state agencies Suggestions for as well as private volunteer groups are participating in the monitoring. the Newsletter Contact Ben Hamilton beniamin.hamilton{o)doh.wa.clov Residents of Southwest Washington encouraged to take precautions against mosquito bites Clark, Cowlitz, Skamania, and Wahkiakum County Health Jurisdictions, September 12, 2006 Yesterday's announcement by Oregon health officials that two birds tested positive for West Nile Virus in Multnomah County is a reminder that the virus continues to spread and that people in nearby areas, including southwest Washington, should renew their efforts to protect themselves against mosquito bites. . Page 2 "Some bird species such as crows,jays, and magpies are especially susceptible to West Nile Virus, and their sudden death can indicate the presence of the virus," t said Dr. Mimi Fields, Cowlitz County Health Officer. "Residents in southwest National WNV Washington can help health officials monitor the presence of West Nile Virus by Statistics for 2006 reporting dead birds." • As of September 19th forty-eight states+ DC and NYC have reported Read the entire news release at the Clark County Health Department's Web site, some type of West Nile http://www.co.clark.wa.us/news/news-release.asp?pkNewsSeq=1030. virus activity to the CDC. Humans e ..k_ Total human case- West Nile virus activity in the United States, 2006 patients: 2171 Surveillance findings reported to CDC, September 19, 2006 Patients with meningitis 71 and/or encephalitis: 829 in Indicates human disease case(s). , Avian,animas or mosquito infections, Total human deaths: 74 ,> WA .,4' MT ND : VT E,.. NH Presumptively viremic 1 blood donors: 176 OR 3 IG+ SD Wl M ,� Y _..----" MA Avian WY ., 23 � IA RI PA �� Total dead bird cases NV NE '1; OH CTO reported positive: 2880 CA iO ins �t4 i 'Co ILUT IN 18 197 199 KS MD xv VA NJ Number of corvids 14 si reported positive: 2329 _ OK TN N ,`% DE s AZ NM �, AR �\ States/districts reporting �r, Ms AL GA SC MD� positive dead birds:41 ,,.,--. TX LA DC II " AK :i., Veterinary `.., FL WV® • Total number of HI ' Puerto ako veterinary cases(2 other species, remainder are equines): 670 National maps and data available at States/districts reporting http://www.cdc.gov/ncidod/dvbid/westnile/sury&control.htm. positive veterinary cases: 30 Mosquito Pools Mosquito group wants wider net <„F , f Total number of positive By Kaitlin Manry The Herald September 9, 2006 mosquito pools: 8401 States reporting positive CAMANO ISLAND - They're smaller than the average mosquito pools:40 fingernail and easily succumb to a well-placed slap. But Most frequent mosquito these ladies have a penchant for blood. pool species reported positive: Mosquitoes are enemy No. 1 to the Camano Island Mosquito Control District. The 1.Culex tarsalis group is battling the peskysra insects with more than the traditional Off! It's 2.Culex pipiens- spray. restuans(mixed) employing surveillance traps, larvicides and a political campaign. 3.Culex pipiens Sentinels The group is collecting signatures to try to get a vote on the November ballot to allow enlarging the district's coverage area to include all of Camano Island. Total number of sentinel The mosquito district now servesjust a sliver of land on the island's north end, an infections reported q positive:501 area about one-fifth of the island. States/districts reporting "I'vegone to the statepark on field trips with mykids, and it's awful,” said District 0 positive sentinels: 11 Manager Jay Lawrence, wearing a hat emblazoned with a mosquito and the words Page 3 "Bite me." If the issue makes it onto the ballot and passes, Camano Island residents will be DOH WNV taxed between 5 and 25 cents per $1,000 of the assessed value of their homes. Contacts Currently residents living within the district pay 15 cents per $1,000 of assessed • Toll Free Info Line value, equating to $45 for a$300,000 home. 1-866-78VIRUS The money funds the district's mosquito fighting efforts. In the future, it will also Publication Requests help the group map mosquito habitat, collect and identify mosquitoes, and educate Cyndi Free 360-236-3384 homeowners on ways to eliminate mosquito breeding places, Lawrence said. As 360 cyndi.free@doh.wacloy the districts only paid staff member,he makes $30 per hour for the part-time job. • Mosquito and Bird Surveillance Continue reading this article at The Herald's Web site, Jo Marie Brauner http://www.heraldnet.com/stories/06/09/09/1001oc_b 1 camano001.cfm. 360-236-3064 jomarie.brauner(a doh.wa.00v Horse Surveillance Ron Wohrle Washington environmental surveillance summary, 2006 360-236-3369 Reported to DOH as of September 20, 2006 ron.wohriedoh Horses- Birds Sentinel Flocks'-' Mosquito Pools*— County Tested Positive Tested Positive Tested Positive Tested Positive Aquatic Mosquito Adams 0 0 1 0 0 0 0 0 Control NPDES Permit Asotin 0 0 0 0 0 0 0 0 Ben Hamilton Benton 2l 0 3 0 267 0 281 0 360-236-3364 Chelan 01 0 5 0 0 0 5 0 beniamin.hamilton(adoh.wa.00v Clallam 0=1 0 0 0 0 0 0 0 Clark 1' 0 1: 0 0 0 31 0 WNV in Humans Columbia 0s 0 1 0 0 o D' 0 Local Health Jurisdiction Cowlitz 0, 0 10 0 0 0 94 o or Douglas 0' 0 0. 0 0 0 0 0 Ferry o;; 0 o 0 0 8; o DOH Communicable Franklin 11 D 2, 0 0 0 88 0 Disease Epidemiology Garfield 0 l 0 0: 0 0 0 0 0 206-418-5500 or Grant 0 t o 1' 0 0 0 0' 0 • 877-539-4344 Grays Harbor 0; o 5 o 0 0 0 o Island 0 0 14; 0 0 0 0 0 Jefferson 0' 0 7 0 0 0 0" 0 News Releases/Media Response Assistance KtsIng 2, 0 49. 0 0 0 7 0 es P Kitsap 01 0 0`st 0 0 0 0 0 Donn Moyer Kittitas 1' 0 1 D 0 0 0` 0 360-236-4076 Klickitat 1 0 2 0 0 0 0 0 donn.mover(Wdoh.wa.gov Lewis 0< 0 5 D 0 0 0 0 or Lincoln 0' o 1 0 0 0 0` 0 Tim Church Mason al, 0 7 0 0 0 0: 0 360-236-4077 Okanogan 1 o 0 0 0 0 0 0 tim.church(o�doh.wa.cloy Pacific 0' D D 0 D 0 0 0 Pend Oreille 0' 0 0 0 0 0 0 0 Pierce 11 0 63 0 0 0 29 0 WNV Coordinator San Juan li 0 0';; 0 0 0 0 0 Dorothy Tibbetts Skagit o 0 s 0 0 0 0 0 360-236-3361 Skamania 0:: o of 0 0 0 0 o dorothv.tibbettsadoh.wa.ciov Snohomish 2 0 48'` 0 0 0 42 0 Spokane 7'l 0 10 0 0 0 0:' 0 Stevens 0 0 3a 0 0 0 0!: 0 Newsletter Thurston 01 0 18' 0 0 0 0€ 0 WNV Reviewed Wahkiakum 0( 0 0? 0 0 0 0, 0 Walla Walla 1 0 5' 0 0 0 12 0 Rebecca Baer Whatcom 1 0 10 0 0 0 0', 0 • Jo Marie Brauner Whitman 1 i 0 6 0 0 0 0' 0 Anne Duffy Yakima 5- 4 10 1 56 0 358 0 Liz Dykstra Totals 28 4 297 1 323 0 947 0 Cyndi Free Nancy Napolilli *County information was not available for 4 horses that tested negative.WADDL Report:September 14,2006. David Nash '"A total of 302 birds have been tested for West Nile virus;4 specimens unsuitable for testing.1 specimen was from out-of-state.WADDL Dorothy Tibbetts Report:September20,2006. Ron Wohrle "'Sentinel Chicken Sera tested by Benton MCD Report:September 2005. •"'Poois tested by JSACHPPM-Viest Report:September 19,2006.Benton MCD Report:September 6,2006,Franklin County MCD Report August 22,2006.Clark County MCD August 22.2006,Cov litz County MCD August 28.2006.and Columbia MCD September 12, 2006 • Page 4 View the WNV Avian Mortality Report at http://www.doh.wa.gov/ehp/ts/Zoo/WN V/Newsletters/dbreport/dbreport.pdf. FDA Statement on Foodborne E. coli 0157:H7 Outbreak in Spinach--Update, Sept. 20, 2006 Page 1 of 3 tt r I't''' „ • • U.S.D41E:: 101 lation •Fo' od and Drug Adnul' a feeern al Zia• II� s�� � �.�� � � ,�� �r_ ,gin,. . . ,.. g .,. ,. .,., ,.. FDA Home Page I Search FDA Site I FDA A-Z Index I Contact FDA I FDA Centennial FDA Statement FOR IMMEDIATE RELEASE Media Inquiries: Statement 301-827-6242 September 20, 2006 Consumer Inquiries: 888-INFO-FDA FDA Statement on Foodborne E. coli 0157:H7 Outbreak in Spinach Update: Wednesday, September 20, 2006 The U.S. Food and Drug Administration (FDA)will continue to provide the public with regular updates on the E. coli 0157:H7 outbreak each day until further notice. Case Reports To date, 146 cases of illness due to E. coli infection have been reported to the Centers for Disease Control and Prevention (CDC), including 23 cases of Hemolytic Uremic Syndrome (HUS), 76 hospitalizations, and one death. Illnesses continue to be reported to CDC. This is considered to be an ongoing investigation. States Affected • Arizona and Colorado have just been added to the list of states with confirmed cases. There are now 23 affected states: Arizona, California, Colorado, Connecticut, Idaho, Illinois, Indiana, Kentucky, Maine, Michigan, Minnesota, Nebraska, Nevada, New Mexico, New York, Ohio, Oregon, Pennsylvania, Utah, Virginia, Washington, Wisconsin, and Wyoming. Laboratory Findings The New Mexico Department of Health announced today that it has linked a sample from a package of spinach with the outbreak strain of E. coli 0157. The spinach was eaten by one of New Mexico's patients before becoming sick. DNA fingerprinting tests determined that the strain from the spinach matches the strain from patients in the outbreak. The package of spinach that tested positive was "Dole Baby Spinach, Best if Used by August 30." Consumer Advice FDA advises consumers to not eat fresh spinach or products that contain fresh spinach until further notice. Fresh spinach includes bagged spinach, spinach in a clamshell, and loose spinach purchased from retail establishments such as supermarkets, restaurants and farmers' markets. At this time, FDA has no evidence that frozen spinach, canned spinach and spinach included in pre- made meals manufactured by food companies are affected. These products are safe to eat. If individuals believe they may have experienced symptoms of illness after consuming fresh spinach or fresh spinach-containing products, FDA recommends that they seek medical advice. Three (3) Recalls On September 19, 2006, RLB Food Distributors, L.P., West Caldwell, NJ, initiated a voluntary recall of certain salad products that may contain spinach with an Enjoy Thru date of 9/20/06. See: http://www.fda.gov/oc/po/firmrecalls/rIb09 06.html. The products recalled by RLB are: http://www.fda.gov/bbs/topics/NEWS/2006/NEW01459.html 9/21/2006 FDA Statement on Foodborne E. coli 0157:H7 Outbreak in Spinach--Update, Sept. 20, 2006 Page 2 of 3 Balducci's Mesclun Mix 5 oz. Balducci's Organic Baby Spinach 5 oz. Balducci's Mixed Greens 5 oz. FreshPro Mesclun Mix 5 oz. • Fresh Pro Organic Baby Spinach 5 oz. FreshPro Mixed Greens 5 oz. FreshPro Salad Mix with Italian Dressing 4.75 oz. FreshPro Salad Mix with Ranch Dressing 5.25 oz On September 17, 2006, River Ranch, of Salinas, California, announced a voluntary recall of packages of spring mix containing spinach. River Ranch obtained bulk spring mix containing spinach from Natural Selections. The following brands are involved: Fresh N' Easy Spring Mix and Hy-Vee Spring mix containing baby spinach, distributed to retailers in Texas, Iowa and New Mexico. Product was packed in 5 oz. bags and 5 oz. plastic trays. Products that do not contain spinach are not part of this recall. On September 15, 2006, Natural Selection Foods, LLC, of San Juan Bautista, California, announced a voluntary recall of all products containing spinach in all brands they pack with "Best if Used by Dates" of August 17, 2006 through October 1, 2006. These products include spinach and any salad with spinach in a blend, both retail and food service products. Products that do not contain spinach are not part of this recall. Natural Selection Foods, LLC brands include: Natural Selection Foods, Pride of San Juan, Earthbound Farm, Bellissima, Dole, Rave Spinach, Emeril, Sysco, 0 Organic, Fresh Point, River Ranch, Superior, Nature's Basket, Pro-Mark, Compliments, Trader Joe's, Ready Pac, Jansal Valley, Cheney Brothers, D'Arrigo Brothers, Green Harvest, Mann, Mills Family Farm, Premium Fresh, Snoboy, The Farmer's Market, Tanimura &Antle, President's Choice, Cross Valley, and Riverside Farms. The affected products were also distributed to Canada, Mexico, and Taiwan. No illnesses have been reported from these countries. FDA continues to investigate whether other companies and brands are involved. Symptoms of E. coli 0157:H7 Illness E. coli 0157:H7 causes diarrhea, often with bloody stools. Although most healthy adults can recover completely within a week, some people can develop a form of kidney failure called HUS. HUS is most likely to occur in young children and the elderly. The condition can lead to serious kidney damage and even death. Lettuce Safety Initiative The FDA developed the Lettuce Safety Initiative www.cfsan.fda.gov/-.dms/lettsafe.html in response to recurring outbreaks of E. coli 0157:H7 in lettuce. As a result of this outbreak, the initiative has been expanded to cover spinach. The primary goals of the initiative are to reduce public health risks by focusing on the product, agents and areas of greatest concern and to alert consumers early and respond rapidly in the event of an outbreak. This initiative is based on the 2004 Produce Safety Action Plan, intended to minimize the incidence of food borne illness associated with the consumption of fresh produce. FDA continues to work closely with the CDC and state and local agencies to determine the cause and scope of the E. coli outbreak in spinach. Please check www.fda.gov for updates. #### More Information • Nationwide E. co/i0157:H7 Outbreak: Questions and Answers RSS Feed for FDA News Releases [what's this?] http://www.fda.gov/bbs/topics/NEWS/2006/NEW01459.html 9/21/2006 SDA Statement on Foodborne E. coli O157:H7 Outbreak in Spinach--Update, Sept. 20, 2006 Page 3 of 3 Get free weekly updates about FDA press releases, recalls, speeches, testimony and more. Media Contacts I FDA News Page FDA Horne Page I Search FDA Site I FDA A-Z.Ind_.ex I Contact FDA I Privacy I Accessibility • FDA Website Management Staff • • http://www.fda.gov/bbs/topics/NEWS/2006/NEW01459.htm1 9/21/2006 • Washington State D artment of News Release For immediate release: September 20, 2005 (06-148) Contacts: Donn Moyer, Communications Office 360-236-4076 Deanna Mill, Communications Office 360-236-4022 West Nile virus update: dead bird from Yakima County tests positive Yakima area has several horse cases; one confirmed human case in state,from Pierce County OLYMPIA—A magpie from Yakima County has tested positive for West Nile virus. Four horses in Yakima County have tested positive for West Nile infection this season, and the first human case acquired in this state—a Pierce County man in his 40s—was confirmed last week. According to the Washington State Department of Health, the magpie was collected last week near Union Gap and sent to the Washington Animal Disease Diagnostic Laboratory at IDWashington State University for testing. It's the first West Nile virus-positive dead bird in our state this season. "Testing for West Nile virus in mosquitoes, horses and dead birds helps show where the disease is active," said Dorothy Tibbetts, director of the agency's zoonotic disease program. "These tests show West Nile is active in parts of eastern Washington. We put a lot of effort into monitoring and tracking the disease in our state because we know people are concerned. The best protection against West Nile infection is to avoid mosquito bites." The magpie was collected and submitted by the Yakima Health District as part of the state Department of Health monitoring program. Many local and state agencies as well as private volunteer groups are participating in the monitoring. The program has submitted nearly 300 dead birds (at least 296) for testing this season and this is the only positive result, so far. West Nile virus has spread across the country since it was first detected in 1999.Tibbetts says mosquitoes typically are active in Washington into the fall, and she urges people to continue . reporting dead birds to local health agencies for possible collection. —More— Dead bird tests positive for West Nile September 20, 2006 Page 2 Simple measures can reduce the risk of exposure to mosquitoes that transmit West Nile virus. Avoiding mosquito bites is the key: • Schedule outdoor activities away from dusk and dawn when mosquitoes are most active. • Wear long-sleeved shirts and long pants when in mosquito infested areas. • Use mosquito repellents containing DEET, picaridin, or oil of lemon eucalyptus; follow the directions on the container. • Make sure the screens on all doors and windows are working properly. • Get rid of old tires and other containers around your home where water can accumulate and serve as a breeding ground for mosquitoes. West Nile virus is primarily a bird disease. Crows, ravens,jays and magpies are especially susceptible. Mosquitoes become infected by feeding on an infected bird and can pass the virus to humans, horses or other hosts. "Most people infected with West Nile virus don't have any symptoms but in a few cases, the virus can cause serious illness including inflammation of the brain or spinal cord; people over i age 50 have the highest risk for serious illness," said Dr. Jo Hofmann, state epidemiologist for communicable disease. "There's no specific treatment for West Nile virus infection." More information on West Nile virus (www.doh.wa.gov/WNV) is available on the Department of Health Web site and online from The Centers for Disease Control and Prevention (www.cdc.gov/ncidod/dvbid/westnile/). Gordon Kelly of the Yakima Health District is available at 509-249-6507 to answer questions about local West Nile virus monitoring and other local environmental health issues. ### Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. • • Figure 1. Epidemic curve of confirmed cases of E. colt 0157:H7, cluster 0609mIEXH-2c, by date of illness onset, (N=134)* '134 confirmed cases vrit'reported ca-e of initial sysnptxn cnset a • 25. c c 20 C 15 G �s: c 10 a 5 kkhiIiMk N N ¢ �p N N N N N N �a} �cyv tr 33 ab �b_ c r cQ�y ry v- aS Ga ea R t7f i f C75 l75 3i ea 0'd di3 ill u7 oil Date of Initial Symptom Onset • 93%(n=125)of confirmed cases reported onset dates between 8119/2006-91512006 • 6 confirmed cases reported onset dates before 8/1912006 - 0%(n=0)reported fresh spinach consumption • Most recent onset: 919(2006 • — No change since September 13,2006. • • Table 1. Confirmed cases of E coil 0157:H7 for cluster 0609mIEXH-2c reported to CDC as of September 20, 2006, 1:00pm EST Confirmed State Cases AZ 4 CA 1 CO 1 CT 3 ID 4 IL 1 • 17 new cases reported since September IN 8 19, 2006; 1:00pm EST KY 7 - 2 duplicate records removed(NV, ID) ME 2 Ml 4 • 23 states reported confirmed cases MN — 2 new states(AZ. CO)repporting confirmed NE 7 EST since September 19,2006. 1:00pm NM NV 1 NY 9 OH 15 OR 5 PA 7 UT 16 VA 1 WA 2 WI 40 VvY 1 Total 146 • • PORT TOWNSEND POLICE DEPARTMENT 607 Water Street Port Townsend WA 98368 • (360)385-2322 Fax: (360)379-4438 :`► RECEIVED August 18, 2006 4116 2 1 2110 Jean Baldwin MSN Jerson County Director Jefferson County Public Health PublicHealth 615 Sheridan Port Townsend, WA 98368 Deas Ms Baldwin: I would like to submit my application for the Law Enforcement vacancy on the Substance Abuse Advisory Board. I have been in law enforcement since 1973 when I joined the Albuquerque Police Department in Albuquerque, New Mexico. I retired from the police department in February, 1994 holding the rank of Lieutenant. • I joined the Port Townsend Police Department in June, 1994 where I currently hold the position of Chief of Police. I appreciate your consideration of my request to fill the existing vacancy. Sincerely, (//1 otte/L,k9T. /4-z(4. Conner L. Daily Chief of Polio.- .. • • JEFFERSON COUNTY PUBLIC HEALTH Prevention Program - Prevention Coordination & Activities PREVENTION COORDINATION & ACTIVITIES 2006 Program Expense Budget 4,843 9,901 8.47% 17.319;111111111111111V". " 7.31% `y ❑Wages & Benefits •Professional Services ❑Other Operating Costs ❑Interfund Payments 42,464 74.23% • PREVENTION COORDINATION & ACTIVITIES 2006 Program Revenue Budget 0 Federal Grants 3,366 5.86% ■State Grants 21,340 37.16% ❑Intergovernmental Grants 32,715 (CITY) 56.97% ❑Charges for Services •County Contribution • JEFFERSON COUNTY PUBLIC HEALTH Prevention Program - Healthy Communities/Big Brothers Big Sisters HEALTHY COMMUNITIES - BIG BROTHERS BIG SISTERS 2006 Program Expense Budget 2,227 1,107 11,829 2.23% 1.11% 11.84% Wages & Benefits IN Professional Services ❑Other Operating Costs 0 Interfund Payments 84,760 84.83% • HEALTHY COMMUNITIES - BIG BROTHERS BIG SISTERS 2006 Program Revenue Budget 7,000 0 Federal Grants 7.00% ■State Grants 0 Intergovernmental Grants (City) 0 Charges for Services 92,930 93.00% •County Contribution • • JEFFERSON COUNTY PUBLIC HEALTH Prevention Program - Maternal Support Services/Nurse Family Partnership MATERNAL SUPPORT SVCS - NURSE FAMILY PARTNERSHIP 2006 Program Expense Budget 15,419 5,072 7.86% 2.59% 5,460 ❑Wages & Benefits 2.78% ■Professional Services , ❑Other Operating Costs 0 Interfund Payments 170,225 86.77% • MATERNAL SUPPORT SVCS - NURSE FAMILY PARTNERSHIP 2006 Program Revenue Budget 33,184 0 Federal Grants 16.92% 65,661 ■State Grants 33.47% _ 16,881 111111111 8.61% ❑Intergovernmental Grants (MVET) ❑Charges for Services 80,450 41.01% ■County Contribution • -3 Orn • z � rn 0 -� D vn I m Cl) co 71 CI Cr o T Csi D • Jm —rl n L7 0 v a o o O a 3 CD a 0 N C i opo C} a m • -6" g P, JEFFERSON COUNTY BOARD OF HEALTH II November 13,2006 SUBJECT: Clean Indoor Air Act(RCW 70.160)/Initiative 901 Compliance Dear Jefferson County Food Establishment Owner, We,the undersigned members of the Jefferson County Board of Health,are writing to remind all owners and managers of Jefferson County Food Establishments of their obligations under Washington State's newly amended Clean Indoor Air Act. When a 63%majority of Washington State and Jefferson County voters approved Initiative 901 in November of 2005,the law was changed to prohibit all indoor smoking in public places and places of employment. In January of this year,the Jefferson County Board of Health passed an ordinance that establishes enforcement procedures for these new legal requirements.Since most of the food service establishments in Jefferson County are already smoke free,we anticipated very few instances where enforcement would be necessary. In fact, we prefer to help our food service establishments comply with the new regulations through technical assistance visits that are provided at no charge. We acknowledge that changes enacted by voters by adoption of I-901 may have a major economic impact on some food service establishments that previously allowed smoking by patrons. We also know that fewer than 1 in 5 Jefferson County residents are current smokers;that tobacco-related illness is the Nation's leading cause of preventable death;and that environmental tobacco smoke("second hand smoke")is a significant risk factor for heart disease,lung disease,and cancer. By regulation,Jefferson County Public Health responds to non-anonymous complaints of the Clean Indoor • Air Act.If you are contacted by Jefferson County Public Health about a potential complaint,it is because a complaint has been filed with our office. If,after careful investigation, it is determined that smoking is being allowed within a prohibited indoor area or within 25 feet of a window,door,or air intake,we will work with you to assure you are in compliance with the new regulations. Maintaining a smoke free environment for workers and customers not only makes sense from a public health perspective,it is a legal responsibility. We strongly encourage you to take a proactive approach in assuring compliance with these laws. This may include firm reminders to patrons,visible signage, and strictly enforcing non- smoking requirements in outdoor seating areas(within 25 feet of doors or windows). While these measures may seem burdensome,it is important to note that enforcement action can and will be taken. However,Jefferson County Public Health encourages you to review the new regulation carefully to understand what is,and is not required. If you have any questions about this letter,the new regulation,or would like technical assistance or posters to comply with the new regulation,please contact Jefferson County Public Health at 360-385-9400. Thank you for your cooperation in this matter. Sincerely, • -, -,5‘.1,9 ..,...--1 7 7 Z David Sullivan,Chairman 'atrick M.Rodgers,Vice Cha' an 4111 (oNer, 615 Sheridan • Castle Hill Center•Port Townsend• WA • 98368 (360)385-9400 JEFFERSON COUNTY BOARD OF HEALTH 1111 1161A11°1 1 (fib' 61164 Phi wohnson, Fr ty Commissioner District#1 Ji Buhler, i('al Commissioner District#2 \ 41 #111 p ' Masci,Port Townsend City Council Sheila Westerman,Westerman,Citizen at Large(City) Roberta Frissell,Citizen at Large(County) • Background Information: Initiative 901(1-901)passed by voter majority throughout Washington State and became law on December 8, 2005. 1-901 amended the Washington State Clean Indoor Air Act(RCW 70.160)and now prohibits smoking in all public place and within 25 feet of doors, windows that open and ventilation intakes. Local Health Departments are charged with enforcement of RCW 70.160. To view RCW 70.160 or Jefferson County Ordinance 2006-04-0216-06 visit: http://wwwjeffersoncountypublichealth.org/index.php?tobacco ID 615 Sheridan • Castle Hill Center• Port Townsend• WA• 98368 (360)385-9400