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HomeMy WebLinkAbout2007- January • Jefferson County Board of 3-feaCtFi Netiv Business .agenda Item # Vi., • Nurse Family Partnership Update and Netiv Division of EarCy Learning January 18, 2007 • Washington State Institute for Public Policy r II110 Fifth Avenue Southeast,Suite 214 PO Box 40999 • Olympia,WA 98504 0999 (360)586 2677 • www.wsipp.wa.gov October 2006 EVIDENCE-BASED PUBLIC POLICY OPTIONS TO REDUCE FUTURE PRISON CONSTRUCTION, CRIMINAL JUSTICE COSTS, AND CRIME RATES$ Current long-term forecasts indicate thatE Washington will need two new prisons by 2020rtkSummary .. andpossiblyanother prison b 2030. Since aAI r, • ,..; typical new prison costs about$250 million to build 51 A° 1 4 " and $45 million a year to operate, the Washington71 t State Legislature expressed an interest in identifying F, - �1®• • 11 alternative"evidence-based"options that canr � ' (a) reduce the future need for prison beds, (b)save • �• • � I money for state and local taxpayers, and (c) � '� • •,,,roil,,,,...® � contribute to lower crime rates. - g9 5..N; 'fir • �.�b 4,4.4 �: • '`,!,40".4, • • The 2005 Legislature directed the Washington ®° � • , • /� State Institute for Public Polic Institute to -400 report, by October 2006, whether evidence- kti •. � . ;� • based and cost-beneficial policy options exist. • �.• ° . • • o;, ,• -. - t: t 0 If economically sound options are available, then 0-1: _ •ti-::,4,:,,,,% _• •c�' • s , �: -• the Legislature directed the Institute to project the NY • • • • • • ,- „,-,.,45t)-00,,..„,‘,„-in total impact of alternative implementation ° • • scenarios. I�L. _ ? • • i T • s e r•---:,�€ .x This report describes our results to date. We , .!--017L134-04:04,,,,- " " • begin by providing background information onLI t:liti : of " " historic and projected incarceration rates in1.,10,1',40 • � " "® Washington, as well as a history of crime rates and ��'® " �` %wi, 11•14.7.,,,v0-`° fiscal costs of the criminal justice system. We then • • • t describe the process we use to determine if ,3/4 :`,tik_ evidence-based and economically sound options • . t : `: ®: :. . . exist, and we present our findings. We examine ' • ® . adult corrections,juvenile corrections, and •� • • : t prevention programs. This is followed by our • • • ••: a• �• - ploilp projections of the impact of alternative = • i `o :�c ' r �'+ t implementation scenarios. We conclude by t .!j° . N jl• ••stti •,mac• s •• , -044,41,00 -''''' '''..,-,*...„...i, discussing some implications of the findings and ° • next steps. For technical readers, appendices • �- begin on page 19 and describe our research f '�� methods and results in greater detail. ! • ® ,- • ..4,- 0- 44 s ® • " S' ,- • •• • ®e0,44,00,0,...0,-,--,,,,p s• • s •" � - • 0 ®• ''' olym fivorttAlino > - t ter, m Discussion of Findings and Next Steps are standardized treatment protocols that have been shown to reduce crime. We learned from Main Finding. The purpose of this legislatively Washington's experience with one of these • directed study is to test whether evidence-based programs, the Functional Family Therapy juvenile public policy options could: (a) lower the anticipated justice program (see sidebar on this page),that need to build new prisons, (b)reduce state and local when the program was not implemented fiscal costs of the criminal justice system, and (c) competently, then it did not reduce crime at all. On contribute to reduced crime rates. the other hand, when it was delivered as designed, the program produced outstanding returns on We find that there are economically attractive investment. Thus, safeguarding the state's evidence-based options in three areas: adult investment in evidence-based programs requires corrections programs,juvenile corrections programs, ongoing efforts to assess program delivery and, and prevention. Per dollar of spending, several of when necessary, taking the required steps to make the successful programs produce favorable returns corrective changes. on investment. Public policies incorporating these ,•1v . .-, , options can yield positive outcomes for Washington. 4'"'''''''114'4'''''1104)'00ta , , , 14::; We find that if Washington can successfully implement a moderate-to-aggressive portfolio of ®� • -..,,,A„,,, , ,., .' evidence-based options,then a significant level ofr. future prison construction can be avoided, state and ® k - • local taxpayers can save about two billion dollars, m • a ' a ' SZt and net crime rates can be lowered slightly. • • • • mn • a• • : Cautions and Limitations. These positive findingsif- •et =t, - •" 4-14 need to be tempered. Our analysis is based on an • • =_ ' '' •' .• extensive and comprehensive review of what works • - $s • 1,001 atfttf014; to reduce crime, as well as an economic analysis of p t?a s. the benefits and costs of alternative implementation _el ° ; _ scenarios. The results indicate that Washington can • ilr:frO _ obtain favorable outcomes if it can substantially and V: v • 14110,45;.;34.1V4100-• •F successfullyincrease its use of evidence-based • "" options. 10:0yfilmtiv oftgro„ , • It is one thing to model these results carefully on a :itti ® g ® p. sti u • . • •P - computer, it is quite another to find a way to make : ; a ,-I them actually happen in the real world. WemiApli � ,r �� ° e constructed our estimates cautiously to reflect the difficulty that is often encountered when taking programs to a larger scale. Nonetheless, the Next Research Steps. In completing this report, moderate-to-aggressive portfolios described here we were able to make substantial analytical would require Washington's state and local progress in providing Washington with a tool to governments to expand significantly current forecast the long-run impacts of evidence-based evidence-based programs. Incumbent to such an resources that reduce crime. There are, however, a effort would be the policy review and management number of additional steps that could be taken to supervision necessary to hold the evidence-based enhance these efforts. programs accountable for the anticipated savings in crime rates and costs. 1. Sentencing Alternatives. The legislation directing this study required the Institute to analyze In particular, to help assure the"quality control" "sentencing options that will be developed by necessary to achieve these savings, the legislature Sentencing Guidelines Commission." The may want to establish an on-going oversight process Sentencing Guidelines Commission (SGC)has not if it decides to pursue a significant expansion of completed its work on this topic and, when it does, these evidence-based options. Ensuring competent we will incorporate the Commission's work into the ID delivery of programs while maintaining fidelity to the analytical framework presented here. We did not program model appears to be essential. For include in our analysis any existing sentencing example, some of the interventions in our portfolio alternatives (for example, expansion of the existing 16 i GOVERNOR CHRIS GREGOI1.0RE ;;A4‘14011,1 rAri, er - aa. `. 1. �$ fi M ; BLUE RIBBON COMMISSION ON HEALTH CARE COSTS AND ACCESS Final Report January 2007 • • BLUE RIBBON COMMISSION ON HEALTH CARE COSTS AND ACCESS Final Report • January 2007 • TABLE OF CONTENTS 1 Our Charge 2 A Sound,Inclusive Process 3 Our Vision&Goals 4 Our Strategies&Recommendations 5 Recommendation 1: Use State Purchasing to Improve Health Care Quality 6 Recommendation 2: Become a Leader in the Prevention and Management of Chronic Illness 6 Recommendation 3: Provide Cost and Quality Information for Consumers and Providers 7 Recommendation 4: Deliver on the Promise of Health Information Technology 7 Recommendation 5: Reduce Unnecessary Emergency Room Visits 8 Recommendation 6: Reduce Health Care Administrative Costs 8 Recommendation 7: Support Community Organizations that Promote Cost-Effective Care 9 Recommendation 8: Give Individuals and Families More Choice in Selecting Private Insurance • Plans That Work for Them 10 Recommendation 9: Partner with the Federal Government to Improve Coverage 11 Recommendation 10: Organize the Insurance Market to Make It More Accessible to Consumers 12 Recommendation 11: Address the Affordability of Coverage for High-Cost Individuals 13 Recommendation 12: Ensure the Health of the Next Generation by Linking Insurance Coverage with Policies that Improve Children's Health 14 Recommendation 13: Initiate Strategies to Improve Childhood Nutrition and Physical Activity 15 Recommendation 14: Pilot a Health Literacy Program for Parents and Children 15 Recommendation 15: Strengthen the Public Health System 16 Recommendation 16: Integrate Prevention and Health Promotion into State Health Programs 17 A Path Forward • • OUR CHARGE Washington's continued success as a state • The United States spends more on health care than any depends on the health of its individuals.When we other country,but ranks 28th in life expectancy and 37th are each healthy,we are collectively healthy,and with that in health system performance. foundation,we can improve the quality of our lives,further • Approximately 20 to 30 percent of current health our economic wellbeing,and strengthen our communities.It expenditures do not improve or extend life.It is also is in our best interest to align state policies to create a health estimated that adult patients receive the recommended care system that optimizes the health of the population. care only 55 percent of the time. And yet,nationally and in Washington State,our health Within this context,the 2006 Legislature established the care system struggles.Its problems are well documented. Blue Ribbon Commission on Health Care Costs Although most of our residents enjoy good health and easy and Access and charged it with delivering a five-year plan access to care,too many others do not.A small sample of for substantially improving access to affordable health care the research paints a picture of a system failing to work for for all Washingtonians.Co-chaired by Governor Chris Gregoire everyone,and straining to provide affordable,effective care and Senator Pat Thibaudeau,and including twelve other for those it does serve. legislative and state agency leaders,the Commission was 1110 well-positioned to inform and guide state health policy. TODAY: • There are roughly 593,000 Washingtonians without health care coverage,including 73,000 children.Young adults and employees of small businesses represent a sizeable portion of our uninsured. r y. l •?3 4 1'rf • The annual increase in insurance premiums for small businesses in Washington is greater than the increase in ,,i:::::1 Illoi wages or gross business income,some years by a factor :)"-,,,,,,.::: :ii(bit7 ';', , ' 11 of five. � x : • The State spends an estimated$4.5 billion on health care,up from$2.7 billion in 2000.This$2 billion increase � . ,� means that the share of the state budget going to health f r � � mss �, care has increased from 22 percent in 2000 to 28 percent today. • 1 i A SOUND, INCLUSIVE PROCESS Commission members recognized early on 1. Consensus-based.sThe Commission avoided that the complexity of the problem,the varied taking votes,choosing instead the more inclusive but interests at stake,and the historic partisanship demanding route of considering multiple perspectives. surrounding the health care debate necessitated This encouraged a level of dialogue and trust not often a collaborative approach.As the Governor and found in recent health care discussions. Senator Thibaudeau stated in their letter announcing the 2. Sensitive to finite resources.The Commission Commission: understood that many purchasers,including the state, "This Commission will only be successful with are already struggling with the cost of health care and the participation of groups who have first-hand that real solutions must go beyond simply spending knowledge of the strengths and weaknesses of more money.While this did not discount the value of our current system and what might be done to strategic investments,it forced the Commission to dig improve it." deeper and focus on how to best use available funds. Over the course of its nine meetings,the Commission heard 3. Meaningful to the public.It was important from a few hundred individuals,often on behalf of their to the Commission that the public benefit of its 1111 organizations.It also offered a unique opportunity for recommendations be readily apparent.This required anyone to submit a written proposal.Over 70 responses were clear and thoughtful consideration of the true impact of received,totaling 700 pages of detailed information and each proposal it considered. thoughtful ideas.This substantial effort indicates the level of commitment to addressing these issues in our state and The value of the Commission is not limited to this report, made apparent that even among diverse interests,there are but includes the process followed and the information numerous areas of agreement. accumulated along the way.The manner in which Commission members and the public engaged over the past The Commission also recognized that the how we get to a six months will serve as a strong foundation for ongoing solution often matters as much as what that solution is—that work,and reaffirmed the importance of open dialogue on a sound process provides a basis for problem-solving.Three contentious policy issues.Everyone should also build-on the general criteria shaped the Commission's work,including a materials used by the Commission,available at its website: desire that its recommendations be: http://wwwl.leg.wa.gov/Joint/Committees/HCCA. 2 • " 4.4-'-:.--4.. + , .+#. "' �p.s '' 'p, z.,% x 1` ,s s r �eVt `'' •`-i` s ' :s x r s a ,:c4.,,,vii ,"3,-,,,!,,,, ,:,......„,,,,,,,,,,,,,.,,,ti„..::::t;.,.._,...,,..,,,,,,,,..-..„. ,..A .,,,,-4,--:,,,,, *,'i, 7, ;;":1 ."..*&-i`ifj:.,#4,..t,t`ti41,44,; ,* ::.;:t"#.44411.' ' /`" -''.'"- '4,:;;:b"...::. -i, ;IF ,..1 i-t &at. . p i r filo- izt r ti.:`t. F .� z .` `' sur ` „ ,:,...:..,514„,..:',.,711::::,,,,14".14-i,,,,q,,-;: ,..J.,..-t-..,-.,---,., v;:, .,,t - !,-, _ ,4-,:,;.. ,„,,,c,,,,,:t„,,,,..7,‘7.-t...4.,.. ..-,:-,,, ,r,,,,,,,,-1,-,,,, , ,-- - - tt. kti w s. .......,"ii,o; eititort, ,-,.. 40,:,.. : ecom nd , � � of 9 ado ted early in its dit,ibe � ese goals were intended to stretch 44-'4';'.11e members`think� t y 4� � � ompt cansi bi OUR STRATEGIES & RECOMMENDATIONS The recommendations that follow aim for 3. Ensure the health of the next generation. boldness,for consensus,and for initiatives that Improving access to affordable care for children is a high meet the health care aspirations of our state.In priority because healthy children learn better,grow this spirit,the Commission intended that each of better,and have a better chance of succeeding in life. its recommendations address one or more of four We can ensure that the next generation is healthier and strategies to achieve our health care goals: is equipped with a better health care system than our 1. Build a high-quality,high performing health own.The Commission recognized it's about more than care system.We will be able to afford more care if providing insurance,it's about tying that insurance to we purchase only good care,using information and improved health outcomes and encouraging healthy incentives to assure a system in which every dollar lifestyles. spent goes only towards the most appropriate,highest 4. Promote prevention and healthy lifestyles. quality treatment delivered in the most cost-effective No other strategy can compare to healthy lifestyles in way.Limited resources must be directed towards those terms of improving health and stretching our health care products and services that do the most to maintain and dollars.The Centers for Disease Control says that of the • improve health.The Commission agreed that,beginning four factors influencing human health—the others being in July 2012,the State will only pay for health care that environment,genes,and medical care—this is the most furthers these objectives. important,accounting for 51 percent of our well-being. 2. Provide affordable health insurance options Our bodies need exercise,good food,early detection and for individuals and small businesses.Access preventive maintenance. to care is often a function of being insured,meaning These four overlapping strategies lay the foundation for that affordable health insurance options are essential. the sixteen specific recommendations that follow.The This requires a competitive,accessible insurance market Commission deliberately chose not to attach any to a specific that provides consumers with a choice of products strategy,understanding that each may support more than that fit their needs,and sustainable public programs one,and that the strategies and specific recommendations for those whom the private market is out of reach. build upon one another.Consistent with its charge,the The Commission's recommendations envision a shared Commission believes that these recommendations,if pursued commitment and responsibility to finance insurance systematically over the next five years,will lead to substantial coverage from the state,individuals and businesses—that improvements in access to affordable health care for all each have a role to play. Washington residents. 4 S • RECOMMENDATION #1 Use state purchasing to improve health care quality. State government will change the way it pays for h# x health care by rewarding care that measurably improves health. Because the state provides health care to approximately 1.3 million Washingtonians and,in doing so,spends$4.5 billion per year,it can use its presence in the market to influence how health care is delivered.This will result in higher-quality,more cost-effective care for patients, both within and outside of state programs. ACTION: The Health Care Authority will,by September 2007,and the Health and Recovery Services Administration will,by January !:?-f 2008,develop a strategicplan to change reimbursement within 9 f • state health care programs to do the following.Each agency will identify barriers to and opportunities supporting plan implementation,and note the short and long-term steps to be taken. z rt 41 • Reward health outcomes rather than simply paying for particular procedures; • Pay for care that reflects patient preference and is of proven value;and require the use of evidence- • Require"informed patient choice"rather than based standards of care where available; just"informed consent"to assure patient participation in • Tie future provider rate increases to measurable deciding among treatment alternatives. improvements in access to quality care; ACTION: • Direct enrollees to quality care systems; Direct savings attained through quality improvements towards • Better support primary care and provide a medical providing access to care,strengthening the current delivery home to all enrollees; system,or otherwise enhancing health care in the state. • 5 • RECOMMENDATION #2 Become a leader in the prevention and management of chronic illness. It is estimated that half of all health care costs ACTION: come from just five percent of our population, State health purchasing agencies will: generally due to chronic conditions like diabetes or heart disease.By providing Washingtonians with the resources • Integrate proven chronic care management and education they need to avoid or manage these chronic into all state programs; conditions,we can spread available treatment dollars • Require enrollees with chronic conditions to further. participate in such programs. RECOMMENDATION #3 Provide cost and quality information for consumers and • providers. Informed shoppers are smart shoppers,whether ACTION: it's purchasing a car or making decisions about State health purchasing agencies will partner with the Puget health care.Health care consumers need to be engaged Sound Health Alliance and other local organizations to: and have information that will help them decide what the various options for treatment are,which treatments are most ▪ Develop a sound set of measures allowing effective,which providers offer the best success rates,and at consumers to compare provider cost and quality; what cost. • Develop Washington-specific information, modeled after the Dartmouth Atlas,showing how the medical treatment a patient receives varies depending simply on where he or she lives; • Disseminate information on cost-effective treatment and best practices,building on the preferred drug list and the technology assessment program. 6 11) • RECOMMENDATION #4 Deliver on the promise of health information technology. Patient safety is compromised and resources electronic access to patient information from anywhere in the wasted when health care providers and patients lack state,including incentives for providers to purchase health access to health information when it's most needed.Health information technology.Subject to appropriation,implement information technology systems will quickly provide demonstration projects in multiple sites across the state. a specialist treating a patient in Seattle with critical information from the patient's family doctor in Spokane. ACTION: Washington can take a lead in developing incentives to State health purchasing agencies will provide appropriate increase the use of technology,and standards so that systems reimbursement for email consultations and telemedicine where can communicate and ensure privacy. doing so reduces the overall cost of care. ACTION: ACTION: Based on the recommendations of the Health Information Install health information technology in state-owned health • Infrastructure Advisory Board,develop a system to provide care facilities. RECOMMENDATION #5 Reduce unnecessary emergency room visits. Emergency room care is the most expensive Medical Association,other providers,and the Association form of health care,both for insured and uninsured of Washington Healthcare Plans to measure and reduce patients,and should be used only when necessary.Patients unnecessary emergency room utilization. This could include should have information about and access to alternatives to demonstration projects to enhance primary care,use patient emergency room care,and incentives to use them. navigators,and provide nurse hotlines.Consider incentives to hospitals and other providers that demonstrate results. ACTION: Strategies proven effective with state program enrollees could State health purchasing agencies will partner with the be extended to the general public. Washington State Hospital Association,the Washington State 7 • RECOMMENDATION #6 Reduce health care administrative costs. Patients and purchasers of health care should be ACTION: assured that we are using our limited health care resources By September2007,the Office of the Insurance Commissioner in ways that truly improve the health of the population. shall provide a report to the Governor and the Legislature that Any dollar spent on administrative overhead is a dollar not identifies the key contributors to health care administrative available for patient care. costs and evaluates opportunities to address them. The report will be completed in collaboration with providers,carriers, state agencies,the Washington Healthcare Forum,and other organizations. RECOMMENDATION #7 Support community organizations that promote cost- • effective care. Washington is fortunate to have many health care organizations supporting our communities at the local level. In 2006,the Legislature established the Community Health Care Collaborative Grant Program to support community organizations that offer innovative approaches to addressing our health care needs.In an example of true public-private partnership,local funding is matched with state dollars to serve patients. ACTION: The Health Care Authority will evaluate the effectiveness of the Community Health Care Collaborative Grant Program in improving access to high-quality,efficient health care at the local level,and build upon identified successes. 8 • RECOMMENDATION #8 Give individuals and families more choice in selecting private insurance plans that work for them. Washington needs a multi-pronged approach to appropriate mandate exemptions and premiums more tackle the challenges facing our uninsured population.Over closely reflecting the cost of care for this age group; half of Washington's total uninsured population consists • Require health carriers who offer coverage for of young adults ages 19-34.Fifty-one percent of the dependents to extend the eligibility for that coverage uninsured are adults without children.In addition,50,000 to unmarried children up to age 25,retaining an are employees of small business who have incomes in employer's current option of contributing to the cost of excess of 200%of the federal poverty level.Providing these that coverage,or allowing the employee to pay the cost and other individuals affordable insurance options on the in full. private market will go a long way in decreasing the number of uninsured in our state. ACTION: ACTION: Direct an independent study of specific mandates,rating requirements,or other statutes or regulations identified by By February 1,2007,the Office of the Insurance in-state and out-of-state insurance carriers as contributing Commissioner,in collaboration within state and out of the most to the cost of individual and small group insurance state insurance carriers,state health purchasing agencies, to determine the impact on premiums and residents'health if consumers,business organizations and others,shall provide those statutes or regulations were amended or repealed. a report to the Governor and the Legislature identifying the impacts and likely tradeoffs in terms of cost and coverage if state laws were modified to: p • Allow health carriers to offer a health plan to individuals and small businesses not subject to any provider or benefit mandates,with premiums more closely reflecting the cost of providing this particular yu product; • Allow health carriers to offer a health plan - specifically for young adults and/or children,with . 9 • RECOMMENDATION #9 Partner with the federal government to improve coverage. Washington's public health care programs • Assure the continued integrity and viability of serve as an important safety net and are often the State's health care programs; supported through a federal and state partnership.These • Promote the use of private health insurance programs provide insurance coverage to some of our most vulnerable populations.Of the 593,000 uninsured in and buy in to employer-sponsored insurance; Washington,approximately 390,000,or sixty-five percent, • Incorporate benefit designs that encourage are in households with incomes below 200 percent of personal responsibility,healthy lifestyles and prudent the federal poverty level and would qualify for existing treatment choices; subsidized programs if funding were available.Washington • Conform their purchasing strategy to is well-served by working in partnership with the federal recommendations of the Blue Ribbon Commission to government to ensure the sustainability of these programs, promote high quality health care. and make the most effective use of state dollars,particularly in light of recent changes in federal law. ACTION: • The Health Care Authority shall evaluate opportunities to A.Modify Medicaid and the Basic Health Program strengthen the Basic Health Program(BHP),considering to assure their sustainability and cover as many people as possible within available funds. options such as: ACTION: • Promoting high-quality,cost-effective care that improves health outcomes; The Health and Recovery Services Administration and the Health Care Authority will work closely with the United States • Restructuring benefit design and eligibility Department of Health and Human Services on a package to criteria to best serve BHP's mission. reduce the number of uninsured. In doing so,the agencies ACTION: shall: Introduce legislation allowing a person to enroll in employer • Take best advantage of existing state coverage immediately upon their eligibility for the Medicaid funding for health care,including funding in the program. This will increase enrollment in the state's existing Medicaid and State Children's Health Insurance Employer Sponsored Insurance(ESI)program,under which Programs,and the State's Basic Health Plan,in order to Medicaid-eligible employees may use Medicaid funds to pay for maximize available federal funding; employer-sponsored insurance. 10 • • RECOMMENDATION #9 (continued) B.Support federal legislation encouraging health care providers to implement different state-designed innovative state coverage strategies. approaches to achieve sustainable reform. ACTION: ACTION: Work with our federal delegation to pass health partnership Pursue any financial or other assistance made available to the legislation that encourages partnerships among the federal states with the passage of this legislation. government,state governments,businesses,patients and RECOMMENDATION #10 Organize the insurance market to make it more accessible to consumers. • Finding health insurance can be a challenge in • Maximize opportunities for employees our changing economy.Individuals move around a lot more and employers to use pre-tax dollars to purchase than they used to.They often have more than one job.Both insurance; employers and consumers grapple with questions such as, • Offer the opportunity to pool individuals and "Will I be able to find insurance?Will I be able to pay for small business employees to negotiate better rates on it?What are my options?"Washington can help connect their behalf; them with the information and products that best fit their needs—bridging the best of what the public and private • Offer health coverage that moves with a person sector have to offer. when he or she changes jobs,including options that address the specific needs of seasonal and part-time ACTION: workers; Introduce legislation that will,through a public/private • Increase the number of plans from which partnership: individuals and employees can choose; • Allow contributions of an employee and his or . Provide individuals and employees with her employer(s)to be combined with a possible state information to make informed decisions on benefit subsidy to purchase insurance that neither the employee plans. nor employer could afford on their own; • 11 • RECOMMENDATION #11 Address the affordability of coverage for high-cost individuals. Those with severe,long-term or otherwise costly medical conditions pose a particular challenge when it comes to affordability of care.The Washington State Health Insurance Pool(WSHIP)was created in 1987 to serve such patients,and currently provides coverage to �� >PV 44 approximately 3,000 individuals.Many others who qualify, 4 however,cannot afford to enroll,and the cost to cover those who are enrolled is of concern.Washington is well-served { by making sure it has the best model for addressing these44- r particular health care needs. ' r ACTION: • By March 1,2007,the Office of the Insurance Commissioner ACTION: shall provide a report to the Governor and the Legislature Evaluate replacing WSHIP with a reinsurance program and,to evaluating options for restructuring and improving the the extent possible,coordinate with the Reinsurance Institute Washington State Health Insurance Pool(WSHIP),considering: of the Robert Wood Johnson Foundation's State Coverage • Improvements in chronic care management; Initiative through the Spring of 2007. • Changing reimbursement rates and plan designs; • Changing eligibility and subsidy criteria. 12 • • RECOMMENDATION #12 Ensure the health of the next generation by linking insurance coverage with policies that improve children's health. Children's health is critically important to the • Create a standard application form making it future of our state.Washington should follow through easier for parents to enroll their children in the Basic on its statutory commitment to ensure that all children have Health Plan,Children's Health Program,Medicaid and access to health coverage by 2010.But it's not just about the State Children's Health Insurance Program(SCHIP). children having an insurance card,but that the insurance card translates into improved health outcomes.Both theB.Allow parents to cover their children through state and parents have a responsibility in adopting strategies SCHIP. that,taken together,measurably improve the health of the ACTION• • next generation. In the 2007 legislative session,introduce legislation giving A.Enroll all children eligible for state programs parents the option of purchasing health coverage for their through improved outreach and marketing. children at full cost through the State Children's Health Insurance Program. ACTION: Beginning in January 2007,the Department of Social and Health Services will: • Expand outreach for children eligible but not enrolled in state health insurance programs; • Partner with schools and other organizations to provide information on private and public sector insurance options available to families; • Develop a marketing strategy,including the option to re-brand existing state programs,to encourage enrollment of eligible children; r <� • 13 • RECOMMENDATION #12 (continued) C.Use state purchasing to measurably improve • Link increases in payment rates for children's children's health. services to improve performance in these measures; ACTION: • Measure improvements in health outcomes. State health purchasing agencies will: D.Encourage parental responsibility. • Incorporate performance measures,such as well-child services,use of a medical home, ACTION: immunization,and chronic care management into state Cultivate an expectation that parents enroll children in and private coverage contracts for children; affordable health coverage and ensure that they receive appropriate health services. RECOMMENDATION #13 Initiate strategies to improve childhood nutrition and1111 physical activity. In Washington,approximately 25 percent of our 35 major diseases,including type II diabetes,heart disease, youth are overweight. Nationally,the rate of childhood and cancer,with the associated treatment costs. Healthy obesity has more than doubled from 1980 to 2000.Being eating and regular physical activity can curb these trends. overweight increases an individual's risk for developing over ACTION: Promote strategies related to childhood nutrition,physical activity,and the consequences of childhood obesity, v. dA considering options such as: • Partnering with local public health,providers, , - schools and other organizations,such as the Washington • Health Foundation,to increase public awareness; • r- • Introducing legislation to encourage nutritious food options and physical activity for students in K-12 education. 14 • • RECOMMENDATION #14 Pilot a health literacy program for parents and children. As a parent,particularly a new parent,it can ACTION: be overwhelming when a child gets sick.Parents Subject to appropriation,the Health Care Authority will partner should have the information and tools they need to guide with other state agencies and local organizations to implement them through these moments.A recent California pilot a demonstration project that helps families make more program showed a 41 percent drop in missed school days and informed decisions about their children's health care. a 48 percent drop in unnecessary emergency room visits after parents received training about what to do when their child gets sick. RECOMMENDATION #15 • Strengthen the public health system. A strong public health system,with its statewide focus on prevention and health promotion,can keep us all healthier,reducing the need and demand for costly medical treatment.This allows available treatment dollars to be spread further. ACTION:_ Subject to appropriation,invest in public health funding 1 <` strategies that are accountable for improved health outcomes, based on the recommendations of the Joint Select Committee on Public Health Financing. • 15 • RECOMMENDATION #16 Integrate prevention and health promotion into state health programs. State health programs must do more than simply pay for health care when the need arises. They must actively encourage enrollees to be responsible forrte% their own well-being,and seek innovative ways to reduce the i� frequency and cost of medical interventions. * ' -" xf , ACTION: CCS ZOIC By September 2007,the Department of Health,the Health Care Authority,the Department of Labor and Industries and the Health and Recovery Services Administration will develop a strategic plan to do the following. The agencies will identify • • barriers to and opportunities supporting plan implementation, Develop prevention and health promotion and note short and long-term steps to be taken, contracting standards through the Public Employees Benefit Board(PEBB),the BHP and Medicaid • Structure benefits and reimbursements in all Healthy Options; state insurance programs to promote healthy choices and disease and accident prevention; • Strengthen the state's employee wellness program in partnership with the state's Health& • Require enrollees in the Basic Health Plan to Productivity Committee. complete a health assessment,and provide appropriate follow-up; ACTION: • Reimburse cost-effective prevention Support primary care and reward providers for effective activities within the Medicaid fee-for-service and the prevention services. Uniform Medical Plan; 16 • • A PATH FORWARD The Commission's recommendations set a measures,available on its website,to serve as a starting foundation for more work ahead.It did not point for assessing progress towards these goals. intend that they encompass the universe of ideas that the The Commission's work now transitions to the Governor or the Legislature will consider to address our 2007 legislative session.Starting in January,the state's health care challenges.ather,they serve as a starting Governor,the Legislature and all those dedicated to health point.Our challenge now is to transition from an interim care should use their collective wisdom to build upon these of a good conversation to results that are meaningful to all recommendations and take important next steps to improve Washingtonians. the health of our population.It is the Commission's sincere How will we know we are succeeding?Government hope that,by using its work as a foundation,Washington will must be accountable for results and evaluate its success using prove successful in providing higher-quality,more affordable concrete measures.Over the past six months,the Commission care to more people. set forth ambitious goals and then tied them to doable, achievable action steps.It also considered a list of potential LET'S GET TO WORK! • • 17 Jefferson County Board of Health, Now Business .Agenda Item # 'VI., 4 • 'Workshop: Policy Discussion on Performance Measures January 18, 2007 • 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. • • 2 OF 2 Jefferson County Public Health — Planned Performance Measures 2007 FOOD SAFETY • 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 • 1 OF 2 v SUMMARY OF KEY FUNDING/SERVICE ISSUES: Food Safety Program activities are funded solely through permit fees. • 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 IIIfor 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 • 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: 2004 2005 2006 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 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: 2004 2005 2006 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 Proposed Statewide EH Indicators December 11, 2006 • The following three Environmental Health indicators are proposed - pending final approval by the PHIP Indicators Committee. Solid Waste Indicator#1 Percent permitted solid waste facilities in substantial compliance with permit conditions #of permitted solid waste facilities in substantial compliance #of solid waste facilities requiring solid waste permits Outcome Measure #1 (Food Safety Program) Percent of permanent food establishments with 35 or more critical violation points (red items) #of inspected permanent food establishments with 35 or more critical violation points (red items) in time period #of permanent food establishment inspected during time period Outcome Measure #1 (OSS Program) Percent of identified OSS failures with appropriate corrective action initiated by the health jurisdiction within two weeks #of OSS failures with corrective action initiated within 2 weeks #of OSS failures (as defined by state/local code) reported Notes: The Key Health Indicators Subcommittee eliminated the following indicators at their November 3, 2006 meeting: Water Recreation Indicator#1 Percent of public swimming pools with one or more critical violations during time period Solid Waste Indicator#2 Percent identified solid waste complaints initiated w/ appropriate corrective action within 2 weeks. A recommendation to drop the following was given to the Key Health Indicators committee, who will consider it during a conference call on December 15, 2006. Drinking Water Indicator #1 Percent of Group B water systems in compliance with coliform monitoring requirements Drinking Water Indicator #2 Percent of Group B water systems in compliance coliform water quality standards • J:\WORD\Performance Standards\Proposed Statewide EH Indicators 12-11-06.doc Jefferson County Board-of 3-Cealth 0C Business .agenda Item # 17., 2 • 1303-i Action 3-fighag hts September, zoos—December, 21906 January 18, 2007 4110 JEFFERSON COUNTY BOARD OF HEALTH Action Items September, 2005 — December, 2006 Thursday, September 15, 2005 Member Frissell moved to have a public hearing at the October 20, 2005 Board of Health meeting in the Commissioners Chambers. Member Johnson seconded the motion, which carried by a unanimous vote. Thursday, October 20, 2005 Chair Masci moved that the motion be amended to specify the number of junk vehicles. There was additional discussion and it was agreed that a maximum of 2 junk vehicles should be allowed. This amendment was voted on and passed by unanimous vote. Board Member Johnson moved that the motion be amended to adopt a zero tolerance in environmentally sensitive areas and buffers regarding both junk cars and other items. There was additional discussion and the amendment was voted on and passed by unanimous vote. A vote was taken on the main motion that the Jefferson County Solid/Hazardous Waste Regulations Ordinance be adopted as amended. The motion passed by unanimous vote. Board Member Frissell made a motion to direct staff to revise the draft 2006 Environmental Health Fee Schedule to reflect 100% of costs and the addition of a technician position. Board Member Westerman seconded the motion. 1111 There was discussion and ideas offered. Chair Masci suggested that staff review the City's procedures on fees. He also suggested that there be a flat fee for travel. The motion was voted on and passed by unanimous vote. Board Member Westerman moved to authorize Dr. Tom Locke to sign the referenced document and appoint current and future enforcement officers. Board Member Rodgers seconded the motion. A vote was taken and passed by unanimous vote. Thursday, November 17, 2005 Chair Masci entertained a motion for a public hearing on December 15, 2005 at the next Board of Health meeting for the Environmental fee increase. Board Member Sullivan moved to vote for Public Hearing, Board Member Johnson seconded the motion. A vote was taken and passed unanimously. Board Member Sullivan moved to have the Public Hearing include all the Public Health fees including Community Health at the next Board of Health meeting December 15th. Board Member Johnson seconded the motion. A vote was taken and passed unanimously. Fees will be posted 10 days prior to the hearing. Thursday, December 15,2005 Board Member Sullivan made a motion for Mike McNickle to meet with the public as planned and come back with recommendations on how to change either the policy or • ordinance as appropriate. The motion was seconded by Board Member Johnson and the vote passed unanimously. Chair Masci suggested a motion relative to adopting the Jefferson County Public Health & EH fee schedule and Board Member Frissel made the motion. Board Member Buhler seconded the motion. Motion passed unanimously. Thursday,January 26, 2006 Board Member Masci motioned that we approve the sending of the letter with the changes as discussed. Board Member Buhler seconded the motion and the vote passed unanimously. 1111 Thursday, February 16,2006 Board Member Frissell made a motion to approve the "Jefferson County Clean Indoor Air Regulation Ordinance." Board Member Johnson seconded the motion. A vote was taken and passed unanimously. Thursday, March 16,2006 Member Masci made a motion to reappoint Laurie Strong to the Substance Abuse Advisory Board. Member Buhler seconded the motion, which was carried by unanimous vote. She will be appointed to a three-year term. Thursday, April 20, 2006 Board Member Westerman made a motion to draft a letter requesting an amendment to Ordinance Number 03-0505-97. Board Member Masci moved to approve the motion as modified that the BOCC review the request. Board Member Buhler seconded the motion, which carried by a majority vote. Three in favor, two against and one abstention. Board Member Masci made a motion to review the Family Support Partner protocol. Board Member Buhler seconded the motion, which carried by a unanimous vote. Thursday, May 18, 2006 • Board Member Westerman made a motion to change the bylaws to delete the words "at least two Jefferson County commissioners be present" and to make the verbiage between the ordinance and the bylaws consistent. Board Member Buhler seconded the motion. The motion carried with 3 votes in favor and 2 opposed. Thursday, September 21, 2006 Member Westerman motioned to appoint Connor Dailey to the Substance Abuse Advisory Board. Member Buhler seconded the motion, which carried by unanimous vote. Thursday, December 14, 2006 Member Masci moved to approve Anne Winegar's appointment to the Substance Abuse Advisory Board. The motion was seconded and carried by unanimous vote. Member Masci moved to approve Resolution 06-01 with a change in funding to $200 million for the 2007-09 Biennium bringing it in line with King, Snohomish and Grays counties recommendations. Member Frissell seconded the motion, which carried by unanimous vote. • JEFFERSON COUNTY BOARD OF HEALTH 0 Thursday,January 18, 2007 Main Conference Room Jefferson County Public Health 2:30—4:30 PM DRAFT AGENDA I. Approval of Agenda II. Election of Board of Health Chair and Vice Chair for 2007 III. Approval of Minutes of December 14, 2006 Board of Health Meeting IV. Public Comments V. Old Business and Informational Items 1. Seasonal Influenza Update 2. BOH Action Highlights: September, 2005 —December, 2006 VI. New Business II 1. 2007 Legislative Briefing, WSAC budget 2. Governor's budget 3. Blue Ribbon Commission for Health Care Cost and Access Report 4. Workshop: Policy discussion on Performance Measures 5. Nurse Family Partnership update and new Division of Early Learning VII. Activity Update VIII. Agenda Planning IX. Next Scheduled Meeting: February 15, 2007 2:30PM—4:30 PM Main Conference Room Jefferson County Public Health • JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, December 14, 2006 Board Members: Staff Members: David Sullivan, Chairman—County Commissioner District#2 Jean Baldwin,Public Health Services Director Patrick M. Rodgers, Vice Chairman—County Commissioner Julia Danskin,Nursing 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 Go Council Sheila Westerman—Citizen at Large(City) Roberta Frissell—Citizen at Large(County) Meeting was called to order at 2:35 pm on December 14, 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. All staff members were present with the exception of Julia Danskin. A quorum was present. APPROVAL OF AGENDA Board Member Masci moved to approve the agenda as amended to include an update on the 4410 Joint Select Committee on Public Health Funding and a letter of appreciation under New Business. Member Frissell seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Board Member Masci moved to approve the minutes of November 16, 2006, as written. Board Member Buhler seconded the motion,which carried by a unanimous vote. PUBLIC COMMENTS None OLD BUSINESS West Nile Virus Newsletter—2006 Wrap-up Dr. Locke commented on the West Nile newsletter, noting the late season surge in West Nile Virus (WNV) activity. The virus penetrated deep into the state by October of this year. Oregon and Idaho's experience with WNV in recent years was to see a late season surge in bird and animal cases followed by an increase in human cases the next year. Washington's late season detection of WNV in the state could be a harbinger for increased human cases in 2007. Seasonal Influenza Update and Fall 2006 Public Health Newsletter Dr. Locke reported that there has been no significant influenza activity reported in Washington State to date. There have been a couple of isolated cases but no outbreak activity. Although December outbreaks of influenza are possible,they are more likely to occur in January after the holiday season when people are returning from vacation and travel and children are going back to school. With respect to pandemic influenza planning,Julia Danskin is currently working with the schools on an emergency preparedness plan and an infection control initiative as part of our Region 2 Pan-flu Plan. Member Masci recommended that we distribute a Public Health Newsletter as an insert in all city utility bills targeting the January bill mailing. 2007 Assessment Project Update Jean Baldwin reminded the Board that when the Board of County Commissioners passed the 1/10 of 1%tax increase to improve Mental Health and Chemical Dependency Treatment in Jefferson County, part of their plan included a community needs assessment component to give policy makers the information they need to set priorities and make budgetary decisions. JCPH was asked to monitor community needs and the impact of co- occurring disorders. Consequently, JCPH is contracting with Kitsap County Health District, (KCHD)to compile Behavioral Risk Factor Surveillance Survey (BRFSS) data for the last 5 years. The state interviews about 150 Jefferson County residents each year as part of a statewide BRFSS profile. Kitsap is compiling this data and will put it into a format for comparison to previously collected Jefferson County BRFSS date to identify significant trends. KCHD will compile, update and present this information to the Data • Steering Committee in March. Jean Baldwin has formally requested the use of sales tax funds immediately to begin this project. New Water Quality Division Manager Mike McNickle introduced the new Water Quality Division Manager,Neil Harrington. Neil has a strong background in Marine Science. Environmental Health has restructured its organization,replacing the Natural Resources division with a new Water Quality Division. Emergency Preparedness—HAM Radio Certifications Six staff members from JCPH took the Federal Communication Commissions HAM Radio Exam and became certified in December. This capability will allow greater flexibility in maintaining communications during a health emergency and is part of JCPH's Emergency Preparedness Plan. NEW BUSINESS Appointment to Substance Abuse Advisory Board Anne Winegar, Jefferson County Community Network Program Manager, was interviewed for appointment to the Substance Abuse Advisory Board. On behalf of the Interview Committee, Member Masci recommended that Anne Winegar be appointed to the Substance Abuse Advisory Board. Member Masci moved to approve Anne Winegar's appointment to the Substance Abuse Advisory Board. The motion was seconded and carried by unanimous vote. Jefferson County Public Health Heroes–Follow-up Report Jean Baldwin spoke briefly about National Public Health Week, now in its 12th year. Celebrated in April, this year's Public Health Week theme is"Take The First Step!" Preparedness and Public Health Threats: Addressing the Unique Needs of the Nation's Vulnerable Populations." Jean presented the Board with a draft Press Release that included a list of potential categories for award recognition. Jean asked for suggestions and after some discussion it was concluded that the criteria need to be better defined and consolidated into fewer categories. Jean will redraft the News Release and bring it back to the Board for consideration. Jefferson County Sexually Transmitted Disease (STD)Report 2005-2006 Dr. Locke briefed the Board on STD rates for 2005 and most of 2006. He noted that an annual report on Communicable Disease activity to the local Board of Health is one of the standards for local public Health practice for which JCPH is measured. Communicable Disease surveillance data shows a significant increase in Chlamydia cases in Jefferson County from 2004 to 2005. This trend is being seen statewide. This increase prompted intensified efforts by JCPH to promote screening of at risk populations and assure all sexual partners of known cases are treated. Partner treatment is a key strategy in reducing Chlamydia rates. Chlamydia infection often does not cause symptoms—those who have it usually are not aware that they are infected. If an infected women's male sex partner does not receive treatment at the same time she does, that women can become re- infected with Chlamydia. An important strategy to improve partner treatment has been endorsed in recent years by the State Pharmacy Board and State Medical Association and 111 is called `Patient Delivered Partner Treatment'. This treatment strategy allows providers treating Chlamydia to give their patient a course of antibiotics to be given to their partner if that partner declines to be examined and treated. Treatment can be accomplished with a single dose of the antibiotic azithromycin. Dr. Locke reported that preliminary data for the first 11 months of 2006 shows that Chlamydia case reports are at about half the level seen the prior year. If this trend continues, it is strong evidence that intensified control efforts are having their desired effect. Communicable Disease Control Priority Setting Dr. Locke presented a follow up to the 4410 Public Health Funding presentation given at last month's Board of Health meeting. He was asked to be part of the statewide group of local public health officials charged with identifying public health service gaps and setting priorities for how additional funding should be used. The group drafted a list of priorities that identified gaps in public health services throughout the state. Six priority areas were identified: Stop Communicable Disease, Prevent Chronic Diseases, Invest in Healthy Families; Protect Against Environmental Health Risks, Improve Health Information; and Assure Access to Health Services. Investing in improved communicable disease control was the most urgent priority identified. There is a statewide rise in STDs and Washington's immunization rates are far lower than they should be. Jefferson County has one of the highest immunization exemption rates for school aged children. The Joint Select Committee used the priorities developed by the local public health official to make their recommendations for an additional $50 million per year for public health funding. Jean reported back to the Board on the origination of the allocation formula used in determining public health funding. The formula used by the finance committee was based on a population base of 100,000. It was then determined what services and how many FTE equivalents would be needed to meet the criteria. The Senate Joint Select Committee will be looking at four things in the funding formula, including sales tax equalization, local service demand, financial incentives for local jurisdictions, and inter- or multi jurisdictional service effectiveness. Dr. Locke and Jean Baldwin submitted a draft resolution to the Board. This resolution supports an increase in public health funding of$50 million a year for the 07-09 biennium. Jean pointed out that this funding may come from tobacco taxes and utility taxes. Member Masci moved to approve Resolution 06-01 with a change in funding to $200 million for the 2007-09 Biennium bringing it in line with King, Snohomish and Grays counties recommendations. Member Frissell seconded the motion,which carried by unanimous vote. Jean Baldwin reported briefly on the new Human Papillomavirus (HPV)vaccine stating the vaccine will eventually get into the Vaccine for Children Program. However,this federal program stops at age 18. The HPV vaccine is approved for women up to age 26; consequently the 19-26 year old population won't be covered in Washington State. The cost of the vaccine is expensive, at approximately $130 per dose in a 3-dose regime. 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O � � N U � � Qo fY U � o E <" Fs V 0 0 0 C • 0 UN 0 p � 0 _0 75,_ 0 ,(N C0 =— O � 0 Ti0 2 ` 0 ( -0 0v) C OZ v) C - C } M C tJ C C _ C 0 O0 > LL () 4u) 0 800 0 o0 0 OON 0 00., O DN 0 � O o `- moo � — x > �0 Q a a cn a cai a ac 0 a Z Z - 0 1O > lel 2 Om - ,, +.- s OU a> > 'U , U '� > 4� ''''',4^ O O s-40 4, ,- x UU '4 O tiW O U .'J .S cC 3 O (� O 4_, 0- a ;, r ,, .— U R U ^ cd O L ''‘)t, 1 ) ,�` , 0., ,),i' io N N V O 't 3 n� U �O �� W U cC S. ...0 F 4, 1-4 n C �' le ,O a O o V) , o 5 - ,v o \_ � ed 0 n CC W W LL N rn! LO , 4 Q c 0 E Lu ,.. - Us • File Copy ,Jefferson County Board of 3-feaCth Agenda Nlinutes January 18, 2007 • sa WASHINGTON STATE ASSOCIATION OF COUNTIES IL „,,,,r Sii.;4 2007 Legislative & Budget Priorities The Washington State Association of Counties 2007 legislative agenda builds on a continuing set of priorities vital to the health of Washington's 39 counties and adds a set of issues specific to the 2007 Legislative Session. Legislative Priorities • Support Sales Tax Streamlining • Increase Public Health Funding o Support additional, dedicated and stable funding for local public health services as recommended by the Joint Select Committee on Public Health Financing. • County Comprehensive Plans/Growth Management o Support legislation that affirms the authority and discretion each county legislative authority has in adopting County Comprehensive Plans, including the determination of what planning elements are included in GMA Plan "update" and that any appeals to the plan update is limited to those items amended in an update process. • • Real Estate Excise Tax(REET) o Increase flexibility for infrastructure funding o Implementation of the housing elements of a comprehensive plan o Use additional REET in lieu of impact fees as a funding source • Improve Public Works Contracting Methods o Reauthorize and expand alternative methods including General Contractor Construction, design build and Job Order Contracting procedures. • Law&Justice Funding . o Continue and increase funding for District Court Judge Salaries and trial-court indigent defense services, including interpreter services. • Improve Local Transportation Funding o Allow counties to impose by council/commission action, a$15-20 vehicle license fee that is shared with cities within the county and dedicated to transportation purposes. Finally, it is clear that while these are our primary priorities, there are a number of issues and areas, including,but not limited to,Pension Reform and Local government liability for LEOFF 1 • post-retirement medical coverage, that will continue to be closely monitored. 206 Tenth Avenue • Olympia,Washington 98501-1311 e'-ta (360) 753-1886 • 8 (360) 753-2842 www.wacounties.org , ,0 � � og WASHINGTON STATE ASSOCIATION OF COUNTIES ,t1110 t 2007 Legislative & Budget Priorities Budget Priorities • Sales Tax Streamlining Mitigation (included in Governor's Budget) o Supports fully funding sales tax streamlining mitigation for local governments. • Increased Public Health Funding (not included in Governor's Budget) o Supports Joint Select Committee on Public Health Finance (EHCR 4410) recommendation to increase public health funding by$100 million per biennium. • Office of Public Defense (included in Governor's Budget) o Supports Office of Public Defense(OPD)budget submittal,which includes additional funding for mandated indigent defense and interpreter services, statewide implementation of Parents Representation Program, and Becca programs. • Pensions(partially included in Governor's Budget) o Supports complete elimination of gain-sharing with no alternative benefits provided in lieu of gain-sharing. Ill • Extraordinary Criminal Justice Costs (not included in Governor's Budget) o Support fully funding county applications for assistance under the Extraordinary Criminal Justice Assistance Act(RCW 43.330.190),which partially reimburses counties for extraordinary costs associated with aggravated murder cases. • Emergency Management Grants (not included in Governor's Budget) o Supports$5 million for state-funded emergency management assistance grants to local governments. • Human Services(partially included in Governor's Budget) o Supports more funding for a state children's mental health initiative. o Supports budget proviso to authorize the use funds in the Division of Alcohol and Substance Abuse to provide treatment to youth and adult ADTSA, GA-U, and low-income persons. o Supports vendor rate increases for all mental health and economic services providers. o Supports additional funding for Economic Services field staff to provide expedited Medicaid eligibility services to persons incarcerated in local jails. o Supports grant increases in TANF and GA-U,GA-X at amount agreed upon in state collective bargaining agreements. • o Supports Housing Trust Fund increase. 206 Tenth Avenue • Olympia,Washington 98501-1311 W (360) 753-1886 • 8 (360) 753-2842 www.wacounties.org Jefferson County Board-of 3-feaCth Netiv Business Agenda Item # 'VI., 2 • Governors Budget ,January 18, 2007 • ., • _A C RE HEALTH as irgt a ili s eacc ss tohigh-quality, • p //W affordable . I re.' t1'i-,,P'#'k.,4,4r,.:,f-,'N4:ffre'i.:-''A-r",,., 0..-4,'?,:," '..,„ .,-'P 4i,:3I„1, roductive and vibrant communities ,a r ar depend on healthy people, and g i Washington families will stay healthy with r better access to high-quality, affordable #t ` health care. Governor Gre oire is makin ,0'4 0 state-funded health care a model of efficiency. Governor Gregoire is investing in medical care that works. We will make ` health care options easier to evaluate and . use information technology to better { manage our health. We will take personal 7 7 responsibility for our health with smart , ` . choices, but also have guidance and information to get the most out of our care. We will continue to remove barriers, encourage responsibility for healthy choices, and use the latest research to make sure that Washingtonians have access to high-quality, affordable care. MAKING CHANGES FAMILIES CAN COUNT ON • 21 Governor Gregoire's Budget for Health Care: • Provides high-quality Delivers on our promise to provide health insurance for children.Ensures that all health care children eligible for state health care programs are enrolled so that they may access care and stay healthy. Expands outreach to inform families that their children can get state health insurance coverage. Covers an additional 32,000 Washington kids. $30.8 million GF-State,$29.8 million federal funds Gives pediatricians a fair reimbursement.Ensures that children covered by Medicaid get the medical treatment they need by increasing the rates paid for pediatric services to equal to the rates paid for these same services under the State Employee Uniform Medical Plan.$15.8 million GF-State, $13.4 million federal funds Covers prescription co-pays for seniors on Medicare.Helps seniors and other vulnerable populations who are enrolled in the new Medicare prescription drug program, Part D,to cover the cost of their prescription drugs. Because these people lack the resources to pay on their own, Governor Gregoire negotiated one-time federal funding last year to cover the co-pays,while seeking federal action to cover these costs in the future.Until the federal government acts,we will make sure that low-income seniors and others with debilitating conditions continue to have access to life-saving medications.$608 million GF-State Makes prescription drugs more affordable.Partners with Oregon to expand the Prescription Drug Consortium,using evidence-based and bulk purchasing strategies that have saved the state$46 million in the past two years and are expected to save . an additional$21 million next year in the purchase of prescription drugs. $871,000 Health Services Account Manages chronic illness better.Modifies the Washington State Collaborative to train providers in delivering a"medical home"chronic-care model.Changes chronic care management from focusing on a single disease to addressing multiple,interrelated conditions. Incorporates the concept of a medical home into programs currently assisting patients who struggle with multiple chronic diseases,such as diabetes,asthma and congestive heart failure.$2.2 million GF-State, $816,000federalfunds Keeps foster kids healthy.Improves care for foster children with a pilot Center for Foster Care Health Services,which provides medical evaluations within 72 hours of a child's entry into foster care,timely access to medically necessary primary and specialty health services,and a medical home for one-stop coordinated care.$972,000 GF- State, $1 million federal funds Promotes prevention Increases childhood immunizations. Supports routine immunizations and provides and responsibility new vaccines for rotovirus,which causes childhood diarrhea,the virus associated with cervical cancer and chicken pox. Maintains Washington's designation as a"universal vaccination"state by the Centers for Disease Control,protecting all our children from preventable disease.$262 million Health Services Account Prevents and treats disease.Increases testing,education,prevention and treatment for sexually transmitted diseases,including HIV,chlamydia and gonorrhea. $5.1 million GF-State, $1.4 million local funds • 22 • Provides better Protects the public health.Investigates communicable diseases in a timely fashion. information Promotes public awareness of healthy lifestyles,including nutrition and physical activity. $10 million GF-State Helps people figure out cost and quality.Supports statewide expansion of the Puget Sound Health Alliance's common database to provide Washingtonians with accurate, consistent information on the quality and cost of health care services.The Puget Sound Health Alliance brings together providers,carriers, consumers and employers to address health care quality and costs.$2 million Health Services Account Provides better information for families. Pilots a health care literacy program that gives families the tools they need to make informed decisions about their children's health,such as when to go to the emergency room and how to take care of common illnesses. Provides grants to local community organizations in a public-private partnership with Johnson &Johnson and the Johnson&Johnson/UCLA Health Care Institute.$442,000 Health Services Account Helps people navigate the health care system.Creates a pilot"health navigator" system to assist racial, ethnic and cultural minorities in obtaining quality care. Minorities are at disproportionate risk of receiving poorer health care due to language and cultural barriers. Health navigators will help people through the health care system,ensuring that patients receive high-quality and timely care.$1.4 million GF- State Improves the use Expands technology compatibility among providers.Gives patients and providers of information better access to medical records. Demonstrates health information systems that can technology talk to each other from anywhere in the state,similar to how consumers access their bank account information. Establishes a public-private partnership to help providers install health information technology systems.$9 million Health Services Account Connects state health care facilities with electronic medical records.Develops a strategy to incorporate the use of electronic medical records in state facilities such as Eastern and Western State Hospitals and the Departments of Social and Health Services, Corrections and Veterans Affairs, to ensure that patients and providers have timely and secure access to health information.$2.7million GF-State • f 23 0 Jefferson County Board-of 3fealth New Business Agenda Item # TI., 3 • BCue ibbon Commission for 3fealth Care Cost & .access R.e_port January 18, 2007 • 110 Jefferson County Board of 3-feaCth Netiv Business Agenda Item # 17I., 1 • 2007 LegisCative Briefing 1/17-SAC Budget January 18, 2007 • i 0 Nurse F Costs & Benefits: ' • /moo/ Partnership The Economic Return Helping FirstTiimeParents Succeed on Investment NFP National Office • 1900 Grant Street,Suite 400 • Denver, Colorado 80203-4304 www.nursefamilypartnership.org • 866.864.5226 • fax 303.327.4260 Nurse-Family Partnership (NFP) is an evidence-based nurse home visitation program that improves the health, Benefits well-being and self-sufficiency of low-income, first-time parents and their children. Several independent studies* have weighed the costs and benefits of implementing the NFP program and concluded that the program,when implemented with fidelity to the model,produces significant benefits for children and their parents,and over time will return $2-5.70 for every dollar invested. Savings accrue in the following areas: ► Health Care Delivery ► Child Protection ► Education ► Criminal Justice ► Mental Health ► Welfare and Public Assistance ► Taxes Paid by Employed Parents In the first trial of the program,costs were recovered by the time children reached the age of four and cost savings continued to build throughout the lives of both mother and child. The ability to get maximum return on investment is dependent on three important factors: •Highly educated registered nurses deliver home visits to low-income mothers who are pregnant for the first time; ■The program is implemented with fidelity to the intervention model tested in the randomized trials;and •Services are delivered at sufficient scale to benefit from basic operational efficiencies (generally 100 families served). • • Nurse-Family Partnership(NFP)ranked highest in terms of cost return Washington State�.nstihjte among pre-kindergarten,child welfare,youth development,mentoring,youth f..or Public Policy substance abuse prevention and teen pregnancy prevention programs. Imple- *13ene6ts and Costs of Prevention and' mentation costs of the Nurse-Family Partnership program were estimated(in i arlyTnterventiori;Programs for Youth 2003 dollars) at$9,118 and benefits were estimated at$26 298 leaving S As R;Lieb,J Mayfield;,M.Miller,and A', g a net PennuoWashtngtan tate Institute far PubLe return to government of$17,180 per family served.Direct savings related to Ixcy. Olympia,l?A,2004. low birth weight,child injury and immunizations were not included. Summary of Benefits & Costs Per Youth for Child Welfare/Home Visitation Programs Pro�;r am Benefits Costs Benefits per Dollar Benefits Minus Costs of Cost P iniy"partnership $2 3 $9,f18 I-ome Vt itirig pro tams for $10,9 9 $4&)2 � 4 $( r« A-nsk ±atta rs and C dren * Patent hill interaction Therapy X4,724 $1, 6 6 $3,427 13eahthy Fa:nr�Zes 'At*riea Systems of+dare/Wtaparoiind Programs** $0 191 y�1 P tlyPte e n vices hex ** . 0 axilxeierisi^ e S.+.li _ _r ) t'� '. "s ,� •r Infant l l altll S Dyad'opmentprfl� �:, z a **Programs marked with asterisks are the average effects for a group of programs;programs without an asterisk refer to individual programs. The entire report and remaining table of Summary of Benefits Sc Costs for all Prevention and Early Intervention Programs for Youth is available at www.wsipp.wa.gov/rptfiles/04-07-3901.pdf The 1998 RAND study identified at least four types of significant savings to government: Increased Tax Revenues from increased employment and earnings by program participants including state and federal taxes,Social Security R ►ND orporation contributions and state and local sales taxes; nve.ttfsg uiour Chi dre.: What We Know grid �tn't- oevv About the Costs Ansi eneftts of 1. Decreased Welfare including Medicaid, Food Stamps,Aid to Families Piro, r;© teneutrons h'-karoly5T W with Dependent Children and general assistance by counties; xeeinvood,S:S Bveriiagl'arrl,J;;flonbe, .m.:,, ,.R.:,,, It ► Reduced Expenditures for Education,Health and Other Services lbux a l' Ryde11,14f.Sanders,and 1:,-,7;7::::::,,, tesa ��Corporation,Sam_a Monica,�A 1�8 including special education,emergency room visits and homeless shelters; and .- Lower Criminal Justice System Costs including arrest,adjudication and incarceration expenses. The report concluded that net reductions in public costs begin to accrue by the time the children are four years old. The 2005 RAND study reported: There is evidence that the economic returns from investing in early intervention programs are larger when programs are effectively targeted.The return for each dollar invested[in Nurse-Family Partnership]was $5.70 for the higher risk population served. *Karoly,Lynn A.,Kilburn,M.Rebecca,Cannon,Jill S.,Early Childhood Interventions:Porten Results,Future Promise,Santa Monica,CA:RAND Corporation,MG-341-PNC,2005. New York City Department"of.Health - Over time,further savings may accrue from longer-term benefits: and Mental Hygrene Education costs associated with developmental delays and *17iron t4f k anti and trategrc Matiagetnnt,C•ffiee of learning disorders. Research Evacuation T Dnrnanovslcy I- Manana Cw Y ; Y,2004 Social services spending for public assistance,child abuse 0 _ and neglect and foster care. Anticipated Program Effects per 100 Spending for emotional and psychological problems participating families t including low self-esteem,problems bonding and forming relationships,aggressive behavior,depression and post- 10- 50% ost- 50% reduction in language delays, saving between traumatic stress and conduct disorders. $133,000-$440,000 Financial burdens on families that result from limited eco- ► 50% reduction in reported child abuse and neglect nomic,social,and emotional support of non resident fathers; through the child's second birthday,saving productivity losses among caregivers and injured children $38,500 later in life;permanent disability by injury leading to chronic pain or loss of motor or cognitive functioning. t Based on NIT program effectiveness studies. C onai v fll tS Facts about health costs associated with births in the U.S. 1aalatlarl x Research shows that Medicaid finances 40% of the 4 million annual births liffc'rts to lmprov:_'''',-,,,:',,r,',::-..:::::i, i,„.,,,._„_-_,,„„,,,- :','00.14103.4.1,--t,..,,,utc rnes and`Rduce fitgl ltrsk >•tsin the U.S. assanra tlea11,NA Center I. Medicaid pays for 50%of the low birth weight/premature births T?r..;::,;acticesd94 Average cost per diagnosis of premature birth is $75,000 ► Premature birth rate is estimated at 12.1% Studies show that implementation of the Nurse-Family Partnership program in.Louisiana reduced the incidence of premature births by 52%* for women participating in the program. Similar outcomes have been achieved in other states.The implications for potential healthcare savings alone are staggering. 11! �* Boris,N.Nurse-Family Partnership Preliminary Year-end Report,July 2003,LA Dept.of Health«WW.ntzrsefamilypartncrship.org • 06/2006 juvenile and adult sex offender sentencing Additional research could also be undertaken to test • alternatives) pending completion of the SGC's recommendations. how the effects of individual evidence-based programs may diminish as they are implemented at increasingly higher penetration rates;we only 2. Prevention Programs. Due to time constraints approximate this in the current report. It would also for this project,we were not able to update our be possible to enhance the model by developing previously published work on evidence-based "phase-in" procedures to estimate better estimate prevention programs.23 We include a few important the first few years of portfolio implementation. and representative prevention programs in this study, but a fuller research investigation would likely Finally, there is a need to monitor the latest yield additional investments in early childhood evaluation research findings on effective ways to programs that could produce cost-beneficial reduce crime and achieve improvements in other outcomes for Washington taxpayers. outcomes of policy interest. In this report, we included studies we were able to locate and analyze In particular, since we have previously found that in time for this publication. As new research child abuse can have long-term adverse becomes available, our results should be updated. consequences for criminality, then prevention and We suggest the legislature establish an on-going intervention programs that limit child abuse have the independent review process so that information on potential to make long-term contributions to the latest developments in evidence-based reductions in crime, prison construction, and criminal programs can be made readily available for justice costs.24 Additionally, we have found that policymakers in Washington. long-term crime rates can be lowered by successful evidence-based early childhood and K-12 educational programs that foster academic achievement and increased high school graduation rates.25 We also did not include some Washington prevention programs such as the Becca truancy laws, since we did not have time to conduct a full • cost analysis of this effective statute.26 For this report,we did include two representative evidence- based prevention options that achieve these outcomes: the Nurse Family Partnership program and pre-K education for low income 3-and 4-year- olds. A more comprehensive inquiry, however, into all prevention programs is an important next analytical step. 3. Evaluations of Washington's Programs. In this study, we relied on the outcomes of 571 rigorous evaluations of adult and juvenile corrections programs and prevention programs. Unfortunately, only a few of these evaluations were of programs in Washington State. We recommend that the legislature initiate an effort to evaluate the outcomes of key programs in Washington. If the evaluations are conducted with rigorous and independent research designs, then policymakers in Washington will be able to ascertain whether taxpayers are receiving positive rates of return on their dollars. 4. Extensions of the Institute's Research. In order to complete this project on budget, we had to defer several analytical steps that subsequent research could address. In addition to updating and extending our earlier study of prevention, these additional steps include performing a formal risk analysis to test the degree to which the model's findings are sensitive to key data inputs.27 17 • Jefferson County Board of 3-Cealth _Media Report • January 18, 2007 • Jefferson County Public Health . December 2006 — January 2007 NEWS ARTICLES 1. "Jefferson's United Good Neighbors at 40 percent of goal," Peninsula Daily News, December 7, 2006. 2. "PT shelter opens without a hitch," Peninsula Daily News, December 11, 2006. 3. "Alcohol compliance checks maintain a 17+% sell rate," Port Townsend Leader, December 13, 2006. 4. "Partnership issues plan for restoring Sound," Peninsula Daily News, December 13, 2006. 5. "Ban on trans fats in food may come to Washington," Peninsula Daily News, December 14, 2006. 6. "Parties clash on Jefferson recall bid," Peninsula Daily News, December 15, 2006. • 7. "Clallam looking to toughen smoking rules," Peninsula Daily News, December 18, 2006. 8. "Flu money used for any disaster," Peninsula Daily News, December 18, 2006. 9. "Set sights on quitting tobacco," Port Townsend Leader, December 20, 2006. 10. "Doctor touts smoking cessation pill, Chantix," Port Townsend Leader, December 20, 2006. 11. "Health board ponders penalties," Peninsula Daily News, December 20, 2006. 12. "Now's a good time for flu shots," Peninsula Daily News, December 22, 2006. 13. "State expand bird testing for avian flu," Port Townsend Leader, December 27, 2006. 14. "New passport rules for air travel begin Jan. 23," Peninsula Daily News, December 27, 2006. 15. "PT sewer line offshore break is fixed," Port Townsend Leader, December 27, 2006. • 16. "Belenski loses recall attempt," Port Townsend Leader, December 27, 2006. 17. "Tip line rumors swirling," Port Townsend Leader, January 10, 2007. • Jefferson's United • Good Neighbors at 40 percent of goal • BY JEFF CHEW net programs through dona- PENINSULA DAILY NEWS tions to the county's food PORT TOWNSEND — A banks, Meals on Wheels pro- contribution of more than gram and emergency shelters. $29,000 from Port Townsend Some examples of the Paper Corp. employees has agency's reach in Jefferson pushed the 2006-'07 United County: Good Neighbors of Jefferson ■All five food banks served County fundraising campaign more than 7,000 residents last - well past$100,000. year. Fund drive donations now ■Nutrition programs deliv- total" $119,361, which is 40 ered 8,853 meals last year. percent of the goal of ■ Emergency shelter pro- $295,000. , "We just got word today," grams provided 6,613 bed Bob Peden, the group's execu- nights last year. five director, said Wednesday United Good Neighbors of the donation for$29,391.87. supports other programs that "That's far and away the address the needs for children largest business contributor in through medical support, the county." early intervention or after- The mill is the county's school programs. • largest private employer, with Other programs target the a staff of about 320. disabled or the most vulnera- Peden and Lizanne Coker, ble members of society the group's fundraising cam- through assistance and physi- paign director, said they cal support. expect several "fairly signifi- For more information about cant" donations to come in by United Good Neighbors, year's end. phone Peden or Coker at 360- Coker said she was confi- 385-3797 dent the goal would be or reached, with most of ther , ‘ de• expected to roll in by Jan. • 30. Clallam County "I would say that we are in In Clallam County, the step with last year," Coker United Way's annual fundrais- f said. ing campaign is in full swing. "I'm confident we'll do it again." As of Wednesday, donations The campaign runs until to the Clallam County United June. Way totaled$551,000,which is It has even received dona- 55 pereent of this year's goal of$1 million, said Nola Grier, tions. from Clallam County, Coker said. internal operations manager "An important thing is that at Port Angeles office. people in Clallam can earmark their donations for UGN," she Port Townsend/Jefferson County Edi-< said. tor Jeff Chew can be reached at 360-385- United Good Neighbors 2335 or jefl chew supports community safety peninsuladailynews.com. ! 1 • PbA) 107-7-0 • ....„,, (c., rwe,.„0,,,„,,,,i,t.,..*, ‘,„.A.i.r ,,,,,c, 1g 2 0.....1 al = , s ## .cw + m gq? E!! moOt . 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G ;,v� o Ep o�o +� ro Q �1 C/� CCia $ u, ° fin? � � wcgU o�.,w 5 �v�. 5 `� k8•Wednesday,December 13,2006 , Alcohol compliance Mance. checks • maintain a 17+% sell rate Teenagers are successful in since September 2005 by that on past offenses. The AVN pen- purchasing alcoholic beverages in office, the Port Townsend Police alty for the first offense is a five- Jefferson County in almost one out Department and the Washington day suspension or a $500 fine, a of every five tries,according to a State Liquor Control Board second offend is a seven-day sus- Dec. 11 report from the Jefferson The undercover youths have pension with no monetary.option, County Sheriff's Office. This all been teenagers and youthful a third offense is a 30-day suspen- shc was determined through in appearance, with "no attempt sion with no monetary option, 10 compliance checks conducted to `entrap'by using a minor who and a fourth offense is a license is 20 and/or older in appearance," cancellation. reported the sheriff's office. Stores that refused to sell were In a check on Oct.27,only one awarded compliance activity - store violated its licensing agree- appreciation certificates honor- , ment, birt three establishments ing those clerks and stores for sold alcohol to a minor on;Dec. their part in reducing under- 8. Two of the stores are located age drinking in our community. in Port Townsend:Port Townsend These include,in Port Townsend: Tasting Room & Lounge and Jodie's on Madison, El Serape Castle.Key Restaurant&Lounge Mexican Restaurant, La Isla at Manresa Castle,and two are in Family Mexican Restaurant, Port Hadlock: Scampi &Halibut Lehani's Deli & Coffee, Penny Seafood Grill and QFC. Saver Mart, Key City Fish, BPO Clerks/owners who furnish Elks Lodge 317, Mulligan's • alcohol to a minor receive a Pub &.Eatery, Hanazono Asian criminal citation. Liquor licensed Noodles, Silverwater Café, The establishments receive either an Belmont, Waterfront Pizza, The administrative violation notice Wild Coho, Lanza's Ristorante (AVN)or a written warning from and. Pizzeria, Fiesta Mexican the Liquor Control Board, based Restaurant, Four Corners Store, and Bayview Restaurant. Other Jefferson County establishments that refused to sell alcohol to a minor are Jackpot Food Mart in Port Hadlock and Chimacum Chevron in Chimacum. • Concerns or complaints regard- ing alcohol sales to minors can be voiced by calling the Washington State Liquor Control Board's toll- free tip line at 888-838-3956. This compliance check was funded through a Reducing ?Tr. LL04(2-PA Underage Drinking grant award- ed to Jefferson County Sheriffs • Office by the Washington State (o� -( 3 -0, Division ofAlcohol and Substance Abuse. In support of the statewide Drive Hammered, Get Nailed emphasis patrol to remove 110 impaired drivers from our road- ways in the month of December, the sheriff's office plans more compliance checks during the holidays. • • V m o > . °C O L. .U, C O JT. w'�" 1 qi . !ii 40 "� 0o , 3mvm '8 �� d� OOJ❑ . -ses • i 3�=,°a mains 2 hod C 8z �pp �.y ' Z. COW N q °) cd °-. 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You don't trade advised 1,800 residents to cut vaccination drill, using this business cards during a their water consumption, used year's flu vaccine. disaster.” emergency sirens to give The drive-through flu clinic updates to the public and MARY tested the re 'on's MC. SELECKY installed desalination equip- g' emergency Washington state health secretary ment. vaccination plan by giving this year's flu shots to volunteers Selecky said one of the ben- who agreed to help the health during a disaster." efits of the federal focus on department test a new proce- Selecky pointed out the pandemic flu preparation — dure. preparation has been espe- even if it can seem a little like Erickson said state and cially helpful for the smallest the "crisis of the month" —is county officials learned a lot communities and American that it reminds people to get from the exercise: they need Indian tribes, which are also ready for emergencies. written materials to be trans- getting state and federal "People forget that you're lated into more languages, money to update their emer- supposed to be doing all-haz- they underestimated the vol- gency plans. ards preparedness," she said, ume of people who would show At Neah Bay, the Makah adding that it doesn't really up, they needed more volun- tribe used its updated emer- matter if you're preparing for teers directing traffic and they gency plan — a plan that had an earthquake or a flood or an needed to plan for inclement previously been updated in the infectious disease. weather. 1970s—during a severe water "It all comes down to a cer- Meetings with the various shortage this summer. tain level of preparedness." • government agencies and business groups has been use- r ful for a variety of reasons, such as learning the right per- son to call to get emergency rations or fix a tainted water , supply. "Relationships are every- - thing," Selecky said. "You don't trade business cards • Set sights • on quitting tobacco New Year's is a time of reso- chealth.org/survey/cessationsur- lutions and fresh starts.It is also a vey.php or call Kellie Ragan traditional time for tobacco users at 385-9446. Local cessation to set their sights on quitting resources will be printed in the Among the 3,000 adult tobac- department's Tobacco Cessation co users in Jefferson County, Resource Guide and posted on about 1,700 of them have tried its website. to quit tobacco in the past 12 For the tobacco user who is months. Quitters use over-the- trying to quit, "keep trying," counter aids like nicotine patch- advises Ragan."Start with small es or nicotine gum, prescription steps or go cold turkey, memo- drugs like Zyban, and recently rize your list of reasons to quit, approved Chantix. Quitters take start replacing smoke breaks aid through counseling, nutri- with walk and water breaks, tional supplements, bodywork, set a quit date, talk with your acupuncture, yoga, meditation healthcare provider about a quit and more, plan." The Tobacco Prevention Smokers can contact the Program at Jefferson County Washington State Quitline at Public Health wants to hear from 800-,QUIT-NOW(formerly 877- those who offer services that help 270-STOP)or quitline.com."We 411 people quit tobacco. To request know that it takes an average of a Cessation Provider Survey, eight attempts to quit and stay visit www.jeffersoncountypubli- quit,"says Ragan. (Z" 'JO 4;) • Port Townsend&Jefferson County Leader Doctor touts smo • • • • in cessationpill, antix ByAllison Arthur • tive than cocaine and heroin. It Leader Staff Writeris harder for people to give up What drug So i—bang;FDA say about Chantix r cigarettes than it is for people to If Jefferson Healthcare phar- For tnoftlrIO.P9f14040 Chantix JVarenIglrte)from the mann :. give upalcohol,meth or heroin, m +,;; thuom prea11879 2426849 acist Brenda DiPrete had her =faeturar�AadtoutltrtKw.fhan„ { �„ ,. he said of what people say. way, employers in Jefferson For 10910.1#0,0, 9q lndlyent"progmotfferedt roughmanufac And people have a hard time County would take a look at the turerPfizecJn call 6(106 2400 rastaying off cigarettes during cost of Chantix,then look at the For mote Infomwtion on what the Federal Food end Drug, stressful times. cost of providing healthcare to Administration has,to say about Chantix,check out www.fda.gov "I've had people who haven't employees who smoke cigarettes or call 888-INFO-FDA,(888-463.6332.)The FDA website notes that smoked for 10 years," he said. and they'd buy Chantix today Chantlx has not been studied In children 18year;and younger and But when a wife ends up in the "I'm really excited about Is not recommended,for*;.children under 19.Patients are advised hospital or there's some other Chantix," DiPrete said Dec. 8 to tell their dpctors if they have or haw(tad kk)ney Pr,#,' i.S;or stress at home, people can end after Dr.W.Kirk Hams spoke on -r•al a eycity$ or.re.trying to become or already 0rep . up resuming their smoking habit, the benefits of the newest drug nant.Peo0?iilu�inglnlsliin,asthmamedicinesorbloodthinnersalso he said. on the market aimed at helping should advise their doctor prior to asking for Chantix. Hams also said if he has a people stop smoking. "In my patient who wants to quit smok- perfect world, an employer will ing he tries to engage the per- pay for Chantix," said DiPrete, reward sensation,"Harris said of home office. A spokesman did son's partner to stop smoking as who also is a certified smoking how the pills work. not call by press time. well to eliminate temptation for cessation specialist. Side effects of the drug are Pharmacist Don Hoglund of the patient of just being around , Not only would helping mild compared to other drugs, Don's Pharmacy said Monday the smell. employees stop smoking reduce Harris said. Some patients it's a mixed bag in terms of He also listed a number of healthcare costs by an estimated experience mild nausea, which which insurance companies techniques for quitting smoking, $3,400 a year per employee, it he said doesn't last. Although cover it. In one batch of pre- including putting cigarettes in also would eliminate sick days there are no liver concerns, he scriptions,four out of five were the trunk of a car to make it more for people who do smoke, and said there are kidney concerns. billed to insurance companies difficult to get to them. it would improve the health of Anyone who also is using a drug successfully,he said. "You have to decide not to their children,said Kellie Ragan, that requires blood tests to check As for patient comments, have one puff ever again," the who coordinates the Jefferson for impacts on liver may not be Hoglund said:"I'm getting some physician said of how the first County Public Health Tobacco able to use Chantix,he said. positive feedback that it's effec- thing a person needs is the desire • Prevention Program.The health Users also could expert- tive. One patient said it was to quit. department sponsored Harris ence changes in dreaming, gas quite easy to stop smoking on "You can't lose heart when a coming to Port Townsend to talk or vomiting, according to a that drug." smoker has quit and then starts to both employers and health- patient-information pamphlet on In addition to offering the drug again,"Harris said. care officials about his expert- Chantix. for free to poor people who qual- He noted statistics from the ences with Chantix. ify, the drug maker also offers World Health Organization that A family-practice physician Insurance issues a free support program called indicate there are more than 1.3 from Tumwater who is paid by Insurance companies are now Get Quit,an online program that billion smokers worldwide. He the drug manufacturer Pfizer starting to cover Chantix,which offers support and advice to stay also said smoking is the No. I Inc. to promote Chantix, Harris does require a doctor's prescrip- off cigarettes,the Chantix website preventable cause of death. said he has seen excellent results tion,Harris said. says.Regular check-in e-mails or John Newport, a Port with the new drug that contains Chantix costs about $100 a phone calls also are offered,as is no nicotine but works on the month for those without insur- a cravings hotline for support and Townsend wellness counselor same receptors in the brain that ance and, depending on the encouragement. who specializes in helping bpeo- use nicotine uses to make people insurance, about $38 a month "Chantix is proven to be Ple with alcohol and drug-abuse addicted. for those who do have it,Harris effective, but it's not a magic Problems, said he had the sad Released and approved by said. It's not known whether pill. For most people, smoking experience of dealing with coun- the Federal Drug and Food Washington's Basic Health Plan is both a physical and behavioral selors who were skilled at help- Administration earlier this year, for indigent people covers the addition. That's why we also ung people with drug and alcohol Chantix, which comes in pill medication, but a Pfizer rep- offer a su lan.Chantix can issues but who were dying of pport P tobacco-related illnesses. form, is getting rave reviews resentative said Pfizer has its help reduce the urge to smoke. because it has a better success own program for people who Get Ne cause said of death is osg Quit can help you learn to a leading death among rate than drugs such as Zyban, are poor and have no insurance, break your smoking routine,"the Harris said. and she advised people to check Chantix website says. people who are recovering from What patients keep telling him out www.chantix.com for more The approved course of alcohol and drug additions. is that when they are on Chantix, information. Chantix treatment is 12 weeks. Newport indicated an interest they smoke, but when they do, Both pharmacies in Port Patients who successfully quit in exploring whether the state's they say, "I keep smoking, but Townsend carry Chantix. smoking during Chantix treatment healthcare insurance program my cigarettes don't work." A spokeswoman for Safeway may continue with an additional for poor people covers Chantix. "You don't get the pleasure or referred questions to the Bellevue 12 weeks of Chantix treatment And Robin Hake of The Food to further increase the likelihood Co-op said she would pass the of long-term smoking cessation, information about Chantix on according to both Harris and the in a newsletter. She said people drugmaker's website. should set an example for their children and protect them by not • p-7-/ Stopping smoking smoking. • Harris spent a considerable Ragan said Jefferson County's time outlining the woes of smok- health department is ahead of the ing before detailing the benefits game by providing information / — --1f71, of Chantix. about new smoking cessation " Nicotine; which is both a opportunities, like Chantix, to stimulant and has a' calming both employers and healthcare effect on users, is more addic- providers. (Allison Arthur can be reached at aarthur@ptleader • • •. A6 WEDNESDAY,DECEMBER 20,2006 PeninsulaN orthwes. �U; F Health boardn 4 • Smoking scofflaws Jan.'16 meeting---had thanked her he said x� meeting. for enabling him to visit the Loeb pg �d�KS may face harsher Then, , z club agax z .. ' 8 board mem- '� • Miller;,an Eagles member "; that® 'ad $ $ � )Un1S�1n1entS berg:-must ��' for 30 years;said he has a in �'s ag "� ," �" schedule a �' chronic lung ailment: BY JIM CASEY public hear- In Jefferson County, niton is the talc s- PENINSULA DAILY NEWS ing on the where"Locke also iS health � #that fox.; PORT ANGELES Cla1- regulation, officer,the Board of Health • " r l ussian agetit Texan- lam C9untY health authori- probably ¢ adopted a law that allows it " ' derx t�enko u�London on` after another g Locke t4 suspend;"ox cancel aIx NoY g k ' ties won't have a way to stub month,• establishment's foods ce su �e out scofflas smokers for at In the meantime,Ewes license for repeated sm id � f' least a couple of months. Aerie 483, 110 S Penn vrolat ons s �a have en County Board of Health• apparently has decided o req �� ant members Tuesday •instructed comply with Initiative p01, ho we even'tersn p s Dr. Tom Locke, their health the law that bans indoor a�euthokted t . ex t even v ere the to th tehaes�;b`l�hxaent officer,to meet with law smoking at any glace of " p s p enforcement officials about411 employment. yet' ' d ' ' ticketing people who smoke "I have not had any corn �, x �t - HCl mutant form , in defiance of the state's plaints in three weeks,"said a f a of the ► Ko flu that Y Clean Indoor Air Act. Iva Burks,head of the ' " Important health I su+e a demrc in 196$, As for restaurants and county's Health and Human he bars that permit smoking, Services Department. Although Loc1e amici law Them ill,ops after Locke.was told to draft an Early last month,Locke enforcement otl` rs and Christmas Locke said,after ordinance that employs esca- and Burks sat down with prosecutors might,place a people have traveled to other luting warnings before issu- Eagles officers to tellthem low on smoking vio pax of the country. ing a civil citation. to obey the law or face the lata n ,Initiative J �s as { Ian,the virus is spread. Currently,Clallam's fines of up to$205 per day " im t as foib riding peon among students"returning to , Board of Health has no legal that Initiative 901 allows. ple i dump raw e*a anto. sehnol,he sed. standing as an enforcement Burks also said Carl the ground agency,Locke said. Miller of Port Angeles�- , "There's few;tangs we �i . Locke will present his who complained about elle Can do that have,so•larg ani ? ordinance to the board at its Eagles at the board's Oct.'24 ' impact[on pul3 C health]," �itn.Ca ey�� t'oral asc+ r • ,n, that's what we do, ° •ntific research.It's not ' :'4 °' managing a facility," r� 11 �J aid. 1 :isula College used to � �` { g • ;,,,,:.:,.. .,....,,,,,,,44,07.-.„..4 �u,,tr 1t '� ��{ tT" i oney to the cen {,, £ � JS �� jAk B' N Ra« vE r ow, Eaton said. Peninsula College ='�� ` ; > money from the city µ.,-.,.w .._ • ,. . ..•••'-•:'''',•...:•-:••,:•• ` i `- 500 in its 2007 budget . :: the college contributes sv °r astructure and admin i � �sA n, he said. � k n said the most such A t c THoapt t StNstlt,A Dnn.Y NEws i marine life centers gniunda base some CE•TO � I. foundation or some- tofth. Lurie VlcGarvie left, a rejiresentatwe or00., p..: :..::-...,...:::,,,::,:...,,,,.::::...zacVl+ ical Center, talks with t of them only use grant i itto supplement their 1,ar t Federal Savings &Loan savzngs counselorett3arnmond, center, ons, the base funding andl teller'supervisor.Julze earzdeau after donating tx box o�books to the ,retty solid sources, he medical center on Th"ursday xn Port Angeles the books were ollected through the,Olympzc.Memortal. 'c ondom's Escape By Reading'program,_ , have recognized if this which provides books,to ehddren c ad other patients cif the hospital. Several. .ve will survive it won't hundred donated books•have;made their:" y thrr ugh" 1i program government funding .e our budgets are,get ss and less. So we•have something different," ow's agood time : for flu shots said. we're able to pull this will be fabulous and an PENINSULA DAILY NEWS there is no•shortage such as Most area doctors and the nic driver. Otherwise, it Now may be the perfect there was in 2004. health department have an ill be fabulous and have time for both children and About 2,000 doses were ample supply of the vaccine, 31c is potential." ordered for Clallam County, Locke said. adults to be immunized said Christina Hurst, public In Jefferson County, adults against the flu, said Dr. Tom health program man er. Locke, health officer for Clal p can contact their doctors or iter Brian Gawley can be The Jefferson County pharmacists to see when and at 360-417 3532 or lam and Jefferson counties. Health Department onl offers wley�peninsu{adailynews.com. Because children returning p y where vaccinations are avail- to school in early January will vaccinations.for children and able. int caught ordered about 440 doses, said The public health depart bring viruses back from vaca- tion to their peers, a key time Jane Kurata of the county ment has open clinics from to get the flu vaccine shot Public Health Immunization 8 30 a.m. to 11.30 a.m. each \I* er had been sought on would be before Christmas. ProgramTuesday and from 1 p.m. to 4 nts allegingsecond- "The ideal time to be In fact, some areas in the m. each Wednesday. murder and first degree immunized is two weeks nation are predicting sur p. immunization is $30 at before exposure," said Locke. .pluses of the vaccine,although caredly stole ss duringhrY, an isflight,the "The peak immunity period it is too early to tell if that will the Youldon't need an appoint- CA is about two weeks after you happen in Jefferson or Clal 1's office said in a news lam, Locke said. meat,and there usually isn't a e Thursday get. the shot so it would be » .ed he car was taken at knife- good to get it before Christmas The immunization shots wait, Locke said. or even on into January- ie anuary came in during the third week For more information.in from a grocery store in Clallam County, on Hurst Iy My prediction would be of November, later than usual. P vood, northeast of Seat- hearing of some cases in Janu The advice is generally to at 360 417-2364. and was discovered ary after school is back in." get a flu shot in October. For more information in esday at a gas station in Because plenty of flu vac- Some grocery stores and Jefferson. County, phone 360- cee, Calif. cine has been made this year, pharmacies have clinics. 385 9400. • WELLS .. F RGU s �GN4 D-1"7'C S CAi1 REPAIR Harness T The strength Of Wells Fargo FREE S'T'ANDARD OIL Home Mortgage CHANGE WITH TUNE ui •PriarityBuy&MPre-Approvals • •Government and Conventional Loans OR •Exceptional Service SCHEDULED, MAINTENANCE Call us today! Locations in Sequim and Port Angeles I. for your convenience ► DE C AN ONLY! tori Taylor I art✓ :{360)683-1512 Sequlr (530�+ali1�,with 5150 service). ( fl 4c7-9721 P©rt 1n lel+ s • State expands birdtesting for avianflu To protect public health and Earlier this year, WDFW northwest bird populations, the began testing hunter-harvested Washington Fish and Wildlife and•free-flying birds for avian Commission has adopted a rule influenza,said Dave Ware,game requiring game-bird farmers to manager for WDFW. The test- test their flocks for avian influ- ing,which focuses on shorebird enza at least once a year. and waterfowl species vulner- The commission, which able to avian influenza,is part of sets policy for the Washington a national surveillance effort. Department of Fish and Wildlife Although the strain of avian (WDFW), approved the bird- influenza transmissible to testing rule during a public meet- humans has not been found in ing in Olympia on Dec. 8-9. North America, other strains of The new rule, developed by the virus have been found in WDFW in cooperation with wild birds,Ware said. the Washington Department of "With hundreds of thou- Agriculture, requires approxi- sands of migratory waterfowl mately 80 game farms raising and shorebirds passing through game birds and waterfowl in Washington each year, it's Washington state to annually test important that we expand the 10 percent of their flock—up to a monitoring effort for avian influ- maximum of 30 birds.Testing at enza to include game-bird farms the game farms was previously in this state," said Ron Ozment, conducted on a voluntary basis. chairman of the commission. ?/r7 N UII $ co ° 1 t•-• co wE0Uo9 � o�� °p"�� ate" `' zg em • a o E-'e° . 1.1.; 4°, 2 a.3 o cc'.c'i o-i° ra'.-4 ° • wA W" 4Nl-- ayW."ACg oi• C+. yIC 03a10 cow A CZ • y Q. ° rn dog °'0 14 WIM a ID .-. 8 E.N 0 2 0 3 0 000N: MI �, a) °A 003 0, °� c" c4' °•- 0. •03-6.0 ":a ow' °.� NoMin o tiE �s ° 4 [ci ° yc • ^\ Q.g 3 °v°•g 35 as 4° 2' c..Ng 0.,,,,, "2.c.,- n. 8.Ub tC CA Q ■� -0 co T)0•tl d"-' a m O y pla 4'° ty o %U-0 a ° .n �� m3xp"x�„3 a3 0 .0 ci) .a.5.0.a 3.Q a 2 °w 2 ' l •111.1 3.5 I 1 s c "'Fp o a�," -_ O 1„ C t• °bi) ° a• rJ ° °'-4 ,, to. tip y r-1 °.0 •4:2 3: O 1 w on_ EC ^�.o a�o h C 8 7., y v� .O pas as.U a- ai T. Q a)w • O co s +s > g.ox ,, 00 >x ca3J3 um -o� A � °' -C• �0N� N °• o y y ca - 4 N„ -o a u o x o° o o CA 0 O a CA t" ° U >, y y ° 0 IN E CAc0 HU .0 s. 3 a Ast • � en U 2 3 ti .� Q .� a� IliPliflhl c) 2 2 I z a) u v o a. Z o y.5,!.'W�. , ,a A.5 PT sewer line offshore break is fixed A leak in the City of Port offshore, and access to the leak but it didn't stink,he said. Townsend's sewer outfall line was particularly difficult during The county health department at North Beach was fixed on last week's stormy weather. closed the beach to swimming sdaX Dec.49,It-tookabout .... .. "It was shooting up like and shellfi4h collection as a pre- week to fix tho'break-..in. Q atthful;..,saidia.roan, %ho ' , �utw,u� sa�,d+ 1'ers�han�, because it occurred-about 20 feet' " reportedt'the'proble`nv lastNieek,1"rthroitiajAWaraharsuperin tendent. As of Thursday, Dec.. — 21, the city was awaiting a re- evaluation of the situation by the health department,he said. The effluent is fully treated at the city's award-winning sewer plant on Kuhn Street and then • flows by gravity to the outfall, which empties it into the Strait of Juan De Fuca about 900 feet from shore,he said. Merchant said it cost about $2,500 to repair the break,which occurred in a joint in the outfall line. e-P C ��� �/ On Thursday, Dec. 21, there • _ was some bubbling at a point 1 in the line just inland from the beach. Crews later replaced some bolts to fix that problem. • • A 4•Wednesday,December 27,2006 loses:' recallattempt •B enski . .By Barney Burls he was"not at all surprised"by icost]," said Leader Staff Writer the decision, Belenskl; "I "I felt I Belenski, who has sued the wouldn't have. A Clallam County Superior county on numerous occasions :;. done it if I „ Court judge has dismissed the and recently won a court injunc- ' \, felt I couldn't was heard. ' recall petition filed by Mats tion preventing the county from ' win." Mats resident Mike Belenski enforcing a sign ordinance that ' Judge Mike Belenskl against Jefferson County allows real estate signs to be Williams said recall petitioner Commissioners Phil Johnson larger than political signs, said Mike Belensid that one of and David Sullivan. he has no plans to appeal. Belenski's and Sullivan said Belenski goes The written decision issued by "I felt I was heard," said three charges, too far. Judge Ken William on Dec. 22 Belenski. "I just appreciate the related to inadequate meeting "It is being abused," said found that none of three charges fact that the judge put his reason- space for several public hear- Johnson. Sullivan estimated that in Belenski's amended petition ing down in writing so it can be ings,was"close to frivolous." large requests from a half-dozen rises to the standard of malfea- understood. Belenski's other charges relat- citizens keeps the equivalent of sance or misfeasance.The judge Johnson and Sullivan said ed to the sign ordinance issue and two or three county employees also ruled that Belenski filed his they haven't received the final an agreement with the Washington busy all year. petition in"good faith,"and thus bills from the attorneys hired Environmental Council whereby . county taxpayers, not Belenski, by the county to defend them. that group agreed to put a lawsuit New issue are responsible for paying for "There's something we won't on hold pending revisions to the Meanwhile, Belenski has the two private attorneys who be able to do because of this," Critical Areas Ordinance, which moved on to his next records defended Johnson and Sullivan. Sullivan said of the legal expens- resulted in several contentious request. He said that RCW Asked if he felt vindicated, es. He said it might make sense hearings on those environmental 36.32.210 requires county corn- >ullivan said,"Yes,but still it's a to amend state law on recall protections. missioners to submit an inven- vaste of time and money." petitions "so people are more As long as they are not tory of all county assets(includ- "I think the outcome is appro- accountable." brought in bad faith,even frivo- ing land,infrastructure,vehicles, riate," said Johnson, who said "I feel bad about that [the lous charges can be brought in etc.)by March 1 of each year recall.actions under Washington and Jefferson County has not III _._ law,Judge Williams explained. done that. "Democracy is not as effi- If a county fails to submit cient as dictatorship, and to be a proper inventory, the stat- successful, democracy requires ute says, "It is the duty of the government to hear the voic- prosecuting attorney ... to insti- es of all citizens, even those tute proceedings against such who cynically nitpick,complain offending official and in addition I excessively or frequently allege thereto to prosecute appropriate impropriety, or otherwise con- action to remove such commis- test the actions of government," sioners from office." Judge Williams wrote. Tuesday afternoon, Chief Recall petitions usually fail, Civil Deputy Prosecutor David said Craig Ritchie, one of the Alvarez characterized the inven- attorneys defending Johnson tory issue as a "hyper techni- and Sullivan. "My usual ques- cal" violation of state law. The tion with people who are subject county is largely in compliance, to recall charges is:Did you kill he said,but he will ask the Board (-pt. anybody,did you steal anything, of County Commissioners to .„...i2_,/, did you do anything bad?If not, review the issue in January. then you are going to win." (Leader staff writer Patrick Johnson thinks the petition J. Sullivan contributed to this i -- �-�—0 was clearly an act of bad faith, story.) quoting a statement Belenski had made earlier about"wanting this on our rap sheets."He sug- - gested that Belenski was "just out to get us." Regarding the Washington Public Records Act, which illBelenski has used to investi- gate..SIA employC t4Se.Q t1111•,.., Iritpirf§tAigotherissucs,Jolinso V Ur.110 no.L � x a k ar+hat`' r"v t'tY r ,wj i ,r ,,,-,,-'7,,t.',•44,',..14,;:-.., x, ,1 t,+ 8j � ,7iltk Tip line .,. ;,,;, „,,.,,,,, ,,,,..y.,....„,„„ . „„, . , „, , , . ,.. , :„,,,,...... , ,,,,,„„,„,..„,,,„..,::„..,,, ,,,,,,,,,..... ,...,„ ,, , .. ..,,,,,,,,,,„:„.4.5,...,.,. ..,,„„. ,A,''''',,,',. ,,, ,,,"'.' '''' P, ' , '. - -;I.;'''P,P.',''#'.. • '� `�.' q. R A Yr 2 t f �H Y' • ..RIR�v+i�C Ai"Po 5 dM1 :. �L i f swirling g �,�. aa4 u`�r a .'tl^m 4�"m wrRr rx^Far, 9{'ve k f "{F r IXn 'k, e r• rxars °"+ wn a�°' ir" ,.�k fY +�.:44,t7'i rra7�" a �" ,� 4 " 'r'°:nem ' ar•w xlK �u r r a t ?w D Amico has noiiictit ',A�,y,� . '' " r" comment; Brees, ) (+ . Belenski deny it By Allison Arthur Leader Staff Writer So who at 360-333-3869 is hunting - - '. for dam •agtrtg information on Jefferson was 55 minutes late on Its 35-minute crossing from Whidbey Island due to windy conditions early Tuesday afternoon. County officials?And why? done of the dock's wooden dolphins(center). Its a question that's been per- Photo by rami Hewitt plexing some county officials and perturbing others. )rl'n a 3OAn advertisement in The Leader e#zliril'..a -�•#•� k,' rr that ran six times in November and " " ' " December asked people to call the r , �` rrf � „ sF ,•,� a `. Jefferson County Tip Line if they �' " knew of any"illegal,immoral or civil ?r or not, it's a wild winter J� ty t+ M` •,` �t t rights violations by Jefferson Coun k �' :E �x government officials against any citi- es from last Friday accident scenes. �rw g ! ' "fir i` zen,employee or property owner." en't all been cleared Dial 511 for traveler's assistance a r, ,' "• The anonymously placed ad has vild winter weather is road. conditions, floating bridge condi- x"4 ` not been published so far in January. d forecast. tions and state ferry reports. �( t.",',, r *: But the questions about who could :e, snow: Take your Dial 911 to report actual emergen- ^'4 be behind the mysterious Jefferson rig upon your location cies. • County Tip Line have not ceased. 40 ty,within the next two d ' ~. While Jefferson County officials could see it all. Ferry delay ' declined to speculate on the record se Mother Nature is Last Friday's winds disrupted the about who could be trying to col- de,as the wild winter Port Townsend-Keystone state ferry • '':• :•'•' d lect potentially damaging infotma- eady proven, route for a day, and even more trouble ,l'''''..- �'• ,r tion about them,several did say they e of possible school happened yesterday. • !' there are three people who have been sures if road condi- Tuesday's high winds broke afloat- ` ° "' outspoken and who might go so far ck for updates on our in dolphin at the ferry dock,and it took Claire Deleo has lived in her home along as to pay for information. :r.com or visit www. three or four attempts to finally land the Oak Bay Road just outside Port Hadlock The most discussed individual is Klickitat at the westerly dock with the since 1974.The first windblown trees to Joe D'Amico,president of Security ire hoping there won't single-lane ramp.No injuries or damage actually fall on her house hit last Friday Services Northwest Inc.He operates ow days." The Port to vehicles were reported. night.This is the soggy rootball from the a security and armored car service District has already "It was wild,"said walk-on passe largest fallen fir."Don't ever buy a house at on property south of Gardiner. The of year by postponing ger Gwen Sam of Whidbey Island.The the bottom of a hill,"she said."Its surpris- operation includes a firing range, Zencement from June crew stayed calm and did an outstand- Ing how wet the ground becomes." which has created noise issues that ;ount for days already ing job, she said. "They were so great Photo by Patric kJ.Sullivan for two years has been the subject of that I wasn't scared." boat,he said."It was pretty crazy." complaints from neighbors or distant to wild winter weath- "I didn't think they would let us on" Ferry dock attendant Mike Tucker homes around Discovery Bay. iin issue: said Rick Jones of Port Angeles,anoth- said that the crew chose to dock at the D'Amico is embroiled in a war caned wire as a live er walk-on passenger."I'm a surfer,"he westerly dock with the one-lane ramp See TIP,Page 8 rr.Also, stay cleaz of said,and he would have enjoyed surfing because of the broken floating dolphin les working around in the 6-to 8-foot swells that rocked the The Surf ��``,, See STORM,Page 9 - -,. R= ;, . K� 1r n adrift in „.,,,,-.„,,,.:,,,7!"..ii"---'',,-" t�`n' 'w R ,. b �t �t�4t'— ' • t ! shor • e ,41;:,:z:,1;;;ZTf,',';',---;21,,, ,, ...„...... ,_ , ,,. 5,14 ill -,-,-..-- - 01,0'.- '.."1.,1 N,-- � � 'fes ' & 94'.4,1%,,,k,..,,, M1dG'!� y �:;r�k. w tom s �d-ua�'�'i dr�, r .1.,./ - , _ � , �rr„a544 � � elan :_ k . can y �� rules * d ., ua..4„x.. $ • ''..,,,t',A. kd 1 - •e�+-e :4�'” ,�:r g fl �ufi,t'�.,y'�'Ji6 By Ramey Burke .. nice so oner our ranges LU uLesc • departments immediately, with- out delay.This is a public safety ��tthe :for pp line seeks issue and these departments needips your support,"e D'Amico departments wrote A`dl$Play advertisement publ d to The Leader six times .n November and December asked people to call the Jefferson County commissioners. Tip Line about any illegal immoral or civil rights violations." to County Administrator John Persons with knoetledge of use and sales of narcotics are especially Fischbach said Monday he Continued from Page 1 ^ �ticouraged to tail"tike gd said. ;., would be talking to Scalf about of words and lawsuits with The ad further noted that there is a reward for information upon . D'Amico's request. the county over land use laws "conv!dionor recover.''It didn't spell out what the reward is. "I need to determine whether restricting his business. He's Duplicating the message on the tip line's answering service,the ad the board has the authority to repeatedly asked the county to :': said all information would be kept confidential. grant an emergency or not. I'm come to terms with him,and he The ad has a disclaimer in smaller print that says the tip line is for not sure how the code is writ- recently asked that the state attor- °tnformational purposes only.The_tip line is not affiliated with ten,"Fischbach said.He said he ney general's office investigate any Jefferson County government agency.Emergencies should be ` would respond by next Monday. his complaints against Jefferson directed to 911.` "Obviously, there are a lot County Prosecuting Attorney , of questions to consider.Who is Juelie Dalzell. He has issued authorized to do the training?" public challenges to other coun- details of which officials cannot retaliation," said Jefferson ty employees. Several elected discuss due to medical privacy County Commissioner Phil officials thought D'Amico might 'laws. She was a key member Johnson. "Some people feel ) be hunting for ammunition to of county staff working on the intimidated by it. Whoever is M. 1. . A L T Y . use against the county and the SSNW,case and was singled out doing it is basically impugn- Oak Bay Road • Port Ludlow staff in retaliation for the county in documents D'Amico had filed ing the integrity P employees," attempting to enforce regulations to raise doubts about how the Johnson said,adding he thought d and Operated Q® MIS against the firing range aspects county was handling his case. it was pathetic.He added that he of his business. is not personally intimidated. PORT LUDLOW D'Amico in December Belenski,Brees "I don't like it.I think it's like requested a copy of Dalzell's Mike Belenski's name also Big Brother looking over us," WATER VIEW LOT daytime planner for 2005 and came up because of his recent Johnson said. "It's an uncom- . r" °" 4 2006 through the state Open unsuccessfulrecal1petitionagainst fortable thing having something ` Public Records Act,Daizell said. Jefferson County Commissioners hang over the employees of the ; ,a , :'* "";07 She said it took her assistant at Phil Johnson and David Sullivan. county." t; .— least an hour to copy it all. Belenski is persisting with his ..,,�,,._ ..".1-...,” D'Amico has repeatedly self-described efforts to oust the Rumors&innuendo said"no comment"when asked two elected officials. It's rumors about how gov- •,i y =i whether he's the man behind "I don't know anything about ernment operates in Jefferson �*'' the tip line.And The Leader has that.I'm sure people might think County that led to the birth of `' f * asked him more than once. it's me, but it's not," Belenski the tip line, said a man who One county official, who said. answered the tip line and identi- 40 of the only LARGE water view parcels remain- declined an on-the-record com- "Somebody must be dissatis- fled himself only as Scott. He n the Port Ludlow resort.Over 6/10ths of an ment,said he suspects D'Amico fled with someone,"he added. declined to give a last name. with views of Port Ludlow Bay.Sewer hookup is behind it because of tip line Richard Brees' name was "Some of what we're trying idy paid($10,000 value);in an area of estate pamphlets passed around at the mentioned because he ran unsuc- to do is to separate the rumors les,close to golf,marina,tennis,Club,exercise no-shooting ordinance hearing cessfully last year against Sheriff from the facts,"said Scott. hies,more.$425,000 MLS#26197200 last November. Mike Brasfield and has sued The tip line is looking for Last year, a longtime county the county. On Jan. 4,2007,he hard, usable information about employee most recently a permit filed a complaint in U.S.District "corruption" in county govern- w,from the Hood Canal investigator with the Department Court accusing Jefferson County, ment,he said.Scott said tip line these great listings! of Community Development the Jefferson County Sheriff's creators want to remain anony- i LO W A D M I R A LT Y.C O M went on family medical leave, Office and three sheriff's depu- mous for now because they are ties of violating his civil rights. in an information-gathering stage But in regard to the tip line, and there are people, includ- 2 Brees said he didn't do it. ing county employees, who are sq ft Only And like.Prosecutor Dalzell, scared about the information Howie Brees said he got curious and they have on their bosses, for $79,900 called the tip line.He also had a example. message for whoever is doing it. . "No comment," said Scott , ''''r''''- 3 � � ; a g "I told him I had a real prob- when asked who was behind the '*.-.(2,-,f. ` * ' '. z uz lem with him because he wasn't tip line and what kind of infor- ;LE • willing to step up in the light mation has been gathered so far. i E ' ". ,04.0„.„,,,,,,,..g rF of day and he was operating in "I'm not going to describe .TION a asecrecy," Brees said. "If he's who we're talking to.Some peo- doing something honorably, I pie are scared about the informa- mes -iii.. don't believe you need to hide in tion they have,"Scott said. ''' ''9 i l ; i t ,, v' the shadows." Asked how long the tip line red �,' , r will be in operation Scott said, Walls Dalzell called "That's like saying When will 7n - r=2�•��^ l Prosecutor Daizell wanted to we get out of Iraq?' There are DININGli know what was up,so she called too many factors." "re'" KITCHEN�Y MFSTEfl BEDRM "y... x the tip line and asked. He said it would stay operat GARAGEill Sheriff Mike Brasfield said ing"for as long as it takes." ANT ster baths V ___ " P 7 if the folks who operate the tip But Scott did say that there — 1 �..O{7 CLOSET line come up with anything, he would come a time when the Ited ceilings GREAT ROOM LAUNDRY O S I! assumes they'll call him and information he and his agents are anty on siding " "r O share.Brasfield won't call them. collecting will need to be shared I ENTRY RDENo If anything, the tip line has with the public.He said the infra..optional �T I been the topic of courthouse mation might be taken to the state COVERED RORCN grumblings and gossip over who attorney general's office or per. -----.,,..., uuuwl«cu to uv um uauung: public challenges to other coun- details or wtuch otnctals cannot retaliation," said•°'Jetterson' ty employees. Several elected discuss due to medical privacy County Commissioner Phil officials thought D'Amico might 'laws. She was a key member Johnson. "Some people feel A T �/ ' be hunting for ammunition to of county staff working on the intimidated by it. Whoever is D, M, I R A L ■ i;; use against the county and the SSNW case and was singled out doing it is basically,impugn- . Oak Bay Road • Port Ludlow staff in retaliation for the county in documents DsAniico had siled ing the integrity,of employees," ed and Operated ^ attempting to enforce regulations to raise doubts about how the Johnson said,adding he thought 6 ': ® MLS against the firing range aspects county was handling his case. it was pathetic.He added that he °` of his business. is not personally intimidated. PORT LUDLOW D'Amico in December Belenski,Brees "I don't like it.I think it's like WATER VIEW LOT requested a copy of Dalzell's Mike Belenski's name also Big Brother looking over us," daytime planner for 2005 and came up because of his recent Johnson said. "It's an uncom- rrwmatt' E �� � -i 2006 through the state Open. unsuccessfulrecallpetitionagainst fortable thing having something ` § Public Records Act,Dalzell said. Jefferson County Commissioners hang over the employees of the A i;l '`' She said it took her assistant at Phil Johnson and David Sullivan. county." least an hour to copy it all. Belenski is persisting with his D'Amico has repeatedly self-described efforts to oust the Rumors&innuendo ,-" said"no comment"when asked two elected officials. It's rumors about how gov- :^ Aa w ;> �, , whether he's the man behind "I don't know anything about ernment operates in Jefferson ' ar "r the tip line.And The Leader has that.I'm sure people might think County that led to the birth of asked him more than once. it's me, but it's not," Belenski the tip line, said a man who One county official, who said. answered the tip line and identi- of the only LARGE water view parcels remain- declined an on-the-record corn- "Somebody must be dissatis- fled himself only as Scott. He n the Port Ludlow resort.Over 6/10ths of an ment,said he suspects D'Amico fled with someone,"he added. declined to give a last name. with views of Port Ludlow Bay.Sewer hookup is behind it because of tip line Richard Brees' name was "Some of what we're trying )dy paid($10,000 value);in an area of estate pamphlets passed around at the mentioned because he ran unsuc- to do is to separate the rumors es,close to golf,marina,tennis,Club,exercise no-shooting ordinance hearing cessfully last year against Sheriff from the facts,"said Scott. ties,more.$425,000 MLS#26197200 last November. Mike Brasfield and has sued The tip line is looking for Last year, a longtime county the county. On Jan. 4,2007,he hard, usable information about employee most recently a permit filed a complaint in U.S.District "corruption" in county govern- N,from the Hood Canal investigator with the Department Court accusing Jefferson County, ment,he said. Scott said tip line these great listings! of Community Development the Jefferson County Sheriff's creators want to remain anony- LO W A D M I R A LT Y.C O M went on family medical leave, Office and three sheriff's depu- mous for now because they are ties of violating his civil rights. in an information-gathering stage But in regard to the tip line, and there are people, includ- 2 Sq ft onlyBrees said he didn't do it. ing county employees, who are And like Prosecutor Dalzell, scared about the information Honie $79,900 Brees said he got curious and they have on their bosses, for called the tip line.He also had a example. • message for whoever is doing it. "No comment," said Scott "` rAr "I told him I had a real prob- when asked who was behind the z xS g z%,2 s• as k• Asx. LES lem with him because he wasn't tip line and what kind of infor- �' willing to step up in the light ma'tion has been gathered so far. E ,.:-.,*,,..4,15',A: , of day and he was operating in "I'm not going to describe TION secrecy," Brees said. "If he's who we're talking to.Some peo- ti doing something honorably, I ple are scared about the informa- les N t --, ,, _ don't believe you need to hide in tion they have,"Scott said. ,d N! the shadows." Asked how long the tip line Halls will be in operation Scott said, fi� Dalzell called "That's like saying When will 1 — ®■-■ _■ = Prosecutor Dalzell wanted to we get out of Iraq?' There are DINING iva] know what was up,so she called too many factors." KRTHEN„y MASTER BEDRM 401- GARAGE �® ®BATH ,3 x,e the tip line and asked. He said it would stay operat- (Or ONAL) ter. ,.,.,'.\fid ,,,,, g Sheriff Mike Brasfield said ing"for as long as it takes." er baths ____ :: if the folks who operate the tip But Scott did say that there r 1C; ine come upwith ed ceilings ! cosLosET anything, he would come a time when the GR,EAT ROOM LAUNoRY" assumes they'll call him and information he and his agents are ity on siding ° ' share.Brasfield won't call them. collecting will need to be shared ENTRY )ptional ® •e x I If anything, the tip line has with the public.He said the infor- DDVERED PORCH --- been the topic of courthouse mation might be taken to the state J grumblings and gossip over who attorney general's office or per- .. SEDAN 2 REDRM.3 is gunning for what information haps the Washington State•Patrol. Every Home ,2,0.,,,, 1 „az,r Protected by the to be used for what purpose. He also suggested newspapers G!8 Microbe SbleldibehnoloiSi While some elected officials such as The Leader and Seattle have expressed curiosity, oth- newspapers ought to be engaged 100%Financing Available O.A.0 4 .Counb eC ers are expressing concern.They in the same kind of information- Get pre-qualified for your construction loan , suggest the ad is being used as a gathering process about Jefferson JR SITE today!Call Jennifer Nance 1-866-459-7736 ,:_.. HOME LOANS tool to intimidate public officials County government. and county employees who are And Scott also acknowledged 40 e online • - just trying to do their jobs to the that some of the calls the tip line ■H LIhe Homes■com best of their ability- has been getting are "whining "It has almost a feeling of See CONCERN,Page 9 d i - u--..w_-y.. , r Port Townsend&Jefferson County Leader .s`, rfq Concernr2:1C.7.11 fo4ii'',FSurfic r Continued from Page 8 . , calls"from people who call the sheriff's office about barking Continued from Paget has been closed since it was bat t , dogs. .a :ev tered by a storm in November • That's not the kind of infor- 2005. :. s mation the tip line is looking `` The Surf and the adjacent 11 ` for,Scott said. Hastings Building are owned .. 1 "Details of corruption or 1, by the Hastings Estate Co. The .mss wrongdoing of any county offi- v company had requested revisions ,�<• t cial"is more what the tip line F , ,, to the city's shoreline program r creators have in mind,he said to accommodate its proposal to h replace The Surf,built circa 1930, t County opinions a;:. .,-,F. A e v e ` with a new building up to 50 feet Because it's her job to pros- , criminals in Jefferson the Jefferson County " Health in height with approximately the The Surf b same j . as a result County, elected county Department, footprint"over the water questioned the tip The city's new shoreline pro- Prosecuting Attorney Dalzell line's purpose. Baldwin sug- replace it gram does not include those revi- says she wants to know what- gested it makes employees feel poral is to l sions, and the DOE concurred ever the tip line generates that threatened but does not con- with that position, said Senior could lead to criminal activity. tribute to oversight. Feeling it was her duty to "My concern with the tip Planner Judy Surber. After the vr council meeting, she explained Surber. F check it out, Dalzell said she line is the implication that if that an application filed by residentii called and asked if whoever you work for government your I was collecting information had behavior is suspect,"she said. Hastings is vested under the pre- floor use I vious shoreline rules because it building any anythingshare to with her County employees are was filed last year. not allow office. She said a man who being asked to uphold the law, I identified himself as Scott said and that often means enforc- Under the old shorelinerules, tures. r he didn't have anything but he ing rules, some of which are The Surf ist a legal noncon- The S forming building, said Surber. dates to had heard rumors and innu- unpopular. Accordingly, it can be replaced Dudley, endos. Every day,health officials by a new building of the same Estate C "If you have any informa- are in restaurants enforcing size and height, or it can be estimate tion, would you please give it food-safety law, on private r to me because I'll prosecute," property monitoring stream replaced by a building up to 35 a Band feet in height with a footprint he said, • Dalzell said she told him."He runoff, septic systems and such that the total square footage repair we 3 had nothing to give me is what water quality, and in homes, is no larger,she said. not inclu he said," Dalzell recalled. "I offices and business through- "We would like to see rede- ing the told him if he was uncomfort- out the county,"she noted. t able giving it to me he could Someone is likely to object give it to the state attorney to those actions,but they aren't 5to r • I general and he said OK." illegal,she said. 1 Dalzell and a few other "Two years ago a former , • county officials say they have Jefferson County resident was no idea who is behind the tip murdered by a patient while Continued from Page 1 service s I line, and while Dalzell has a working with Kitsap Mental at the other dock. "We didn't trunk fro suspicion of who it might be, Health,and last yearthere was want to chance it," he said. causing she's reluctant to say the name a stabbing of a Seattle-King Tucker said the extent of the age or hi publicly. County Health Department damage isn't known yet,but the below. • Like other county officials, WIC clerk by a`walk in'at the dolphin broke apart as the waves Inspec D• alzell said she could see how clinic,"she noted. and high winds pounded it. Gated tha r the tip line could be demof ho oraliz- Treatment of county "Everythnt real smooth," estimated Tucker said how the crew han- the trunk ing for non-elected employees. employees is an issue, several dled the situation. "You couldn't with fou 1 "We know what we're sign- officials said. ask for a better captain or mate — probat i ing up for,"Dalzell said. A Jefferson County than the C watch,"he said. ing projl • I Sheriff Brasfield would not Assessor's Office appraiser, windston t say who he thought it might Dennis Pownall,was assaulted Tree removal the tree a 1 be. a year ago when he went on Small trees and branches posed rootball s "It's fruitless to try to guess private property to reassess problems on county roads and Port who paid for the ad,"Brasfield the land.A man lunged at the Townsend city streets. A 70-foot I said. He said he hadn't seen appraiser and knocked a cam- fir tree broke in the wind at Fort it and has no clue who might era out of his hands. Worden State Park and smacked ,...,. . �..:....: ,..:...nil . __ ___ j "It's fruitless to try to guess private property to reassess �' ' � `°' • • '" l"'`un " who paid for the ad,"Brasfield the land.A man lunged at the Problems on county roads and Port said. He said he hadn't seen appraiser and knocked a cam- Townsend citystreets. A 70-foot +* i it and has no clue who might era out of his hands. fir tree broke in the wind at Fort ANDERS want such information. Coincidentally, Pownall Worden State Park and smacked • 1. "I would assume if they was the county employee who the roof of the Joseph W.Wheeler have information that the sher- last week submitted a petition Theater.However,the 1932 brick iff's office or prosecuting attor- signed by 28 employees in building took the hit well,with no ney should have, they'll call," the courthouse who want to no broken damage to brickwork and c" he added. no broken windows. see more security at the court- op,t t "Any effort to proac- house. `"' Parks crews patched a few � ° tively contact them could be limb-poked holes in the theater .':>fi if i perceived to have a chilling County staff roof early Saturday,but officials s effect," Brasfield said of not Assessor Jack Westerman knew the tree had to come off ` k s wanting to appear to interfere III, who has been in office the roof before the next storm with the tipline. arrived. Bruce&Wanda Anderson , 28 years, said that his office Denturist County Administrator John has dealt with a lot of angry A Fort Worden staff member f Fischbach also declined to people over the years. In the made an estimated 40 calls in Serving Kitsap& , comment on who he thought early days, appraisers who the phone book—from Jefferson Jeff Since County might be behind the tip line. went out to reappraise property County to Clallam and to Kitsap 1995 A public official for more might be confronted by gun- —before finding an arborist from than 30 years, Fischbach says toting property owners. In the Port Orchard who could come to he's not aware of any public 1970s, the issue was finding Port Townsend. government corruption here. marijuana-growing operations Walt Lider of Triple A Tree "I think government is in the hinterlands. Nowadays, the same in all parts of the he says the concern is meth ""'` "' country. People are distrust- labs tucked into rural nooks Your friend ful of government, and that's and crannies. Of those three, �ltl Real Estate 1 being portrayed here in Port Westerman said the meth labs A�N'NIC.K Harper NO VV Townsend and Jefferson probably are most dangerous ��301-538$call see County," Fischbach said. He of all for his people. +rnrnursats�tgtsbynkkhnrpsrapm added that he thinks the dis- Westerman also said he's trust might be more prominent concerned about the lack offilrAe Ft er�ng� here than in other places he's civility he sees in political set- REMAX Firstip�Townsend : ;, ,, , :., E'M'S worked, including Colorado tings and throughout society. and Vancouver,Wash. "If you don't agree with me % AlrlltQ�81{�dC Cap • then you are my enemy," is Angry people how Westerman said some P�CE17l�ICt'1 �Vd�U Jean Baldwin, director of people are behaving. ;., � �� ,f �C}'rt�trdt'Cl10�1'aIt'r� Kiwanis crab feed Jan.13 Imaging The Kiwanis Club of Port Although the crab din- FOIjOW UpS Townsend hosts a crab and ner is not an all-you-can eat spaghetti dinner from 5 to 8 affair, with 300 fresh crabs K I TS A I p.m.this Saturday,Jan. 13 at available there should be the Elks Lodge. Ticket cost enough to go around, said tae �FpT, is$15 per person. Ken Brink, Kiwanis club PR�� CARD,I The event is a fundraiser president. `° V ^ i(11)31 for the community service The Elks Lodge is located �/r CONS (ONS club's youth activities and at 555 Otto St. about two Yote Yl"S or senior citizen projects, miles from the city limits. Schools www.kitsapcz February " e \. \.. 7 Night -S. ...,:?„, , .., . �s� Hawaiian Cruise • �s 3 Ne $1:',',`` tiA: :, p 1, aE" . 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