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HomeMy WebLinkAbout2007- February File Copy • Jefferson County Board of 3-Health .agenda Nl inutes • February 15, 2007 JEFFERSON COUNTY BOARD OF HEALTH Thursday, February 15,2007 Main Conference Room Jefferson County Public Health 2:30—4:30 PM DRAFTAGENDA I. Approval of Agenda II. Approval of Minutes of January 18, 2007 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. Seasonal Influenza Update 2. Immunization Update for Physician's Offices 3. 2006 BOH Action Items Thumbnail—Final Copy • V. New Business 1. HB 1825 /SB 5729 Introduced 2. Other Legislative Issues 3. Leadership Development at JCPH 4. On-Site Sewage Operation and Maintenance Privatization Discussion V. Activity Update VII. Agenda Planning VIII. Next Scheduled Meeting: March 15, 2007 2:30PM—4:30 PM Main Conference Room Jefferson County Public Health ski • JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, January 18, 2007 Board Members: Staff Members: Phil Johnson—Count'Commissioner District#1 Thomas Locke,MD, Health Officer David Sullivan—County Commissioner District#2 Jean Baldwin,Public Health Services Director John Austin, Vice Chairman—County Commissioner District Julia Dans kin,Nursing Programs Director #3 Mike McNickle,Environmental Health &Natural Jill Buhler—Hospital Commissioner District#2 Resources Director Geoff Masci—Port Townsend Ciy Council Sheila Westerman—Citiyen at Large(City) Roberta Frissell, Chair—Citi,en at Large(Count') Meeting was called to order at 2:30 pm on January 18, 2007 by Chair Sullivan in the conference room of Jefferson County Public Health. All Board members were present with the exception of Members Phil Johnson and Roberta Frissel. A quorum was present. • ELECTION OF BOARD CHAIR& VICE CHAIR Chair Sullivan called for nominations to elect the new Board of Health Chair. Board Member Westerman nominated Roberta Frissell. Board Member Buhler seconded the motion. The vote passed unanimously. Chair Sullivan called for nominations to elect a new Board Vice Chair. Board Member Buhler nominated John Austin. Board Member Westerman seconded the motion. The vote passed unanimously. APPROVAL OF AGENDA The agenda was amended to include two items under Old Business and Informational Items; signing the Re-executed Ordinance 09-1020-05 due to a scrivener's error in the original document and presentations from Environmental Health staff on new additions to the Department's website. APPROVAL OF MINUTES Board Member Buhler moved to approve the minutes of December 14,2006, as written. Board Member Westerman seconded the motion,which carried by a majority vote. PUBLIC COMMENTS • None OLD BUSINESS • Seasonal Influenza Update Dr. Locke briefed the Board on widespread influenza outbreak activity on the East Coast that is starting to affect Midwestern States. He reported that Washington State is seeing sporadic cases of influenza but no increased level of school absenteeism or other major markers for the start of flu season. The influenza strains that we are seeing nationally appear to be covered by this year's vaccine formulation. He predicted that widespread influenza activity would likely be seen in Washington State in February or as late as March. A question was raised about vaccination of children. Dr. Locke responded that while the vaccine is most effective in children it has traditionally been targeted at children at highest risk for influenza complications. This year there is a surplus of vaccine and greater use in healthy children up to age 5 is being encouraged. If the U.S. were able to make enough vaccine to immunize all school children and vaccination was mandated for school entry(as with several other vaccines) it is thought that seasonal outbreaks of influenza could be largely eliminated.Dr. Locke informed the Board that, on average, 36,000 people a year in the die from influenza in the U.S. People are still being encouraged to get their influenza immunization. Member Austin stated that he would like to see advertisement around influenza and the availability of the vaccine. • Solid Waste Regulations Ordinance 09-1020-05 At the June 15, 2006 BOH meeting there was discussion on the language discrepancies between the Uniform Development Code(UDC) and the Solid Waste Regulations. A motion was made and seconded, at that meeting,to amend the language and assure consistency between the UDC and Solid Waste Ordinance regarding a"no tolerance" policy towards abandoned vehicles in environmentally sensitive areas and limiting the number of junk or abandoned cars to 2 on any single property. Due to a scrivener's error in the amended language correction, County legal counsel has recommended that the Board resign the document. The Board Members were presented with the re-executed Solid Waste Regulations for signature and all original voting members signed it. Environmental Health—Records Accessible on the Web Angela Pieratt, Environmental Health Specialist, was introduced to the Board. Angela gave an overview presentation of the On-site records that have been scanned, formatted and downloaded onto the county website. 2001 records are now available for viewing. She noted that many Environmental Health records are requested by the public and having this information accessible on the web will be a significant benefit. Sarah Murphy, Environmental Health Specialist, Food Safety Coordinator, demonstrated the Food Safety Restaurant inspection results now accessible on the Jefferson County website. She walked the Board through the food safety inspection violations report and the point scoring system used. A complete food establishment list is published on the website. BOH Action Highlights • A list of past year Action Items, from BOH meetings, was presented to the Board for review. This list could be used as a tracking tool for policy actions. There was discussion by the Board including ways to use, improve and expand on the list. In conclusion the board agreed it would be a beneficial tool to summarize yearly activities. Member Masci made a motion to endorse the staff recommendation to create the Action Item addition to the Public Health website. Member Westerman seconded the motion,which carried by unanimous vote. NEW BUSINESS 2007 Legislative Briefing, WSAC Budget Jean Baldwin briefed the Board on the WSAC Priorities. She referred to the 2007 Legislative and Budget Priorities, which supports the increase in public health funding and supports additional, dedicated and stable funding for local public health services as recommended by the Joint Select Committee on Public Health Financing. Dr. Locke commented that additional public health funding for emergency preparedness in recent years, without a corresponding increase in local health infrastructure, has had the unintended consequences of shifting staff resources from communicable disease control and other core public health services. He stated that although we are better prepared for pandemic influenza and other public health emergencies, this increased • preparedness has come at the cost of more cases of chlamydia, gonorrhea and tuberculosis. Local health officials are strongly advocating for an increased state investment in a wide range of public health services, not just emergency preparedness. Member Westerman suggested that further research be done on the status of public health and greater attention be given to Washington's low level of public health funding relative to other states. Member Masci suggested that lobbying be done for B&O tax, earmarking it for public health. In conclusion, Dr. Locke reiterated that this is the time to weigh-in with our legislators. The Legislative session has just started and remains in session for the next 4 months with Bills just now starting to be introduced. Governor's Budget Jean spoke briefly about the Governor's Budget, which has an emphasis on children and insurance for children and the cleanup of Puget Sound. Blue Ribbon Commission for Health Care Cost and Access Report Dr. Locke offered a thumbnail sketch of the governor's Blue Ribbon Commission, which was convened in June and assigned the task of coming up with a series of recommendations for ways to reform the health care system . He summarized that this report establishes the goal of universal access within the next five years and seeks to achieve this through an expansion of the current health insurance system. Universal health insurance for children is given a high priority. An increased investment in public health services as well as health promotion/disease prevention was included in the Commission's recommendations. • Workshop: Policy Discussion on Performance Measures Mike McNickle referred to the 2007 JCPH-EH Performance Measures and introduced the Statewide Environmental Health Indicators in conjunction with the Public Health Improvement Plan Indicators Committee. Environmental Health Directors took the indicators currently used and decided on 3 that have been shown to make an improvement in public health. Mike brought this to the board for recommendation and asked board if they wanted to replace the existing indicators with the 3 indicators approved by the state. Member Masci moved that the BOH set the 3 proposed solid indicators as presented by the Director of Environmental Health. Member Buhler seconded the motion. Vice Chair Austin opened the floor for discussion. Discussion ensued regarding HB4410 funding as it relates to performance indicators. Mike pointed out that EH was 6th on the list of priorities and the proposed 3 measurable outcomes were tied to that revenue. Member Westerman stated that she did not want to drop the existing performance indicators in favor of the 3 statewide indicators. After some discussion it was decided not to post performance measures on the web. Member Masci amended the motion to approve the 3 indicators 'in addition' to the existing indicators being used. Member Buhler seconded the motion,which carried • by unanimous vote. Nurse Family Partnership Update and New Division of Early Learning Quen Zorrah, Public Health Nurse, Infant Mental Health Specialist, gave a presentation on prevention for families. Quen attended both the Governor's Roll-out Education Summit in the fall of 2006 and Governor Gregoire's Early Learning Summit. She touched on highlights of these conferences. The emphasis was on creating a seamless continuum of services for children with shared responsibility and accountability. The ultimate goal is to build a system for early education, not just another collection of programs. Services start pre-birth and continue through college. School assessment records show that half of all Washington children entering kindergarten are not ready to learn. Science has proven that prenatal environment affects a baby's ability to learn. Depression, cigarette smoking, drug abuse, stress, violence, and other factors have an impact on whether that baby will have more or less capacity to learn. Depression screening done at the health department shows 30-40% of all pregnant or new birth mothers are screening positive for depression that can result in their babies born with depression, therefore not fully ready to learn. The most rapid pace of brain development happens within the first three years. A high quality environment increases language and cognitive development as well as impulse control and improving social skills. Creating a public-private partnership, crossing all the boundaries of health, education, • childcare, and family support to create a seamless continuum of services with blended funding sources was also discussed. Strategic planning for this system needs to be driven by data. Funding needs to be generated to create and support infrastructure. It cannot be any one agency. Quen also spoke about `Thrive by Five', a new public-private • partnership which has decided to fund 2 communities to see if a community could unite in a vision and provide a seamless continuum of services for children from the prenatal period to school age. Yakima and White Center communities were chosen because they had already created a vision for their community. Each community was awarded $9 million. `Thrive by Five' statewide, has pledged $100,000 over the next 10 years to communities who are able to unite in a shared vision. The have pledged to provide the infrastructure and the leadership to each community willing to come together and work in a collaborative fashion. Quen says that we still face many challenges. JCPH is seen in a leadership role in young children's issues, more than any other agency, we cross all the program boundaries in young children's issues and is committed to bridging program boundaries. This is a great opportunity to think about what we want for our families. There will need to be enough people in the community who share this vision to take the next step-- finding the funding to build the needed infrastructure. This will require a partnership among all involved agencies. Member Westerman suggested that staff members contact community groups from this program to determine what the group did to get started. Jean and Quen will research ways to proceed with community development. This information was well received by the Board and more discussion will follow in the BOH this year. • Activity Update Member Masci made a request to the County,through the health department,to support the City's proposed compliance officer. He feels that the city would be better served by combining compliance services through an Interlocal Agreement. Member Masci requested the support of the Board of Health. Member Westerman stated that this proposal should come from BOCC. Jean said that she and Mike McNickle would be willing to go to a meeting with the City Council and have a discussion on solid waste issues. Agenda Planning On-site sewage maintenance privatization Meeting adjourned at 4:40 pm. Next Board of Health meeting is February 15, 2007. 1110 JEFFERSON COUNTY BOARD OF HEALTH • Board of 3feaCt( Old Business .agenda Items # IV., 1 • Seasonallnfluenza Update February 15, 2007 Flu kills girl, 7, in Kent; Blanchet closed Page 1 of 2 SEATTLE POST-INTELLIGENCER http://seattlepi.nwsource.com/loca1/302875_blanchet08.html • Flu kills girl, 7, in Kent; Blanchet closed Symptoms soar at Seattle school and at many others in the area Thursday, February 8, 2007 By SCOTT GUTIERREZ AND SUSAN PHINNEY P-I REPORTERS A 7-year-old Kent girl has died from the flu, and Bishop Blanchet High School in Seattle was shut down Thursday as a precaution as cases of flulike symptoms soared at the school in the past week. The girl, identified as Sarah J. Homer, died Monday from heart tissue inflammation caused by the viral infection, the King County Medical Examiner's Office reported. Her case marked the first pediatric flu death in King County since 1999, said James Apa, spokesman for Public Health-- Seattle & King County. He said a few hundred King County residents are estimated to die from the flu each year. "It's a rare complication that can occur in children who are previously healthy. We don't have any evidence that this reflects an unusually severe illness in the community, or an unusually severe illness in children at this time," Apa said. • During the 2004-05 flu season, the federal Centers for Disease Control and Prevention recorded 41 child deaths nationwide from the flu, he said. Officials at Lake Youngs Elementary, where the girl attended school, sent letters home to parents this week about her death, Kent fire Capt. Kyle Ohashi said. The letters informed parents that the girl's death was from a rare reaction to a viral infection. Her family called 911 Monday about 9 a.m., Ohashi said. Blanchet officials decided to shut the school down today and Friday after nearly a third of the student body -- about 300 students out of 1,000 -- called in sick, many with flulike symptoms. Still, the outbreak is less severe than previous flu seasons, according to health officials. In all, 33 schools have had absentee rates greater than 10 percent this week, Apa said. Most absences were attributed to influenzalike illness, according to the health department. Schools throughout the county have been affected, with elementary and kindergarten-through-eighth- grade schools accounting for about 75 percent of the absenteeism reports, the department said. "Absenteeism reports for the week represent a marked increase over the previous week, when five schools reported. But current absenteeism levels are consistent with those observed at the peak of previous influenza seasons," the department noted on its Web site. http://seattlepi.nwsource.com/printer2/index.asp?ploc=t&refer=http://seattlepi.nwsource.co... 2/9/2007 Flu kills girl, 7, in Kent; Blanchet closed Page 2 of 2 Incidences are below what could be expected in Western Washington and throughout the state, it said. In addition, widespread outbreaks of noroviruses (often referred to as stomach flu) are being reported in schools and nursing homes around the state,health officials said. • "We can say that the flu season is on the upswing. We can't say for certain all (the most recent) cases are the flu. This time of year we see other infections and viruses," Apa said. At Blanchet, students are expected to participate in a "virtual school day" today, said staff member Shirley Epton. That means they get their assignments online and turn in the homework Monday. Friday was to have been a freshmen retreat, which has been postponed. Epton said absenteeism had increased each day this week. "If the numbers would have gone down,we wouldn't have canceled school." Ten teachers were also on the sick list, she said. Although Public Health -- Seattle & King County doesn't advise school closures for infection control, Apa does recommend that students who are sick stay home, and advises frequent hand washing for all. It's impossible to predict when flu season will peak, but if it follows trends, it will peak in February and fizzle out in April. P-I reporter Scott Gutierrez can be reached at 206-448-8334 or scottgutierrez@seattlepi.corn. ©1998-2007 Seattle Post-Intelligencer • • http://seattlepi.nwsource.com/printer2/index.asp?plot=t&refer=http://seattlepi.nwsource.co... 2/9/2007 Washington: Washington has seen an increase in influenza activity for weeks four and • five (January 21 through February 3, 2007). Washington States influenza activity level is being raised from local to regional. Increased absenteeism has been seen in schools, but is well below expected levels for this time of year. For reporting schools, absenteeism levels are in the 10-15% range. Mixed symptoms are being reported: influenza-like symptoms (fever and upper respiratory), noro-like viruses and/or gastroenteritis's-like illnesses (diarrhea, vomiting and nausea). Stomach flu is a misnomer for these illnesses which are not related to influenza. Laboratory confirmed cases of strep throat are also being reported. While school absenteeism reports are increasing, absenteeism is well below expected levels for this time of year. Pneumonia- influenza deaths are below expected levels for this time of year. Fifty-five percent of reported influenza cases have been in the 19 and younger age groups, with 18% in the 20-29 age groups. Only 5.7% of cases reported have been in the 60 and above age group. Only one laboratory confirmed influenza A outbreak has been reported in long term care facilities. Unfortunately, one pediatrics death has been reported this season. This is an extremely rare occurrence in Washington State and in the US as a whole. Ninety-seven percent of the cases reported in Washington State are influenza A, covered in this years trivalent influenza vaccine. It is not too late to receive influenza vaccine California and Idaho: Both are reporting regional influenza activity. Oregon: Sentinel and laboratory reports received in week 04 are indicative of an increase in the level of community transmission of influenza and other respiratory viruses in • Oregon. Oregon is reporting regional influenza activity. Respiratory viruses identified to date in Oregon are adenovirus (8), Coxsackie B (1), influenza A (97), influenza B (1), parainfluenza type 2 (4), parainfluenza type 3 (19), parainfluenza type 4 (1), rhinovirus (8), and RSV (23). USA: Weekending January 27, 2007 Week 4 Synopsis: During week 4, influenza activity increased in the United States. Among specimens tested by U.S. World Health Organization (WHO) and NREVSS collaborating laboratories for influenza, 17.9% were positive. ILI data was above baseline for week 4. Eight states reported widespread influenza activity (AR, IN, IA, MD, MN, OK, SC, and TX), 14 states reported regional influenza activity; 15 states reported local influenza activity; and 13 states, the District of Columbia, and New York City reported sporadic influenza activity. The reporting of widespread or regional influenza activity increased from 18 states for week 3 to 22 states for week 4. The percent of deaths due to pneumonia and influenza remained below baseline level. Seven pediatric deaths have occurred since October 1, 2006. British Columbia: During week 4 (Jan21-Jan 27, 2007) BC laboratories reported 37 influenza-positive results. This is an increase over previous weekly reports. Seventeen new ILI outbreaks were reported in schools. Four ILI outbreaks were reported in LTCF's, one of which was confirmed as influenza A. The rate of ILI visits to physicians was substantially lower than the expected level for this time of year. • Board of Health Odd Business .agenda Item # IV., 2 Immunization Update for Physician's Offices • February 15, 24907 • 0 Jefferson County Public Health • 2007 IMMUNIZATION UPDATE January 29, 2007 Pediarix Combination Vaccine. DTaP + Hepatitis B + IPV. Chris Schattenkerk, GlaxoSmithKline Indications and usage. Washington State supplied beginning in February 2007. New Recommended Immunization Schedules and Newly Available Vaccines. Jane Kurata, RN, BSN and Lisa McKenzie, RN, MPH MMRV - ProQuad. Washington State supplied for children 12-15 months for the first dose of each antigen. May be used for catch-up dose for children 16-35 months for the first dose of each antigen. Limited supply at this time. Not to be used for second dose until supply improves. Storage requirements like varicella. Needs to be kept frozen below 5° F (-15°C). Tdap - Boosterix and Adacel. Washington State supplied for all children 11-18 years - Boosterix. Recommended for all teens. • Private supply for 19-64 years - Adacel. One-time booster dose suggested for everyone. Highly recommended for all health care workers, contacts of infants under 12 months of age. Also highly recommended for new mothers after delivery if more than 2 years since last tetanus booster. Many tetanus-containing vaccines are now available. Capital letters in the vaccine designation indicate a relatively higher concentration of that antigen. Lower case indicates antigens with lower concentrations. Vaccines beginning with a capital "T" are for adults and teens. Adults require lower quantities of diphtheria and pertussis. Human Papillomavirus, HPV - Gardacil. A 4-valent vaccine given in a 3 dose series over 6 months. Includes 2 strains that cause 70% of cervical cancers, and 2 strains that cause 90% of genital warts. Licensed for females 9-26 years old. Currently being studied for use in males. Washington State supplied for girls 9-18 years old soon. Probably available in May. Target group will be 11-12 year old girls, before onset of sexual activity, with catch- up for any unvaccinated adolescent girls. Hepatitis A - Havrix and Vaqta. Now part of CDC's Recommended Immunization Schedule for routine use in all children at age 1. Given as two doses separated by 6 months. Washington State supplied for all children 1-18 years. Highly effective in decreasing hepatitis A rates in the U.S. across all ages. (See Hepatitis A handout.) Herpes Zoster - Zostavax. New adult vaccine for shingles protection. Licensed for those ages 60 and over. • Previous shingles episode is NOT and contraindication. Prevents shingles in about 50% of all people over age 60, 64% in age 60-69 group, and also decreases post- herpetic neuralgia. Washington State does not provide vaccine for adults. Zostavax is available at Safeway pharmacy with a prescription, and it is back-ordered to the Jefferson Healthcare pharmacy. Jefferson County Public Health will not stock this vaccine. Storage requirements like varicella. Needs to be kept frozen below 5° F (-15°C). Rotavirus - RotaTeq. New rotavirus vaccine on the market. Probably will be available as a Washington State supplied vaccine in the second half of 2007. Live, oral vaccine. Previous rotavirus vaccine withdrawn after 9 months in 1999 due to rare, but increased incidence of intussusception. Study group for new vaccine >70,000 babies, and incidence of intussusception was the same as in unvaccinated babies. Will only be given between 6-32 weeks of age. More information will be provided when the vaccine becomes available through the Washington State Immunization Program. Thimerosal. • Parents continue to have questions about thimerosal in vaccines. NO pediatric vaccines supplied by Washington State contain thimerosal except influenza vaccine supplied in multi-dose vials. ALL other vaccines are thimerosal- free. Packet contains an interesting article by Dr. Paul Offit of the Children's Hospital of Philadelphia about thimerosal in vaccines. May help answer some parents' questions. Light Sensitivity. Several of the newer vaccines, as well as some of the older ones, are light sensitive. Please keep all vaccines in their boxes and the boxes closed to preserve efficacy. Child Profile Immunization Registry. State vaccine registry can be very helpful in obtaining or verifying immunization histories. If the newest EMR upgrade is able to download data to CPIR, all clinics are strongly encouraged to utilize the registry again. Contact Jane Kurata for information and staff re-orientation. Pediarix Combination Vaccine. DTaP + Hepatitis B + IPV. Chris Schattenkerk, GlaxoSmithKline • Indications and usage. Washington State supplied beginning in February 2007. 1 Instructions for the Use of • Vaccine Information Statements Required Use I. Provide VIS when vaccination is given. As required under the National Childhood Vaccine Injury Act (42 U.S.C. §300aa-26), all health care providers in the United States who administer to any child or adult any vaccine containing diphtheria,tetanus, pertussis,measles,mumps,rubella,polio,hepatitis A (use of hepatitis A VIS required effective July 1, 2006), hepatitis B,Haemophilus influenzae type b (Hib),trivalent influenza,pneumococcal conjugate,or varicella (chickenpox) vaccine shall,prior to administration of each dose of the vaccine,provide a copy to keep of the relevant current edition vaccine information materials that have been produced by the Centers for Disease Control and Prevention (CDC): - to the parent or legal representative* of any child to whom the provider intends to administer such vaccine, and - to any adult to whom the provider intends to administer such vaccine. (In the case of an incompetent adult,relevant VISs shall be provided to the individual's legal representative.* If the incompetent adult is living in a long-term care facility, all relevant VISs may be provided at the time of admission,or at the time of consent if later than admission,rather than prior to each immunization.) If there is not a single VIS for a combination vaccine,use the VISs *"Le'gal ;epr'es ntative".is def ned as a;a' parentorertndivtd�al tubo for all component vaccines. i gshu�#1 ' „ptis The materials shall be supplemented with visual presentations or d Sts ,lawb cots ento oral explanations, as appropriate. un unuorof a minor ld or Wo*Ofe":0:40K, 2. Record information for each VIS provided. • Health care providers shall make a notation in each patient's permanent medical record at the time vaccine information materials are provided indicating: (1) the edition date of the Vaccine Information Statement distributed and (2) the date the VIS was provided. This recordkeeping requirement supplements the requirement of 42 U.S.C. §300aa-25 that all health care providers administering these vaccines must record in the patient's permanent medical record (or in a permanent office log): (3) the name,address and title of the individual who administers the vaccine, (4) the date of administration and (5) the vaccine manufacturer and lot number of the vaccine used. Applicability of State Law Current Editions of VISs Health care providers should consult their legal counsel to Diphtheria,Tetanus,Pertussis (DTaP/DT): 7/30/01 determine additional State requirements pertaining to Haemophilus influenzae type b: 12/16/98 immunization.The Federal requirement to provide the Hepatitis A: 3/21/06 vaccine information materials supplements any applicable Hepatitis B: 7/11/01 State laws. Inactivated Influenza: 6/30/06 Live,Intranasal Influenza; 6/30/06 Availability of Copies Measles,Mumps, Rubella (MMR): 1/15/03 Single camera-ready copies of the vaccine information Pneumococcal conjugate: 9/30/02 materials are available from State health departments. Polio: 1/1/00 Copies are also available on the Centers for Disease Tetanus Diphtheria (Td): 6/10/94 Control and Prevention's website at Varicella (chickenpox): 1/10/07 • 110 http://www.cdc.gov/nip/publications/VIS. Reference • 42 U.S.C. §300aa-26 ! ' i Copies are available in English and in other languages. •/ ,� 1/17/07 • Board of Health Old-Business Agenda Item # 117., 3 • 2006 BOW-.fiction Items Thumbnail February 15, 2007 • 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 allowed on any piece of property. 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 Rodgers moved that the Jefferson County Solid/Hazardous Waste Regulations Ordinance be adopted. The motion was seconded by Vice-Chair Sullivan. • Discussion followed and 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. 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 Sullivan moved that a letter be drafted to Port Townsend City Council in response to Mr. Timmons' proposal to allocate the 2006 PTLET in the PT Police BudgetBoard Member Johnson seconded the motion. A vote was taken and the motion passed by unanimous • vote. Board Member Westerman moved to authorize Dr. Tom Locke to sign the referenced document( "Appointment of Enforcement Officers for 7.80 RCW and Jefferson County Solid Waste Ordinance No. 09-0175-04" ) 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 Health fee increase. Board Member Sullivan moved to vote for a 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 (junk car). The motion was seconded by Board Member Johnson and 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 moved for a public hearing for the new fees and amended fee schedule at February's BOH meeting. Board Member Frissell seconded and the vote passed unanimously. 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. After public hearing, Member Rodgers made a motion to add the enforcement fees to the existing schedule for rebuttal application. Member Johnson seconded the motion, which carried by unanimous vote. 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. The current ordinance requires two County Commissioners be present for a quorum or a vote to take place by the Board of Health. The proposed change would allow all Board of Health members equal voting authority by eliminating the County Commissioners requirement. Board Member Masci moved to approve the motion for the BOCC to review the request. Board Member Buhler seconded the motion, which carried by a majority vote. Three in favor, two against and one abstention. Board Member Masci made a motion to review the Family Support Programs mandate. 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 HB4410 with a change in funding, to $200 million from $10 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. • • 7 CO 01 A A 2 @ @ 2 2 0co 2 - CO CD CD 2 $ / \ / 0) k / o % % 6 6 a e 6 % 6 a R R 0 CD CD 0 R R 0 R R CD R • 2 0 0) 2 e 0) 0) 0) 2 c o 2 2 m rtJ \ I IgEI 3 -°0 « z ƒ « « 0 3 > 0 2 > ° g ° 3 n a ° 0 ° m & 0 I 0 2 f 3 0 0 ± < a 0) o ea 0 o E « (7 m & 2 o a o 2 5 o o - m & & o r = -I m — ] f 7 \ m_ : = cum / / E 0 o < R & 0 _ ° � � ° ° � ( R § ° 0 E \ E E 07 £ m 77 R \ o a) / 0 o / a < # / . a c m m = & $ o , & m m = = o o m < a o m 2 m £ 0- _ _ @ 7 7 0 2 o ja c & o o ] 7 a • coa -0 k a a c c o \ co ] e « 0 8 co/ CD E : # � 7 ■ > /1• i' i / / / \ _0_ co A a / / J § ¥ ) %/ ( k 7 » / / / �\ m c a Co § £ 0a a ^ = e / / 7 ƒ f o & @ 2 > R K § 9 M / k ® 3 3 / k _A ƒ Cn w o $ 3 3 ) / O m 0 0 k_ / co 0 k E \ cn = 2 / o E mc c ' o \ A 03 d CD C f 5- 2 3 q Cl) & - ® — 7 § k 7 Z > � k a) e _■ ¥ \ 0 0 5 Ell 0 o \ m m 00 / 0 -n I M > r w / / = / Z / a k \ ¢ / / < > \ \ \ / / s / \ \ 2 CD 7 2 a 7 g G S g U ƒ a o 2 2 R a ƒfa o c \ « \ / \ / / / E D) 2 2 / c R -' / g o a a a a a o 7 a , 0 o _ m CD J ' ' 7 \ 9 ' J o / 03 E 5. a \ / ƒ k 0 ƒ a E 0 a « o e a a) _ i 0 = e o _, a & E ) « R 0 " a 0 2 _ co o CD 0 = - 0 « m m O IQ ° 70 c / I 0 C g \ m k CD \ 3 / a 0 N9 / / ƒ � • s a)Co U C O C • C a) O O O r � O v. m 4— = C r _O E- CD O C O O N 't EA O U) N C LL N C o• � Q Q. O as cm O Y C O O 2 3 • c0 O O r N • Board of Health Wow Business .agenda Item #`V., 1 • 3-1131825 / SB 5729 Introduced February 15, 2007 H-0976 .2 411 HOUSE BILL 1825 State of Washington 60th Legislature 2007 Regular Session By Representatives Schual-Berke, Curtis, Dunshee, Moeller, Lovick, Morrell, Seaquist, McCoy, Clibborn, Barlow, Green, Appleton, Pedersen, Darneille, P. Sullivan, Kenney, Rolfes, Simpson, McIntire, Roberts and Ormsby Read first time 01/30/2007 . Referred to Committee on Health Care & Wellness . 1 AN ACT Relating to public health funding; amending RCW 82 . 24 . 020, 2 43 . 70 . 575, and 43 .70 .520; adding new sections to chapter 43 . 70 RCW; and • 3 adding a new section to chapter 43 . 135 RCW. 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: 5 Sec. 1. RCW 82 . 24 . 020 and 2003 c 114 s 1 are each amended to read 6 as follows : 7 (1) There is levied and there shall be collected as provided in 8 this chapter, a tax upon the sale, use, consumption, handling, 9 possession or distribution of all cigarettes, in an amount equal to the 10 rate of eleven and one-half mills per cigarette. All revenues 11 collected during any month from this tax must be deposited into the 12 local public health financing account created in section 3 of this act . 13 (2) An additional tax is imposed upon the sale, use, consumption, 14 handling, possession, or distribution of all cigarettes, in an amount 15 equal to the rate of five and one-fourth mills per cigarette . All 16 revenues collected during any month from this additional tax shall be 17 deposited in the violence reduction and drug enforcement account under 18 RCW 69 . 50 . 520 by the twenty-fifth day of the following month. 411 p. 1 HB 1825 a 1 (3) An additional tax is imposed upon the sale, use, consumption, 2 handling, possession, or distribution of all cigarettes, in an amount 3 equal to the rate of ten mills per cigarette through June 30, 1994 , 411 4 eleven and one-fourth mills per cigarette for the period July 1, 1994, 5 through June 30, 1995, twenty mills per cigarette for the period July 6 1, 1995, through June 30, 1996, and twenty and one-half mills per 7 cigarette thereafter. All revenues collected during any month from 8 this additional tax shall be deposited in the health services account 9 created under RCW 43 . 72 . 900 by the twenty-fifth day of the following 10 month. 11 (4) Wholesalers subject to the payment of this tax may, if they 12 wish, absorb one-half mill per cigarette of the tax and not pass it on 13 to purchasers without being in violation of this section or any other 14 act relating to the sale or taxation of cigarettes . 15 (5) For purposes of this chapter, "possession" shall mean both (a) 16 physical possession by the purchaser and, (b) when cigarettes are being 17 transported to or held for the purchaser or his or her designee by a 18 person other than the purchaser, constructive possession by the 19 purchaser or his or her designee, which constructive possession shall 20 be deemed to occur at the location of the cigarettes being so • 21 transported or held. 22 NEW SECTION. Sec. 2 . A new section is added to chapter 43 .70 RCW 23 to read as follows : 24 (1) Protecting the public' s health across the state is a 25 fundamental responsibility of the state. With the commitment to state 26 funding of the public health system as provided in section 3 of this 27 act, the state expects that measurable benefits will be realized to the 28 health of the residents of Washington. In addition, a well-funded 29 public health system is expected to become a more integral part of the 30 state' s emergency preparedness system. 31 (2) This increase in public health funding shall deliver the 32 following outcomes, subject to available funding levels : 33 (a) Create a disease response system capable of responding at all 34 times; 35 (b) Stop the increase in, and reduce, sexually transmitted disease 36 rates; 37 (c) Reduce vaccine preventable diseases; 411 HB 1825 p. 2 J 1 (d) Build capacity to quickly contain disease outbreaks; 40 2 (e) Decrease childhood obesity and diabetes rates; 3 (f) Increase childhood immunization rates; 4 (g) Provide home visiting services that improve birth outcomes and 5 decrease child abuse; 6 (h) Reduce animal-to-human disease rates; and 7 (i) Monitor and protect drinking water across jurisdictional 8 boundaries . 9 (3) Benchmarks for these outcomes shall be drawn from the national 10 healthy people 2010 goals, other reliable data sets, and any subsequent 11 national goals . 12 NEW SECTION. Sec. 3 . A new section is added to chapter 43 . 70 RCW 13 to read as follows : 14 (1) The definitions in this subsection apply throughout this 15 section unless the context clearly requires otherwise. 16 (a) "Base year" means the calendar year ending December 31, 2006 . 17 (b) "Core public health functions of statewide significance" or 18 "public health functions" means health services that : • 19 (i) Address : Communicable disease prevention and response; 20 preparation for, and response to, public health emergencies caused by 21 pandemic disease, earthquake, flood, or terrorism; prevention and 22 management of chronic diseases and disabilities; provision of services 23 to promote healthy families and the development of children; assessment 24 of local health conditions, risks, and trends, and evaluation of the 25 effectiveness of intervention efforts; and environmental health 26 concerns; 27 (ii) Promote uniformity in the public health activities conducted 28 by all local health jurisdictions in the public health system, increase 29 the overall strength of the public health system, or apply to broad 30 public health efforts; and 31 (iii) If left neglected or inadequately addressed, are reasonably 32 likely to have a significant adverse impact on counties beyond the 33 borders of the local health jurisdiction. 34 (c) "Local funding" means discretionary local resources for public 35 health functions, including amounts from general and special revenue 36 funds, but excluding amounts received from fees and licenses and other 410 p. 3 HB 1825 1 user fee types of payments for service. "Local funding" does not 2 include payments received from the state or federal government . 3 (d) "Local health jurisdiction" or "jurisdiction" means a county 4 board of health organized under chapter 70 . 05 RCW, a health district 5 organized under chapter 70 .46 RCW, or a combined city and county health 6 department organized under chapter 70 . 08 RCW. 7 (e) "Population" means the most recent population estimates by the 8 office of financial management for state revenue allocations . 9 (2) The local public health financing account is created in the 10 state treasury. All receipts from RCW 82 .24 . 020 (1) must be deposited 11 in the account. Money in the account may be spent only after 12 appropriation. Expenditures from the account must be used for the 13 purposes specified in subsections (3) and (4) of this section. 14 (3) Beginning January 1, 2008, and on the first business day of 15 each January thereafter, the state treasurer shall distribute from the 16 local public health financing account five million four hundred twenty- 17 five thousand dollars to be shared equally amongst all local health 18 jurisdictions . Jurisdictions shall use the money to fill at least two 19 full-time equivalent positions to address core public health functions 20 of statewide significance. 41021 (4) Beginning January 1, 2008, and on the first business day of 22 each fiscal quarter thereafter, the state treasurer, in consultation 23 with the department of revenue or the department of health, as 24 necessary, shall distribute money in the local public health financing 25 account as provided in this subsection (4) . The distributions under 26 this subsection (4) are subsequent to the distribution under subsection 27 (3) of this section. 28 (a) Sixty-seven percent of the distribution under this subsection 29 (4) must be apportioned to local health jurisdictions in the manner 30 provided in this subsection (4) (a) . The apportionment factor for each 31 jurisdiction is the population of the jurisdiction' s county as a 32 percentage of the statewide population for the prior calendar year. 33 For two or more counties that have jointly created a health district 34 under chapter 70 .46 RCW, the combined population of all counties 35 comprising the health district must be used. Money received by a 36 jurisdiction under this subsection (4) (a) must be used to fund core 37 public health functions of statewide significance, and until July 1, 410 HB 1825 p. 4 • 1 2008, money shall be used to fund only known deficiencies in core 40 2 public health functions of statewide significance of the jurisdiction. 3 (b) (i) Sixteen percent of the distribution under this subsection 4 (4) shall be deposited into the local core public health incentive 5 account hereby created in the custody of the state treasurer. 6 Expenditures from the account must be used only for the funding of core 7 public health functions of statewide significance by local health 8 jurisdictions, and until July 1, 2008, money shall be used to fund only 9 known deficiencies in core public health functions of statewide 10 significance of jurisdictions. Only the secretary, or the secretary' s 11 designee, may authorize expenditures from the account . The account is 12 subject to allotment procedures under chapter 43 . 88 RCW, but an 13 appropriation is not required for expenditures . 14 (ii) For a jurisdiction to receive funding under this subsection 15 (4) (b) , an application must be submitted to the department . The 16 application must be in a form and manner prescribed by the department . 17 A distribution to a jurisdiction under this subsection (4) (b) shall 18 equal the lesser of : (A) The amount by which local funding spent by 19 the jurisdiction on public health functions in the previous calendar • 20 year exceeded the amount of local funding spent by the jurisdiction on 21 public health functions in the base year; or (B) sixteen percent of the 22 revenue collected under RCW 82 .24 . 020 (1) in the previous calendar year, 23 as reduced by the distribution in subsection (3) of this section in the 24 previous calendar year, multiplied by the county' s population as a 25 percentage of the statewide population for the prior calendar year. 26 For two or more counties that have jointly created a health district 27 under chapter 70 .46 RCW, the local funding and population amounts must 28 be determined by combining the amounts for the counties comprising the 29 health district . The department shall distribute money to a 30 jurisdiction under this subsection (4) (b) in the same calendar year in 31 which the jurisdiction applied for funding under this subsection 32 (4) (b) . A jurisdiction must reapply every calendar year to receive 33 funding under this subsection (4) (b) . Distributions under this 34 subsection (4) (b) are subject to available funding. Beginning with the 35 account balance existing on December 31, 2008, and the balance on 36 December 31st of each year thereafter, any balance remaining in the 37 local core public health incentive account in excess of three million 411 p. 5 HB 1825 • 1 dollars must be transferred, within thirty days, to the state 2 treasurer. The state treasurer shall distribute the excess funds in 3 accordance with (a) of this subsection. 4 (c) Seven percent of the distribution under this subsection (4) 5 shall be deposited into the local core public health incentive account 6 created in (b) of this subsection (4) . For a jurisdiction to receive 7 funding under this subsection (4) (c) , an application must be submitted 8 to the department . The application must be in a form and manner 9 prescribed by the department . A jurisdiction may receive a 10 distribution under this subsection (4) (c) if the jurisdiction' s per 11 capita local funding in the previous calendar year exceeded the median 12 per capita local funding for all jurisdictions in that year. A 13 distribution to a jurisdiction under this subsection (4) (c) shall equal 14 the lesser of : (i) Fifty percent of the difference between the per 15 capita local funding of the jurisdiction in the previous calendar year 16 and the median per capita local funding for all jurisdictions in that 17 year, multiplied by the county population of the jurisdiction in that 18 year; or (ii) seven percent of the revenue collected under RCW 19 82 . 24 . 020 (1) for the previous calendar year, as reduced by the 20 distribution in subsection (3) of this section in the previous calendar • 21 year, multiplied by the county population of the jurisdiction as a 22 percentage of the statewide population for the prior calendar year. 23 For two or more counties that have jointly created a health district 24 under chapter 70 .46 RCW, the local funding and population amounts must 25 be determined by combining the amounts for the counties comprising the 26 health district . The department shall distribute money to a 27 jurisdiction under this subsection (4) (c) in the same calendar year in 28 which the jurisdiction applied for funding under this subsection 29 (4) (c) . A jurisdiction must reapply every calendar year to receive 30 funding under this subsection (4) (c) . Distributions under this 31 subsection (4) (c) are subject to available funding. 32 (d) (i) Ten percent of the distribution under this subsection (4) 33 shall be deposited into the innovative local public health services 34 account hereby created in the custody of the state treasurer. 35 Expenditures from the account may be used only for the funding of core 36 public health functions of statewide significance provided on a 37 multijurisdictional basis. Only the secretary, or the secretary' s S HB 1825 p. 6 e 1 designee, may authorize expenditures from the account . The account is 411 2 subject to allotment procedures under chapter 43 . 88 RCW, but an 3 appropriation is not required for expenditures . 4 (ii) A multicounty health district or two or more local health 5 departments jointly may submit an application to the department for 6 funding under this subsection (4) (d) . The application must be in a 7 form and manner prescribed by the department . An application must 8 include a description of changes that a multicounty health district or 9 local health departments, acting jointly, have made to improve delivery 10 of health services related to core public health functions of statewide 11 significance on a multijurisdictional basis . Priority for 12 distributions under this subsection (4) (d) shall first be given to 13 counties that establish multicounty health districts, under chapter 14 70 .46 RCW, after the effective date of this section, before funding is 15 provided to jurisdictions that consolidate resources or health services 16 on a multijurisdictional basis, but have not created a multicounty 17 health district . Distributions must be made on a competitive basis and 18 are subject to available funding. Beginning with the account balance 19 existing on December 31, 2008, and the balance on December 31st of each 20 year thereafter, any balance remaining in the innovative local public 410 21 health services account in excess of one million dollars must be 22 transferred, within thirty days, to the state treasurer. The state 23 treasurer shall distribute the excess funds in accordance with (a) of 24 this subsection. 25 (5) Funding for jurisdictions under subsections (3) and (4) of this 26 section is contingent upon the jurisdiction complying with the 27 performance measures adopted under section 4 of this act . 28 (6) To receive distributions under subsections (3) and (4) of this 29 section in calendar year 2009 and thereafter, total local funding spent 30 by the jurisdiction on public health functions in the calendar year 31 prior to the previous calendar year must have exceeded total local 32 funding spent by the jurisdiction on public health functions in the 33 base year. The department of health shall notify the state treasurer 34 to discontinue distributions if the jurisdiction does not meet this 35 requirement . 36 (7) The department may adopt rules necessary to administer this 37 section. • p. 7 HB 1825 • 1 NEW SECTION. Sec. 4. A new section is added to chapter 43 . 70 RCW 2 to read as follows : 3 (1) The public health improvement committee is established 4 consisting of sixteen members appointed by the governor. In choosing 5 appointees, the governor shall make reasonable efforts to select 6 individuals with expertise in management, performance management, 7 quality management, or systems management . The committee shall be 8 comprised of the following members : 9 (a) Two local public health officials from different-sized local 10 health jurisdictions, at least one of which is an epidemiologist; 11 (b) Two members who serve on a local board of health; 12 (c) One member who serves on the state board of health; 13 (d) One member of the faculty of the University of Washington 14 school of public health and community medicine; 15 (e) Two representatives from nonprofit organizations that address 16 public health issues, at least one of which works with issues relating 17 to global health; 18 (f) One member with expertise in the development of evidence-based 19 medical guidelines or public health guidelines; 20 (g) One representative of community clinics; 21 (h) One representative of tribal health interests; 22 (i) One member who is a representative of a large employer; 23 (j ) One representative of a local emergency management agency; 24 (k) One representative of the interests of physicians; 25 (1) The secretary, or his or her designee; and 26 (m) One member representing the interests of the public. 27 (2) Members of the initial committee may be appointed to staggered 28 terms of one to four years, and thereafter all terms of appointment 29 shall be for four years. No member may serve more than two consecutive 30 full terms . Each member shall hold office until a successor is 31 appointed. Members of the committee shall be compensated in accordance 32 with RCW 43 . 03 .250 and shall be reimbursed for their travel expenses 33 while on official business in accordance with RCW 43 . 03 . 050 and 34 43 . 03 . 060 . The committee shall elect a chair from its members to serve 35 for a term of one year or until a successor is elected. Meetings of 36 the committee shall be at the call of the chair. The committee may 37 appoint work groups to assist in the completion of its 38 responsibilities . • HB 1825 p. 8 t 1 NEW SECTION. Sec. 5. A new section is added to chapter 43 . 70 RCW 410 2 to read as follows : 3 (1) By April 1, 2008, the committee shall develop a list of 4 activities and services offered by local health jurisdictions that 5 qualify as core public health functions of statewide significance as 6 defined in section 3 of this act . 7 (2) By October 1, 2008, the committee shall develop appropriate 8 performance measures applicable to the core public health functions of 9 statewide significance that local health jurisdictions must provide 10 pursuant to section 3 of this act . In developing the performance 11 measures, the committee shall consider levels of performance necessary 12 to promote uniformity in core public health functions of statewide 13 significance among all local health jurisdictions, national standards 14 of performance, and innovations in public health practice. The 15 performance measures shall be developed to meet the goals and outcomes 16 in section 2 of this act . The office of the state auditor shall 17 provide advice and consultation to the committee to assist in the 18 development of effective performance measures and health status 19 indicators . • 20 (3) The committee may revise the performance measures as 21 appropriate. 22 (4) The department and the local health jurisdictions shall abide 23 by the list of activities and services and the performance measures 24 developed pursuant to this section. Prior to modifying the committee ' s 25 list, the department must consult with the committee and provide 26 written notice of its rationale for such changes . 27 (5) The department shall provide technical and administrative 28 assistance to the committee. 29 NEW SECTION. Sec. 6 . A new section is added to chapter 43 .70 RCW 30 to read as follows : 31 (1) Beginning July 1, 2009, local health jurisdictions are eligible 32 to receive funds under section 3 (4) of this act from the local public 33 health financing account only upon demonstrating that the local health 34 jurisdiction has : 35 (a) Complied with the performance measures adopted under section 5 36 of this act; and 411 p. 9 HB 1825 1 (b) Spent funds received after July 1, 2008, under section 2 of 2 this act in accordance with the criteria established in that section. 3 (2) The secretary shall adopt a schedule for reviewing the 4 compliance of local health jurisdictions with the performance measures 5 and spending requirements such that each local health jurisdiction is 6 reviewed at least once every two years . Each local health jurisdiction 7 shall submit to the secretary such data as he or she determines is 8 necessary to allow the secretary to assess the compliance of the local 9 health jurisdiction. The secretary shall inform the state treasurer 10 that a local health jurisdiction is eligible to receive funds from the 11 local public health financing account after it has been determined that 12 the local health jurisdiction has demonstrated compliance with the 13 performance measures and that prior funds received from the local 14 public health financing account have been spent to improve core public 15 health functions of statewide significance, as defined by the committee 16 or its successor in section 5 of this act . 17 (3) The secretary shall provide any local health jurisdiction that 18 has failed to meet the eligibility requirements in subsection (2) of 19 this section with a notice of noncompliance and a detailed accounting 20 of its deficiencies . The secretary shall provide technical support to 21 assist the local health jurisdiction in meeting eligibility 410 22 requirements . 23 (4) Any local health jurisdiction that has failed to meet the 24 eligibility requirements in subsection (2) of this section must return 25 to compliant status within one year of the secretary' s issuance of a 26 notice of noncompliance. After one year, the secretary shall inform 27 the state treasurer that the local health jurisdiction is not eligible 28 to receive funds from the local public health financing account . Funds 29 may resume once the local health jurisdiction has submitted a plan of 30 correction to the secretary and demonstrated that it has returned to 31 compliant status with respect to the performance measures and spending 32 requirements . 33 (5) The secretary may temporarily suspend the eligibility 34 requirements established in subsection (2) of this section to allow for 35 the continued receipt of funds where the secretary finds that the local 36 health jurisdiction was not able to comply with the performance 37 measures and spending requirements due to extraordinary circumstances 411 HB 1825 p. 10 • 1 requiring the local health jurisdiction to respond to a serious public III2 health threat . 3 NEW SECTION. Sec. 7 . A new section is added to chapter 43 .70 RCW 4 to read as follows : 5 By November 15, 2011, the department shall report to the 6 legislature and the governor on the distribution of funds under section 7 3 of this act and the use of those funds . In addition, the report must 8 discuss the performance measures adopted by the advisory committee and 9 the impact of the funds to improve compliance with the performance 10 measures and health status indicators . 11 Sec. 8 . RCW 43 . 70 . 575 and 1995 c 43 s 2 are each amended to read 12 as follows : 13 Unless the context clearly requires otherwise, the definitions in 14 this section apply throughout RCW 43 . 70 . 570 through 43 . 70 .580 15 43 . 70 . 520, and sections 4 through 7 of this act . 16 (1) "Capacity" means actions that public health jurisdictions must 17 do as part of ongoing daily operations to adequately protect and 18 promote health and prevent disease, injury, and premature death. The 19 public health improvement plan identifies capacity necessary for 20 assessment, policy development, administration, prevention, including 21 promotion and protection, and access and quality. 22 (2) "Committee" means the public health improvement committee 23 established in section 4 of this act . 24 (3) "Department" means the department of health. 25 ( ( (3) ) ) (4) "Local health jurisdiction" means the local health 26 agency, either county or multicounty, operated by local government, 27 with oversight and direction from a local board of health, that 28 provides public health services throughout a defined geographic area. 29 ( ( (4) ) ) (5) "Health outcomes" means long-term objectives that 30 define optimal, measurable, future levels of health status, maximum 31 acceptable levels of disease, injury, or dysfunction, or prevalence of 32 risk factors in areas such as improving the rate of immunizations for 33 infants and children to ninety percent and controlling and reducing the 34 spread of tuberculosis and that are stated in the public health 35 improvement plan. • p. 11 HB 1825 1 ( ( (S) ) ) (6) "Public health improvement plan, " also known as the 2 public health services improvement plan, means the public health 3 services improvement plan established under RCW 43 .70 .520, developed by 411 4 the department and the committee, in consultation with ( (lo al health 5 0- 0. - - o ' - - - - __- _ _ -. - , -- --- - 6 services commission, area Indian health services, and) ) other state 7 agencies, health services providers, and residents concerned about 8 public health, to provide a detailed accounting of deficits in the core 9 functions of assessment, policy development, and assurance of the 10 current public health system, how additional public health funding 11 would be used, and to describe the benefits expected from expanded 12 expenditures . 13 ( ( (6) ) ) (7) "Public health" means activities that society does 14 collectively to assure the conditions in which people can be healthy. 15 This includes organized community efforts to prevent, identify, 16 preempt, and counter threats to the public ' s health. 17 ( ( (7) ) ) (8) "Public health system" means the department, the state 18 board of health, and local health jurisdictions . 19 Sec. 9. RCW 43 . 70 .520 and 1993 c 492 s 467 are each amended to 20 read as follows : 21 (1) The legislature finds that the public health functions of 22 community assessment, policy development, and assurance of service 23 delivery are essential elements in achieving the objectives of health 24 reform in Washington state. The legislature further finds that the 25 population-based services provided by state and local health 26 departments are cost-effective and are a critical strategy for the 27 long-term containment of health care costs . The legislature further 28 finds that the public health system in the state lacks the capacity to 29 fulfill these functions consistent with the needs of a reformed health 30 care system. 31 (2) The department of health and the committee shall develop, in 32 consultation with ( (lo al health departments and districts, the state 33 board of health, the health services commission, arca Indian health 34 Service, and) ) other state agencies, health services providers, and 35 citizens concerned about public health, a public health services 36 improvement plan. The plan shall provide a detailed accounting of 37 deficits in the core functions of assessment, policy development, HB 1825 p. 12 1 assurance of the current public health system, how additional public 2 health funding would be used, and describe the benefits expected from 410 3 expanded expenditures . 4 (3) The plan shall include: 5 (a) Definition of minimum standards for public health protection 6 through assessment, policy development, and assurances : 7 (i) Enumeration of communities not meeting those standards; 8 (ii) A budget and staffing plan for bringing all communities up to 9 minimum standards; 10 (iii) An analysis of the costs and benefits expected from adopting 11 minimum public health standards for assessment, policy development, and 12 assurances; 13 (b) Recommended strategies and a schedule for improving public 14 health programs throughout the state, including: 15 (i) Strategies for transferring personal health care services from 16 the public health system, into the uniform benefits package where 17 feasible; and 18 (ii) Timing of increased funding for public health services linked 19 to specific objectives for improving public health; and 20 (c) A recommended level of dedicated funding for public health . 21 services to be expressed in terms of a percentage of total health 22 service expenditures in the state or a set per person amount; such 23 recommendation shall also include methods to ensure that such funding 24 does not supplant existing federal, state, and local funds received by 25 local health departments, and methods of distributing funds among local 26 health departments . 27 (4) The department shall coordinate this planning process with the 28 study activities required in section 258, chapter 492, Laws of 1993 . 29 (5) By March 1, 1994, the department shall provide initial 30 recommendations of the public health services improvement plan to the 31 legislature regarding minimum public health standards, and public 32 health programs needed to address urgent needs, such as those cited in 33 subsection (7) of this section. 34 (6) By December 1, 1994 , the department shall present the public 35 health services improvement plan to the legislature, with specific 36 recommendations for each element of the plan to be implemented over the 37 period from 1995 through 1997 . p. 13 HB 1825 1 (7) Thereafter, the department and the committee shall update the 2 public health services improvement plan for presentation to the 3 legislature prior to the beginning of a new biennium. 4 (8) Among the specific population-based public health activities to 5 be considered in the public health services improvement plan are: 6 Health data assessment and chronic and infectious disease surveillance; 7 rapid response to outbreaks of communicable disease; efforts to prevent 8 and control specific communicable diseases, such as tuberculosis and 9 acquired immune deficiency syndrome; health education to promote 10 healthy behaviors and to reduce the prevalence of chronic disease, such 11 as those linked to the use of tobacco; access to primary care in 12 coordination with existing community and migrant health clinics and 13 other not for profit health care organizations; programs to ensure 14 children are born as healthy as possible and they receive immunizations 15 and adequate nutrition; efforts to prevent intentional and 16 unintentional injury; programs to ensure the safety of drinking water 17 and food supplies; poison control; trauma services; and other 18 activities that have the potential to improve the health of the 19 population or special populations and reduce the need for or cost of 20 health services . 411 21 NEW SECTION. Sec. 10. A new section is added to chapter 43 . 135 22 RCW to read as follows : 23 RCW 43 . 135 . 035 (4) does not apply to the transfer in RCW 24 82 . 24 . 020 (1) . --- END --- HB 1825 p. 14 S HB 1825 - DIGEST Declares that protecting the public ' s health across the state is a fundamental responsibility of the state. With the commitment to state funding of the public health system as provided in this act, the state expects that measurable benefits will be realized to the health of the residents of Washington. In addition, a well-funded public health system is expected to become a more integral part of the state ' s emergency preparedness system. Requires this increase in public health funding to deliver the following outcomes, subject to available funding levels : (1) Create a disease response system capable of responding at all times; (2) Stop the increase in, and reduce, sexually transmitted disease rates; (3) Reduce vaccine preventable diseases; (4) Build capacity to quickly contain disease outbreaks; (5) Decrease childhood obesity and diabetes rates; (6) Increase childhood immunization rates; (7) Provide home visiting services that improve birth outcomes and decrease child abuse; (8) Reduce animal-to-human disease rates; and (9) Monitor and protect drinking water across 410 jurisdictional boundaries. Requires that, by April 1, 2008, the committee shall develop a list of activities and services offered by local health jurisdictions that qualify as core public health functions of statewide significance as defined in this act . Requires that, by October 1, 2008, the committee shall develop appropriate performance measures applicable to the core public health functions of statewide significance that local health jurisdictions must provide pursuant to this act . Provides that, beginning July 1, 2009, local health jurisdictions are eligible to receive funds under this act from the local public health financing account only upon demonstrating that the local health jurisdiction has : (1) Complied with the performance measures adopted under this act; and (2) Spent funds received after July 1, 2008, under this act in accordance with the criteria established in that act . Requires that, by November 15, 2011, the department shall report to the legislature and the governor on the distribution of funds under this act and the use of those funds . In addition, the report must discuss the performance measures adopted by the advisory committee and the impact of the funds to improve compliance with the performance measures and health status indicators . • Making Washington One of the Healthiest States in the Nation MOVING PUBLIC HEALTH FORWARD IMPROVING THE PUBLIC'S HEALTH PUBLIC HEALTH January 2007 ALWAYS WORKING FON A SAFER AND HEALTHIER WASHINGTON Outcomes for Initial $100 Million of New, Dedicated Funding The Joint Select Committee on Public Health Financing produced a bi-partisan consensus report finding that there are genuine gaps in the public health system and that the system is deteriorating. It recommended that as a first step,the state should dedicate$100 million per biennium of new funding with accountability for that new funding. Public health officials are set to deliver on that recommendation. In addition to reversing a decline in basic public health support,this funding would achieve the following public health improvements: ;74.TET:wiTt!H::;;::', iiNiat EE, ) tewlYiS t8 de Hoa • By 2009, 100%of case investigations for immediately reportable diseases2 are started within 60 minutes of report any time of the day or night. (Assure appropriate treatment;Allow for quick identification of others at risk for serious,life-threatening diseases.) • By June 2009,outbreaks are contained quickly with limited transmission for those reached in time to implement effective prevention and control measures. (Reduce illness and death in those unknowingly exposed to disease.) • By 2011,stop the increasing rate of Chlamydia and gonorrhea infections and then decrease the rate,particularly in females 15 -24 years of age. (Prevent pelvic inflammatory disease(PID), sterility,ectopic pregnancies,neonatal conjunctivitis or pneumonia,and HIV infection.') •Stopping By 2012,bring the number of syphilis cases back to their all time low of 0.2 cases per •communicable 100,000 population4. (Prevent long term consequences including neurological and heart disease.) diseases before they • By 2011,increase the percent of 24 month old children on Medicaid(Healthy Options)who spread are adequately immunized5 from 63.6%in 2005 to 80%,for a 25%increase. $28.5 Million' • By 2009,increase the percentage of 19 to 35 month old children with 4:3:1:3:3 in the CHILD Profile Immunization Registry from 33%(2006)to 50%. (Prevent illness and death to children and their families.) • By 2008,increase the total percent of public and private health care provider sites actively participating in the CHILD Profile Immunization Registry to 80%(from 69%in 2006)and to 85%by 2009. (Assure individuals have a complete immunization history;Assist health providers in determining immunizations a child needs.) • By 2009, 100%of public health jurisdictions will use statewide electronic database(PHIMS) to track and monitor disease rates and will implement quality improvement programs. • By 2009,all remaining reportable disease modules will be completed for the statewide electronic database and produce management reports. • For those local health jurisdictions able and choosing to implement the evidence-based Investing in programs,they will demonstrate: healthy families • Healthier pregnancies and better birth outcomes(e.g.,reduced low birth weight babies and reduced neonatal intensive care unit usage); $12 Millions • Improved school readiness ■ Reduced child abuse and neglect • Core%Public H \\\ tiltewids Health Outcomes ' 4 ley • By 2013,decrease the percent of 10th graders who are overweight/at risk for overweight to no more than 17%(a 25%reduction from 22.5%in 2004). (Reduce the increasing rates of diabetes in our io children.) • By 2011,decrease the percent of 10t graders who consume two or more sodas from 22.5%to 17%(a 25%reduction). (Reduce obesity.) • By 2011,increase the percent of 10Th graders who eat fruit and vegetables five or more times a day from 23.2%to 29%(a 25%increase)and then have them maintain that through 12th Reducing chronic grade. (Improve children's diets.) disease rates and • By 2012,increase the percent of 10t graders who meet the recommendation for vigorous impacts physical activity from 69.6%to 77.1%to maintain 8th graders percentage(Improve physical activity.) $38.3 Million' • By 2009,all public health jurisdictions have contracted with DOH for specific,locally prioritized physical activity and nutrition activities with specific performance measures aimed at decreasing obesity and overweight conditions to reduce rates of heart disease,diabetes, stroke,and some cancers. (Based on 2003 statewide Physical Activity and Nutrition Plan,which uses best science and establishes data points for tracking results.) • By 2009, 100%of public health jurisdictions obtain county-level behavioral risk factor data for their community8 and report on the fmdings to their local board of health and community stakeholders. (Currently,the vast majority of public health jurisdictions do not have access to this information of risk behaviors in their community. ) • By 2009, 100%of public health jurisdictions will have either contracts with or employees who are public health veterinarians or have specific zoonotic training. (Implement animal disease surveillance activities;Implement programs that reduce cases of animal borne human disease and respond to animal disease reports with a threat to human health.) Protecting against • By 2010, 100%of fairs,petting zoos,animal shelters,animal stores,and child care and environmental health schools with animals will have disease control measures implemented to prevent the risks transmission of disease from animal to humans. (Prevent E.coli,salmonella,psittacosis,monkey pox and other diseases.) $8.4 Million9 • 100%of local public health jurisdictions will implement public education campaigns to prevent mosquito bites during mosquito season. (Prevent West Nile virus infection.) • 100%of local public health jurisdictions will have capacity to analyze and monitor water quality trends to preserve drinking water resources and protect them from contamination. • By 2009, 100%of all local health jurisdictions will have the capacity to conduct program evaluation for the activities funded with this$100 million,to develop performance management systems,and to implement quality improvement programs. Health Assessment • By 2009, 100%of local health jurisdictions will have a performance management plan $9.5 Million10 submitted to the state and be implementing that plan. • By 2009, 100%of local health jurisdictions will have the software and hardware tools necessary to implement these program evaluation and performance management plans and will have their staff trained to implement the plan. • The State Department of Health will provide technical assistance to local health jurisdictions and provide data technology support for statewide data systems. This will include: Department of Health • Real time technical assistance to local health jurisdictions during outbreak Support to Local investigations; Public Health • State staff deployment to local health jurisdictions when local capacity is non- existent,exceeded,or specialized knowledge is required; $3.3 Million11 • Maintenance and upgrading of electronic disease reporting systems;and • Advanced data analysis on local health and disease information when local skill and 411) expertise is exceeded. Total: $100 Million Washington State Association of Local Public Health Officials • ' This includes$26 million for disease investigation and education staff and$2.5 million for outreach to high-high risk populations and risk-reduction education. 2 WAC 246-101 identifies the over 75 reportable diseases and conditions that health care providers,veterinarians,hospitals,and laboratories are required to report to public health authorities. Immediately notifiable conditions which must be reported whenever there is a suspected or confirmed case are: animal bites,anthrax,arthropod-borne viruses(WNV,Eastern&Western equine encephalitis)botulism,brucellosis,cholera,diphtheria,diseases of suspected bioterrorism origin,disease clusters of suspected foodborne origin,diseases clusters of suspected waterborne origin,enterohemorrhagic E coli,haemophilus influenzae invasive disease for those under 5 years of age,hemolytic uremic syndrome,hepatitis A acute,herpes B virus, leptospirosis, listeriosis,measles (rubeola),meningococcal disease,paralytic shellfish poisoning,pertussis,plague,psittacosis/ornithosis,poliomyelitis,Q fever,rabies, relapsing fever(borreliosis),rubella, salmonellosis,shigellosis,tick-borne diseases,trichinosis,tuberculosis,tularemia,typhus,yellow fever,unexplained critical illness or death,rare diseases of public health significance,and pesticide poisoning. 3 Washington state chlamydia rates have increased 78%since 1996. Reported cases have steadily increased from 2,020 reported cases in 1996 to 18,617 cases in 2005. Not all of these identified cases were investigated by public health. The chlamydia rate has steadily risen from 167/100,000 population in 1996 to 298/100,000 population in 2005. Particularly alarming is the rate in adolescent/young adults. The Washington state chlamydia rate was 2,273/100,000 population of females 15-19 years old(411 cases/100,000 for males) and 2,302/100,000 population of females 20-24 years of age(and 842 cases/100,000 for males). a Washington state syphilis rates have increased 1,100%since 1996. Reported cases have steadily increased from 9 reported cases in 1996 to 152 cases in 2005. It is estimated that the vast majority of these were investigated by public health. This change corresponds to a rate of 0.2 case/100,000 population to 2.4 cases/100,000 population. 5 Adequate immunization is defined as: 4 doses of diphtheria/tetanus/pertussis,3 doses of polio, 1 dose of measles/mumps/rubella,3 doses of haemophilus influenza type b,3 doses of hepatitis b,and 1 dose of varicella. 6 This is funding to support first time,low-income moms and other high-risk moms with home visiting nursing support through programs such as the nurse-family partnership,maternity support services,first steps,and other model programs. This includes$32.7 million to implement best practices in the physical activity and nutrition plan(as a reference,to fight tobacco Suse,this state spends$52.5 per biennium)and$5.6 million for population surveys in every county to obtain behavioral health risk nformation and to analyze and report on that data. On any given year,only about 8 of 35 local health jurisdictions have adequate sample size to give county-level information on behavioral risk factors. 9 This includes$6.2 million in funding to hire staff or contract with veterinarians or other specialists with specific training in identifying and controlling animal to human disease(zoonotic disease)and providing public education and outreach for the prevention of zoonotic diseases(e.g.,West Nile Virus,hantavirus,avian flu, salmonellosis,mad cow disease,monkey pox,etc). It also includes $2.2 million for water quality and on-site septic system maintenance and operations funding. 10 This includes$4.7 million in funding to hire or contract with staff to conduct performance evaluation activities and quality improvement programs and$4.8 million to purchase hardware and software for all local health jurisdictions to assure statewide consistency and to train all local health jurisdiction staff in program evaluation and quality improvement(the level of training will vary depending upon each staff person's role and responsibility). "It is estimated that support will be required provided in the following areas:$0.5 million for food safety and environmental public health support;$1.3 million for electronic disease reporting and information infrastructure;$0.7 million for technical assistance and staff deployment for outbreak investigations,disease monitoring,and health assessment at the local level;and$0.8 million for technical assistance with health information data analysis. • Washington State Association of Local Public Health Officials Making Washington One of the Healthiest States in the Nation MOVING PUBLIC HEALTH FORWARD tip DRAFT HB1825 & SB5729 February2007 PUBLIC HEALTH ALWAYS WORKING FOR A SAFER AND HEALTHIER WASHINGTON Public Health Funding and Accountability Legislation d yg 2 p , ' 5....pi" ' -aP^ � ..^ 0 ➢�"a`p aw" xx d"r 'F p _w p"� " i ,„u'o' : .kd rre '` LL A c ar"�;3 ;,�ai�.� a} yr sr} di o• x� m�i umlw�,3.�l a ,• •i gfrs i o sce=:say twyi ® ! u " Ax,`3vp-&6ti r,�5''s rseaye •�®®Ilse s.cyam 'q� tli> ''''VW114:14 o Ich• l : s rmi' •ro p © re,bbtoonies za e ,pdood • ess '44 e �� • •�; •!' i t ® ® o • . a @ e t i sr• : 404, Offal w_.4 " i• tt •, ,_ .a.t• .+w. _ 2 i„r,�,xa ,^yrs. - a 3 .,S.:�ari _ �__ +aa « ri,'mw �;. Outcomes to be purchased and delivered Some of the initial outcomes to be achieved are: • By 2009, 100% of case investigations for immediately reportable diseases are started within 60 minutes of report any time of the day or night and assure that all • TB, hepatitis, HN, measles, mumps and other diseases are investigated. • By 2011, increase the percent of 24 month old children on Medicaid(Healthy Options)who are adequately immunized from 63.6% in 2005 to 80%, for a 25% increase. • By 2011, stop the increasing rate of Chlamydia and gonorrhea infections and then decrease the rate, particularly in females 15 -24 years of age. • By 2013, decrease the percent of 10th graders who are overweight/at risk for overweight to no more than 17%(a 25% reduction from 22.5% in 2004). • 100%of local public health jurisdictions will implement public education campaigns to prevent mosquito bites during mosquito season. • By 2010, 100%of fairs, petting zoos, animal shelters,animal stores, and child care and schools with animals will have disease control measures implemented to prevent the transmission of disease from animal to humans. • By 2009, 100% of all health jurisdictions will conduct program evaluation for the activities funded with this $100 million,develop performance management systems, and implement quality improvement programs. These and other outcomes would be accomplished by allocating approximately $28.5 million for stopping communicable diseases before they spread, $38.3 million to reducing chronic disease rates and impacts, $12 million to investing in healthy families and babies, $8.4 million to protecting against environmental health risks, $9.5 million to program evaluation, performance management, and health data,and $3.3 million to the state department of health to provide technical assistance during disease outbreaks, deploy staff to local jurisdictions when needed and maintain and upgrade disease reporting systems. Accountability Secretary of Health will develop performance measures for each activity funded. Secretary shall contract for services and performance measures starting in January 2008. • Local health jurisdictions not performing will be determined as not in compliance, given one year of technical assistance, and if still not compliant will lose access to this funding until compliance can be demonstrated. • $154,980 2.5 staff,25%ben,23%indirect $155,000 2FTE staff as a base $50,000,000 Total Annual Funding $5,425,000 Base $44,575,000 Remainder $44,575,000 $for per capita distribution(67%) Ra vUzi•# 5krW:" J 411 ari Garfield County Health Dist. 2,400 0.04% $155,000 $17,830.00 $172,830.00 $72.01 Wahkiakum County Health Dept. 3,900 0.06% $155,000 $26,745.00 $181,745.00 $46.60 Columbia County Health Dept. 4,100 0.06% $155,000 $26,745.00 $181,745.00 $44.33 Lincoln County Health Dept. 10,200 0.16% $155,000 $71,320.00 $226,320.00 $22.19 Skamania County Health Dept. 10,600 0.17% $155,000 $75,777.50 $230,777.50 $21.77 San Juan County Health Dept. 15,700 0.25% $155,000 $111,437.50 $266,437.50 $16.97 Adams County Health Dept. 17,300 0.27% $155,000 $120,352.50 $275,352.50 $15.92 Klickitat County Health Dept. 19,800 0.31% $155,000 $138,182.50 $293,182.50 $14.81 Asotin County Health Dist. 21,100 0.33% $155,000 $147,097.50 $302,097.50 $14.32 Pacific County Health Dept. 21,500 0.34% $155,000 $151,555.00 $306,555.00 $14.26 /Jefferson County Health Dept. 28,200 0.44% $155,000 $196,130.00- $351,130.00 --- --$12.45 r/' Kittitas County Health Dept. 37,4000.59% $155,000 $262,992.50 $417,992.50 $11.18 Okanogan County Health Dist. 39,800 0.62% $155,000 $276,365.00 $431,365.00 $10.84 Whtiman County Health Dept. 42,800 0.67% $155,000 $298,652.50 $453,652.50 $10.60 Mason County Health Dept. 53,100 0.83% $155,000 $369,972.50 $524,972.50 $9.89 0 Walla Walla County Health Dept. 57,900 0.91% $155,000 $405,632.50 $560,632.50 $9.68 NE Tri-County Health Dist. 61,900 0.97% $155,000 $432,377.50 $587,377.50 $9.49 Clallam County Health Dept. 67,800 1.06% $155,000 $472,495.00 $627,495.00 $9.26 Grays Harbor County Health Dept. 70,400 1.10% $155,000 $490,325.00 $645,325.00 $9.17 Lewis County Health Dept. 72,900 1.14% $155,000 $508,155.00 $663,155.00 $9.10 Island County Health Department 77,200 1.21% $155,000 $539,357.50 $694,357.50 $8.99 Grant County Health District 80,600 1.26% $155,000 $561,645.00 $716,645.00 $8.89 Cowlitz County Health Dept. 96,800 1.52% $155,000 $677,540.00 $832,540.00 $8.60 Chelan-Douglas Health Dist. 105,800 1.66% $155,000 $739,945.00 $894,945.00 $8.46 Skagit County Health Dept. 113,100 1.77% $155,000 $788,977.50 $943,977.50 $8.35 Whatcom County Health Dept. 184,300 2.89% $155,000 $1,288,217.50 $1,443,217.50 $7.83 Benton-Franklin Health Dist. 224,800 3.53% $155,000 $1,573,497.50 $1,728,497.50 $7.69 Thurston County Health Dept. 231,100 3.62% $155,000 $1,613,615.00 $1,768,615.00 $7.65 Yakima County Health Dist. 231,800 3.64% $155,000 $1,622,530.00 $1,777,530.00 $7.67 Kitsap County Health Dist. 243,400 3.82% $155,000 $1,702,765.00 $1,857,765.00 $7.63 Clark County Health Dept. 403,500 6.33% $155,000 $2,821,597.50 $2,976,597.50 $7.38 Spokane Regional Health Dist. 443,800 6.96% $155,000 $3,102,420.00 $3,257,420.00 $7.34 Snohomish Health District 671,800 10.54% $155,000 $4,698,205.00 $4,853,205.00 $7.22 Tacoma-Pierce County Health Dept. 773,500 12.13% $155,000 $5,406,947.50 $5,561,947.50 $7.19 Public Health-Seattle&King County 1,835,300 28.79% $155,000 $12,833,142.50 $12,988,142.50 $7.08 Totals 6,375,600 99.99% $5,425,000 $44,570,542.50 $49,995,542.50 $7.84 $49,995,542.50 Total • 2 FTE base NFP$out • Board of 3CeaCth Netiv Business .Agenda Item #V., 2 0 Other Legislative Issues February 15, 2007 1 ON Ait U JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 .0Iht3 • www.jeffersoncountypublichealth.org January 5, 2007 The Honorable Lynn Kessler PO Box 40600 Olympia, WA 98504-0600 Dear Representative Kessler, After reviewing the findings of the Washington State Legislature's Joint Select Committee on Public Health Funding on December 14, 2006, the Jefferson County Board of Health unanimously passed the enclosed resolution. This resolution "urges Jefferson County's legislative delegation to support legislation in the 2007 session, implementing the JSC recommendations for stable, dedicated public health funding" and recommends that the Joint Select Committees funding proposal of$50 million per year be doubled to $100 million per year. As Health Officer for Jefferson County, I must alert you to the urgency of the public health funding crisis facing local health jurisdictions. Demand for local public health services has never been greater— emergency preparedness, communicable disease control, threats to • safe food and drinking water, and the growing ranks of community members without access to basic health services. In the face of these unprecedented demands, resources have not only failed to keep pace, they are actually shrinking. Our ability to maintain essential public health services is becoming more precarious with each passing year. The Joint Select Committee has done an admirable job of identifying the critical gaps in our public health systems. Each of these gaps represents a lost opportunity to prevent disease and improve community health. Failure to address these critical deficiencies will not save money— it will only serve to accelerate the runaway costs elsewhere in the health care system. What is needed is an immediate and substantial investment in our long-neglected public health system. On behalf of the Jefferson County Board of Health, I ask for your support in addressing the crisis in public health funding and averting the even greater crisis that will result from continued inaction. Sincerely, Thomas Locke, MD, MPH Jefferson County Health Officer 411 COVELOPTEHTALMMUNITY DISABILITIES PUBLIC HEALTH ENVIRONMENTAL HEALTH MAIN:360-385-9400 ALWAYS`WORKING FORA SAFER AND NATMAAL RESOURCES FAX:360-385-9401 HEALTHIER COMMUNITY AIX:360-385-9444 FAX:360-385-9401 S02, JEFFERSON COUNTY PUBLIC HEALTH 4;si;0"° 615 Sheridan Street • Port Townsend •Washington • 98368 www.jeffersoncountypublichealth.org • January 5, 2007 The Honorable Kevin Van DeWege PO Box 40600 Olympia, WA 98504-0600 Dear Representative Van DeWege, After reviewing the findings of the Washington State Legislature's Joint Select Committee on Public Health Funding on December 14, 2006, the Jefferson County Board of Health unanimously passed the enclosed resolution. This resolution "urges Jefferson County's legislative delegation to support legislation in the 2007 session, implementing the JSC recommendations for stable, dedicated public health funding" and recommends that the Joint Select Committees funding proposal of$50 million per year be doubled to $100 million per year. As Health Officer for Jefferson County, I must alert you to the urgency of the public health funding crisis facing local health jurisdictions. Demand for local public health services has never been greater— emergency preparedness, communicable disease control, threats to safe food and drinking water, and the growing ranks of community members without access to basic health services. In the face of these unprecedented demands, resources have not • only failed to keep pace, they are actually shrinking. Our ability to maintain essential public health services is becoming more precarious with each passing year. The Joint Select Committee has done an admirable job of identifying the critical gaps in our public health systems. Each of these gaps represents a lost opportunity to prevent disease and improve community health. Failure to address these critical deficiencies will not save money— it will only serve to accelerate the runaway costs elsewhere in the health care system. What is needed is an immediate and substantial investment in our long-neglected public health system. On behalf of the Jefferson County Board of Health, I ask for your support in addressing the crisis in public health funding and averting the even greater crisis that will result from continued inaction. Sincerely, Thomas Locke, MD, MPH Jefferson County Health Officer COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH • DEVELOPMENTAL DISABILITIES ALWAYS`a`ORKING FOR A SAFER AND NATURAL RESOURCES MAIN:360-385-9400 HEALTHIER COMMUNITY MAIN:360-385-9444 FAX:360-385-9401 FAX:360-385-9401 • G JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 fir nG www.jeffersoncountypublichealth.org 111 January 5, 2007 The Honorable Jim Hargrove PO Box 40424 Olympia, WA 98504 Dear Senator Hargrove, After reviewing the findings of the Washington State Legislature's Joint Select Committee on Public Health Funding on December 14, 2006, the Jefferson County Board of Health unanimously passed the enclosed resolution. This resolution "urges Jefferson County's legislative delegation to support legislation in the 2007 session, implementing the JSC recommendations for stable, dedicated public health funding" and recommends that the Joint Select Committees funding proposal of$50 million per year be doubled to $100 million per year. As Health Officer for Jefferson County, I must alert you to the urgency of the public health funding crisis facing local health jurisdictions. Demand for local public health services has never been greater— emergency preparedness, communicable disease control, threats to safe food and drinking water, and the growing ranks of community members without access • to basic health services. In the face of these unprecedented demands, resources have not only failed to keep pace, they are actually shrinking. Our ability to maintain essential public health services is becoming more precarious with each passing year. The Joint Select Committee has done an admirable job of identifying the critical gaps in our public health systems. Each of these gaps represents a lost opportunity to prevent disease and improve community health. Failure to address these critical deficiencies will not save money— it will only serve to accelerate the runaway costs elsewhere in the health care system. What is needed is an immediate and substantial investment in our long-neglected public health system. On behalf of the Jefferson County Board of Health, I ask for your support in addressing the crisis in public health funding and averting the even greater crisis that will result from continued inaction. Sincerely, Thomas Locke, MD, MPH Jefferson County Health Officer COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES ALWAYS WORKING FOR A SAFER AND NATURAL RESOURCES MAIN:360-385-9400 MAIN:360-385-9444 FAX:360-385-9401 HEALTHIER COMMUNITY FAX:360-385-9401 State of Washington House of Representatives • sTATR O,s °Isir y' e$ `1Oy y'L las January 12, 2007 ECEI Thomas Lock, MD, MPH Jefferson County Public Health 2007 615 Sheridan St Port Townsend, WA 98368 Jefferson Counts, public Heattr Dear Dr. Locke, • Thank you for sending me the resolution supporting the findings, conclusions, and recommendations of the Joint Select Committee on Public Health Financing. As a firefighter/paramedic, I see every day the results of our under funding of public health. It is regrettably common for me to go on calls to people whose health problems have been exacerbated by a lack of access to basic health services. I have not yet had time to look closely at the recommendations of the committee, so I cannot commit to supporting them quite yet. I will say however that a serious response to the healthcare crisis in Washington State is extremely important to me and I will take all necessary steps to get us there. Please keep in contact with my office with any further guidance or information on public health issues. Kevin Van De Wege State Representative, 24th Legislative District PO Box 40600 Olympia, WA 98504 (360) 786-7916 • VanDeWege.Kevin@leg.wa.gov State of STATE REPRESENTATIVE Washington APPROPRIATIONS 24th DISTRICT House of RULES LYNN KESSLER MAJORITY LEADER Representatives EXECUTIVE RULES S ,scAt o ,:4'.. 4 x ,..:, y'L 1889 4"..' January 17, 2007 Thomas Locke, MD, MPH Jefferson County Health Officer Jefferson County Public Health 615 Sheridan Street Port Townsend, WA 98368 Dear Dr. Locke: Thank you for your letter dated January 5, 2007 regarding public health funding. I understand the need and will support an increase, but with the overwhelming needs for education, health care, etc. it's unlikely we will be able to double the amount as • requested but we will do our best. Thank you for your dedication and service to our community. Sincerely, ,/ i/ 5 Linn • LEGISLATIVE OFFICE: 3rd FLOOR LEG.,PO BOX 40600,OLYMPIA,WA 98504-0600 • 360-786-7904 TOLL-FREE LEGISLATIVE HOTLINE: 1-800-562-6000 • TDD: 1-800-635-9993 RESIDENCE: 62 KESSLER LANE,HOQUIAM,WA 98550 • 360-533-1944 E-MAIL: kessler_ly@leg.wa.gov PRINTED ON RECYCLED PAPER ®4ar,13 {object] Page 1 of 2 America must cut the pipeline that funnels young people into lives of crime and ■ violence.We take a hard-nosed look at research on what keeps kids from becoming Invest in Kids k. criminals and put that information in the hands of policy-makers and the public. Washington Read ou_rSchool and_Yout_tLVioler�c�PreyentionPlan ABOUT US NEWS ROOM POLICY RESEARCH !Search 2 IN WASHINTO WASHINGTON NEWS RELEASE We are fighting crime across Email this to a friend Washington. For more information about our work in your state or in our national office use the drop down menu below. Law Enforcement Leaders Call on Lawmakers to Increase Funds for Home Visiting to Improve School Readiness and Cut Crime State Offices New Report Says One Year of Child Abuse and Neglect Leads to 270 Future Violent Criminals in Washington EARLY EDUCATION CONTACT:Laura Wells,206 664-7110 CHILD ABUSE&NEGLECT FOR RELEASE:Thursday,January 25,2007 Olympia,Jan. 25—Seattle Police Chief Gil Kerlikowske led a delegation of law enforcement officials to the capital today to ask lawmakers to invest more state dollars in home visiting programs for at-risk families to 0 prevent child abuse and neglect, improve school readiness and cut crime. Kerlikowske, Snohomish County Sheriff Rick Bart and Sumner Police Chief Colleen Wilson released a report by Fight Crime: Invest in Kids Washington showing that one year of abuse and neglect leads to 270 future violent criminals in the state. The law enforcement leaders testified before the House Early Learning and Children's Services Committee in support of a home visiting bill introduced by Rep. Ruth Kagi(D-32). Kagi and Rep. Maureen Walsh(R- 16)later joined Kerlikowske, Bart and Wilson at a news conference. Home visiting programs strengthen families by helping at-risk parents raise healthy children who will succeed in school and in life.They are voluntary.Trained personnel help parents understand the health and nutrition needs of infants,learn to identify signs of problems with their child, make their home safe and find resources in their neighborhoods such as doctors and child care help. "Research shows that child abuse and neglect can be prevented by programs that also prepare children to succeed in school," Kerlikowske said. "It's just common sense for Washington's lawmakers to increase the state's investment in intensive home visiting programs." Kerlikowske said an additional state appropriation of$14 million over the next two years would mean that 3,500 more at-risk families would have access to the support they need to reduce child abuse and neglect and ensure that children enter school ready to learn. "If today is like most other days, 18 children in Washington will be bruised, burned,sexually molested,or left alone, hungry,without needed medical treatment or love," Bail said. "The home visiting bill will help IIIprevent those tragedies." Some 6,700 children a year in Washington are victims of abuse and neglect. Sixty-one kids were killed in http://www.fightcrime.org/releases.php?id=264 1/29/2007 [object] Page 2 of 2 the last four years.The U.S.Justice Department estimates the cost to the state and its residents at$2 billion a year. Although Washington has a number of programs to help at-risk families raise healthy children,they are so ill under-funded they serve only a fraction of the eligible families who would accept help if it were available. Bail pointed out that the only program targeted at low-income, pregnant women under 19—a high-risk population—has enough funding to serve just 600 of the 3,800 such women in the state. Wilson cited research on one such program,the Nurse-Family Partnership.The research showed that children of mothers who received home visits were half as likely to be abused or neglected as children of similar at-risk mothers not in the program.Also, as they grew up,the children in the programs had nearly 60 percent fewer arrests than the children of mothers who did not receive visits. A study by the Washington Institute for Public Policy found that the Nurse-Family Partnership reduced crime so effectively that it saved over$27,000 per family served. "We know that home visiting cuts crime,"Wilson said. "By helping parents become better parents,we ensure that Washington's most vulnerable children won't become Washington's most wanted adults." Not only is child abuse a crime, but it may launch a cycle of violence that extends into the next generation, Kerlikowske said.One study showed that poor mothers who had been abused and neglected as a child were 13 times more likely to abuse or neglect their children than similar mothers who were not abused and neglected. Citing the Fight Crime: Invest in Kids'finding that one year of abuse and neglect leads to 270 future violent criminals, Kerlikowske called it a conservative estimate, but still a significant toll of future crime that will tax Seattle's Police Department and all of Washington's law enforcement agencies for years to come. Kerlikowske, Bart and Wilson are members of Fight Crime: Invest in Kids Washington.The bipartisan, fp nonprofit, anti-crime organization is comprised of 125 police chiefs, sheriff, prosecuting attorneys and victims of violence. Kerlikowske is chairman of the board of the national Fight Crime: Invest in Kids organization. To view report, click here. Fight Crime: Invest in Kids Washington * 3706 NE 42nd St., Suite 200 *Seattle,WA 98105 * (206)664-7110 National Home I Contact Us I Jobs I Subscribe to E-Newsletter I Donate I Site Index I Privacy. California I Illinois I Maine I Michigan I New York I Ohio I Oregon I Pennsylvania I Tennessee I Washington • http://www.fightcrime.org/releases.php?id=264 1/29/2007 Board of 3-feaCtFi Netiv Business .agenda Item #`V., 3 • Leadership Development at JCP3-f 3ebruary 15, 2007 • Collaborative Leadership Fundamental Concepts • Collaborative LeadershipSkills ®A Critical Component Because collaborative interaction is challenging, it takes special skills to shepherd a group through this developmental continuum. Collaborative leadership is apparent in those who inspire commitment and action, lead as a peer problem solver,build broad- based involvement, and sustain hope and participation. Based on research with noted leadership experts and the public health practice community, the Turning Point Leadership Development National Excellence Collaborative identified a number of core collaborative leadership capacities in 2001. This National Excellence Collaborative, funded by The Robert Wood Johnson Foundation and made up of public health practitioners from around the country, has worked to better define, describe, and build the skills of collaborative leadership among those who participate in public health work. Collaborative Leadership Practices Clearly there are a number of critical skills and capacities collaborative leaders should possess. Many of the skills are not necessarily unique to a collaborative form of leadership and have already been described in the literature and developed into training curricula. The work of the Turning Point Leadership Development National Excellence Collaborative, however,has illustrated six key practices that are unique to the practice of leading a collaborative process. They are: • Developing Clarity—Visioning&Mobilizing: Defining shared values and engaging people in positive action. • • Developing Trust&Creating Safety: Creating safe places for developing shared purpose and action. • Sharing Power and Influence: Developing the synergy of people, organizations, and communities to accomplish goals. • Assessing the Environment for Collaboration: Understanding the context for change before you act. • Self Reflection—Personal CQI (Continuous Quality Improvement): Being aware of and understanding your values, attitudes, and behaviors as they relate to your own leadership style and its impact on others. • Developing People—Mentoring and Coaching: Committing to bringing out the best in others and realizing people are your key asset. Each of these elements is key to the collaborative process. They are not mutually exclusive but support each other and provide a comprehensive picture of the essential skills of a collaborative leader. Having clarity of values is a quality that characterizes collaborative leaders. Commitment to a cause which transcends the self, the recognition of a spiritual reality or imperative, ethical, and moral standards that provide guidance--whatever the source of the inner gyroscope, collaborative leaders seem to exhibit clarity of purpose, often about creating and sustaining a process. "Visioning and mobilizing," in relation to clarity of values, has to do with a commitment to a process or a way of doing things. Often "mobilizing"refers specifically to helping people develop the confidence to take action 4111increased sustain their energies through difficult times. Clarity leads to focus which leads to increased group energy(power). Often too little time is spent in the process of"informal Turns ew int ti Participant's Guide exploring"to understand problem,thereby developing clarity. A shared vision can be inspiring. The capacity to promote and sustain trust is often overlooked in the collaborative process. Leaders sometimes believe that once individuals or groups are gathered together, then a plan can naturally be made and commitment obtained. If a collaborative leader fails to engender trust among participants, however,their involvement will wane and the best ideas and innovative approaches will not be shared. In this context,the collaboration will have lost its capacity to draw the best ideas from those involved. A clearly uncommon trait among leaders, involved the capacity to share power and influence. American society traditionally rewards individual achievement,but collaboration cannot be achieved through a single effort. Participants in the decision- making process need to feel empowered in order to contribute fully. In a successful, visible response to a public health problem it is sometimes just the head of an organization who receives the public accolades. Invariably, however, it is the shared effort and wide range of experience of a large team of people that actually has shared in the decision-making and brought their influence and expertise to bear. Increased energy leads to increased power. Power is not finite resource; energy of people focused on a goal creates power. Another important quality of collaborative leadership is assessing the environment. The capacity to recognize common interests, especially the capacity to recognize and understand other perspectives, is a fundamental quality of collaborative leadership. • Collaboration seeks goal attainment around shared visions,purposes, and values. When you bring different points of views to an issue or problem, a collaborative leader attempts to facilitate connections and encourage group thinking that identifies clear,beneficial change for all participants. Assessing also involves setting priorities and identifying barriers and obstacles. Collaborative leaders are personally mature. To be successful leading a collaborative process, individuals use self-reflection to examine and understand their values and think about whether their behaviors are congruent with their values. At critical junctures in the collaborative process, through reflection, successful leaders make time to consider their verbal and nonverbal communication within the group. They think critically about the impact their actions and words have on the group's progress toward achieving its goals. Great collaborative leaders have the ability to recognize the impact of their behavior and adjust accordingly. A genuine concern for developing people,bringing out the best in others, maximizing the use of other people's talents and resources,building power through sharing power, and giving up ownership or control are themes which relate to realizing and promoting the potential in other people. Coaching and mentoring creates power which increases leadership capacities. Build confidence by experimenting, setting goals, and receiving performance feedback. • Turn iSPpint 2 Creating Clarity S Improving Collaborative Leadership: Practical Tools from Turning Point March 5, 2005 Betty Bekemeier Bud Nicola Turning Point National Program Office The Turning Point Leadership Development National Excellence Collaborative Vision:Collaborative leadership is used to its fullest potential to achieve policy and systems change that maximizes the public's health. • Mission:Increase collaborative leadership capacity across sectors and at all levels. Other Turning Point National Excellence Collaboratives: •Modernize public health statutes •Create accountable systems to measure performance •Utilize information technology •Invest in social marketing Slide3 Networking—Exchanging information for mutual benefit. Coordinating—Networking and altering activities to achieve a common purpose. Cooperating—Coordinating and sharing or pooling resources. Collaborating—Cooperating and enhancing the capacity of another for mutual benefit to achieve a common purpose. Competing—Exchanging some amount of information,but not "proprietary"information;altering activities to meet own needs; sharing resources minimally or with a"hidden agenda." • i. Creating Clarity Group Relationships )nvol -men'. Collaborating 9 Corn 't ent Cooperating Res.a ces oordinatin/ (e g ,me, Neewo ing Problem Types • Type I: A broken leg • • Type II: Air pollution • Type III: Problem drug use - ','Slide S - _. Problem Types and Leadership Roles Type Problem Solution Locus of Work Leadership Role I Clear Clear Expert-Leader Expert-Leader Solves the problem II Clear Unclear Expert-Leader Expert diagnosis: Group or Multiple Leader helps group Stakeholders problem solve III Unclear Unclear Group or Multiple Leader helps group Stakeholders problem solve •yA 41110 2 Creating Clarity • What is Leadership? tWtiVf'Z Leadership is • A TRAIT and a PROCESS Trait-the ability to exert influence and have others accept that influence producing changeor performance • »Chrislip,Sweeny Chritian,Olsen,2002 —Process—A process whereby an individual or small group influences others to achieve a common goal »Northouse,1997 Authority is • The power to determine, adjudicate, or otherwise settle issues or disputes, jurisdiction, the right to control, command, or determine —Webster's New Universal Unabridged Dictionary • 3 Creating Clarity • What is Collaborative Leadership? • The processes, activities, and relationships in which a group and its members engage in collaboration. • Collaboration is defined as"exchanging information and sharing or pooling resources for mutual benefit to achieve a common purpose." What is a Collaborative Leader? • Someone who safeguards and promotes the collaborative process. • a--slide t2 Who is a Collaborative Leader? Skills Capacities Conflict management Uncertainty Developing trust Taking perspective Communication Self-reflection Decision-making Ego control Creating safety Assessment � .�'x tom;* � � � . 4 Creating Clarity Why is Collaborative Leadership Important? • Most public health problems are complex, interdependent, and messy. • These type of problems require a systems approach with diverse input and multiple perspectives. • Many sectors need to`own"the solution for it to be successfully implemented. Six Practices of Collaborative Leadership . Six Practices of Collaborative Leadership ▪ Identified by the Turning Point Leadership Development National Excellence Collaborative • Research included: —Literature reviews —Individual interviews —Focus groups —Expert panel debates —Attendance at leadership development training programs . 5 Creating Clarity • 0 fomptmi -a' EfctOv Assessing the Environment Simla 20 Context of Collaboration • Identify the problem type. ® Identify stakeholders. • Assess extent of stakeholder • • agreement. Evaluate community's readiness and capacity. • Identify where problem can be most effectively addressed. Slide 21 �r ad ml ( I I� Nei+ is.;iy Surctssuea IDa . ra�w coag S r,o0 e, EvaWa:e~ PUn '0 d 447., i(y Heass` 04ssessfl da eb dhm Wro,&Ooa comm rainy dCh`4dm Offeatr(uKCW)nmepwr:m :111 vrn M[DCtCCC0nN¢n¢Grvgmn far Dmeca cmrrolW VRwma(c0c). ')a4 „ • Creating Clarity • Sl2x .u_ Methods for Change • Exposure to different ideas • Exposure to different cultures • Experience/Practice • Self-reflection (e.g., logs,journals) • Mentoring/Coaching 360-degree assessment, shadowing • Peer support Slide 23 Collaborative Leadership Products Materials are available through the Turning Point Leadership Development National Excellence Collaborative web site www.turningpointprogram.orq or www.collaborativeleadership.org t4444140:4-12tittl-PO'n':4477:;* • 8 • Board of Health Netiv Business .Agenda Item #17., 4 On-site Sewage • Operation & Nlaintenance Privatization Discussion February 15, 2007 • JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 • www.jeffersoncountypublichealth.org February 9, 2007 Memo As you know, JCPH is undertaking a rewrite of the Operation and Maintenance (O&M) section of the on-site sewage (OSS) code. At present, we have a (rough) draft of the new ordinance that we have shared with the PUD. Last month, I spoke to the PUD at length about the new ordinance. We discussed the possible transfer of the O&M program to JCPH. At the meeting, we discussed some of the highlights, which included: 1) PUD would continue to perform O&M on all large and community OSS systems (i.e., Beckett Point) throughout the county. 2) JCPH would begin certifying people from the private sector to become O&M Specialists to perform O&M via contracts on all non-proprietary systems. Proprietary systems (i.e., Glendons, Whitewater, etc.) would still require private sector O&M, but the certification process is two-fold: they must be certified by JCPH and have permission from the manufacturer to perform O&M on the system. 3) O&M is performed on all systems. The attached table shows the O&M required • by system type and by risk factors. 4) There will be an opportunity for homeowners to perform O&M on their own OSS (does not apply to landlords for rental properties). They will have to take a class on how to perform O&M (available through WOSSA) and become certified by JCPH. There is a reporting requirement, which could be controversial. 5) Enforcement would be through civil infraction notices (tickets) and denial of future building permits. Through this new ordinance, we will have a system that bears close resemblance to Kitsap County's O&M program, with some key exceptions (i.e., homeowner O&M allowed for all system). We believe this new O&M program will help achieve a good balance between the concerns of public health and the need to respect property rights. I'll be happy to discuss this further with you during the BOH meeting. Thank you. Mike McNickle Director, Environmental Health COMMUNITY HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIESLy �4 � F l PUBLIC HEALTH NATURAL RESOURCES MAIN: 360-385-9400 ND MAIN: 360-385-9444 FAX: 360-385-9401 HEALTHIER COMMUNITY FAX: 360-379-4487 • OPERATIONS/MONITORING INSPECTION SCHEDULE FOR ONSITE SEWAGE SYSTEMS aY ■ViBs• 4 im gugIo Y =4444leg h k . .., a$te , ;` 1:014 ; is`Q * Annually Every 3 years Every 6 years Annually iikr, ed sy' t��ms FrioAnnually Every 3 years Annually •ntaiin�tig re ' ent tierces , atm s c9r1t V tIPi. Annually unless more frequent inspections are required per DOH atm nt dew�c •r �Isneirvclu" s,4 or manufacturers' guidelines These inspections do not alleviate the responsibility of the homeowner to complete inspections as required in the 0 & M Manual provided by the system designer and maintain the system when problems are observed. All maintenance of proprietary devices shall be completed by factory authorized personnel. • • • Board of Health 3Wedia Report • february 15, 2007 • Jefferson County Public Health January 2007 NEWS ARTICLES 1. "Volunteer Honored", Peninsula Daily News, January 12, 2007 2. "State community hospitals adopt charity standards" Peninsula Daily News, January 12, 2007 3. "Arrest cuts meth trade, police say", Peninsula Daily News, January 18, 2007 4. "Plan approved for sanctuary at Native rock", Peninsula Daily News, January 24, 2007 5. "Volunteers to visit haunts of homeless", Peninsula Daily News, Jan. 25, 2007 . 6. "Peninsula above-average in selling youths cigarettes", Peninsula Daily News, January 30, 2007 7. "Locals asked to take survey on substance abuse", P.T. Leader, February 7, 2007 8. "Food inspection reports on web", P.T. Leader, February 7, 2007 • ✓ , Pen i ns u 1 a N o h V Y es 1, FFtmAY JANunxY 12 2007 C5 • . ....... . , .. .• • . . , , . . . . . ... .. . . .: . . . . .. . ,,,,,,,A,-•„..,,..-•.,.,-:::,,„.;!,,,„,• :, ,,. • ; ,i. .r 4,,) , . ..,,, . ..,,, : . , ,., oto,__ ' tTax� '..,,,t,,, •.,:,,,, ,,,,. ..„. ..„,,..,s, ,,;.,,,,,,,,,,,-,I.,,,,i,,,'..,....,-.,,...,...-.,:., , :, ..,, ., , , :.7,7,-7:,— ,- ::- add5,s 1f� ,;g g if.4.. .,,,.„ ,„„..,,,,,„_<,.:.,,,.,,,,„..;,,,,...;,,,,,ttil. ,,, :. , ,,,. .1.,:it.:,.;;;J:,:,. . ...,i „ ,.,.... i: 1 i . ,,.,,,,.,,,,,.. ,:„7..,:..: ,„.,,,,;;;,04.,,,.:,.,..,..: ,, ,i. ,,.,.,iiitit .. ...Ai . .,„. ..,,, w, : . I, t _§.- r ,, 1 1,-,,i;,,,I;,,,, r c,:::,:-.'4.:,..`,1, a f t. ! t„ � Ay,g 8 a 3 SF df Aim ~,'; -&b °6 ;.✓w,. �; • X r ) ,yY •g?1'- '.1t2 ^”fit : ` d ` , y� 1S k x�' ,.� 4 'Y Ram. X k ' ?...:. » � kms , EvAN CAniJPsmxsuLA DAILY NEws VOLUNTEER HONORED Jefferson County Commissioners Phil Johnson, John Austin and`David Sullivan,from left, present a certificate of appreciation to Sheila Westerman to recognize her 15 years of volunteer service on the Jefferson County.Developmental Disabilities Board. Commissioners made the presentation at their regular meeting this week. • ,, • • • • FRIDAY,JANUARY 12,2007 A9 State community hospitals ado t p charity standards THE ASSOCIATED PRESS cent over cost, association SEATTLE — Washington's spokeswoman Cassie Sauer 97 community hospitals have For 40 percent of the hos agreed on uniform standards ts the voluntary P I for charity care, the first time tatay agreement is such benchmarks on free or dis- less generous than existing poli- counted care to needy patients cies, but at least some of those has been adopted in the state. hospitals plan to keep their cur- Under the new guidelines, rent policies,Sauer said. adopted with the encourage- "For most hospitals,our new ment of the Washington State Pledge is an expansion," she Hospital Association, those said. with incomes up to poverty Either way, Washington level — $13,200 for a couple State Hospital Association offi- and r • $20,000 for a family of four • cials say it's more , than —are entitled to free care, required under state law,which Residents with incomes up requires hospitals must write to twice the poverty level will be off charges for indigent patients charged only the hospital's cost, but sets no minimums. and people with earnings up to Hospit ds also are required three times the poverty level by law to treat anyone with a who lack insurance and have medical emergency, regardless limitedassets will be asked to of ability to pay. pay the same as a typical Private doctors' fees are not insured patient. covered by the standards, The agreement comes as which also do not apply to state nonprofit, tax-exempt hospitals mental hospitals or to military nationwide face growing ques- hos itals. • tions about how much charity p care they provide, as well as "Uninsured patients' ability criticism for those that charge to get private physician care higher rates for uninsured, remains a serious concern," patients than for those covered Sauer said. by health plans. 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Q' ,�+ w �•a> fr" +' g0-0 oU] o' •C �.o,' c0�-'•�+�•°■ C.73 G.cb 3`..bplt?-o S.-t �t Cow cg av o �� m m °ay a tom aAxb� m Peninsula aboveaverage in cigarettes • re for a first offense,$300 for a second BYJIMCASEY offense, $1,000 and a six-month sus- „,DAILY NEws .e, pension of their tobacco licenses for Youngsters can buy cigarettes ille- a third offense,and$1,500 fines and ''C I,' 12-month thereafter. gaily twiceo asn easily in Jefferson canon andoa As for the rest suspensionsof thereafter. r. Clallam counties as they — onq s A ”' average—in the rest of the state. state ` 4'''Y s� i. , `" i ," health authorities said last week that 95 percent of businesses refused to Ten percent of"sting" operations W• -�# �:.` sell tobacco to minors during 2006- - in which youth operatives enter i, ° stores and ask to buy brand-name ¢ P,# 1. up from 88 percent in 1999. `. 1,, 1 tobacco products — resulted in ille Ragan Anderson Undercover teens gal' sales in both counties in 2006, 9 according to state health officials. stores failed the test. In the sting operations, tobacco Ninety percent of stores and their In Jefferson County, that meant prevention officers recruit 15- and clerks identificationied with the law refusing— to two stores out of 20 that were 16-year-old people and send them Ing for and checked. into stores. sell to persons younger than 18 — said Clallam County Tobacco Pre- In Clallam,four businesses out of They are told to dress as usual, 38 sold tobacco illegally. produce identification if asked, and s and Control officer Rachel Both the clerks who sold tobacco tell the truth about their age. Anderson on Monday. If officers are checking a business "To have a 90 percent compliance to minors and the stores where they where patrons must be 21 or older to rate is pretty exciting for our worked received citations. enter, the youth operative does a county," she said. Clerks faced fines of $50 for the .shoulder tap" — asks an adult to According to Kellie Ragan,Ander- first offense and $100 for each sub- buy tobacco for him or her. son's counterpart in Jefferson sequent offense in a two-year period. TURN TO YOUTHS/A5County, a similar 10 percent of The stores faced penalties of$100 TUESDAY,JANUARY 30,2007 A5 Youths: Most clerks ' OK' • CONTINUED FROM Al If the youths succeed in More illegal young smokers buying tobacco, they are pho- tographed standing outside in Clallam than Jefferson the store, holding the product ' they bought. A 2004 SURVEY of tobacco in the 30 days The tobacco is logged into youths in Clallam County before the survey. evidence, and the case is for- asked if individuals had A similar survey in Jef warded to the local Liquor used tobacco in the past 30 ferson County revealedr' Control Board agent. days, I 80 percent of eighth, The agent may issue a cita- The results: graders,75 percent of 10th tion. ■96,percent of sixth In stores that get into trou- graders,88 percent of grades,and 60 percent of ble, said Anderson, clerks fail eighth graders,and 80 per- 12th graders,said they had, to ask for identification or fail cent of 12th graders had not used tobacco products.' to inspect it correctly. not smoked or chewed Peninsula Daily News "Most of the clerks are def- doing a great job, and the stores are doing a great job of keeping tobacco out of the Some of the stores promi- lowering youth smoking rates," hands of minors,"she said. she said display the certificates, said Selecky.tate Secretary of Health Stores win certificates McFerran and Anderson will "By making cigarettes teach a class this spring to harder to get, fewer kids will At some stores, clerks lec- inform clerks how to read Iden- h will lure the operatives about the tification cards and how to spot gitakve them a much e up this habit, which war dangers of tobacco, Anderson phony or forged identification. chance of a longer, healthier said. For details, phone Ander- Anderson and Pat McFer- son,360-565-2608. life." • ran, liquor and . tobacco Tobacco-related diseases kill enforcement officer for the 8,000 deaths a year about 8,000 people every year state Liquor Control Board, in Washington — more than award certificates to clerks Since 1999, the number of AIDS, alcohol, drug abuse, car . and stores that deny tobacco 10th graders statewide who crashes, murders, suicides and to minors. said it was "sort of hard" or fires combined—said Selecky. "People really are excited "very hard" to obtain tobacco when they don't sell," Ander- climbed from less than 17 per- son said. cent to 46 percent. Reporter Jim Casey can be reached at "They feel they've passed a "Making it tough for kids to 360-4t7.3538 or at pm.casey@ test,and in a sense they have." get tobacco is one of the keys to penlnsuladadynews corn. ar � Food inspection • reports „, on web H t 1,4) Results of food safety inspec- Any facility that serves food, tions for all Jefferson County from the corner grocer to fine food establishments are now dining restaurants, must be per- found on the Jefferson County miffed by the Public Health Public Health website. Visit department. Food inspections www,jeffersoncountypubli- are conducted on an annual or Locals a chealth.org and select the Food biannual basis,depending on the s ke d to Safety link. kinds of foods offered. If there From there, choices are are any serious food safety vio- available to learn more about lations noted, there will be more take sur the procedures for food safety inspections performed on an as- ve v o n inspections, safe food handling needed basis. The goal of food �J practices and information about safety inspections is to ensure closed restaurants. Also avail- safe food handling practices substance abuse able is a searchable database of through education and enforce- all the businesses in Jefferson ment of proper techniques. ty that serve food. The Thealso incudes How do you feel about sub- determine the needs of people in inspect ons shown are those that information onte how to get alfood stance abuse issues in your corn- our community who are addicted have been completed since May worker's card, how to open your munity? What is done well in —or at risk of becoming addict- 2005. New information is added own restaurant and information Jefferson County to help people ed — to drugs and/or alcohol. on a regular basis, on food-borne illness. with substance abuse problems? Community input will be used • Do you feel there is a problem to create the Jefferson County with underage drinking and drug Strategic Plan and guide future use in your community? What planning efforts throughout the improvements could be made to county to create programs that better address substance abuse will enhance the wellbeing of - prevention, intervention, treat- the entire community. ment and aftercare in Jefferson The strategic plan will County? address county-specific needs, A countywide survey seeks resources and implementa- answers to these questions as tion strategies for community- part of an effort to improve the based substance abuse preven- substance abuse continuum of tion, intervention, treatment care throughout the county. and aftercare/support services. The survey is conducted by Results of the survey will be Jefferson County Community compiled by the organizations Network, the Jefferson County above, and a final report and -o drug and alcohol coordinator recommendations will be avail- (funded a— by the Department of able in July 2007. Alcohol and Substance Abuse The survey is available Services), and Safe Harbor online at www.surveymonkey. Recovery Center/Beacon of com/s.asp?u=225003100296. Hope counseling. Residents are asked to complete These organizations want to it by Friday, Feb. 9. • • F- U w CO Cl) z - - L O Q W_ C • Vo V Q• z Q r V 11.1 _ w I a w it I .05 .0 Occ � m `n w 0 Z G