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Home My WebLink About2007- September File Copy • Jefferson County Board of 3-feaCth .Agenda ivl inutes • September 20, 2007 • • JEFFERSON COUNTY BOARD OF HEALTH Thursday, September 20,2007 Main Conference Room Jefferson County Public Health 2:30—4:30 PM DRAFTAGENDA I. Approval of Agenda II. Approval of Minutes of August 16,2007 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. National Health Service Corps Provider Recruitment 2. Jefferson County Public Health in the NACCHO News 3. Board Correspondence • V. New Business 1. Policy Issues Related to Formation of a Jefferson County Public Health District: Progress Report 2. Public Health Emergency Preparedness Funding Cuts 3. 2008 Jefferson County Public Health Budget: Impacts on Programs and Staffing 4. West Nile Virus Update: State Emergency Funding and Local GIS Data VI. Activity Update VII. Agenda Planning 1. November 15 Schedule Conflict VIII. Next Scheduled Meeting: October 18, 2007 2:30 PM-4:30 PM Main Conference Room Jefferson County Public Health • JEFFERSON COUNTY BOARD OF HEALTH • MINUTES Thursday, August 16, 2007 %4St\ Board Members: Staff Members: Phil Johnson— County 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#3 Julia Dans kin,Nursing Programs Director Jill Buhler—Hospital Commissioner District#2 Mike McNickle,Environmental Health & Geoff Masci—Port Townsend City Council WaterQuality Director Sheila Westerman—Citizen at Large(City) Roberta Frissell, Chair—Citizen at Large(County) Meeting was called to order at 2:30 pm on August 16, 2007 by Chair Frissell in the conference room of Jefferson County Public Health. Board members present: Chair Frissell, Member Austin, Member Sullivan, and Member Westerman. Members absent: Member Johnson, Member Masci and Member Buhler. A quorum was present. APPROVAL OF AGENDA Board Member Austin moved to approve the agenda. Member Sullivan seconded • the motion,which carried by a unanimous vote. APPROVAL OF MINUTES Board Member Austin moved to approve the minutes of July 19,2007, as written. Board Member Sullivan seconded the motion,which carried by a unanimous vote. PUBLIC COMMENTS None OLD BUSINESS Jefferson County Clean Water District Press Release Neil Harrington, Water Quality Division Manager, informed the Board about the public meetings being held to discuss formation of a Clean Water District to protect Jefferson County's water and shellfish resources.Neil reported that there has been a lot of useful input from the public. Member Sullivan remarked that it would be up to the County Commissioners to approve a Clean Water District and that the City and the County will not overlap in funding for the same services. An MOU would need to be drawn up for implementation purposes. Current estimates projects a tax amount of approximately $18.00 per parcel, with the City eincluded. Without the City's participation,the tax would be approximately $24.00 per parcel. He explained the difference between households and parcels. There are 11,000- Jefferson County Board of Health,August 16,2007 Page 1 of 6 12,000 households and 25,000 parcels. If the amount was based on households the tax per household would be approximately$40-45. Gibbs Lake Closure Neil Harrington reported to the Board on the monitoring and sampling done at Leland, Gibbs and Anderson Lakes. Three weeks ago samples taken at Gibbs Lake showed levels of Anatoxin A, 5 parts per billion. Health and safety guidelines specify a cut off at anything above 1 part per billion. The State Parks were notified and the Gibbs Lake was closed for recreational water uses. The other Park facilities remained open. This week's test results are due back on Wednesday, August 22nd. If that test comes back indicating no toxins or shows toxins below 1 part per billion, the lake will reopen. Pharmacy Rule Change Takes Effect Dr. Locke provided information regarding the Pharmacy dispensing rules that went into effect July 26, 2007. This new ruling emerged as a result of pharmacists declining to fill legal prescriptions for emergency contraception. The rules were adopted by the Board of Pharmacy after a lengthy public hearing process. The ruling states that if an individual pharmacist will not fill a prescription, then the pharmacist must make sure another pharmacist is available to do so. If the drug is out of stock, then the patient can ask the pharmacist to find another drug store that has the medication in stock and refer the patient to that pharmacy. Board Correspondence Dr. Locke made reference to the letter from the Port Ludlow Yacht Club Women's • Group. The Port Ludlow Yacht Club Women's Group made a contribution of$4,014.88 and presented it to Jefferson County Public Health to benefit the Jefferson County Breast and Cervical Health Program. Member Austin asked about the letter that was requested by the Board to be written to Jefferson County Hospital District#2. This letter recommended pursuing application for assignment of a National Health Service Corp doctor for the rural and poverty areas of Quilcene and South County. Dr. Locke responded that the letter has not yet been sent. Other correspondence included an EnviroStars award and a letter to the Port Ludlow Marina for their continued efforts in eliminating and recycling hazardous wastes. A Green Business letter and award was presented to Matthew Berberich Professional Gardening Services for their efforts in conserving water, energy and other valuable resources. NEW BUSINESS Big Brothers Big Sisters Presentation Crisann Brooks, Vice-President of Programs and Recruitment, from King County Big Brothers Big Sisters (BBBS) and Sylvia Platt, Jefferson County Program Coordinator for Big Brothers Big Sisters gave a presentation to the Board and thanked Jefferson County Public Health for their contribution and highlighted the successes of the program. She noted that Port Townsend, Chimacum and Quilcene schools serve as key stakeholders Jefferson County Board of Health,August 16,2007 Page 2 of 6 411 with the program. Ms. Brooks thanked the Resource Advisory Committee for their hard work in expanding awareness to the program. There are currently 135 matches in the program with a projection exceeding 150 matches over the next year. Ms. Brooks talked about outcomes and evidence that showed that the program works. BBBS of America conducted a nationwide study looking at the outcomes of effective mentoring. In Jefferson County results showed that nearly all of the little brother and little sisters surveyed, improved and maintained their status on self-esteem, self-confidence, social skills, school performance, and positive relationship with adults, family members and peers. Ms. Brooks touched on the strengths of the program through strong positive community relationships that have been built, challenges ahead with financial stability, local leadership and the need for volunteer mentors. Sylvia Platt shared her excitement about the success of the program and her involvement in it. She said she was pleased at how many high school students are involved. There are 64 high school students that are BBBS to the 135 enrollees. Sylvia shared her experiences as a Big Sister in the program. This year the focus will be on early intervention, getting elementary school faculty to refer kids before they reach middle school. Sylvia spoke about local support and the Cool Card program she implemented. With the Cool Card, volunteers can take their little brother/sister to various local retail stores and purchase at a 2-for-1 price. Also sharing their stories of success and gratitude was a parent from the community • whose son is a little brother in the program and Linda Atkins, from Environmental Health, who is a Big Sister. Public Hearing: Jefferson County On-site Sewage System Management Chair Frissell called the Jefferson County On-site Sewage System Management public hearing or order at 3:20 p.m. There was no one from the public in attendance for comments. Dr. Locke explained that this plan is in response to two government mandates, one from the new state on-site sewage regulation,which was passed two years ago and took effect last month. This mandate requires a specific plan for Operation& Maintenance which is reviewed and adopted by the Board of Health through the public hearing process. The second mandate is legislative and requires plans for establishment of Marine Recovery Areas in the 12 counties with Puget Sound shoreline. These two mandates were combined to create a unified plan. This plan is eligible for$100,000 in implementation funding. There were no further comments or discussion. Chair Frissell closed the hearing at 3:25 p.m. John Austin moved to adopt the On-site Sewage System Management Plan as written. Member Sullivan seconded the motion. Member Westerman complimented the staff on their hard work. The motion passed by unanimous vote. • Jefferson County Board of Health,August 16,2007 Page 3 of 6 Jefferson County West Nile Virus Response Plan . Dr. Locke reported that the state West Nile Virus (WNV)plan has been in development for the past 5 years. We are the only state in the lower 48 that has not had significant WNV activity. Washington's plan focuses heavily on exposure prevention. Dr. Locke emphasized the 4"Ds", (dawn, dusk, dress and Deet), which will reduce the likelihood of people getting bit. Alisha Hicklin, from EH, has been doing extensive mosquito surveillance on the Peninsula. She collects and sends samples weekly to the lab from different areas in the county. There have been samples containing Tarsalis species in Eastern Jefferson County, which, along with Pipiens species, are the major WNV carriers. Alisha reported that there have been 444 human cases of WNV reported so far this year,predominately in California, Colorado and North and South Dakota, and 15 deaths have occurred. There has not been any WNV detected in mosquito pools or birds in Washington. Washington is one of 6 states that has no detected activity. Oregon and Idaho are just now detecting activity. Alisha described the four tier alert system used in mosquito surveillance and monitoring. Level 1 alert occurs when there have been no human or horse cases and no detection of the virus in mosquitoes. Level 2 alert follows confirmation of WNV in wild birds or sentinel flocks or mosquito pools. Level 3 alert indicates confirmation of horse or human cases and/or multiple positive birds, and/or sentinel flocks and/or mosquito pools,which means humans are more likely • to come in contact with mosquitoes carrying WNV. Level 4 alert indicates escalating epizootic in horses and birds and multiple human cases likely to have been acquired locally due to high levels of WNV activity. This level could warrant larvaciding or adulticiding. These interventions would only be implemented after consideration of the risk to human health, taking several factors in account such as the time of year and weather conditions, documentation of the presence of WNV in the area, the abundance and species of the mosquito populations and the potential impact on people and the environment. Dr. Locke explained that the symptoms of the virus were flu-like and most people would not know they had been infected with virus. There is no treatment for the infection. Approximately 20% of those infected experience West Nile Fever and are at risk for persistent neurological complications. 1 in 150 are at risk of a neuroinvasive disease that can be fatal. Hepatitis A After Action Report Dr. Locke stated that this report came as a result of an emergency response to a Hepatitis A incident in June 2007. He stated that Hepatitis A is a highly contagious illness but there are effective tools to prevent it. After a case of Hepatitis A was detected in a produce handler at a local community sponsored agriculture operation, an investigation was conducted and multiple individuals were identified as potentially exposed. The Hepatitis A vaccine and Human Immune Globulin was offered to everyone exposed. There were a • few individuals who chose not to receive either. Jefferson County Board of Health,August 16,2007 Page 4 of 6 The Communicable Disease staff and the Environmental Health staff work effectively as Sa team to coordinate activities and contain the illness. The investigation report was written up as part of emergency preparedness training and offers the Board an unusual amount of detail into outbreak control efforts. Julia Danskin related to the Board how a larger outbreak would be handled. She stated,if the outbreak is a local outbreak, our first level of response would be to ask for help from Kitsap and/or Clallam County Health. At the second level she would go through the Emergency Operations Center and would activate the Medical Reserve Corp. The third level of response would be to set up a phone tree and recruit support from the state. As of August 9, 2007 there are no reported secondary cases of Hepatitis A. Jefferson County Public Health Budget and Timeline An excerpt of the complete submitted JCPH budget was handed out to the Board for review for in future board discussion. ACTIVITY UPDATE Chair Frissell spoke to the Board about the memorial service for Dr. Chris Hale. Chair Frissell presented the family of Dr. Hale with the Public Health Hero Award named in honor of Dr. Hale in recognition of her many achievements and contributions to our community. Chair Frissell said the service was well attended. • Member Austin announced that he has applied for membership to the State Board of Health. He will keep the Board informed throughout the process. AGENDA PLANNING • Presentation of pros/cons of becoming a Health District • Budget proposal discussion Member Westerman moved to adjourn the meeting. Member Austin seconded the motion,which carried by unanimous vote. Meeting was adjourned at 4:15 p.m. Next Board of Health meeting is September 20,2007. • Jefferson County Board of Health,August 16,2007 Page 5 of 6 JEFFERSON COUNTY BOARD OF HEALTH • Roberta Frissell, Chair Sheila Westerman,Member Excused John Austin, Vice Chair Geoff Masci, Member Excused David Sullivan, Member Jill Buhler,Member Excused Phil Johnson,Member • Jefferson County Board of Health,August 16,2007 Page 6 of 6 • Board of Health Odd Business Agenda Items # TV., 1 • National3-feaCth Service Corps Provider Recruitment September 20, 2007 • Z"),, Na114 Mat `s°ire lealt 4.11 AMERICA'S HEAITH CARE HEROES Dear Site Administrator: Thank you for your interest in the National Health Service Corps (NHSC). Enclosed please find the NHSC Multi-Year Recruitment and Retention (R&R) Assistance Application. Every site must complete and submit this application in order to be considered for approval as an eligible NHSC Service Site for NHSC Scholars or individuals interested in participating in the NHSC Loan Repayment Program (LRP). Please read the "Instructions for Completing the NHSC Multi-Year R&R Assistance Application" carefully before completing the application. All sites must be located in a federally-designated Health Professional Shortage Area (HPSA) and meet all requirements outlined in Section 5 of the application at the time of submission. Sites cannot apply and be approved by the NHSC if all requirements are not currently being met. In addition, the"charges for services" require- ments apply to all clinicians at the site, not only the NHSC clinicians that may serve there. Your application will be reviewed by both NHSC staff and the State's Primary Care Office to determine eligibility as a NHSC Service Site. Determination of your site's eligibility will be made by the NHSC and you will receive written notification of the outcome of your application. Most notifications are made within 4-weeks of application submission. Please remember that submission of an application does not guarantee approval. In addition, approval as a NHSC Service Site does not guarantee that clinicians you hire will be eligible to serve a NHSC • commitment at your site. They must apply and be approved for NHSC programs and approved for service at your site. If your site's application is approved, you will be able to post current job opportunities on the NHSC On-Line Opportunities List as vacancies arise. The NHSC markets the Opportunities List, attracting hundreds of clinicians looking for health professional jobs in underserved areas, including but not limited to NHSC Scholars and those with an interest in applying for the NHSC LRP. To keep our list as accurate as possible, we ask that, if approved, your site agrees to notify the NHSC regarding the status of vacancies so that we may update our on-line list. Once approved, and as long as your site remains in a HPSA and continues to meet NHSC requirements, your site can continue to list vacancies on the NHSC On-Line Opportunities List. Your site does not have to reapply until the HPSA designation is updated. This usually occurs every three years. If the area loses the HPSA designation while a NHSC clinician is serving, that NHSC clinician will be allowed to continue service until the obligation to the NHSC is fulfilled. However, new NHSC clinicians or those clinicians under the NHSC LRP who want to amend their LRP contracts for an additional year of service will not be approved for service if the HPSA is not designated. We look forward to working with you toward improving the health of the Nation's underserved. If you have any questions regarding the application or application process, please contact the NHSC at 1-800-221-9393. Sincerely yours, • Richard J. Smith, Ill Associate Administrator Bureau of Clinician Recruitment and Service Us karma'al ilat end Now Stnitei • Board of 3fea�th Old Business .agenda Item # IV., 2 0 Jefferson County Public 3-fealth in N.ACC310 News September 20, 2007 • fNATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS AUGUST 2007 .�.`, a: - .F a `- .;za t-�� "�� r' i e� �. ,$,:. `? A ® t , -1 argie tie , -Sin 41,1r. d INTRODUCTION BACKGROUND Mental illness is a complex health Maternal depression is associated with specific demographic, biological,genetic, concern,characterized by a wide array and social risk factors(see Figure 1). However, depression among pregnant of disorders that affect men and women women and new mothers is often unrecognized or under-diagnosed.As a result, at different rates. Depression—one of many cases of depression among women go untreated. the many mental disorders that affect millions of Americans each year—occurs Estimates of the prevalence and incidence of perinatal depression vary widely, most often among women.' Women are from five percent to 25 percent of pregnant women and new mothers.3 These twice as likely to suffer from depression differences are due to how depression is defined,the type of assessment tool as men are, and women are particularly used,when the assessment is administered, and what population is screened. vulnerable during the perinatal period Symptoms of depression include prolonged periods of depressed or irritable (i.e., the period around childbirth, mood,fatigue, loss of interest in activities, changes in sleep or appetite,feelings especially the five months before and one of guilt or worthlessness, or thoughts of harming oneself or someone else. month after birth). Depression among Maternal depression not only negatively impacts a mother's psychological well- women is a significant public health being but also her child's development and family functioning.4 concern because of its potential impact on the health of the woman and her Maternal depression also affects children prenatally and after birth. Perinatal family. depression—depression that occurs during pregnancy or within a year after delivery—puts infants at greater risk of being small for gestational age and being --6,,,::-- born prematurely.'After birth, a mother's ability to bond with her child may talso be compromised by depression.This compromised bond puts infants of i I - ' '" 'tip; '*; depressed mothers at risk for delayed social and emotional development.° Children of depressed mothers experience more social and emotional problems lethan children whose mothers are not depressed. Delays or impairments in cognitive, linguistic development, and social interactions may exist. Children of mothers with continued depression are more likely to develop long-term behavioral problems and are at greater risk of developing psychopathology, including affective(mainly depression), anxiety,and conduct disorders, later in life.'Depressed mothers also generally show less attentiveness and responsiveness In order to understand better the ways to their children's needs and are less likely to use preventive services.° that local health departments(LHDs) are addressing this public health concern, the National Association of County FIGURE 1. Risk Factors for Maternal Depression' and City Health Officials'(NACCHO's) Maternal and Child Health and Primary Care projects queried several LHDs to 4 Previous or family history of depression assess the availability and delivery of mental health services for pregnant a History of alcohol dependence and parenting women.This issue brief highlights strategies in addressing a Poor marital relationships depression among pregnant and Life stress parenting women and describes the efforts of three LHDs working to integrate • Low social status omen's mental health activities into existing services.The brief also describes a Lack of social support or absence of a challenges LHDs experience and discusses community network next steps LHDs can undertake to ensure the mental health of the women they • Unplanned or unwanted pregnancy serve. 1 NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS AUGUST 2007 ... ate. �. - u' m - ' _ k 111111 LHDS ADDRESS MATERNAL MENTAL HEALTH FIGURE 2. Challenges to Providing Integrated Mental health and public health are integrally linked because Mental Health Services of the significant role each can play in health promotion and a Insufficient capacity or funding within disease prevention. LHDs address women's mental health health department through various programs and activities,which include outreach, e Lack of qualified community providers education, screening, identification, referral, and intervention. e Stigma The following LHDs provide examples of this work. ' Fragmentation of services e Limited access to services Lawrence-Douglas County(KS)Health Department The Maternal and Child Health Program at the Lawrence- Douglas County Health Department(LDCHD)has had success Clinton County (NY) Health Department in identifying mental health needs of pregnant and parenting Through the Mobilizing for Action through Planning and women.Through assessment, referral, and case management, Partnership(MAPP)process, the Clinton County Health LDCHD collaborates with the local mental health center(co- Department(CCHD)has become a leader and facilitator in located with LDCHD)and other community partners to ensure the integration of mental health and public health.The MAPP seamless delivery of services for women. process allowed CCHD to bring together all of the mental health providers in the community, enabling the providers LDCHD assesses mental health needs on an ongoing basis in the to learn more about the services each organization provides prenatal and postpartum care programs and tailors interventions while viewing mental health from the broader prevention to meet those needs.To better serve this population, LDCHD perspective. assigns each family a public health nurse who works with the family throughout pregnancy and up to one year postpartum. Results from the MAPP process indicated that mental health issues, particularly access to and availability of services,were • Once those needs are identified, LDCHD uses its partnership a top priority for Clinton County.This allowed CCHD to with the local mental health center to continue to deliver enhance its prenatal care program to fit mental health into services.The local mental health center has a therapist who the overall vision for healthy mothers, babies, and families.As specializes in women's mental health and accepts direct referrals a facilitator and catalyst for women's mental health services, from LDCHD. If clients are willing, the public health nurses can CCHD is better able to serve pregnant and parenting women accompany them to the center to begin the treatment process. through collaborative relationships with treatment centers and The connection with the local mental health center enables community mental health resources. LDCHD to better serve women, especially young women and teenage mothers, because the complicated intake process is Another initiative within CCHD is the "Medicaid Obstetrical eliminated.The collaborative relationship is further enhanced and Maternal Services"(MOMS)program, a Medicaid- during interdisciplinary case conferences in which the clinical enhanced prenatal care program that offers health education psychologist and nurses jointly review cases once a month. and healthcare services for mothers and babies during pregnancy and postpartum.Women who meet certain income In addition, LDCHD took the lead in developing a community- requirements can receive complete medical care during wide task force, comprising local hospital representatives, pregnancy and delivery and at least two months postpartum. private practice physicians, and public health nurses, to Public health nurses provide emotional support for the women ensure integrated mental health services, especially related to enrolled in the program.The nurses conduct home visits identification, referral, and treatment.The task force developed and provide assessment, education, and case management standard screening and referral protocols for postpartum services. Outreach occurs through WIC clinics, advertisements depression,substance abuse, sexual abuse, and domestic in the local newspaper, private practice physicians'offices, and violence that are used by providers throughout the county. the local hospital. LDCHD also took the lead in developing another community The MOMS program uses a comprehensive assessment tool collaborative effort:the "Success By 6 Coalition."The coalition to examine risk factors in broad categories, such as chronic brings community partners together to look at the needs of conditions,substance use, previous pregnancy complications, young children and their families and to address the gaps in mental health status and history, and the mother's current services. Family resource teams with mental health specialists living situation. CCHD is identifying the most pressing • provide in-home family support and mental health services to mental health needs of women, particularly those in targeted families with young children. Most often these clients are populations(e.g., teenage mothers and smokers),what tools referred through Women, Infants and Children (WIC)clinics are best to use,and how to use the tools most effectively to and school nurses. provide patient education and make referrals for treatment. 2 • NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS AUGUST 2007 : ::__„_:,-:'---:I:70„1_,..15 < : t om: Vi a- .- - , -- h '4 -°� Jefferson County(WA)Health Department NEXT STEPS Jefferson County Health Department(JCHD)integrates mental Integrating behavioral health services into existing services for health services into its other screening, outreach, education, pregnant and parenting women is a challenge. However, LHDs referral, and treatment services. By providing integrated can play a vital role in establishing women's mental health as a mental health services,JCHD is able to serve families with the priority, especially when acting as facilitators and collaborators most complex needs, including those with mental health and with community partners and local mental health centers. LHDs substance abuse needs. can take the following steps to ensure the mental health of the JCHD integrates mental health in as many program areas as women they serve: possible. Public health nurses routinely conduct depression screening in several programs, including WIC,family planning, /t1en effective-nefhQds,f ariyrdentt cation; re�ertron, First Steps, Maternity Case Management Program, and Nurse- arntl4ntervention that'eonenhzlnceseamlessc 01it*M- Family Partnership(NFP). e1?'tcesQr Ivo+►ten ant �eancorporatedno#helDse#tny_, NFP has allowed JCHD to screen every family with a new baby. LHDs can accomplish this through increasing awareness and Additionally, all Maternal and Child Health team members knowledge about the importance of maternal depression, (nurses and social workers)are NFP-trained and,therefore, promoting routine screening with standardized screening tools, have developed skills to provide mental health education and and increasing capacity for referrals and treatment. support. Nurse consultants instruct JCHD's nurses on conducting Increasing awareness may help reduce the social stigma depression screens.The nurse consultants also provide support associated with depression. Recognizing that staff working with and consultation,which has helped JCHD successfully integrate women of childbearing age may feel inadequately prepared to mental health services. deal with mental health issues is an important consideration for Wlients who screen positive for depression are referred to the LHDs that want to enhance their ability to address these issues. ommunity health center, private providers, or hospital providers. Increasing knowledge of providers and training staff to recognize JCHD hopes to increase collaboration with the local mental and treat maternal depression and providing the support and health center to better address the mental health needs of motivation for assessing mental health are key. pregnant women and women with young children. - - er reconeta careo s n rms �faj p � "� - g: �CHALLENGES/BARRIERS TO PROVIDING INTEGRATED WOMEN'S MENTAL HEALTH SERVICES Preconception care includes(1)interventions that identify and modify biomedical, behavioral, and social risks to a woman's Although integration has increased access to mental health services, LHDs face a number of challenges in reaching across health and future pregnancies; and(2)prevention and silos to begin integration and collaboration(see Figure 2).These management, emphasizing health issues that require action challenges may make it difficult for LHDs to address maternal before conception or very early in pregnancy for maximal depression systematically. Moreover, addressing maternal impact.The target population for preconception care is Women of reproductive age, although several components of depression among high-risk pregnant and postpartum women may not be a priority when compared to other significant needs preconception care target men also.The overarching goal of of these women, including the basic needs of nutrition, housing, preconception care is to provide(1)screening for risks; (2)health and access to care. LHD staff members carry heavy case loads promotion and education;and (3)interventions to address and may have limited time to assess and address the mental identified risks.$ health needs of the women they serve.Additionally, public health While the main focus of preconception care is on medical factors nurses may not feel comfortable talking about depression with their clients or may not be adequately trained on screening and such as obesity, chronic conditions, and smoking, mental health intervention. Finally, barriers to or lack of sufficient resources is an important consideration within the context of these risks for treatment can create a disincentive for LHDs to screen for and is a critical component of women's healthcare.Identifying depression. and addressing mental health issues in the preconception period is beneficial because that process recognizes and addresses . co-occurring risk factors. Maternal depression is associated with several other risk factors that may contribute to both the onset and maintenance of depressive symptoms.A preconception framework emphasizes the importance of screening across multiple areas of risk.While a woman is being screened for family history of heart disease, she can also be asked about social risk 3 NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS AUGUST 2007 - , EA-.' ✓. : ' _ £- _ _ kl'o it e F a -b ,,r-- ! ® i ® ► -,o- = t ill fin® ® _ factors,such as her perceived social support REFERENCES or emotional well-being. For women with 1.National Alliance on Mental Illness.Women and depression fact sheet.Retrieved June 25, a history of depression, interconception 2007 from NAMI Web site:www.nami.org/Template.cfm?Section=By Illness&template=/ counseling and care are important.Women ContentManagement/ContentDisplay.cfm&ContenttD=17627. can be encouraged to discuss this history with their providers.Women can also be 2.O'hara,J.W.&Swain,A.M.(1996).Rates and risk of postpartum depression:a meta- analysis.Int Rev Psychiatry,8:37-54. educated on the management of their depression, including possible effects of 3.Gavin,N.I.,Gaynes, B.N., Lohr, K.N.,Meltzer-Brody,S.,Garltlehner,G., & Swinson, antidepressant medications on the future T.(2005).Perinatal depression:a systematic review of prevalence and incidence.Obstet pregnancy. Learning about the warning Gynecol, 106:1071-1083. signs and knowing how to gain access to 4.Onuaku, N.(2005). Improving maternal and infant mental health:focus on maternal treatment as soon as possible are additional depression.Los Angeles,CA:National Center for Infant and Early Childhood Health Policy benefits of preconception counseling. at UCLA. These messages and strategies can easily be 5. U.S. Department of Health and Human Services Office of Womens Health.Depression incorporated into preconception counseling During and After Pregnancy.(n.d.).Retrieved July 26,2007,from www.4women.gov/FAQ/ in the LHD setting. postpartum.htm#5. 6.Diego, M.A.,Field,T., & Hernandez-Reif,M.(2005).Prepartum,postpartum and chronic CONCLUSION depression effects on neonatal behavior.Infant Behav Dev,28:155-164. By viewing women's health as a continuum 7. Beck,C.T.(1999).Maternal depression and child behavior problems:a meta-analysis.I on which intervention, screening, and health Adv Nurs,29:623-629. education do not solely commence at the beginning of a pregnancy or immediately 8. Centers for Disease Control and Prevention.National Center on Birth D0 efects and Developmental Disabilities.What is preconception care?Available from www.cdc.gov/ cease at its end, LHDs can identify women ncbddd/preconception/whatispreconception.htm. with maternal depression early and provide a seamless delivery of interventions.Changing the way women's healthcare is delivered ACKNOWLEDGEMENTS can improve perinatal outcomes and create a more collaborative approach in which The National Association of County and City Health Officials is the national social risk factors, such as mental health, are organization representing local health departments. NACCHO supports efforts addressed in the overall picture of women's that protect and improve the health of all people and all communities by health. promoting national policy,developing resources and programs, seeking health equity, and supporting effective local public health practice and systems. Continued collaboration among community partners, providers,and local mental health NACCHO staff who contributed to this report include:Angela Ablorh-Odjidja, centers will help LHDs design and carry out MHS; Erin Cox, MSW, MSPH; Julie Nelson Ingoglia, MPH; Jennifer Joseph, MSEd, comprehensive interventions that address PhD; Navita Persaud, MPH;Cindy Phillips, MSW, MPH and Claire Valderama, MPH. significant risk factors and improve women's NACCHO would also like to thank Caren Clark for editing and Brenna Thibault mental health. LHDs can continue to for the layout and design of this document. promote screening, education, and outreach services while continuing to strengthen For additional information about this publication contact: the links between screening and treatment Erin Cox, MSW, MSPH services that can ultimately improve the well- Program Associate being of women and families. National Association of County and City Health Officials 1100 17th St NW This issue brief is supported by Second Floor 410 Grant#G96MC04449 from the Second Maternal and Child Health Bureau Washington, DC 20036 (Title V Social Security Act), (202) 783-5550, Ext. 277 Health Resources and (202) 783-1583 Services Administration,Department ecox@naccho.org of Health and Human Services. www.naccho.org NACCHO is grateful for this support. 4 • Board of 3-fe aCtf i 0CcCBusiness Agenda Item # XV., 3 • Board CorresponcCence Seytember 20, 2007 • STATE 0,4 • :7 oy • STATE OF WASHINGTON DEPARTMENT OF HEALTH OFFICE OF SHELLFISH AND WATER PROTECTION PO Box 47824 • Olympia, Washington 98504-7824 (360)236-3330 • TDD Relay Service: 1-800-833-6388 September 6, 2007 '`` Mike McNickle, MPA, RS Deputy Director Jefferson County Public Health 615 Sheridan Street Port Townsend,Washington 98368 • Dear Mr. McNickle: In accordance with the procedure established in WAC 246-272A-0015, the Department of Health has reviewed revisions to Jefferson County 8.15 On-Site Sewage Code, which were adopted by the Jefferson County Board of Health on July 19, 2007. The revisions to Jefferson County Code 8.15 are consistent with the intent of WAC 246-272A and are hereby approved. Sincerely, Maryanne Guichard Office Director cc: Dave Lenning, DOH • ft STATEx ''>144' lass • STATE OF WASHINGTON DEPARTMENT OF HEALTH OFFICE OF SHELLFISH AND WATER PROTECTION PO Box 47824 • Olympia, Washington 98504-7824 (360)236-3330 • TDD Relay Service: 1-800-833-6388 September 11, 2007 Roberta Frissell, Chair Jefferson County Board of Health 615 Sheridan Street Port Townsend, Washington 98368 Dear Ms. Frissell, The Jefferson County Health Department submitted the final "Jefferson County On-Site Sewage • System Management Plan"on August 20, 2007. As required by RCW 70.118A.050 and 070,as well as WAC 246-272A-0015, the Department of Health has reviewed the plan and finds: • The plan to be complete, and • The strategy(to find all unknown or existing failing systems and ensure they are repaired) developed for the identified Marine Recovery Area meets the requirements of RCW 70.118A.050 and is approved. We commend your local health department staff for completing the County's local management plan, culminating in its approval by the Jefferson County Board of Health on August 16, 2007. We look forward to the successful implementation of many activities included in the plan and offer our assistance where you think it would be useful. If you have questions,please contact Dave Lenning at (360)236-3382 or Jane Lee at (425) 453-1340. Sincerely, Maryanne Guichard, Director Office of Shellfish and Water Protection Cc Dr. Tom Locke Health Officer, Clallam/Jefferson Co • Mike McNickle, Director Environmental Health Jefferson County Public Health .,e 0�r1 JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 • www.jeffersoncountypublichealth.org August 30, 2007 Mr. Jay Manning Washington State Department of Ecology PO Box 47600 Olympia, WA 98504-7600 RE: BECKETT POINT GRANT Dear Mr. Manning: The purpose of this letter is to thank you and your staff on behalf of Jefferson County Public Health, Jefferson County PUID#1, and the residents of Beckett Point for going the extra mile in locating a source of funds for Jefferson County PUD#1, and the residents of Becket Point, to complete the installation of a large on-site sewage system (LOSS). This LOSS will improve water quality in Discovery Bay which has recently suffered a commercial shellfish downgrade of about 50 acres in the southern part of the Bay. This project will go a long way in helping Jefferson County have those 50 acres reopened as quickly as possible. I especially want to thank Dick Wallace, Steve Carley and Alan Bogner for their persistence in locating and forwarding $50,000 to complete the project. Without this infusion of funds, • the project was in jeopardy. The funding will help pay for the archaeological study and construction costs associated with the project. Again, thank you and your staff for your assistance. It is much appreciated. — 47- Mike McNickle, MPA, RS Deputy Director Jefferson County Public Health Cc: Governor Chris Gregoire Representative Lynn Kessler Representative Kevin Van DeWege Senator Jim Hargrove Jefferson County Board of Commissioners John Fischbach, Jefferson County Administrator Jefferson ZoontyBoardtliieelth4 Tom Locke, Health Officer Jim Parker, Jefferson County PUD#1 • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES tA\S WORKING WATER QUALITY MAIN: 360-385-9400 At,V WORKIN OR A SAFER AND MAIN: 360-385-9444 FAX 360-385-9401 HEALTHIER COMMUNITY FAX 360-385-9401 • Board of.7CeaCth Netiv Business .agenda Item #`V., 1 Policy eCated • FormationIssues of.jCPR3f District:to Progress Report September 20, 2007 .CW 70.05.030: Counties—Local health board—Jurisdiction. Page 1 of 1 How To Use This Site I About Us I Contact Us I Search • Legislature Home I Senate I House of Representatives Print Version I No disponible en espanol _ RCWs>Title 70>Chapter 70.05>Section 70.05.030 Inside the Legislature Find Your Legislator ' 70.05.010 « 70.05.030» 70.05.035 • Visiting the Legislature RCW 70.05,030 • Agendas, Schedules and Counties — Local health board — Jurisdiction. Calendars * Bill Information In counties without a home rule charter,the board of county commissioners shall constitute the local board of Laws and Agency Rules ; health, unless the county is part of a health district pursuant to chapter 70.46 RCW.The jurisdiction of the local board of health shall be coextensive with the boundaries of said county.The board of county Legislative Committees 1 commissioners may, at its discretion, adopt an ordinance expanding the size and composition of the board of Legislative Agencies health to include elected officials from cities and towns and persons other than elected officials as members Legislative Information so long as persons other than elected officials do not constitute a majority.An ordinance adopted under this Center section shall include provisions for the appointment,term,and compensation,or reimbursement of expenses. • E-mail Notifications (Listserv) [1995 c 43§6;1993 c 492§235; 1967 ex.s.c 51§3.] • Students'Page • History of the State ; Notes: Legislature Effective dates--Contingent effective dates--1995 c 43: "(1)Sections 15 and 16 of this act are _,_.. necessary for the immediate preservation of the public peace,health,or safety,or support of the state ide the Legislature government and its existing public institutions, and shall take effect June 30, 1995. • ngress-the Other (2)Sections 1 through 5, 12,and 13 of this act are necessaryfor the immediate preservation of the Washington public peace,health,or safety,or support of the state government and its existing public institutions, and shall take effect July 1, 1995. TV Washington Washington Courts (3)Section 9 of this act is necessary for the immediate preservation of the public peace,health,or safety,or support of the state government and its existing public institutions,and shall take effect * OFM Fiscal Note immediately[April 17, 1995]. Website F (4)*Sections 6 through 8, 10, and 11 of this act take effect January 1, 1996, if funding of at least two million two hundred fifty thousand dollars, is provided by June 30, 1995, in the 1995 omnibus AllikakWaShV .] tg appropriations act or as a result of the passage of Senate Bill No.6058,to implement the changes in „ public health governance as outlined in this act. If such funding is not provided,sections 6 through 8, 10, and 11 of this act shall take effect January 1, 1998."[1995 c 43§ 17.] *Reviser's note:The 1995 omnibus appropriations act,chapter 18, Laws of 1995 2nd sp.sess. provided two million two hundred fifty thousand dollars. Severability--1995 c 43: See note following RCW 43.70.570. Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings--Captions not law--Reservation of legislative power-- Effective dates--1993 c 492: See RCW 43.72.910 through 43.72.915. Glossary of Terms I Comments about this site�I Privacy Notice I Accessibility Information I Disclaimer 0 ttp://apps.leg.wa.gov/RCW/default.aspx?cite=70.05.030 9/13/2007 'hapter 70.46 RCW: Health districts Page 1 of`4 Chapter 70.46 RCW Health districts • Chapter Listing RCW Sections 70.46.020 Districts of two or more counties--Health board--Membership--Chair. 70.46.031 Districts of one county--Health board--Membership. 70.46.060 District health board--Powers and duties. 70.46.080 District health funds. 70.46.085 County to bear expense of providing public health services. 70.46.090 Withdrawal of county. 70.46.100 Power to acquire, maintain,or dispose of property--Contracts. 70.46.110 Disincorporation of district located in county with a population of two hundred ten thousand or more and inactive for five years. 70.46.120 License or permit fees. 70.46.130 Contracts for sale or purchase of health services authorized. Notes: Local health departments,provisions relating to health districts:Chapter 70.05 RCW. 70.46.020 Districts of two or more counties—Health board—Membership—Chair. Health districts consisting of two or more counties may be created whenever two or more boards of county commissioners shall by resolutio establish a district for such purpose.Such a district shall consist of all the area of the combined counties.The district board of health of su a district shall consist of not less than five members for districts of two counties and seven members for districts of more than two counties, including two representatives from each county who are members of the board of county commissioners and who are appointed by the board of county commissioners of each county within the district, and shall have a jurisdiction coextensive with the combined boundaries. The boards of county commissioners may by resolution or ordinance provide for elected officials from cities and towns and persons other than elected officials as members of the district board of health so long as persons other than elected officials do not constitute a majority.A resolution or ordinance adopted under this section must specify the provisions for the appointment,term, and compensation,or reimbursement of expenses.Any multicounty health district existing on*the effective date of this act shall continue in existence unless and until changed by affirmative action of all boards of county commissioners or one or more counties withdraws[withdraw]pursuant to RCW 70.46.090. At the first meeting of a district board of health the members shall elect a chair to serve for a period of one year. [1995 c 43§10;1993 c 492§247;1967 ex.s.c 51 §6; 1945 c 183§2;Rem.Supp.1945§6099-11.] Notes: "Reviser's note: For"the effective date of this act"see note following RCW 70.05.030. Effective dates--Contingent effective dates--1995 c 43:See note following RCW 70.05.030. Severability--1995 c 43: See note following RCW 43.70.570. Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings --Captions not law--Reservation of legislative power--Effective dates --1993 c 492: See RCW 43.72.910 through 43.72.915. Severability--1967 ex.s.c 51: See note following RCW 70.05.010. • ttp://apps.leg.wa.gov/RCW/default.aspx?cite=70.46&full=true 9/13/2007 'hdpter 70.46 RCW: Health districts Page 2 of 4 • 70.46.031 Districts of one county—Health board—Membership. A health district to consist of one county may be created whenever the county legislative authority of the county shall pass a resolution or ordinance to organize such a health district under chapter 70.05 RCW and this chapter. The resolution or ordinance may specify the membership,representation on the district health board,or other matters relative to the formation or operation of the health district.The county legislative authority may appoint elected officials from cities and towns and persons other than elected officials as members of the health district board so long as persons other than elected officials do not constitute a majority. Any single county health district existing on*the effective date of this act shall continue in existence unless and until changed by affirmative action of the county legislative authority. [1995 c 43§11.] Notes: *Reviser's note: For"the effective date of this act"see note following RCW 70.05.030. Effective dates --Contingent effective dates--1995 c 43: See note following RCW 70.05.030. Severability--1995 c 43: See note following RCW 43.70.570. .060 icthealth board—Powers and duties. The district board of health shall constitute the local board of health for all the territory included in the health district,and shall supersede and exercise all the powers and perform all the duties by law vested in the county board of health of any county included in the health district. [1993 c 492§248;1967 ex.s.c 51§11; 1945 c 183§6;Rem.Supp.1945§6099-15.] Notes: Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings--Captions not law--Reservation of legislative power--Effective dates --1993 c 492: See RCW 43.72.910 through 43.72.915. Severability--1967 ex.s. c 51: See note following RCW 70.05.010. 70.46.080 District health funds. Each health district shall establish a fund to be designated as the"district health fund",in which shall be placed all sums received by the district from any source,and out of which shall be expended all sums disbursed by the district. In a district composed of more than one county the county treasurer of the county having the largest population shall be the custodian of the fund, and the county auditor of said county shall keep the record of the receipts and disbursements, and shall draw and the county treasurer shall honor and pay all warrants, which shall be approved before issuance and payment as directed by the board. •ch county which is included in the district shall contribute such sums towards the expense for maintaining and operating the district as shall be agreed upon between it and the local board of health in accordance with guidelines established by the state board of health. ttp://apps.leg.wa.gov/RCW/default.aspx?cite=70.46&full=true 9/13/2007 'hapter 70.46 RCW: Health districts Page 3 of4 [1993 c 492§249; 1971 ex.s.c 85§10;1967 ex.s.c 51§19;1945 c 183§8;Rem.Supp.1945§6099-17.] Notes: 411 Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings--Captions not law--Reservation of legislative power--Effective dates--1993 c 492: See RCW 43.72.910 through 43.72.915. Severability--1967 ex.s. c 51: See note following RCW 70.05.010. 70.46.085 County to bear expense of providing public health services. The expense of providing public health services shall be borne by each county within the health district. [1993 c 492§250;1967 ex.s.c 51§20.] Notes: Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings--Captions not law--Reservation of legislative power--Effective dates--1993 c 492: See RCW 43.72.910 through 43.72.915. Severability--1967 ex.s. c 51: See note following RCW 70.05.010. Expenses of enforcing health laws: RCW 70.05.130. • 70.46.090 Withdrawal of county. Any county may withdraw from membership in said health district any time after it has been within the district for a period of two years, but no withdrawal shall be effective except at the end of the calendar year in which the county gives at least six months'notice of its intention to withdraw at the end of the calendar year. No withdrawal shall entitle any member to a refund of any moneys paid to the district nor relieve it of any obligations to pay to the district all sums for which it obligated itself due and owing by it to the district for the year at the end of which the withdrawal is to be effective.Any county which withdraws from membership in said health district shall immediately establish a health department or provide health services which shall meet the standards for health services promulgated by the state board of health. No local health department may be deemed to provide adequate public health services unless there is at least one full time professionally trained and qualified physician as set forth in RCW 70.05.050. [1993 c 492§251;1967 ex.s.c 51 §21;1945 c 183§9;Rem.Supp.1945§6099-18.] Notes: Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings--Captions not law--Reservation of legislative power--Effective dates--1993 c 492: See RCW 43.72.910 through 43.72.915. Severability--1967 ex.s.c 51: See note following RCW 70.05.010. ttp://apps.leg.wa.gov/RCW/default.aspx?cite=70.46&full=true 9/13/2007 'hapter 70.46 RCW: Health districts Page 4 of 4 70.46.100 0P er to acquire,maintain,or dispose of property—Contracts. In ddition to all other powers and duties, a health district shall have the power to own,construct, purchase,lease,add to,and maintain any real and personal property or property rights necessary for the conduct of the affairs of the district.A health district may sell, lease, convey or otherwise dispose of any district real or personal property no longer necessary for the conduct of the affairs of the district.A health district may enter into contracts to carry out the provisions of this section. [1957 c 100§2.] 70.46.110 Disincorporation of district located in county with a population of two hundred ten thousand or more and inactive for five years. See chapter 57.90 RCW. 70.46.120 License or permit fees. In addition to all other powers and duties, health districts shall have the power to charge fees in connection with the issuance or renewal of a license or permit required by law: PROVIDED,That the fees charged shall not exceed the actual cost involved in issuing or renewing the •se or permit. [1993 c 492§252;1963 c 121§1.] Notes: Findings--Intent--1993 c 492: See notes following RCW 43.20.050. Short title--Severability--Savings --Captions not law--Reservation of legislative power--Effective dates--1993 c 492: See RCW 43.72.910 through 43.72.915. 70.46.130 Contracts for sale or purchase of health services authorized. See RCW 70.05.150. • ttp://apps.leg.wa.gov/RCW/default.aspx?cite=70.46&full=true 9/13/2007 • Board of 3fealth Netiv Business .agenda Item #17., 2 Public 3-fealth Emergency • Preparedness JuncCing Cuts September 20, 2007 • • EMBARGOED UNTIL: Monday, 9/10/2007, 4:00p.m. (ET) Contact:Todd Kutyla,tkutyla(a,,burnesscommunications.com or Nick Seaver,nseaver@burnesscommunications.com phone: 301-6521558 Federal Cuts Threaten Advances in Public Health Emergency Preparedness Washington D.C.—Federal funding received by local health departments for all-hazards emergency preparedness fell 20 percent last year, according to a new report by the National Association of County and City Health Officials (NACCHO). The report says that continued cuts in funding provided through the Centers for Disease Control and Prevention(CDC) threaten important, hard-won advances made in recent years in response planning to natural disasters, bio-terrorism events, emerging infectious diseases, and other public health emergencies. The report,Federal Funding for Public Health Preparedness: Implications and Ongoing Issues for Local Health Departments, provides the first detailed account of the effects of reduced funding on local governments' improved abilities to protect communities during • public health crises occurring on a nationwide, regional, or local scale. "While local health departments are making emergency preparedness a top priority, federal funding is not keeping up with federal requirements," says Karen Smith, MD, MPH, chair of NACCHO's Public Health Emergency Preparedness committee. "In order to maintain the remarkable level of progress made by local health departments over recent years, they'll need adequate federal funding to help them hire qualified permanent staff and train and drill continuously so they can respond effectively to public health emergencies." In the wake of the September 11, 2001, terrorist attacks and the 2001 anthrax episode, most local health departments (LHDs) significantly increased their capacity to anticipate and respond to an array of public health emergencies, thanks in large part to increased support provided by the U.S. Congress through CDC, including the Cities Readiness Initiative (CRI). According to the report, the percentage of LHDs with a comprehensive emergency response plan rose from 20 percent in 2001 to more than 90 percent today and nearly all report improvements in preparedness. Now, funding cuts are affecting the ability of LHDs to implement these plans and to respond to the growing number of threats the agencies are expected to address, from weather disasters to a pandemic influenza outbreak to food poisoning to a local"dirty bomb." The report finds that: • • Due to federal funding cuts, 28 percent of LHDs reduced staff time on • preparedness, 27 percent were forced to delay completion of preparedness plans, and 17 percent delayed or canceled workforce training. • Fifty-six percent of LHDs report that CDC funding is insufficient to meet grant requirements. • Forty percent have delayed or canceled acquisition of equipment and supplies. • Difficulty hiring needed qualified staff presents the greatest barrier to LHDs' preparedness efforts. "All disasters occur in communities where we live,work and play," says Patrick Libbey, NACCHO's executive director. "As public health professionals,we're making great progress preparing our communities for worst-case scenarios,both natural and manmade, but our forward momentum is hampered by a lack of reliable and adequate federal support. Ultimately, everyone in America will pay the price if needs aren't met." In FY 2002, CDC distributed $918 million to states, territories, and four large cities for all-hazards emergency public health preparedness, through cooperative agreements. In the next five years that funding declined by 27 percent,to $665 million in base funding for FY 2007. In FY 2004, when CRI was implemented to help selected metropolitan areas prepare for emergency mass distribution of antibiotics, 21 cities shared$27 million in funding. In FY 2007, $57 million is being divided among 72 designated cities. Between FY 2005 and 2006 alone, the size of the average CRI grant distributed to LHDs declined 29 percent, threatening vital preparations. • September is National Preparedness Month, a nationwide effort to encourage Americans to take simple steps to prepare for emergencies in their homes,businesses and schools. Find out more about National Preparedness month on NACCHO's web site. http://www.naccho.org/topics/emergency/NationalPreparednessMonth2007.cfm A pdf version of the full report, Federal Funding for Public Health Preparedness: Implications and Ongoing Issues for Local Health Departments, is available on NACCHO's web site, http://www.naccho.org/documents/SurveyReport_Final.pdf NACCHO is the national organization representing America's approximately 2,800 local health departments. NACCHO supports efforts that protect and improve the health of all people and all communities by promoting national policy, developing resources and programs, seeking health equity, and supporting effective local public health practice and systems. Federal Funding for Public Health Preparedness: Implications and Ongoing Issues for Local Health Departments Talking Points for Local Health Departments • • • Every day public health professionals answer the call to help our communities prepare for and respond to an increasing number of threats to our health, both large and small. A recent national report showed that over 90% of local health departments have instituted comprehensive emergency response plans, compared to just 20% six years ago. We're proud to be one of them. We're particularly proud of(list accomplishments). • Our ability to continue making significant advances in our preparedness requires reliable and adequate emergency preparedness funding from the federal government. This year, the Centers for Disease Control and Prevention (CDC)will split about$665 million in all-hazards emergency preparedness funding among 62 states,territories and large cities, down from$918 million soon after 9/11. As funding decreases so does our ability to maintain the advances we've made in the last six years. • During National Preparedness Month we're taking stock of the progress our health department has made to assure quick and effective response to both natural and manmade disasters. The most important focus, though, remains encouraging every member of the community to take a few simple steps to prepare for emergencies in their homes,businesses and schools. (Quick and easy help can be found at http://www.bt.cdc.gov/preparedness/.) • • The additional funds made available to us on a one-time basis for pandemic influenza preparedness are being well spent. We need continued support for this long-term effort. • With the help of the federal government after 9/11, local health departments increased their capacities to prepare and respond to a growing number of potential threats, from pandemic influenza to an attack with biological weapons. Continued support from the federal government is essential to maintaining the advances local health departments have made in preparedness over the past few years. Losing this support concerns us greatly because it threatens to undermine much of what we've accomplished. • Emergency preparedness is an essential function and primary focus of every local health department,just as it is for our fire and police departments. Only with constant training and reliable support can we respond quickly and effectively to protect our community during an emergency. Of the billions of dollars the federal government spends on homeland security and bioterrorism preparedness, only a small percentage is spent on the kind of public health preparedness efforts that help keep (name of jurisdiction) safe in the event of a terrorist attack, disease outbreak or natural disaster. • EXECUTIVE SUMMARY This report describes the results of two surveys conducted by the National Association of County and City Health Officials that examine the local impact of changes in federal fund- ing for public health preparedness. Since the terrorist attacks of 2001, local health depart- ments (LHDs) have significantly increased their capacity to prepare for and respond to emergencies with the support of funding from the Centers for Disease Control and Prevention (CDC).Since 2001,the percentage of LHDs with a comprehensive emergency responsive plan has risen from twenty percent to over ninety percent.In recent years,federal funding to sup- port all-hazards preparedness has declined dramatically, and there is concern about the negative impact of these cuts on LHDs'new preparedness programs. Some of the key findings from this study include: NI Nineteen percent of LHDs feel that they are now"highly prepared"for an emergency; however,77 percent of LHDs feel they have made improvements but more improve- ment is needed; The average amounts of CDC funding that LHDs received for all-hazards prepared- ness and the Cities Readiness Initiative declined by 20 percent and 29 percent respectively between FY05 and FY06; • Due to cuts in their funding,28 percent of LHDs reduced staff time on preparedness, 27 percent were forced to delay the completion of preparedness plans,and 17 percent delayed or canceled workforce training; 11 Fifty-six percent of LHDs reported that CDC funding is not sufficient to meet their deliverables; • LHDs' top three needs to meet preparedness deliverables are additional qualified staff,additional funding,and additional time to spend funds effectively;and in The three occupations most difficult to hire are emergency preparedness planners, epidemiologists, and nurses. In order for LHDs to continue to build and improve their preparedness and response capabili- ties,LHDs need qualified staff and support for continual training and exercising.Without reli- able funding, most LHDs cannot create and maintain permanent, full-time positions for preparedness.This survey demonstrates that sustained federal funding and support for pub- lic health preparedness is needed to help LHDs continue the progress that they have made and to help them address the challenges of new and emerging threats. The results from this study were derived from two Web-based surveys:the first directed to one representative of LHDs in each state(except Rhode Island),and the second directed to a iosample of individual LHDs. The survey for state representatives yielded 41 completed ques- tionnaires, an overall response rate of 76 percent. The survey for LHDs yielded 223 com- pleted questionnaires,an overall response rate of 47 percent. CDC Letter of Continued Funding for FY2007 • Announcement Type: New. Year Three of Five Year Project Period CFDA#93.283 FY07 CDC Guidance Update: Due to the Pandemic All Hazard Preparedness Act 2006 and constricted review timelines, the guidance will not be ready for distribution until late July 2007. Summary of Letter: To maintain a continuity of operations for the programs, during the review of the application, CDC is releasing 100% funds for FY07 with the majority of funding restricted. Unrestricted access will be 30% of the base. A brief workplan for these funds are due to the CDC by August 1, 2007. It is anticipated that an approved amended Notice of Award will be presented before the end of November 2007. Grant Amount: $17,735,544 (10% decrease in total funds) — 30% unrestricted funds: $5,320,663 — 70% restricted funds: $12,414,881 • For further information please contact Sabine Meuse of the Washington State Department of Health's Public Health emergency Preparedness Program at(360)236-4069. PUBLIC HEALTH ALWAYS WORK NG FORA SAFER ANO HEALTHIER WASHINGTON Public Health Emergency Preparedness and Response Federal FY07(8/31/07-8/9/08) Base,Pan Flu,CRI,ASPR Total Funding • August 17,2007 FFY07 FFY06 1 FFY05 30%of CDC FFY07 Total Amount ASPR and 30% FFY06 Total All FFY05 Total All LHJ Lead and Counties 2007 Population Unrestricted FFY07 ASPR CDC Sources Sources Kitsap 244,800 157,202 50,000 207,202 663,680 676,402 Clallam 68500 18,840 4,000 22,840 79,301 66,303 Jefferson 28500 9,463L 2,0004 11,463 39,145 34,194 Thurston 238,000 135,5011 50,000 j 185,501 1 578,101 582,369 Lewis 74,100 19,392 4,000 , 23,392 81,543 67,096 Pacific 21,6008,772 2,000 i 10,772 36,199 33,154 Grays Harbor 70,800 19,066 4,000 23,066 80,444 66,799 Mason 54,600 17,469 4,000 21,469 72,838 63,844 Clark 415,000 220,908 50,000 270,908 892,960 744,936 Cowlitz 97,800 31,308 4,000 35,308 128,565 112,710 Skamania 10,700 7,697 _ 2,000 9,697 31,407 31,338 Wahkiakum 4,000 7,037 2,000 9,037 28,462 30,282 Pierce 790,500 323,477 60,000 383,477 1,313,905 1,214,514 King 1,861,300 877,071 315,000 1,192,071 3,645,866 3,383,016 Snohomish 686,300 298,265 60,000 358,265 1,213,692 1,136,147 Skagit 115,300 38,693 6,000 44,693 159,308 141,770 Whatcom 188,300 45,674 6,000 51,674 189,780 152,363 Island 78,400 19,816 4,000 23,816 83,433 67522 San Juan 15,900 8,210 2,000 10,210 33,649 32,197 Chelan-Douglas 107,500 122,178 50,000 172,178 520,709 559,341 Okanogan 39,800 10,567 2,000 12,567 44,244 36,175 • Grant 82,500 20,220 4,000 24,220 84,928 68,334 Kittitas 38,300 10,419 2,000 12,419 43,189 35,680 Benton-Franklin 230,300 166,473 50,000 216,473 695,724 718,071 Walla Walla 58,300 17,834 4,000 21,834 74,949 64,768 Yakima 234,200 40,622 6,0001 46,622 174,147 118,767 Klickitat 19,900 8,605 2,0001 10,605 35,452 32,857 Spokane 451,200 233,007 60,000 293,007 973,171 959,586 Northeast Tri-County 63,150 26,155 6,000 32,155 107,454 98,951 Lincoln 10,300 7,658 2,000 9,658 31,231 31,305 Whitman 42,700 10,853 2,000 12,853 45,563 36,637 Garfield 2,350 6,874 2,000 8,874 27,802 30,034 Columbia 4,100 7,047 2,000 9,047 28,550 30,315 Adams 17,600 8,378 _ 2,000 10,378 34,353 32,444 Asotin 21,300 8,743 2,000 10,743 36,023 33,088 6,488,000 2,969,494 829,000 3,798,494 12,309,768 11,523,609 DOH 1,982,724 2,370,000 4,352,724 10,202,898 9,821,783 $ 4,952,218 I $ 3,199,000 $ 8,151,218 $ 22,512,666 I 21,345,392 1 Notes: • O Vim'I O' O ; O c N. 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Wr () 0 6) c6 N-i 0 ..-„-c e0 ! 0) OIi 44 PCS FC.I cn o c I Cr) • cd w o �I ' I O. v_ c c o M co L W I G1 V v M _— ----!---4 -- ---+— A�CU^ < tY O c N O O • �a) O (U O N '44��./ �1 U � M a) O N CO `V co 6 U .I.r E U o u_ Q co M� W O N N 0 G (0 -4.+ e� �, 1-, a, E OA GJ 0 5 Z '4: ..-6., o .2 a) aor� d m a N m a a co C9 Q ~ �+ cn U a v a (n • Board of HeaCt( Wow Business .agenda Item #V., 4 'West Nide Update: • State Emergency Funding & Local GIS Data September 20, 2007 • Washington State Department of Application for State Funds for I-Iecilth Emergency Mosquito Control in 2007 I. Background and Description During a West Nile virus disease outbreak, local communities may consider adult mosquito control (adulticiding) and larviciding, if indicated by surveillance findings, to be important tools to help limit the spread of disease. The state will strive to provide support for emergency mosquito control when the Department of Health determines it is an appropriate tool in mitigating the effects of an outbreak based on the following criteria: • Declaration of an emergency by local authorities • Local capacity to conduct effective mosquito control using integrated pest management practices. Integrated pest management (1PM)mosquito control practices are described in the DOH Guidance for Surveillance, Prevention, and Control of Mosquito-borne Disease, 2007 Edition, page 91 (http://www.doh.wa.gov/ehp/ts/Zoo/WNV/guidance.pdf). • Demonstrated presence of the virus and high risk to human populations State funds may be available to local governments in Washington for mosquito control under emergency conditions during 2007 and future years. If available, funds may be used for targeted emergency larviciding and emergency ground based and aerial adulticiding using integrated pest management practices. Funds may be used only for services,products or equipment required for • mosquito control and monitoring during the current alert level 4 or 5 WNV emergency. Larviciding and ground-based adulticide applications must follow all current federal, state and local laws and regulations to qualify for state funding. If emergency aerial adulticiding is indicated, the Department of Health will request and the Department of Ecology will issue an administrative order(see attached draft)that will address concerns associated with the State Environmental Policy Act (SEPA) for entities implementing emergency aerial adulticiding for mosquito-borne disease prevention. Emergency aerial adulticiding must follow all current federal, state and local laws and regulations, and the conditions outlined in the Ecology Administrative Order to qualify for state funding. II. Who may apply for funding Counties, municipalities, and tribal governments may apply for funding. Mosquito control districts established in accordance with RCW 17.28 may apply for funding. III. Amount of funding available Funds will be limited to $250,000 per county. IV. Application process • A. Notify DOH by phone during regular business hours that you will be submitting an application for emergency mosquito control funding. Call the DOH Office of Environmental 1 Health and Safety at 888-586-9427 to alert the Zoonotic Disease Program of your intent to • submit an application. B. Submit a narrative document with the following information. 1. Provide evidence that the area in which you are proposing adulticiding is experiencing alert level 4 or alert level 5 conditions, as described in the DOH Guidance for Surveillance, Prevention, and Control of Mosquito-borne Disease, 2007 Edition, pages 19-31 (http://www.doh.wa.gov/ehp/ts/Zoo/WNV/guidance.pdf). 2. Provide specific evidence regarding alert levels 4 or 5 that indicates an imminent threat to human health is present, as supported by multiple factors,which may include: a. Documentation of the presence of mosquito-borne viruses in the area b. The abundance and species of the mosquito populations c. Mosquito minimum infection rate(MIR) d. The density and proximity of human populations e. The time of year and weather conditions f. Accessibility to the area where the mosquito vector is located g. Rapidity of the response required as determined by the seriousness of the public health threat h. Other(please identify) 3. Identify the company, agency, or other entity conducting the control work, including a list of current WA State pesticide applicator license(s) with appropriate certification. • 4. Identify the area(s), including total number of acres, to be treated. Provide a map of the area on which bodies of water and treatment boundaries are designated. Provide a rationale indicating that control efforts in this area are likely to result in reduced presence of WNV in the environment. 5. Describe the method of control and treatment frequency. Attach a label of the pesticide product that will be used. State funding support for aerial adulticiding is limited to applications that utilize one of the following active ingredients: permethrin, resmethrin, sumithrin, deltamethrin, or pyrethrins. C. Attach the local declaration of emergency, consistent with RCW 38.52. D. Describe your agency's plan for funding WNV response activities and, if indicated, emergency mosquito control in future years. E. Attach a Proposed budget for services,products, or equipment necessary for emergency mosquito control in 2007.Funds must be used only for services,products or equipment required for mosquito control during the current alert level 4 or 5 WNV emergency. 1. Emergency mosquito control personnel 2. Emergency mosquito control products 3. Other services or equipment required to respond to the current emergency • 2 4. Service contracts entered into legally for application of adult mosquito control • products in response to the current emergency Note: All unused funds must be returned to DOH. F. Include contact information(phone, email, fax) for your agency staff to whom questions and other application follow-up should be directed. G. Submit the narrative Fax the completed application and signed agreement to The DOH Zoonotic Disease Program do Dorothy Tibbetts fax number: 360-236-2261 H. Award notification and acceptance DOH will evaluate that emergency mosquito control is appropriate for ensuring public safety for a particular location/region, and that plans for emergency mosquito control as described in the application are consistent with the criteria described above. If the plans are approved and funds are available, a Grant Award and Agreement will be completed and signed by the grantee and by DOH. The emergency mosquito control plans may then be implemented. • V. Deliverables/Statement of Work The entity receiving funds will: A. Plan and implement emergency mosquito control using larvicides and/or ground or aerial application of adulticides. B. Follow all applicable federal, state, and local laws and regulations and, if aerial adulticiding, follow the specific and general conditions stated on the attached administrative order, including: 1. Applicator requirements 2. Timing requirements 3. Treatment requirements 4. Pesticide label instructions 5. State and local regulations 6. Notification requirements 7. All other requirements stated on the administrative order C. Monitor the effectiveness of mosquito control activities using pre and post pesticide application mosquito monitoring, or other approved monitoring strategies. D. Submit a final written report by December 1, 2007 of 1) the treatment(s) that occurred • (location, time, method and product used), 2) any reported adverse human health effects and 3 adverse aquatic and other environmental effects, including fish kills and other reported • adverse effects, and 3) outcomes of monitoring for efficacy of the mosquito control activity. E. Within 45 days of expiration of this agreement, 1) submit an itemized list of services, products, or equipment purchased with state funds and the cost of each with original or photocopied receipts, and 2)return all unused funds to the Department. VI. Questions regarding the application process and distribution of funds should be directed to: Dorothy Tibbetts Dorothy.Tibbetts@doh.wa.gov 360-236-3361 (voice) 360-236-2261 (fax) • 4 Last week I sent you some information about new directions for state support of local West Nile • Virus (WNV)emergency response efforts should we have a major outbreak of WNV disease in our state. State funding may be available for emergency mosquito control, including emergency larviciding and emergency ground based and aerial adulticiding. As was described last week: during a WNV outbreak, the first response is local, and local governments are best able to determine the approach that will work within their communities. Local agencies may want to use adulticiding as a measure of last resort to protect public health, but may not have sufficient resources to do so. During a serious disease outbreak the state will provide financial assistance for adulticiding based on the following criteria: • Declaration of an emergency • Local capacity to conduct or contract with a company to conduct effective mosquito control using integrated pest management practices • Demonstrated presence of the disease and serious threat to human populations • DOH evaluation that the proposed emergency mosquito control is deemed appropriate in ensuring public safety for a particular location or region We have finalized an application process that will allow local agencies who meet certain requirements to obtain financial assistance for emergency mosquito control efforts during a WNV disease outbreak.Attached are 1.Application description--Emergency Mosquito Control 2.Agreement for Emergency Mosquito Control Also attached are documents with information to help you in planning for mosquito control: • 3. Emergency Mosquito Control Vendor List 4.Aquatic Commercial Pest Control List 5. DOH Larviciding Permitees We will be going over these documents with those who are able to join us for the WNV meet me call scheduled for tomorrow(Sept 13)at 1:30. The call-in number is 360-357-2903 PIN 17400#. If you have questions, please direct them to Dorothy Tibbetts at dorothy.tibbetts@doh.wa.gov, 360-236-3361. Enhanced public awareness and prevention education are two important components of an effective mosquito-borne disease prevention and control program. Educational materials are available from the Department of Health WNV web site at http://www.doh.wa.gov/ehp/ts/Zoo/WNV/education.html For the latest updates on WNV in Washington, the region, and nationwide, go to http://www.doh.wa.gov/ehp/ts/Zoo/WNV/Su rveillance07.html#Statistics Our West Nile Virus website can be accessed at: http://www.doh.wa.00viehoits/Zoo/VVNV/VVNV.html <<Application Description for Emer Mosq Control.doc>> <<Agreement for Emer Mosq Control.doc>> <<Emer Mosq Control Vendor List 9-10-07.doc>> <<Aquatic Commercial Pest Control List 2007.doc>> <<DOH Larviciding Permitees 9-10-07.xls>> Public Health-Always working for a safer and healthier Washington • Gregg Grunenfelder, Assistant Secretary Division of Environmental Health Washington State Department of Health P.O. Box 47820 Olympia, WA 98504-7820 phone (360)236-3050 fax (360)236-2250 I • • Board of Health *Media Report • September 20, 2007 • Jefferson County Public Health August — September 2007 NEWS ARTICLES 1. "Anderson State Park reopens; lake still closed",Peninsula Daily News, August 12, 2007 2. "Lake, pool closures",P.T. Leader, August 15,2007 3. "Our algae kills, but we're not alone",Commentary,Peninsula Daily News, August 22, 2007 4. "Beckett given a green light",(2 pages)Peninsula Daily News,August 23, 2007 5. "Health district proposed",Peninsula Daily News,August 27, 2007 6. "West Nile season fast approaching",Peninsula Daily News, August 27, 2007 7. "3 locations added to list of toxic sites",Peninsula Daily News, August 26, 2007 8. "Shellfish ban on most of Hood Canal",Peninsula Daily News,August 24, 2007 410 9. "Jefferson planning clean water district",Peninsula Daily News, August 28,2007 10. "Big Brothers Big Sisters get Rotary boost",PT Leader, August 29, 2007 11. "West Nile virus returns to state, but no threat yet in Jefferson,P.T. Leader, August 29, 2007 12. "Hood Canal shellfish harvest closed due to human vibriosis", P.T.Leader, August 29, 2007 13. "Counties offer no-strings prescription savings cards",(2 pages)Peninsula Daily News, August 30, 2007 14. "E. coli found in beef sold in Peninsula",Peninsula Daily News, September 3,2007 15. "Discount Rx card rapped",(2 pages)Peninsula Daily News, September 5, 2007 16. "PT leaders balk at county fee proposal",(2 pages)Peninsula Daily News, September 6, 2007 17. "Work to continue on Beckett project", Peninsula Daily News, September 9,2007 18. "County seeks final input on clean water district",(2 pages)P.T. Leader, September 12, 2007 • 19. "County may force city into water district",P.T. Leader, September 12, 2007 � `f1 te .L " t-1 r� 1 21, • � o�vv 'i w, ', ' W > , WHGk• •0 b .- , • t ¢34 x .5% yr C'L li® I . rF Z?1,A, 1 s;ik �Ec. 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'Ora. m4 6 (1.) g 3 , s,..-. 0 � ,.5 c, y'��,�`° „ o. �n 4011.'4 c5 V 0Q Gm tiGpg yrr. tm. 0'.cand d iAamiNCa .'gym' O ai w+, m al al-t A m "0 m.t; U m P,m+0' m r8+. cL. m m � aim �+' q �My0Ato O,.�� u+' m..' d0),040m' a.a m� x q m Ws; U W NUa �3 ain aSEnE 0 Wim. � g6'utio at o m I-11.o•-, 0a).bng •+ '"�•g~'P• n.-'.-.q .5 04' U 0.3 �a8i cil. - 0423 -.q 041 .0 ad d oof 0 d (--,ami+' m m ,- bng 0 . o.ai PortTownsend&Jefferson County Leader hj Lake, pool closures By Lyndie Browning Leader Staff Writer • The bad news: Because of toxic algae concentrations, Jefferson County Public Health has declared Gibbs.Lake closed to swimming. The,good news: Anderson I oke State Park has been reopened to land-based activities. Weekly samples taken by Jefferson County Public Health at Gibbs Lake showed dangerous levels of the toxin anatoxin,pro- duced by blue-green algae of the genus Aphanizomenon. Last summer, two dogs died due to toxic,algae poisoning.A third dog went into a coma but later,recovered. The incidents occurred around Memorial Day. This summer, no dog or human health incidents have been "The message is,please come back and enjoy Anderson Lake for • aU the area's trails,but don't go near the water due to health con- cerns," said Mike Zimmerman, manager of Fort Flagler and Anderson Lake state parks. Harrington noted the dan- gets of exposure to toxic:algae . "Anderson Lake toxrnscan be irritating to the skit);�apd a very incidental:amount`of1ti ese tox- ins can:cause gastrointestinal dis- tress," amngton said. Ever>swiping your nose With a splashed hand can result. hi - -unwanted tummy trouble,40 be sure to stick to the high=:trails - of Anderson Lake•:State 'Park, And don't head to Gibbs Lake if you're itching for a swim, because you might.end-up='itch- . ing something else. This summer looks lace aslun season"for swimming. 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'�'-' o b 4 5.-”',"+'.off 0 • Ti I, z 0 0 0 8 G) rrL.. 4) ° 41 GO A ,t, 2 2 4-' 0 'o-,o N4 g. ar og °' a+� .g 4�- M m 5 a)i vJ m - ;'ttt MONDAY,AUGUST 27,2007 A5 1 IN t Nil • season wiati . approaching „, BY EVAN CAEL six years to prepare for the dis- PENINsULA DAILY NEWS ease that has slowly spread Health officials in both Clal across the country,Locke said. lam and Jefferson counties are Monitoring watching.fora signs of the West Nile virus. Health measures include Both Dr. Tom Locke,health monitoring mosquitoes and col- oficerfor both counties, and letting dead birds to see if they Mike McNickle, director of the carry the virus. Jefferson County Environmen- Veterinarians also are look- tal Health Department urge ing for West Nile outbreaks .residents to report dead birds, >among horses,which also carry especially crows, blue jays and the virus. hawks, tothe department for The virus is spread to testing. humans by_.mosquitoes that "We will'ship them off to first bite infected birds or have them tested for West Nile. horses,then bite people. virus,"McNickle said. Most people who become The virus has not been infected with the virus do not • detected in Jefferson:or Clallam become ill, but some develop counties flu-like symptoms such as fever, Still, the risk exists through headache,body aches,and occa- October, with. September the sionally swollen lymph glands peak month. or a rash,McNickle said. West Nile virus: has been Individuals with severe or - confirmed in two locations in unusual headaches should seek White Swan, southwest of medical care as soon as possible. Yakima, the stgte Department McNickle said a good way to of Agriculture announced on decrease the risk of the West Aug. 17. Nile virus affecting the commu- McNickle said that, because nity is to limit mosquito habitat. it has reached the state,it could "Anywhere there's standing easily spread to the North water is a place they can breed, Olympic Peninsula so it's best to not allow standing "We know the .West Nile water in your yard," McNickle virus is here, and so I say it's said. only a matter of 'tinle," McNickle suggested that McNickle said. those who.find dead birds can The virus was first detected put on rubber gloves, pick up in the United States in New the bird—if it has not deterio- York in 1999. rated too much — put it in a It has spread west and has double plastic bag and bring it been detected in 44 states, to the Environmental .Health. including Washington. office, 615 Sheridan St., Port , Locke said Washington state Townsend. hopes to avoid what'happened Environmental Health spe- last summer to Idaho, when. cialists also will come to pick up early August produced a wave the dead birds for a testing, of human cases that eventually McNickle said. • totaled about 900 and claimed a To report a dead bird,phone dozen lives. 360-385-9444 in Jefferson. "Fortunately,that's not hap- _County and 360417-2274 in pening in Idaho this year,," he Clallam County. said: Washington still the only Reporter Evan Caei can be reached state with little human West at 360:-385-2335 dr evan.caelti Nile activity has had five to peninsuladailynewscom. 3 locati ons list added t.o .• toxicof BY JIM CASEY x PENINSULA DAILY NEWS �t� he ' • One site in Clallam ' County and two in Jefferson �ta`,i` urn rs County have been added to ` the state Department of Ecol- z , ' r ogy's list of toxic sites. TOXIC The Cl&]lam County lots cal sites across "' tion is. the former site of the etate from 1 to 5,r S ' Sequin Bay General Store, i represent ng �' Z 269421 U.S. Highway 101, " lei j�f y where underground storage ".`Warn. z S i•i. tanks had been used since `.szT iin�gs don't'v the 1960s. thevJi ty of An inspection by the county u ii:b Poten,.� IA Environmental Health Divi , 'tial paths�ug ,a sion found the site polluted by ' ch hu ne � # 'x aR benzene, gasoline, toluene, neitive environments xylene and other toxins. k®slid be expose dto Tests in 2004 showed nohazardous substances," contamination of soil 9.5 feet eate pep's .,"-,,,,,,:14';' deep, but previous tests had s o�aktr of Ecology gave x, found toxic chemicals 13 to ;'ese rankings to new 15 feet down, according to ites,in Clallamand Y l' Ecology. Eferson' noes s ; • In Jefferson County,a side- `I Sequin[Bay x walk at the Mount Baker oral'Store,,1,17,,,,,..;,,i.:;,,,,;,:0;;;;£: Block Building,211 Taylor St i7 +69421 U.S.Highway Port Townsend, covers a site k� I y yE i that once held a 940-gallon fount Bakes,vi tank that once fueled a boiler. ock Build ing si t ' Although the tank was 211` ay ori„ , removed,diesel fuel-contanu ` rta ow tse d 5. nated soil was covered with ,„`gI L of lode Ir1 , 4 .1 concrete, said Ecology t plaint,562 spokesman Seth Preston. , ,�• t r 1rondale'k1,. '' 1Y "We are assuming that the y` n �4 y'/4.P4-4404444 , contamination is still there," " iDaily New he said. �Ar..... < etank had been installedThtaby the building's in the plant's foundations, former owner,the.Welchfaro- according to Ecology. ily of Port Townsend,said its The Jefferson County present owner, Sam Kyle of Health Department recom- Issaquah. mended "no further action" In any case, "it's 100 per- be taken at the site in cent guaranteed" that the December 2001, although it site is in the cityright of way, said residue in1 the founda- he said. tion should be removed. "It is sealed up and closed However, sediment sam- off, totally encapsulated," he pling last January revealed said. "It's not a site of con- the presence of diesel fuel. cern,obviously." Furthermore, tissue from Meanwhile, city Public shellfish gathered from the Works Director Ken Clow said site contained arsenic, cad- he was aware of the issue but mium, chromium, copper, that Kyle had dealt with it. lead and zinc. The second : Port The Estate Department of,. Townsend site, where once Health recommended that no • the Irondale Iron & 7 Steel shellfish should be harvested. plant stood at 562 Moore St., �- '-0 might have polluted the land as early as 1881. Reporte360-417r Jim Casey can im reached . 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I.- a 4.,:,, u, vpg Sp a y ow u g �u.� avh> ..2 03 E. u o u Y 0.F7 u �.�u � y.VO �,�.r�yp . o,?;P: ,-2,08-0. .+;•§.„ ,47).-1,A C�.�a uoo � ca'° �.-, >,�'° � �,� u I ��j„" O' �, o�au3 � __, •,r°nxo.2 ^ao oy «° 0 fu0N,90odc0a 0 ` , 0 - ao0 m PI: g g 3 3 a3 m `n o°nrn ra "ate .ata v wPC ° u �U� aa° a ° 8 a�ra �1ge cmd ' uao3 r 3 q m , g > o a; N o a i A.' . = Os L " , _ ° Nr'1o a» . , a0n, c .4.. ;4 ,..A., ......1. 4 ofoma 'p_ '44 w 5 •r .-.1,i.1-; G N .EU 'gmC . wP •a .Mu. AC .. - gi- ...I V vta a R` aiPO oo �. zz o o H O N 4'•O^N N v O 73 .p k o N . , O.. U N 1 13::)Fo li aQavCC m 0oc . 00 c9 ." --0.00.0 .c a, "z' � � Fa� 8a am (So Ne Z32 :.)—. wan . t 41 'a U x p-A . -1 UU - C • � '''''i § . �dG W ° N NIQ+ .w gs ON .0t T ° ° a• a9c • ^ - - 00g1pg•° OcOv° O NO va . oJ . . . .a o • turns to state ,:.. �V�estNile virus re fib ütno threat y in Jefferson West Nile virus has returned 44 states,including Washington; suggestions to reduce the risk of •A horse vaccme is available, to Washington this summer.The it was found in four Washington being bitten by mosquitoes and See your veterinarian. virus, a potentially fatal disease animals in fall 2002. to prevent infection from West Questions about West Ni14 in horses, has been confirmed The virus is primarily a Nile virus: virus,mosquitoes and dead birds in two locations in White Swan bird disease; crows are espe- • Control and stop the breed- can be directed to Jefferson southwest of Yakima, the state cially susceptible. Dead crows, ing of mosquitoes on your prop- County Public Health. The Department of .Agriculture blue jays and hawks are good erty by reducing habitat. Washington State Department of announced Aug. 17. indicators of West Nile virus. • Get rid of old tires and Health West Nile Virus website Many local health depart- Mosquitoes become infected other containers where water can (www.doh.wa.gov/ehp/ts/Zoo/ ments and others are trapping by feeding on an infected bird accumulate and serve as a breed- WNV) also provides informs: mosquitoes throughout the state. and pass the virus to humans, ing ground for mosquitoes. tion about mosquito control, Jefferson County Public Health horses or other hosts when they •Avoid areas where mosqui- surveillance efforts and submis= is currently conducting mosquito bite. Most people who become toes are present, especially at sion of dead birds for testing; surveying, and all tests thus far infected with the virus do not dawn and dusk when mosquitoes along with lists of other informs= have been negative for West Nile become ill. Some develop are most active. tion sources. The department's virus.Birds from 25 Washington mild flu-like symptoms such • Wear long-sleeved shirts toll-free.WNV information line counties, including Jefferson, as fever, headache, body aches and long pants when in mos- provides up-to-date information have been tested for the virus, and occasionally swollen lymph quito-infested areas. about WNV at 866-78VIRUS. and all were negative. In addi- glands or a rash. In rare cases tion,veterinarians are continuing the virus may cause enceph- to watch horses for the virus and alitis, or' inflammation of the physicians are on the alert for its brain. Individuals with severe in humans. esenceor unusual headaches should West Nile virus was first seek medical care as soon as etected in the United States possible. in New York in 1999. It spread The Washington Department west and has been detected in of Health offers the following IP- i . i...e__,_x.p..,v- , , --24_07 • , . Wednesday,August 29,2007•B 5 IP Hood Canal shellfish harvest closed due tohuman vibriosis Recreational harvesting of shellfish in Commercial shellfish harvesting is still consumption. The illness is usually mild to Hood Canal has been closed south of the being allowed. moderate and lasts for two to seven days. Hood Canal Bridge by the Washington State The recreational closure is based on a The state.Department of Health also Department of Health. number of confirmed human vibriosis cases reminds consumers that store-bought shell- Jefferson County.Public Health offi- associated with eating oysters from Hood fish must be refrigerated and handled prop, cials announced the closure Aug. 23. In Canal, according to health officials. The erly to prevent illness. Jefferson County, this affects Hood Canal, advisory covers all species as a precaution. The Washington State Department of Dabob Bay and Quilcene Bay.Recreational Vibriosis is an intestinal illness caused by Health Food Safety and Shellfish Program beaches affected are Triton Cove State Park naturally occurring bacteria known as Vibrio (http://www.doh.wa.gov/ehp/sf/default.htm), and tidelands, Duckabush River tidelands, parahaemolyticus. Vibrio causes a variety website has general information about recre- Dosewallips State Park, Quilcene Bay of symptoms including diarrhea, abdominal ational and commercial shellfish harvest and tidelands, Broad Spit tidelands, Toandos cramps, nausea, vomiting, headache, fever food safety. Peninsula State Park, Point Whitney tide- and chills. Symptoms usually appear about For more information, contact Jefferson lands, Seal Rock U.S. Forest ,Service 12 hours after eating infected shellfish but can County Public Health at 385-9444 or visit Campground,and Hicks County Park. occur anywhere from two to 48 hours after www.jeffersoncountypublichealth.org. • -07 • • • n 1 f r ntstripgs OU $ O , , i . . rid prescriptiona�ll sCd S . Program to provide deep discounts : , - at key outlets it Jefferson; ;C1a11am `::, BY JIM CASEY. __ ,' le; oallty Rx-Card and," 4 i ��41.40 P vsui D E Y,Ni ws its.Jeffs ,linty twin.will need ''..-'`-‘. .•, -•,''-'•.4.-,...,-,--''",-,.-d� ,� ,e 14 If numskulls weren't so craft nqpaperwork. nooco pay, no,e4.04.1,-;:- 0-. , ,��, vgir ,� " : y' . ity requirements includin „' r, this prescription drug card would oe """ `"c "' M �* � foolproof illness—no sign-up•fee andr � 1 . Clallam County 'residents Can i s r � s • r. { take big deductions off the price of" And the countk arc doi a Y . y ` 4;i:•',----•.:4.:-,x'.•.-,"�A , yk �% J i tiling short 01',1/11-41,11.1g it in ara « t.. .. h +t s .r i t e prescription drugs starting Saturday „ 0:4 5 � — list forliving in Clallam Count pockets to get-the card in l ,A ,� �, A1} ,day g e On Oct.;1,:Jefferson Count Citi tion '' �, Y '....•'.-;•'•..,,,A+74,104;4.3•N, rr y 3 sks bearin 1._'” zees can do the sanies, 1) » ha,£ k'!"11'.41.1-.1'."Z... • A no strings=attached program 'about b efit`s'' and copies .i from the `aia al ,Association of cards v go up .wherev.M - ti • €'- Y : t wa,• s w a c e� a ae € 4c 6 '-, " " � ,4 • Counties, t , cardholders a4 ,-." 1x'; �' JimJ..a' } te � .` '`. 8 � e i ... x - between e e .} ereent On pre -,`,",-7-'..",'":v r s.> ,. 4 . �, * ,r Je 'erson unty p scriptiol .that aren't covered .by A. "� ` - John . schbach. s•nrd , lilSt ran.[3e Cards � y 'ATOM THOMPSON/PEISIbISUL'1)Aii.Y NEWS It C$ll a a a Ction with ' Y `-411 1 ' o u � Ilam County. Commissioner ve raii k ,-.s �th Care, ?� :cfis is s a dru ,off the top s e Tha t p y g M�, a nate policy you pay for {� nsumer Can tib a a F i F'cular pre- ,< �` �� facies�a�ss scriv +°ek g_ 4 ., �, xff k, '', z is la. ',i - , X4.0--1 a R r ,�:"-'.4,211.i.,:,-1,-',-, -,-.----:4',--...--',,,: -4L, ''lfk •4-sti ",n3.sd,-. >44U 's<.:"�-''' ,ir. f'''i. 3-6 -07 . • • , ' tea" C'' ''' '4Ift .1 fiT 1 )•`,-,4'''' ,..,'"`" ''''', ' ',"'"'e'rrenV, • d • ,.. ® .ii .rB 9 B.. thet a'. f: .„.,4,04,,,,44,,,,,,• ,,,§,4,.,%.,47..,, ti",-,2%,.......00,vam a e • *sk 5 :: kt Y '?B'1 "'. ys °a. e • 1 £ I 1 vA �r' � T� < Sy B b � � ..144.',,', -�& 1• 1� ® •I a 6 f 1+{. 442 1 B .+. Yi IB iy • t d . +ee e Ba 1... F B :&d k b °1 8 3.: -411 u� � i',' ,'''',."7:;,1At;:,;t.,, 8 t:Bf It"'.4'7`4%!§MV-4tV14,TVI...?.A1444'0X.tis. q,tg'Av `: f9�4;;:t'z''* ;z:::::1 eT"p, 4'' S!n a4 p ! ZA r1 � v.YE=:6 :BI' y kat .BEIa . ,... -,,, .„,,5, ,._, _ din l t 1 n,-.,,,,, 1 1 '' t 91 ;'d B 6 41 ,,,s,, p!� 3 B S �i �P tft 4 9 9' VYa ! I{Yn. 'i "81b dal ,4,,,,,y; , }44 s'i ' ,,,,,,,,„,,, Cards: Filed with • 57,000 pharmacies CorsruvirEn FROM Al will furnish Clallam and Jef- ferson officials with monthly Once the' payment is reports of how many people processed the cardbearer is used the card and how much registered for all participating they saved. pharmacies.......57,000 of them To learn more, visit —acrossthe nation. https:llnaeo.aduancerx:com to The cardbearer's family is find a participating pharmacy, covered,too. get a,price estimate of your As Jones put it Tuesday, prescription,check drug inter- when Clallam County commis- actions, or read articles from sinners officially announced health journals. the plan, it's almost too good Interested persons also can to be true. call he Na 1-2652. Veterinarians"prescriptions The National Association of are eligible if filled ata partic- Counties,which contracted for ipating pharmacy he said. card services with CVS Care- Even f•ail inmates can use it. mark of Nashville,Tenn.,rep- Moreover, it will save tax- resents 3,066 counties across payers money. the country- Because Clallam County 0 covers the whole cost .of retired sheriff's deputies' and Reporter Lim can be reached@ firefighters' health care, the t insula ailyne or, eevaa sey� retirees will be required to use Iva ninsuladaiEvan C com. RepoRK Evan Cael contributed to this the card,Jones said. report. He can be reached at That .could save about 360-385-2335 or evan.cael@ 7 $10,000 a year, said Commis- peninsuladailynews•com sinner Mike Chapman,R-Port Angeles. The association of counties g'-'3u —° E . coil • in twee sold . . on Peninsula. PENINSULA DAILY NEWS Fred Meyer stores. NEWS SERVICES The ground beef was also OLYMPIA — With a Clal- distributed to stores in Alaska, lam County woman and five Idaho and Oregon. other people in Washington Authorities identified the sickened from E. coli bacteria, suspect products as 16-ounce kages of" west Fines health officials are advising 7%Fat, N turalrthGround Beef" consumers to check any pack with UPC code label "752907 ages of ground beef they have 600127" and 16 ounce pack with the Northwest Finest ages of"Northwest Finest 10% brand name. Fat' Organic Ground Beef." A consumer alert was issued last week for products with Identifying marks "sell by" dates between Aug. 1 and Aug. 11. Each package also bore the Even though the products establishment number "Est. are thought to have been 965" inside the U.S. Depart- removed from store shelves, ment of Agriculture mark of food safety inspectors"are con- inspection and had sell-by • cerned that people may have dates between Aug. 1 and Aug. purchased the product, and," 11. said Donn Moyer, it may still Health officials first began be in the freezer a state seeing cases of people becom- Department of . Health ing sick from a suspected E. spokesman. coli illnesses in late July and "We're asking that they early August, Moyer said. check the label," he said. If A man from Island County, they've bought beef products who is in his 20s, became sick involved in the alert "discard but was not hospitalized. it; don't eat it," Moyer said. A total of four people from The action was taken after a King County were sickened possible link was found after eating the beef. between the Northwest Finest Of this group,two were hos- , ground-beef products and pitalized and have since been eight confirmed cases in Ore- discharged,Moyer said. gon and Washington of people The final Washington case sickened with E.coli O157:H7 is an adult woman from Clal- illnesses. lam County. The bacteria can cause Moyer said no information bloody diarrhea and dehydra-. would be provided on her tion, and in some cases is name or age to maintain her deadly. privacy. Children, seniors and those The cases serve as a with weakened immune sys- reminder to consumers to take tems are most at risk for the caution in preparing and cook- disease. ing meat, Moyer said. The products involved in Juices from raw meat, if the alert were made by Inter- they come in contact with state Meat Distributors of other food, can contaminate it, • Clackamas, Ore. he said.And knives used to cut Health officials are not sure raw meat must be thoroughly how the beef became contami- cleaned before they are used . nated by the bacteria. oh other food. They have confirmed that Thoroughly cooking meat in Washington the affected until it has a temperature of Northwest Finest products 160 degrees kills the E. coli were sold at Safeway, QFC and bacteria, he said. '' .y,,,,4„ 5" Rsk,`t ,44,,p4.7 r ^,4R.".wagA ... ..0,--,,,>' ro IZ :' ' x A• H i M''nr �i WS ?,i, a 0, _,-'-‘7;-3.-,F.--.7.-;,-.c r M nr✓e #'r r a .r >*t + ' :2 I J+r� ' �W � �A V" + Y V L. I^ . x ry I y Cd I 74 i— � � di (1) - ... --..:.,,,,' - -, ;., , ':, -,,,. . , . 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(-),...,k3 '7,4.4, o � � o �, > >, CI U a -d -� 03 cs gt $a § 54 c a' +, y c L''.�'rt. ro 3 ro U o 3 c-- "7 Ca ai a. � 'd�v.,>,a f` `� � >.,•Gv� an o v°i ° � �-•� y •v v� ',,,7,z; .-. �„�� 3 � � w c v' � _ +� � >. oF ... � ro � o o ao v U +'' O 0 G's. -,1-. °' a' v°i °t8 `4.51S31.1%8 E''° gz°Ey E d� ti � `�E' g >r, ev Q enro cd= a' y= ro v v�i'�vim. F-1 0 ;x1 0.441 _ .0 .�egZUeI >, ° a °�' n °� o >>� �' ° o v c a' = v • Plan ma hurt dru storesCards: y g CONTINUED FROM Al tions. pharmacist said everyone in sioner Mike Doherty, D-Port "It ends up being a forced the store was too busy to talk Angeles, said he talked with The Rx discounti don't donation," to. everyone who about the impact. Chinook's Peterson, however always make drugs less expen- obtains a card,Cammack said. Jones said that if indepen- and told him he hopes to w sive than they already were, "We want to give back to dent pharmacists had come up with the Washington St he added. - the communityto the ora- with a better idea for-a drug Pharmacy Association and the g state Department of Health on Stan Peterson, who sold nizations we choose. Now discount program,county offs-•• p Chinook to Carlson in January we're giving back to anybody cials would have listened. a discount program that does- after running the pharmacy. who walks in the door. That When the Washington State n't strain locally owned busi- for 29 years, said the card "is person could be making a mil- Association of Counties pre- nesses. not always thatgreat for the year." "The Rx card"does help the y lion dollars a sented Caremark's Rx pro- consumer,"Doherty added. consumer. Our customary For Carlson, one organiza- gram in July,Jones saw it as a "It does not help smaller charge is lower than the dis- tion in need of financial sup- decent deal for consumers. drugstores in rural Washing" count." port is his Chinook Pharmacy. About a third of Washing- ton,in rural America.:' Carlson said a county offs- As the West End's Mom-and- ton's 39 counties have signed - cial told him to simply raise Pop drugstore, it has cus- on to the program,he added. his prices in response to the tomers from Neah Bay to Lake To deny Clallam residents Sequim Editor Diane Urban'de la Paz new program. can be reached at 360"681.2391 or p gr Quinault,he said.- the opportunity to save onpre- diane.urbani®peninsuladailynews.com. "That's what's wrong with When he sits down with a scriptions would be "ridicu- the health care system," was customer to compare the lous." Managing Editor/News Leah Leach his reply he said. card's discount on the price of, Clallam County commis- contributed to this story. At the same time,the Care- a prescription with Chinook's mark program may seriously regular price, Carlson must • hurt locally owned drugstores enter the Rx-card information like Chinook — and Jim's in into the program system and Port Angeles, Frick Drug in pay transmission fees, which Sequim and Don's Pharmacy are funneled to Caremark. • in Port Townsend, the owners Caremark, then, is reaping of the independent pharma- revenue from the Rx program, cies said on Tuesday. both Carlson and Cammack "The discount comes pointed out. directly out of our profit,"said Joe Cammack, who took over "Greater good" Jim's Pharmacy five years ago Jim his father, Jim Cam- Jones, Clallam County mack,retired. administrator, who ordered "We're in business to make 22,000 Rx cards for distribu- III money,"Joe Cammack said. tion, agreed that the corpora- "And when we have our tion is receiving fees while profits cut by a plan like this, small drugstores may make the first thing we cut is dona- smaller profits — but he said "tions. . .to community groups that consumers are saving dike the YMCA, the'United . money on the prescriptions Way,youth soccer." ' they need. Cammack isn't planning to "It's the greater good,quite 'cut contributions yet,and said frankly. he'll have to look at his post- "Thisis exactly the same card profits. argument where towns say, • What Cammack wants to 'We don't want a Wal-Mart," see: a•prescription discount because it will hurt locally program that benefits those owned shops. who need it most. "The small businesses sur- . - : "There's no age or income vive by giving people good ser- eligibility for this. Even your vice. Jim's has given the best :pet can get one,"he added. personal service for many • Consumers can use the card years,and Chinook has proba- :to receive discounts on veteri- bly the cheapest prices on the nary prescriptions, and Peninsula,"Jones said. patients with Veterans Affairs Frick Drug in Sequim is benefits, Medicare and even anotherlocally owned drug- private insurance that doesn't store contending with a wave cover a particular drug can use of Rx cardholders. it to save on their prescrip- On Tuesday afternoon, a • 4 • 3 ��'y�y •g� f# art": eYap'JF A' 1$ ^'FMY. 5N + 4W &RA S g Vd l' 7'A 't "u �frar A" M0"7 'r�` ,„ 4445e."T" .3 B�f£L'd'F' y BJ+rr e,r.'m �.,, *�,A�1uy144y � ° �w yj p k _ rsn,.- »„ .,.ww.1.,sw :'n"¢ rr... e"; .wwnr ,-1,,, * --...,.,._.:.z..., - 7. 'A4 C rW H '.. k-'4k °fir' • • --: - ' � �Por�t Tom` PT leaders b .a a co u n fee proposal Plan weighted , Fr- -,,,, , i.y4 for non-city .r areas, they say §► BY JEFF CHEW 1«° x 1 PENINSULA DAILY NEWS ` �i;; SPORT TOWNSEND — A pro- Welch Randels posal for a countywide clean water district that includes Port Townsend citizens and the disabled would be is proving to be a hard sell for county exempt. health and elected officials. Randels also complained that he "It seems to be county-centric," did not get a copy of the county's said Mayor Mark Welch, responding proposed clean water district ordi- to Jefferson County health officials' nance during the meeting. presentation of the proposal duringIn additionofth , he t thmen- a joint city-county meeting Tuesday. tion e proposal beingsaidthaa "permae "Why are we being asked to pay a nent fundingrosolution" gave him share?" pause. Welch was joined by others on the Councilwoman Catharine Robin- City Council, such as George Ran- dels, who protested that about 6,000 and regressive. of the 27,000 parcels of property That's why city .leaders asked upon which an $18 fee would be county officials to consider phasing levied are in the city of Port in the district, possibly adding the Townsend. city later, after the issue had been . The fee, as proposed, would be publicly discussed and accepted. included on annual property tax bills The county s proposed clean and would amount to about water district is the result of the $500,000 a year for three new state Department of Health restrict- staffers to monitor water quality ing shellfish harvesting from por and perform public outreach and tions of southern Discovery Bay in education on hovy to properly"use winter 2006 because of fecal coliform and care for septic systems. pollution. Timberland, low-income senior TURN TO WATER/A6 A6 THURSDAY,SEPTEMBER 6,2007—(J) Water: CreatiOfl : • CONTINUED FROM Al members that clean water affects residents in East Jef- Instead of isolating the dis- ferson County, including those trict just to that location, who live within the city, county leaders decided to pro- whether through the shellfish pose the creation of a district they eat or the sale of that that would provide a more shellfish, which results in city comprehensive look at the sales tax. water quality of all of east Jef- Since Jefferson County is ferson County and obtain data. the third or fourth largest City Council members, who shellfish-producing county in first heard of the proposal last the state, there is much to week during a joint city- gain,McNickle said. county meeting, asked Jeffer- He reported that in 2005, son County commissioners for shellfish-related businesses more time to study how a pro- accounted for about $1.4 mil- posed ordinance for a clean lion in sales tax between com- water district would benefit mercial .and recreational city residents as well as those sources. around the county. County Commissioner Council members wanted to David Sullivan, D-Cape examine a consultant's report George,said the district would on the proposal's options. not only affect shellfish but A public hearing is tenta- also the Jefferson County bud- tively scheduled Sept. 17 get as well. • before the county commission- "With taxes and construc- era before they make a deci- tion down, things are tight," sion to enact the ordinance, Sullivan said. 11111 to really would require'a major- "We're going ity vote by the three commis- struggle with the choices we sioners. have." If they chose not to change Sullivan said the commis- the draft ordinance,it could be sioners to formuld consider advisory enacted that day. proposal If they want to add to it or board for the district. subtract from it, it would be Councilwoman Laurie enacted on Sept. 24 if at least Medlicott said she would be two of the commissioners vote interested in serving on an for it. advisory board. While the county commis- Welch said he agreed with sioners do not need the city's the county's goal. approval to enact the district, "But at the same time, it under state law, county lead- looks like the county is looking ers have approached the city at us to subsidize what is a in the spirit of being a part of county issue," Welch said. the process. City Manager David Tim- • County Commissioner Phil mons suggested that the Johnson, D-Port Townsend, county commissioners go ensured city officials that through with their action to . county leaders werelistening approve formation of the dis- and were also concerned about trict with the idea of coming the regressive nature of the fee. back later and negotiating the He said the county was also city's participation. considering other funding "We'll certainly consider ofopt sales tax to generate percentage Administrator John Fischbacd Jefferson h. o needed revenues. . County Environmental Jefferson County Editor Jeff•Chew Health Director Mike can be reached at 360-385-2335 or McNickle told City Council jell.chew@peninsuladailynews.com. 'Northwest PENINSULA DAILY NEWS t Ili Work continue . 1 • on Shoreline construction Wessen' and Associates and' completed in mid-August,; uncovered evidence of prehis- halted for study outcome toric remains in graves, Arti facts and middens. BY JEFF CHEW tides that begin after Septem- The study overseen by archaeologist Gary Wessen, PENINSULA DAILY NEWS ber. ', He also believes work will and his team of tribal repre , DISCOVERY BAY — Work be extended down Viewpoint sentatives and archaeologists; is scheduled to resume this screened sediments at each: week on the lower portion.of Lane, an area in doubt retort location to find any cultural: Jefferson County Public Util- Wessen's archaeological report materials present. ity District's Beckett Point said that the beach the lane community septic-system pro- fronts had been disturbed in Bone fragments ject,which was stopped in May the past to the point that shellfish and other middens Pape & Sons was trenching; when Native American from ancient campfires were for the project in late May; remains and artifacts were obscured or gone. when 58 bone and bone frag- uncovered. The community septic sys- ments were discovered, shut-: PUD Manager Jim Parker tem, which Beckett Point resi- said the contractor building ting down the project under. the $2.8 million project, Pape dents have each paid $28,000 federal laws protecting antiq . &Sons, delayed for a week the as their contributions, will uities. work on the lower portion, replace some 88 failing septic In a mid-July report,. which involves installation of systems along the eastern Wessen said a single partially; about 80 septic system grinder shore and uplands on Discov- intact human grave was found; ery Bay. along with concentration of, pumps, instead opting to corn- plete drainfield work on the The community is within other disturbed bones, stone, uphill portion of the project. 300 yards of the closest aqua tools and shell middens, the; "They're moving along," culture operation, a geoduck remains from ancient beach; farm and the shores of Dis- campfires. Parker said. "They're work- p ing." covert'Bay are rich with other The late prehistoric: The state Department of commercially harvested shell remains were between a few Historic and Archaeological fish. hundred and a few thousand Preservation had stopped the After pressing state Depart years old, Wessen reported. ment of Ecology officials, Jet- shoreline p- shoreline portion of the pro- In recovering remains and; ferson County Environmental ject pending the outcome of an Health Director Mike artifacts, Wessen and another' archaeological study. McNickle secured a ,$50,000 archaeologist have been joined grant to compensate PUD for at the site by Jamestown Work to be monitored S Klallam, Port Gamble' archaeological studies and S'Klallam and Skokomish ' But PUD was allowed to other work delay costs. tribe representatives. continue work on the upland So far, cost for archaeolo- Wessen and Associates' portion of the project so long gists to study the Beckett study researched the history as an archaeologist with Point site have run as high as Wessen and Associates of Seat-. $30,0000, with Jefferson of Beckett Point, conducted a tle monitored the work. County chipping in $16,000, surface survey and investi- Parker said that although said Parker. gated buried deposits from 91 the contractor has given the The bill for construction test holes and two backhoe- green light to dig 6-foot holes delays and other expenses dug trenches, the report for the system's grinder have yet to come through, states. III pumps, which will pump according to Parker. The possible presence of wastewater uphill and away Jefferson County commis additional graves and/or dis from the shoreline, he is now sinners recently approved a turbed human bones remains concerned about Puget Sound letter of agreement with PUD, a concern throughout the Energy providing power to with the county agreeing to study area, Wessen reported. test two new booster stations. pay up to $250,000 in addi- Parker hopes the job will be tional project costs. Jefferson County Editor Jeff Chew complete before winter The archaeological study can be reached at 360-385-2335 or �/lye ,, weather and seasonal high conducted by Seattle-based jeffchew@peninsuiadaitynews.corn. C Port Townsend&Jefferson County Leader • • County seeks final input . . . • By Allison Arthur • Leader Staff Writer OSF hosts meeting on proposal Options on how to fund a The Olympic Stewardship Foundation(OSF)hosts a meeting to look "clean water district" sur- at a proposed clean water district for Jefferson County.The meeting faced briefly on Monday, with is at 7 p.m.Thursday,Sept.13 at Quilcene Community Center. Jefferson County Commissioners The OSF was formed in June to promote individual stewardship over Phil Johnson and David Sullivan prescriptive regulation on the Olympic Peninsula.The citizens advo- taking no action but asking cacy group stepped to the forefront just as the Jefferson County for information on carving out Planning Commission requested more time to work out a compro- Discovery Bay into its own dis- mise on a draft critical areas ordinance. trict. Jefferson County Deputy Director of Environmental Health Mike County Administrator John McNickle said that as of Monday his department had not been Fischbach presented an outline invited to participate Sept.13. of pros and cons with various For more Information,contact Norm MacLeod at 379-8914 or Dick options for raising up to$500,000 Bergeron,president of the Mountain Coalition,at 796-0132. a year to fund a comprehen- sive monitoring and cleanup of sources of fecal coliform bacte- Mason County has two bays ers in the critical areas ordinance ria that could lead to closures of that are in trouble, and state and future instream flow rule," shellfish harvesting areas. Sen. Tim Sheldon, who also is he added. A single water-monitoring a Mason County commissioner, Commissioner Johnson said station in Discovery Bay that has proposed the two-tenths tax, he saw a benefit of including failed state tests led to the state McNickle said. One of the big- Port Townsend in the district: Department of Health giving the gest shellfish producers in Mason real estate sales. He said if word county 180 days earlier this year County is being impacted by a got out that beaches in the corn- to come up with a cleanup plan. proposed shellfish closure, and munity were contaminated,sales That plan has morphed from Mason County is under the gun could drop. . a proposed shellfish protection to create a shellfish protection There also was discussion district for just Discovery Bay district much as Jefferson County of creating a clean water dis- into a clean water district that is under the gun because of trict only for Discovery Bay. would encompass all of East Discovery Bay,McNickle said. Commissioners asked McNickle Jefferson County and be funded "One way or another we have to look at Discovery Bay and by a fee on parcels. to do something about Discovery identify where the boundary line A public hearing on a pro- Bay. It's either going to be as could be if it included only the posed ordinance to create a clean a clean water district for all of watershed that feeds into the water district is set for 10 a.m. East Jefferson County or simply bay. Monday,Sept. 17 in the Jefferson for Discovery Bay or something Options and their pros and •County Superior Courtroom on in •between," McNickle said cons also were outlined, includ- •the courthouse's top floor. Monday. ing: One proposed funding mech- The county has two fears if • Per parcel fee:The pros are anism is to charge all parcel no action is taken: The state that the fee is targeted and dedi- owners in East Jefferson County could refuse to provide any grant cated. The cons are that it is a an$18 fee.Commissioners argue funding or, down the line, pri- regressive tax and that a decision the shellfish industry is impor- vate shellfish operators could needs to be made by the end of tant to the county's economy sue the county for failing to do September,with the city voicing and that clean water is important something about pollution in a as well. part of Discovery Bay should Even if parcels in the City of it remain closed to harvesting, Port Townsend were excluded, McNickle said. the fee has been proposed at When the City Council's idea $18 per parcel per year in the of deleting the word "perma- ordinance, according to Mike nent" from the proposed ordi- McNickle, deputy director of nance came up, Commissioner Jefferson County Public Health. Sullivan said there is a need to • Legislative options fund monitoring now and into the future. There was discussion of "I think this is something making the fee "sunset" if the we've needed for a long time," Legislature allows for a two- Sullivan said. "I don't think it's tenths of 1 percent sales tax responsible to wait to see what to be used for shellfish pro- problems we have," mut le)uay,3eplemUer IL,LW/•A 13 istrictone eanwater • include that it would be a one- "banked" instead of collecting « time-only solution and that it from property owners in previ- One way or would eliminate the county's ous years. Pros include broad flexibility to fund programs or use and flexibility. A drawback Another we have projects that surface during the is that it is considered regressive to do something year, such as giving money to because it amounts to raising ' the Tri-Area Teen Center. taxes and the county wants to about Discovery • Public Infrastructure Fund: save it to fund a.sewer system Commissioners were told this and emergencies. Bay. It's either fund could not be used for a • Grant funding: Relying on clean water district. grant money means less local going to be a • "Banked" property tax money would.be required, but capacity: There are a number the state Department of Ecology clean water of pros and cons with this idea. will not fund ongoing fresh/ There is $488,000 a year avail- marine water monitoring. district for all of able if the county chooses to (Leader staff writer Barney- use property tax increases it Burke contributed to this story.) East Jefferson • County or simply — for Discovery Bay or something in between. " • Mike McNkkle deputy director Jefferson County Public Health objections to being included: •Budget cuts:The pro is that there would be no increase in costs.The cons are that it would be a one-time option that would , eliminate what county officials called "progressive" spending - • and that it would hurt lower income people more because public health and parks and rec- reation budgets likely would take the brunt of budget cuts. • Use county reserves: One pro is that there would be no increase in costs to people.Cons • °'� 3v, „ er0v I 3 38° 64 . y °' 8N Q > > .. •o .5v, oa ° u Ep oaw 6 v 8 0 o Y • v O N ° Q 'd g N O ° y N • N �a o ° c > P. •• ° N - Ti 3 e o v N ' is u 0 0 V•I 0 -04) ° o p o ° Q ff ' °O - g) i,4 5 rd oj 4.a v � vc 3 � 5 U N UN g . .2c080N QL. 8 ✓ 00 p .e 4 a u0 ,y v 2 .• o 'd I C w 3 ." 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U <5 W° 8 .5 e $ W° o of::. .ve • aN -" _ M1 1:3a U - a .. • a) co N 11 L ai -23150 ' N ++ CL ss,ci H N — CO 'r H C 10 d e •t r-.- a a N r c 1 cu'• I I I C 1 0 N6 �m I cP 3 0 (� w cr CD w 0 J I glI O f„,. 1 1 U I 0 HI 0 CA W � 1 CDI s >e 0,E: 5g g, I W H� I ` mill r "� s4I a& lma a Aet.I..,.� / je� ed3e84�¢ty 0 a 1 I .v $s as�w z ii I ; PtiweS,! ao'as��' � ri I � I 1 I 9 I i (n tf I — >, 1 a IN, a ( l''' 1 Ca t ; iN L r ,= 0 fts �d ii a r.....,,,„,„," ... ,.. I IN I a • 17 I :.?. H t.1 ; IP ..... • THE ROYER GROUP www.theroyergroup.com Building Healthy Communities • Mr. Mike McNickle Deputy Director Jefferson County Public Health 615 Sheridan Street Port Townsend, WA 98368 Dear Mr. McNickle: On behalf of our team, The Royer Group, I am pleased to submit this proposal in response to your RFP The Transformation of Jefferson County Public Health Into the Jefferson County Public Health District. We are excited about the potential opportunities to partner with you as you evaluate this important initiative. We have provided a detailed response to your request and a conceptual overview of the areas where The Royer Group feels it can provide more general assistance to your department. We work collaboratively, and look forward to exploring other areas where we can add value for you and your team. I will act as lead on this project, and can be contacted at the following phone • numbers: Gregory Kipp 206 812 1169 (office) 206 769 2775 (cell) 425 836 8030 (home) We are happy to discuss any of the ideas presented here, answer any questions, and provide additional examples of our work. Please don't hesitate to call. Thank you for your consideration. We look forward to your response. With best regards, Gregory Kipp, Partner 411 316 Occidental Ave S,Suite 300,Seattle,Washington 98104 • Phone 206.812.1167 • Fax 206.812.1222 Royer Group—Jefferson County The Transformation of Jefferson County Public Health into the • Jefferson County Public Health District Proposal from The Royer Group Project Team The Royer Group (TRG) is a team of experienced, executive-level managers that have an extensive background in organizational change and are uniquely qualified to provide a feasibility study on whether the Jefferson County Public Health Department can become a stand-alone Health District. The TRG team lead for this project will be Gregory Kipp, former Deputy Director/Chief Administrative Officer for Seattle-King County Public Health Department. The other key contributor to this project will be David Moseley, former city manager for the cities of Federal Way, Ellensburg, and Steilacoom Washington, and former Community Development Director for the City of Seattle. In addition to Mr. Kipp's experience in public health, both Mr. Moseley and Mr. Kipp have extensive experience in public policy and finance, with Mr. Kipp having served and the Assistant Budget Director for the City of Seattle and Mr. Moseley being responsible for the annual operating and capital budgets, and overall administration of three Washington State cities and a major Seattle department. Supporting Mr. Kipp and Mr. Moseley are Charles Royer, former mayor for the • city of Seattle, and Hal Calbom, a communications and media affairs specialist. Mr. Royer and Mr. Calbom will provide, as needed, advice on the political, public policy, and communications strategies associated with this project. Scope of Work: Jefferson County Public Health Department is seeking a feasibility analysis to determine whether the department can and should become a stand-alone health district, under the provisions of RCW 70.46. The two major determinants in making such a decision are the political feasibility and the financial feasibility surrounding this issue. This latter determinant, financial feasibility, includes an assessment of the infrastructure requirements to support a stand-alone health district. The scope of work proposed by TRG to determine the feasibility of converting the Health Department into a Health District is to conduct a qualitative assessment of the political feasibility and a more quantitative analysis of the financial and infrastructure feasibility. It is recognized that the political and financial feasibility assessments will not be independent of each other as several success factors to becoming a Health District cross both areas. • 9 Royer Group-Jefferson County Political Feasibility: • To undertake the political feasibility assessment, TRG will conduct interviews of key stakeholders in Jefferson County, including (but not limited to)the following: Jefferson County Board of Health members including all Jefferson Co Commissioners Jefferson County Public Health Director Jefferson County Health Officer Jefferson County Administrator Port Townsend City Council members Other city elected officials and stakeholders as identified by JCPH The purpose of these interviews will be to ascertain the extent of political support for a conversion to a health district, and whether there would be any change of expectations regarding the financial commitment and/or policy role of the county, should the health department convert to a health district. Additional interviews will be conducted with key health districts throughout the state of Washington including Snohomish, Kitsap, Benton-Franklin, Chelan- Douglas. The purpose of these interviews is to determine what opportunities and challenges each have experienced as health districts. Similar interviews would be conducted with representatives from the Washington State Department of Health (DOH) to ascertain their perspective on the transformation of a health • department into a health district. TRG will also contact representatives from two former health districts that have subsequently reverted to become county health departments. These former districts were the Cowlitz- Wahkiakum Health District and the Clark—Skamania - Klickitat Health District. These interviews will be to identify the key factors that contributed to the decisions to revert back to health departments, and determine whether such factors are likely to exist in Jefferson County. Financial Feasibility: Along with the need to assure there is the political support to establish a stand- alone health district in Jefferson County, the other critical question is whether such a district can be financially sustainable. To assess the financial feasibility of establishing a health district, TRG will begin by reviewing the Jefferson County Budgets for the past five years (2003-2007) and in more detail, the Jefferson County Health Department Budgets for 2003-2007. TRG will also seek information on the proposed Health Department budget for 2008, especially in relation to additional public health funding expected from the recent state legislative session. • 2 Royer Group-Jefferson County TRG will also review the fee schedules for all permit activities undertaken by Jefferson County Health Department to determine the extent to which they cover • the full cost of providing these permit related services, and if not, the feasibility of restructuring the fees. TRG will be looking at the trend lines for revenues and expenditures for the Health Department and identifying vulnerabilities to a sustainable financial outlook for a new district. Infrastructure: As part of the financial feasibility analysis, TRG will identify the basic infrastructure costs necessary to support a stand-alone health district. These infrastructure costs include buildings, vehicles, IT, and administrative support such as legal services, human resources, payroll, etc. TRG will review the year-end financial reports and any other pertinent information available from the JCHD to determine the extent to which the department has assets (buildings, vehicles, equipment, etc) that are under the sole control of the department, and whether the department has any long term liabilities that need to be considered. Once these budgets and financial reports have been reviewed, TRG will determine the ongoing annual costs necessary to sustain a stand alone health district, including all infrastructure costs (IT, facilities, administrative, legal). TRG will also identify any one-time start up costs that would be necessary in establishing a health district. One of the key factors in conducting the financial feasibility will be the extent to which Jefferson County will continue to provide ongoing annual operating revenues to a newly created health district, as well as the county's willingness to 411) transfer any capital assets (facilities and equipment) to the new district. Another assessment will be to determine if Jefferson County would allow a newly formed health district to contract with the County for certain services such as Human Resources, Payroll, IT, and other support services. The basis for this assessment would come from our interviews with Jefferson County officials. One other financial consideration that should be explored is whether there is any interest from the City of Port Townsend to play a stronger political and/or financial role in support of a stand alone health district. This would be explored through TRG's interviews with key elected officials and administrators from Port Townsend. Recommendations: Following TRG's assessment of the political and financial feasibility of converting the health department into a health district, TRG will outline the prerequisite criteria necessary to successfully establish a health district in Jefferson County. For each prerequisite criteria, TRG will identify whether the criteria has been met, and if not, what is needed to meet the criteria. TRG will also provide a risk assessment on the long term sustainability of each criteria being satisfied. • 3 Royer Group-Jefferson County Providing the criteria are met, TRG will outline the necessary steps to undertake • the conversion from a health department to a health district. This will include the legislative and legal requirements, along with an outline of recommended public relations strategies to accompany the transition. Budget and Schedule: TRG's proposed schedule and estimated time to complete specific tasks is outlined below. TRG's hourly rate for governmental agencies is $150.00. While the actual hours for each task may vary, TRG will commit to completing the proposed scope of work for$10,000.00. Week 1 Review the Jefferson County Budgets for the past five years (2003-2007) Review the Jefferson County Health Department Budgets and year-end financial reports for 2003-2007. Review the fee schedules for all permit related activities undertaken by Jefferson County Health Department. Sub Tasks: In preparation for this review, TRG will request copies of these • budgets and other materials from Jefferson County in advance. Any questions arising from these reviews will be addressed in the interviews with the JCHD Director and/or County Administrator. TRG Lead: G. Kipp & D. Moseley Hours: 16 Week 2 Tasks: Interview Jefferson Co Commissioners, Jefferson County Board of Health members, Jefferson County Public Health Director, Jefferson County Health Officer, Jefferson County Administrator, and Port Townsend City Council members. Sub tasks: Calendaring of these interviews will be done in coordination with JCHD with the objective of interviewing several County Commissioners/BOH members in joint sessions. TRG also suggests that the interviews with the Health Director and Health Officer occur together. TRG would attempt to meet with several Port Townsend City Council members concurrently as well. TRG Lead: G. Kipp & D. Moseley • Estimated Hours: 16 4 Royer Group-Jefferson County Week 3 • Tasks: Interview Snohomish Health District, Kitsap Health District, Benton- Franklin Health District, and Chelan-Douglas Health District. Interview Washington State DOH representatives. Sub Tasks: These interviews will be conducted by phone with each health district, and DOH being interviewed separately. TRG Lead: G. Kipp Hours: 5 Week 4 Prepare and submit to JCPH, the first draft assessment of prerequisite criteria for successfully establishing a stand alone health district in Jefferson County, with findings identifying which criteria are met. First draft would also provide initial recommendations on what it would take to meet any prerequisite criteria that may not be currently satisfied. TRG Lead: G. Kipp & D. Moseley Hours: 24 • Week 5 Task: Following the receipt of comments on the draft report, which TRG will accept in writing and/or via telephone conversations, TRG will prepare and submit to Jefferson County Health Department, the final report with findings and recommendations on how to proceed with the establishment of a stand alone health district in Jefferson County. TRG Lead: G. Kipp Hours: 8 This schedule provides for the final report to be submitted to JCHD prior to the end of October, as requested in the RFP, assuming that a contract for this work is signed by Jefferson County and TRG by mid September. 5 Royer Group-Jefferson County Description of Related Work by The Royer Group: • The Royer Group is a recently formed partnership of former government and private sector executives with a long track record of advising and implementing major policy and organizational changes throughout the state of Washington and in other large cities in the country. A few examples of work similar to the Jefferson County Health Department's RFP are summarized below. Transfer of Seattle-King County Health Department from Seattle to King County: Prior to 1981, the City of Seattle administered the Seattle-King County Health Department with the two jurisdictions providing funding in proportion to their populations. In 1981, then Mayor Charles Royer--now partner in the Royer Group-- led a reorganization effort which transferred the administrative control of the department to the County, while the City retained direct policy and funding control over the Seattle Services Division. Both Greg Kipp and David Moseley were on Mayor Royer's staff at the time. Many of the issues--both political and financial--presented in the Jefferson County request for proposal, were issues that the Royer administration dealt with • in 1981. As a result of a well thought out consolidation plan, the transition was very successful and the Seattle-King County Health Department has become one of the premier health departments in the United States. Environmental Health Fee Restructuring for Seattle-King County Health Department: As Deputy Director/Chief Administrative Officer for the Seattle-King County Health Department, Greg Kipp—a partner in The Royer Group -- led numerous organizational and fiscal improvements in the department. One of these improvements was restructuring the Environmental Health Division's fees for their regulatory work (food establishment inspections, on-site septic reviews/inspections, drinking water reviews/inspections, etc) to make these activities fully fee supported. These fees are now reviewed every five years to insure they continue to cover the full costs of business. Prior to this restructuring, the Environmental Health Division was consistently competing for the limited general fund tax dollars available to the Health Department. This restructuring has provided a far more sustainable funding source for these critical public health functions as the financial challenges to 4111 pursued health increase and allows for other Environmental Health initiatives to be pursued with funding that previously was required for regulatory work. 6 Royer Group-Jefferson County This change required not only a fiscal feasibility analysis, but also a political • assessment and strategy to gain the support of the Board of Health. A similar assessment and set of recommendations for the entire Jefferson County Health Department will be required for the successful conversion to a health district. Annexation Analysis: The political, financial and infrastructure analysis requested by Jefferson County for the transformation from a health department to a health district is similar to the analyses necessary to assess the feasibility of a potential annexation. David Moseley-- a Partner in The Royer Group and a member of the Project Team for this project-- managed such annexation feasibility analyses for potential annexations in all three jurisdictions where he served as city manager. An annexation feasibility analysis requires a detailed analysis of the political receptivity to an annexation both in the potential annexation area and in the "receiving"jurisdiction. Such a feasibility analysis also requires a detailed financial analysis of the impact on the receiving jurisdiction. Finally, an annexation feasibility analysis requires an analysis of the receiving jurisdiction's infrastructure and what it would take to accommodate an annexation. All of these analytical tasks are very similar to the tasks required for the Jefferson County Public Health feasibility project. Resumes: • The resumes for all four partners in The Royer Group are attached. • • Charles Royer Partner The Royer Group Charles Royer is President of the Institute for Community Change (ICC) and National Program Director for The Robert Wood Johnson Foundation's Urban Health Initiative. He is a Senior Lecturer at the University of Washington with appointments in the School of Public Health and Community Medicine and in the School of Public Affairs. From 1990 until 1994, Mr. Royer served as Director of the Institute of Politics at Harvard University and as Lecturer at Harvard's John F. Kennedy School of Government. Prior to his appointment at the Institute of Politics, Charles Royer served as Mayor of Seattle for twelve years. He was elected Mayor in 1977 following a career in newspaper and television journalism. During his three terms as Mayor, Royer became a national spokesman for American cities in housing, the arts, health care, energy, civil liberties, and the needs of children and youth. He served as President of the National League of Cities in 1983 and was named one of the top 20 American Mayors in 1988 by U. S. News and World Report. In 1989, Seattle was named one of the ten best-managed cities in the nation by Business Month Magazine and Mr. Royer received the 1989 Distinguished Urban Mayor Award from the National Urban Coalition. • During his tenure as Mayor, Charles Royer was instrumental in bringing new investment to Seattle while maintaining the city's high quality of life. Seattle was named the nation's "Most Livable City" in 1989 by Places Rated Almanac. While Mayor, Royer led efforts to streamline city government; craft an international treaty with Canada for sustainable and low-cost electric power; develop low- income and affordable housing; create a community health-clinic system; establish the nation's most successful residential recycling program; and strengthen Seattle's neighborhoods with new land-use policies and zoning. Royer was a member of the Democratic National Committee and a member of the Democratic Party's Platform Committee in 1988. He served on the US Conference of Mayor's Advisory Board and was for seven years President of the American delegation to the Japan-American Conference of Mayors and Chamber of Commerce Presidents, which recently named him a life member. Mr. Royer also chaired the National Advisory Committee to the Robert Wood Johnson Foundation's Health Care for the Homeless Initiative, served on the National Commission on State and Local Public Service, the President's Commission on White House Fellows, and is a Trustee of Partners for Livable Communities. • David Moseley Partner --- The Royer Group 2006 to President Vice President, Institute for Community Change, Seattle, Washington. Serve as chief financial and operating officer of private, non-profit organization dedicated to helping foundations, governments and non-profit organizations implement project initiatives. Examples of Institute work include: management of multi-city, large scale community change initiative to improve the health and safety of children; conducting site assessment and readiness for multi-city integrated services in school initiative; and comprehensive health and human services site assessment and organizational capacity. Manages internal fiscal and operating procedures, maintenance of financial record systems and operating reporting requirements. 1999 to 2006 City Manager, City of Federal Way, Washington. Chief Executive Officer of seventh largest city in Washington State. Responsible for administration of all city personnel, services and departments including: public safety, community and economic development, parks and recreation, street improvement and maintenance, surface water utility, planning and permitting, financial management, capital projects funding and management, • intergovernmental relations and regional coordination. Major accomplishments include: obtained over$50 million dollars in federal and state grants for infrastructure improvements and other community capital projects; purchase and renovation of office building for new City Hall; planning and development of new $20 million multi-purpose community center; established funding plan for$170 million capital investments over six years; successful financial management resulting in bond rating upgrade. Total annual budget of$79 million with regular staff of 315. 1995 to 1999 City Manager, City of Ellensburg, Washington. Chief Executive Officer of full- service municipality. Responsible for administration of all city personnel, programs and activities including: four City-owned utilities, community and economic development, police and fire services, parks and recreation, planning and permitting, financial management, capital projects funding and management, library and conference facilities, and coordination with other public and private agencies including other jurisdictions, the business community and a major higher educational institution. Major accomplishments include: completed and implemented comprehensive plan; developed comprehensive financial plan; improved City financial condition; increased economic development activities; improved electric and natural gas utility services. Total annual budget of$44.5 million with full and part time staff of 223. • 1992 to 1995 Town Administrator, Town of Steilacoom, Washington. Chief Administrative Officer of full-service municipality. Responsible for all personnel, programs and activities including: supervision of five Town-operated utilities, management of police and fire services, planning, community and economic development services, parks, capital projects and finances. Major accomplishments include: funding and redevelopment of regional saltwater park; improved Town financial position from deficit to surplus; developed capital improvement program and funding to improve electric utility; improved roadway system and developed comprehensive financial plan. Total annual budget of$12 million with full and part time staff of 75. 1990 to 1991 Staff Director, Speaker's Office, House of Representatives, Olympia, Washington. Responsible for management of Speaker's Office including: coordination of public policy and legislative development, community and constituent relations, and political and legislative strategy. 1984 to 1990 Director, Department of Community Development, City of Seattle, Washington. Responsible for administration of all department personnel, • projects, programs and services including: economic development, housing planning and development, historic preservation, neighborhood planning, and grant development and administration. Major accomplishments include: developed nationally recognized affordable housing program; managed all major development projects; crafted downtown and neighborhood development plans resulting in substantial redevelopment; helped small businesses receive low interest loans; preserved historic buildings including Franklin High School and Admiral Theater. Total annual budget of$24 million and staff of 110. 1982 to 1984 Director of College Relations, Seattle Central Community College, Seattle, Washington. Responsible for directing planning, fund development and community relations for the college. 1979 to 1981 Director, Division of Youth Services, City of Seattle, Washington. Responsible for administration of youth service programs including juvenile justice, employment and training, and education. • 1974 to 1978 • Project Manager, Community Accountability Program, City of Seattle, Washington. Responsible for innovative juvenile justice program. 1970 to 1974 Director, Telegraph Avenue Community Center, Oakland, California. Responsible for agency providing nine social service programs. EDUCATION 1986 Certificate, Harvard University, John F. Kennedy School of Government, Cambridge, Massachusetts 1972 Masters of Divinity, Golden Gate Theological Seminary, Mill Valley, California 1969 Bachelor of Arts in Political Science, Willamette University, Salem, Oregon APPOINTMENTS/PROFESSIONAL ACTIVITIES 1998 to 2000 Member, Board of Directors, Association of Washington Cities 1996 to 2001 President, Vice President, and Board Member, Washington City . Management Association 1995 to 1998 Member, State Land Use Study Commission, Governor Appointee 1979 to 1981 Member, National Advisory Committee for Juvenile Justice and Delinquency Prevention, Presidential Appointee S 110 Gr Kipp Kipp Partner --- The Royer Group Areas of Expertise Public Health: Policy, Planning & Administration Land Use: Policy, Regulation, Planning & Development Budget & Finance: Operating Budgets ($35 — 250 million) Criminal Justice: System-wide Planning, Program Development & Evaluation Government and Community Relations: State, Regional, Local and Neighborhood Management: Organizational Development, Personnel/HR, Reorganizations, Labor Relations • Positions Held Chief Administrative Officer/Deputy Director Public Health-Seattle & King County — 2,400 employees, $250mi1 Budget Director, Development & Environmental Services Department King County— 300 Employees, $35mil Budget Assistant Budget Director, Office of Management & Budget City of Seattle Director, Criminal Justice Planning Department Yakima & Kittitas County Council of Governments • Skill Sets S Executive-level Leadership & Management, Policy Development, Regulatory Administration, Legislative Broker Financial Management, Budget & Business Plan Development, Project Management Organizational Development, Organizational Turn Around, Organizational Culture Setting Media Communications, Community Relations, Collaborative Problem Solving Interest-Based Negotiations, Human Resources, Labor relations Education Harvard University 1983 Masters in Public Administration University of Washington 1973 • Bachelors in Urban Planning Professional & Community Affiliations University of Washington College of Architecture & Urban Planning Professionals Council to the Department of Urban Planning Mentor Program Co-Chair Issaquah Schools Foundation Past President and 10-yr Board Member Current Advisory Committee Member 1998 PGA Championship, Sahalee Golf& Country Club Government Relations Committee Chairman • Hal Calbom Partner --- The Royer Group Areas of Expertise Writer, producer and consultant with rich experience in the publishing, media, corporate training, adult education, and high tech industries. Special experience in: • assessing new markets and distribution opportunities • forging relationships and consensus • defining deal structures • communicating results Positions Held Crisp Publications, Inc. Vice President, Strategic Development • • Managed all reseller and partner channels • Created fifteen new partnerships / alliances • Led strategic planning and business development process resulting in successful sale of company to a prominent buyer 1 Minute Learning Corporation Founder/ Partner • Executive Producer of 20 e-learning courseware programs • Led concept development, production and fundraising activity KING Television — Seattle NBC affiliate News Anchor/ Host/ Producer • On-air daily news reporter and anchor • Hosted weekly public affairs magazine program • Wrote and produced over 300 news stories and magazine pieces • Skill Sets • Marketing Analysis --- successfully guided clients and partners through rapidly evolving market conditions and technical upheavals in media production, corporate communications, digital content adaptation and re-purposing, and new media strategy Content Conversion --- created and brought to market hundreds of high quality courseware and media products adapted from original print sources into video, audio, CD ROM, and online formats Presentation and Sales --- represented clients and partners through public relations, product and partnership evangelism, writing, broadcast hosting and interviewing, public speaking and salesmanship Deal Making --- conceived, negotiated and executed business relationships involving partnerships, intellectual property rights, new distribution channels and market opportunities Education University of Exeter Devonshire, England • Master of Arts in English Harvard College Cambridge, MA A.B. cum laude in Government, Knox Fellowship University of Southern California Los Angeles, CA National Merit Scholar, Great Books Scholar, Division One full athletic scholarship Professional Honors and Affiliations Institute of Management Consultants Member, Pacific Northwest Chapter National Academy of Television Arts & Sciences Seattle Chapter 5 Emmy Awards for Writing and Production Washington Special Olympics Pro bono media production and fundraising REQUEST FOR PROPOSALS THE TRANSFORMATION OF JEFFERSON COUNTY PUBLIC HEALTH INTO THE JEFFERSON COUNTY PUBLIC HEALTH DISTRICT NOTICE IS HEREBY GIVEN that the Jefferson County Public Health is accepting proposals from firms specializing in organizational change/development, strategic planning, financial analysis, public health, and the ability to clearly communicate to decision makers. Jefferson County Public Health is the contracting authority. The resulting contract will be signed by the prime consultant and Jefferson County Public Health and the work will be directed by Jefferson County Public Health. Seven copies of proposals must be received no later than 4:30 p.m. on August 10, 2007. Late responses will not be accepted. Electronic mail, mailgrams, telex or facsimile proposals will not be accepted. The proposals should be sent or delivered to: Mr. Mike McNickle Deputy Director Jefferson County Public Health 615 Sheridan Street Port Townsend, WA 98368 Questions regarding the project scope and contents of the Request for Proposals should 4 be directed to Mike McNickle mmcnickleAco jefferson.wa.us . Complete RFP found at http://wwwjeffersoncountypublichealth.org •