Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2008- August
File Copy i Jefferson County Board of Health Agenda & LMinutes • August 21, 2008 • 4111 JEFFERSON COUNTY BOARD OF HEALTH Thursday, August 21, 2008 2:30 PM - 4:30 PM Jefferson County Courthouse 1St Floor Conference Room Port Townsend, WA 2:30—4:30 PM DRAFTAGENDA I. Approval of Agenda II. Approval of Minutes of July 17, 2008 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. Port Townsend Paper Air Quality Agreement 2. Mental Health Consultation Outreach Access Line • 3. Board of Health Letter re: City of Victoria Sewage Treatment V. New Business 1. Nurse Family Partnership Annual Update 2. Port Townsend/Chimacum School Based Clinic Update 3. Cyanobacteria (Blue Green Algae) in Jefferson County Status Report 4. Jefferson County Public Health 2009 Budget Planning VI. Activity Update VII. Agenda Planning VIII. Next Scheduled Meeting: September 18, 2008 2:30—4:30 PM Site to be Announced cd JEFFERSON COUNTY BOARD OF HEALTH Nor MINUTES Thursday, July 17, 2008 2:30 PM—4:30 PM j Masonic Hall, Port Townsend f 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, Chair, County Commissioner,District#3 Andrew Shogren, Environmental Health Director Chuck Russell,Hospital Commissioner,District#2 Julia Danskin, Nursing Services Director Michelle Sandoval,Port Townsend City Council Sheila Westerman, Vice Chair, Citizen at large(City) Roberta Frissell, Citizen at large(County) Chair John Austin called the meeting of the Jefferson County Board of Health to order at 2:30 PM in the Masonic Temple, 1338 Jefferson Street, Port Townsend, WA. Members Present: John Austin, Roberta Frissell, Chuck Russell, David Sullivan, ex-officio member, Frances Joswick, Substance Abuse Advisory Board Members Excused: Phil Johnson, Sheila Westerman • Staff Present: Jean Baldwin, Dr. Thomas Locke, Andrew Shogren, A quorum was present. APPROVAL OF AGENDA Member Chuck Russell moved and Dr. Locke seconded the approval of the agenda. The motion to approve the agenda, as written, was passed by unanimous vote. APPROVAL OF MINUTES Member David Sullivan moved for approval of the minutes for June 12, 2008. Roberta Frissell noted a missing item: She said that during the June BOH meeting, following the presentation by Andy Brastad, a question had been asked regarding the amount of money Clallam County had spent thus far on the new sewage regulations process. She recalled that his response was "over $200,000", and requested that that should be reflected in the minutes. Dr. Locke said that the amount was uncertain, and offered to have staff check the recording. Chair Austin suggested that the approval of the minutes be postponed until the data item was verified, which was accepted by Member Sullivan. Chair Austin indicated that approval of the June 12 minutes would be on the agenda for final approval at the August meeting. • Jefferson County Board of Health Page 1 of 11 July 17, 2008 PUBLIC COMMENTS Chair Austin read aloud the rules of order for the Public Comment period. • OLD BUSINESS Presentation -Tobacco Prevention T-Shirt Design Contest Awards Karen Obermeyer of the Tobacco Prevention and Control Program, Public Health Department, gave a brief update on the program. There are four main areas of focus. The first is to increase the capacity for tobacco control. The next meeting of the Tobacco Control Coalition is August 13 at 4:00 PM at the Health Department. The second area of focus is to promote tobacco use cessation and referred to the Quit Line and stated this is a free State service including counseling and products to help smokers quit. The tobacco prevention program also works with physicians to help them get tobacco use treated as a vital sign. The third area of focus is elimination of second hand smoke exposure. The fourth area of focus is prevention of the initiation of tobacco use. For example, the program monitors tobacco retailers regarding sales to minors; she said there is a 90% compliance rate in the County. She discussed the TATU (Teens Against Tobacco Use) high school program, which includes peer education training. Ms. Obermeyer then introduced Helen Pilling, who presented the awards for the Tobacco Prevention T-shirt Design Contest. Heather King and Emily Rose Strickland, both from Port Townsend, received awards for their designs "Killing You Slowly" and "Tobacco Facts", respectively. • Media Releases Dr. Locke spoke briefly about the Washington State Department of Health's Shellfish Health Advisory regarding Vibriosis risk. The intention is to warn the general public of the risk in eating shellfish harvested when temperatures are very warm and naturally occurring marine bacteria rise to toxic levels. The release provides a list of tips to recreational shellfish harvesters. Correspondence Jefferson County Public Health's Traveler's Immunization Clinic—Jean Baldwin briefly discussed the letter from Lisa McKenzie, Communicable Disease Program Coordinator, to Jefferson County Primary Healthcare Providers. This is an information packet for providers to clarify clinic services and the increasing number of vaccines provided. The Traveler's Clinic is part of the Immunization Clinic and Communicable Disease Team. Septic Tank Inspections—Letter from Davis Steelquist and reply from Dr. Locke Copies were included in the packet. There were no comments or discussion. WA WIC Nutrition Program 2007 Annual Report Julia Danskin spoke briefly about the state-wide annual WIC report and information specific to Jefferson County. She reviewed pertinent statistics regarding the number of women, infants, and • children served by the Health Department, and the federal dollars spent at local grocery stores/farmer's market, under the Farmers Market Nutrition Program. She said WIC authorized Jefferson County Board of Health Page 2 of 11 July 17, 2008 stores, including Safeway, QFC, Food Coop and the Quilcene Grocery Store, to accept WIC . vouchers distributed by the Health Department. She said the total dollars dropped slightly in 2007 but is again rising in 2008, both state-wide and locally. The challenge is to distribute the block grant funds equitably, although demands and needs for families may rise and fall. She said that thus far it has not been necessary to place any families on a waiting list. Member Sullivan asked for clarification on the statistic regarding percentages of families living in poverty. Julia Danskin explained that 60% of WIC families are working families and 65% of WIC families are living in poverty (that is, a family of four with $1721 or less monthly income). The WIC program is funded from federal and County (General Fund) monies. Ms. Danskin also noted that about $2,000 is given to families annually to be spent at the Farmer's Market; this year there will be an effort to ensure that more dollars are spent there. WIC is seeking more farmers to be authorized vendors in the program and there is no waiting period. However, to be authorized, a Farmer's Market must have a requisite number of local vendors selling local produce; arrangements are made through the market manager. Region 2 Public Health Newsletter Dr. Locke reminded the Board that the target audience for this newsletter is healthcare providers. This issue focuses on the disposition of the modest increase in funding from the legislature intended for increasing immunization rates and improving communicable disease control. Provider participation is especially needed in the CHILD profile system, an electronic registry used for immunizations and other preventive health services; 100% child enrollment is sought. • Currently 70% of the children in the State are registered. Jean Baldwin briefly described a technical problem with the system resulting in only 25% of County children's records being included. She said that data interfaces with that system, at an added cost, may become mandatory in order to receive the State sponsored vaccines. Hood Canal Dissolved Oxygen Program Update Andrew Shogren briefly noted the set of articles in the packet relating to Hood Canal dissolved oxygen assessment and modeling studies. There was no further discussion. NEW BUSINESS Jefferson County On-site Sewage Code: Review of Homeowner Inspection Programs in 6 Washington Counties and Proposals for Jefferson County Homeowner Inspection Program Andrew Shogren introduced this agenda item. Angela Pieratt, Environmental Health Specialist, walked the Board through a PowerPoint presentation entitled "What's New with the Jefferson County Operations and Monitoring (0 & M) Program?" She recalled that the previous BOH meeting had included a status report from Clallam County about their Homeowner Inspection Program (HIP)programs. She discussed changes to the existing Jefferson County program and • code, the history and background, program challenges, and future planned improvements. She also addressed several questions that had been raised previously. Jefferson County Board of Health Page 3 of 11 July 17, 2008 Recent changes—In 2007,the inspection frequency changed to three years for gravity systems and annually for all others. In addition, a monitoring agreement is required for any site where a • system is permitted. Inspections may be done by County 0 & M specialists ($274) or private industry. The intention is to update the code for the Homeowner's program to allow homeowner inspections. History—The Inspection Program began in 1987. Successive changes to the program are outlined in the handout entitled"Septic Monitoring in Jefferson County 1983-2008". Ms. Pieratt noted that, as with many technologies, there has been a shift from simplicity (conventional gravity systems)to more complexity(alternative systems). State and county regulations have evolved accordingly over the years. In terms of internal challenges, in January 2008,the Jefferson County Public Utility District (PUD) discontinued performing automatic inspections, and had stopped creating contracts. Meanwhile,the State Code increased the required frequency of inspections. Professionals are now completing the majority of home inspections but, for those previously done by the PUD, a number of systems are now"falling through the cracks". Since 2000,the County code requires that all systems must be monitored. Registration is triggered at the sale of a property or building permit application. Ms. Pieratt said that the number of certified professionals will rise from 6 to 9 this year, in addition to designers who work within the County. The Health Department and the PUD may also perform inspections. Member Russell asked how many of the certified professionals work for pumping companies. She said she knows of two owners and two employees of pumping • companies. There was agreement that it would be desirable for pumpers to be trained inspectors. There was also clarification that there a two reports: the monitoring report, which qualifies a system and drain field, etc. and verifies that the system is in good operational order;the pumping report deals only with the tank, and amount of material pumped. The cost of the inspection was estimated at between$150—$300, depending on the complexity and the amount of time required. Vision—The vision for the future is to update and improve the existing program, as well as to pursue the homeowner inspection component. Emphasis will be on action through education, outreach and incentives. The inspection schedule will remain at every three years for conventional systems and annually for all others, which is consistent with State code. At this time, sensitive areas do not have additional inspection requirements, but will be considered. For time of sale and building permits, a professional inspection will continue to be required. The existing filing fee is $39. Other sources of funding expected include permit fees,the Clean Water Assessment program and operational certificate fees. Implementation—Ms. Pieratt briefly listed the components of Implementation. Education offered includes free TLC for your Septic classes; there have been five classes to date this year. A variety of brochures are available in the office and online. Trained staff is now available in the office five days per week. Future education will likely include Homeowner Septic 0 &M, 101 and 102, and mailings to targeted communities. She noted that other counties have had good success with market based solutions and financial incentives. Funding would be required in order to offer rebates for timely inspections or the like. • Jefferson County Board of Health Page 4 of 11 July 17, 2008 A phased implementation would likely begin with PUD contract holders, then properties with a boundary within 200 feet of the shoreline. (Board Member Russell requested clarification of whether the property line or drain field location would determine this priority group. Staff explained that this decision would require further consideration and would need to be consistent with the Shoreline Master Plan updates.) Homeowner notification would be handled through bulk mailings to targeted communities, direct mailings and compliance reminders. Phase 1: 2008-2012 —Ms. Pieratt provided an outline of plans for Homeowner Training and Inspections. Ideally, training (five hours of field and classroom work) would be offered free and taught by County Public Health staff. Only conventional systems would be eligible for Homeowner Inspection. It is estimated that about 10,000 of the 13,000 on site septic systems in the County are conventional, gravity systems. Requirements for shoreline systems are yet to be determined. Other conditions include: the septic system must be a permitted system; only residential systems may be homeowner inspected. Professional inspection is required at time of sale and for certain types of building permits. In response to a question about the appropriate process during sale of properties (or building permit application) with previously unpermitted systems, Ms. Pieratt said that a careful inspection would be done and a record would be established. Unless the system is clearly failing, a new system would not be required. Dr. Locke added that the septic permit is an installation permit not an operating permit. It does not make sense to issue an installation permit has been in use for decades. Member Sullivan mentioned that he was aware of anonymous handbills with misinformation about this program recently distributed in Port Hadlock. Staff was • not aware of any increase in recent inquiries related to that "publicity". Ms. Pieratt summarized the additional sources of information related to State and County regulations and plans that are available online. She noted that paper copies of septic permits are being scanned for inclusion in a reference database. Currently, applications/permits from 1979 to 2004 are already online. To access them, the parcel and septic permit number can be obtained from the County web site. She also described the eOnsite program which, when fully implemented, will allow a streamlined process for entering septic system evaluations online and making them accessible to others. A special interface will allow the Health Department to review the reports electronically. Ms. Pieratt described the ShoreBank Septic Loans program, which provides excellent financing arrangements for repair or replacement of residential systems, with zero out-of-pocket expenses. Board Chair Austin added that, in many cases, recipients will not need to repay the cost of the loan until the sale of the property. There was agreement that this is a great resource for County residents. Contact and web information for the County Public Health Department and ShoreBank organizations was provided: www. JeffersonCountyPublicHealth.org and www.sbseptic.com. Ms. Pieratt addressed a question that had been asked by Member Westerman at the previous meeting about the Kitsap program. She said she had obtained information from the person currently responsible for the program. The previous Kitsap homeowner program was not based . on certification. Homeowners were allowed to take a test, and were then expected to report inspections. Apparently, over 200 people had taken training and been tested, but less than 0.5 % had turned in a report. Kitsap then changed their regulations to ensure that people passed a Jefferson County Board of Health Page 5 of.11 July 17,2008 • certification exam (for $150) and paid a certification fee ($336), as well as met additional requirements (proof of necessary equipment; waiver from inspection contract; etc.). • Homeowners were not permitted to inspect others' systems, presumably because of liability concerns. At present, there are no certified homeowner inspectors. [Chair Austin called a short recess to allow reconfiguration of furniture and presentation equipment at 3:35 PM. The meeting resumed at 3:45 PM.] Appeal of Solid Waste Administrative Hearing Decision Dated April 24, 2008 Regarding Notice and Order to Correct Violation on Parcel#901253002, Property of Ms. Linda Sexton Chair Austin opened the hearing for the appeal. He explained that the BOH was asked to review this decision, and that proper protocol was to be followed. He read the rules of order appropriate to this gathering. He said it was important to note that this is a closed record appeal, meaning that no new information could be presented. He said the purpose was to review the propriety of the administrative hearing that was conducted on April 24. "Since it is a quasi-judicial hearing it is important that we have all the elements of fairness. The hearing must be fair in all respects, meaning in form, in substance and in appearance." He then asked if any Board Members had any interest in this property or if any should stand to lose or gain any financial benefit as the result of the outcome of this hearing, or if any member had any disclosures to make about any special interest in this property. Chair Austin and each of the Board Members stated that they had no such interests, nor did they stand to gain or lose any financial benefit. He then asked if there was anyone in the audience who had objections to any Board Member participating in the • proceedings. There were no objections voiced. He said that the purpose of the hearing was to hear the appeal and to take action related to the prior administrative appeal. The order of speaking to be followed was previewed: staff presentation; argument from the appellant, Ms. Linda Sexton; testimony from any proponents of the appeal; testimony from any opponents or those neutral to the appeal; any argument from the appellant in response to the opposition to the appeal; response from staff; and any questions from the members of the BOH. Chair Austin then introduced Dr. Tom Locke, who made the staff presentation. Dr. Locke said he would begin by identifying each of the set of documents relevant to the appeal that had been included in the packet. Dr. Locke explained that all BOH codes (on-site, food safety and solid waste)have appeal processes. The solid waste code stands apart from some of the other BOH codes. Other codes are based on State BOH or State Department of Health rules. The solid waste code is based on the State Department of Ecology rules and local health departments have been mandated to enforce those rules. He said many of the rules in the code do not have a direct health bearing, and decisions about enforcement are not made strictly based on health considerations. The emphasis is upon definitions in the State codes and what the local health jurisdictions is required to do in enforcing them. Dr. Locke briefly reviewed each of the documents: • 1. Letter to Ms. Sexton informing her of the appeal scheduling dated June 19, 2008. It included a request of Ms. Sexton to resubmit materials that had not seemed to be in logical order. He noted Jefferson County Board of Health Page 6 of 11 July 17, 2008 that the packets contained the original materials and that the resubmitted materials were also • available for this meeting. 2. Dr. Locke's memorandum to the BOH dated July 10, 2008. He said he would return to this document in presenting his analysis and argument. 3. Document dated April 24, 2008 representing the result of the administrative hearing. He said the format was standard for administrative hearings and included findings of fact as well as conclusions of law. He noted that these findings are the subject of the appeal at hand. 4. Case summary of complaint#1069. This is a chronology of this case prepared by Margie Boyd, the Solid Waste Code enforcement staff involved in this case. 5. Letter to Ms. Sexton from Ms. Boyd dated September 18, 2007 requesting permission to visit her property. 6. Letter to Ms. Sexton from Ms. Boyd dated January 14, 2008 informing of the open complaint and again asking permission to enter the property. 7. Notice and Order to Correct Violation (NOCV) to Ms. Sexton dated January 14, 2008. This was the subject of the appeal at the administrative hearing. 8. Supporting documents included at the administrative hearing, including maps, reports and photographs taken by Fire Rescue and staff. 9. Documents submitted by the appellant, including letters and arguments submitted by Ms. Sexton at the time of the administrative hearing. Dr. Locke returned to the document numbered 2 above. He said that the case before the Board focuses on the administrative hearing of March 13, 2008. He said that it is easy to become confused in this appeal due to the decade of complicated solid waste enforcement actions by • various county agencies. He recommended that the Board stay focused on the NOCV issued in January 2008 (document 7) and the subsequent administrative hearing on March 13. Dr. Locke said he believed that there are three key areas that are raised in this appeal: 1. Ms. Sexton disputes the legality of entry to the property by the building inspectors and therefore argues that if their entry was improper, then any observations they made would be void or inadmissible. 2. Ms. Sexton disputes the legal definition of several solid waste code terms, specifically the definitions of"discarded commodities" and "bulky waste", which were cited in the violation. 3. Ms. Sexton asserts a first amendment right for a religious exemption to solid waste code based on strongly held religious beliefs. Dr. Locke said that in Washington State laws, there are certain public health codes that do allow religious exemptions. He cited the examples of public health codes where exemptions are permitted for vaccinations or to refuse treatment for tuberculosis. However, he said that to his knowledge there are no religious exemptions to solid waste codes. Dr. Locke said that, in the administrative hearing, he had attempted to deal primarily with the two issues, i.e. the legality and appropriateness of staff acting on the complaint they had received. His determination and reasoning was that the legality of the entry by the fire department and subsequently by the building inspectors was a moot issue, in terms of the complaint. Complaints are not a form of evidence; complaints are not ruled admissible or inadmissible. A complaint is essentially an unconfirmed allegation, which anyone can make. From the standpoint of the Health Department, a standard of reasonableness is followed. If a complaint seems to be reasonable, an investigation is conducted, during which evidence is gathered. All decisions, in terms of whether or not a violation has occurred, are based on that • evidence. That evidence must follow all rules of evidence, be legally gathered, and be admissible in both Board of Health hearings and court hearings. Rules of evidence definitely Jefferson County Board of Health Page 7 of 11 July 17, 2008 apply to the evidence gathered by the Health Department, but Dr. Locke had determined that a complaint in itself is not a form of evidence. • The second issue for which Dr. Locke made a determination was that definitions of solid waste are not a matter of individual prerogative. Under Washington State codes, each individual does not define what is or is not solid waste. The definitions contained in the state and local codes as understood by the enforcement agencies determine what those agencies are required to enforce. He said that his determination was that the definitions of discarded commodities and bulky waste are reasonably clear in the State codes. When applied to the evidence (photographs)that had been submitted,those photographs confirmed the presence of those types of solid waste on the property. With regard to the present BOH hearing, Dr. Locke asked the Board to make determinations in the three key areas. He said that if all three of these components are not present, then the administrative hearing conclusions should be reversed by the Board. At a minimum,there is the issue of whether the solid waste code violation filed by the Jefferson County building inspector in conjunction with a site visit on February 7, 2006 was sufficient to warrant a site inspection or complaint inspection by the solid waste code enforcement staff. Did the department act properly in gathering evidence about this site? Secondly, was the evidence, i.e. photographs obtained with the permission of a neighboring property owner from a neighboring property, gathered in a legal manner? Thirdly, does this photographic evidence constitute proof that a solid waste code violation was occurring and justified issuance of the NOCV on January 14, 2008? He said these were the key issues pertinent to the appeal in the present hearing, and concluded the staff presentation. i Chair Austin then asked Ms. Sexton to make her presentation to the BOH and asked that she limit her remarks to about five minutes. Ms. Sexton said that she thought the time allotment of five minutes was very unfair, but that she would comply. She mentioned that it was probably more (time)than she got previously. She said Public Health staff hadn't discussed any issues in particular that she was concerned about related to solid waste definitions. Ms. Sexton also mentioned that she was not a solid waste county facility or a solid waste recycling center. Ms. Sexton said that, as a responsible land owner, she was submitting a copy of a document that is an accounting of her receipts for the last year for solid waste disposal. Ms. Sexton next discussed an administrative hearing in August 2007, over another violation, which she said had eventually been voided, based upon illegal entry. She said she was trying to provide some historical context because the same issue had been going on since the 1980s. She mentioned a letter she had written to Senator Hargrove in 1988 seeking clarification on the issue of solid waste, and distributed copies of that document. Ms. Sexton said she was contacted by the Health Department in 1996 about her problems. She said that since she was bed ridden with a knee injury, she had agreed to meet with staff in her home. At that time,the staff person asked to see her property, and she escorted him while on crutches. She said that she was unaware that he was intending to do a site investigation and take photographs, which were then presented a hearing. She said she had not been shown the III photographs. Ms. Sexton said she had been told that she had"too much stuff' and had not been given a reasonable explanation or clear definition of what was too much. She then received a Jefferson County Board of Health Page 8 of 11 July 17, 2008 notice of violation that referred to her property as an unpermitted solid waste facility and/or • recycling center, which she disputed. In seeking clarity and guidance, Ms. Sexton said she contacted the Department of Ecology and obtained copies of a 100 page document with solid waste related definitions. She noted that the definition of"discarded commodities" (items that are no longer usable for their intended purpose) had not been added until 1988. Ms. Sexton protested the definition, stating that it is completely unclear and ambiguous as to meaning. She said she wishes to define her own intent, and to have her own choice as to what items are "in use". Ms. Sexton said that she had been told that she had no "private property". She mentioned dump trucks, excavators and back hoes, and fear of violence upon her property. She mentioned considerable correspondence with the Governor's office. Chair Austin interjected briefly, indicating that the procedure would be to allow for another three minutes for a proponent of the appeal. He said that Ms. Sexton could take that time herself or allow someone else to speak. Ms. Sexton indicated that she would like to take the time herself. Chair Austin then asked the attendees if anyone else had come to speak as a proponent. No one voiced that intention. Chair Austin indicated that Ms. Sexton could continue for that additional time. Ms. Sexton described hearing discussions about the definition of the term `solid waste'. She said that she was told to "sign here, we want to monitor everything that you collect, that you get, where you're going to put it, how you are going to use it, how long you're going to store it there, Swhat is your intention." She said she was falsely accused of violating the rural residential storage ordinance in 2004. She also mentioned having been warned or cited for building too close to the property line. She said her property and her house were entered by County employees without her permission when she was out of town, but witnessed by her tenants. She mentioned a Notice of Violation that she did not understand because the document did not make clear what the violation was for. She mentioned fencing in connection with County employees entering her property, and stated that she had offered to raise the height of fences on her property. Ms. Sexton mentioned that her privacy had been invaded on several occasions. Chair Austin informed Ms. Sexton that she had one more minute to speak. Ms. Sexton said she would discuss the fire incident, which occurred in 2006. She explained that her tenant had called 911 about a chimney fire caused by a special clean out log. She said that the fire department had said everything was okay, but that the DCD (Department of Community Development) staff had appeared two hours later. She said they made an error in not contacting her. She pointed out that there was no damage, and she did not know what the emergency was. Chair Austin informed Ms. Sexton that her time had been expended. He asked if there were any persons present who wished to speak in opposition to the appeal. There were none. He asked if there were any other persons who wished to speak about the appeal, for any reason. There were none. Since there were no comments regarding the appeal, Chair Austin invited Board members to ask any questions about the appeal, either of Ms. Sexton or the staff There were no questions • from the Board. Jefferson County Board of Health Page 9 of 11 July 17, 2008 Chair Austin said that since there was no further comment,he would close this portion of the hearing. He stated that it was now in order for the BOH to discuss the matter. He reminded that, • although a number of other issues had been raised, that the focus of this hearing were the elements of the order to correct violation. He restated the three key questions: 1) Was the complaint that was issued sufficient to warrant a site inspection, 2) Was the photographic evidence, taken from the adjacent property, obtained in a legal manner, and 3) Was this photographic evidence sufficient proof that a solid waste code violation occurred. With regard to the first question, Member Sullivan stated that anyone can make a complaint. Member Russell said that he believed it would be logical to have a motion on the floor as the basis for discussion. Chair Austin verified that while that was not an essential part of the protocol, it was certainly permissible. Member Russell moved for denial of the appeal. Member Sullivan seconded the motion. Chair Austin asked for any discussion on the motion to deny the appeal. Member Frissell addressed the third question. She said that in her opinion the photographic evidence was sufficient to prove that a solid waste violation occurred, and that she was in favor of the motion on the floor. There was no further discussion. Chair Austin called for the question. The Board of Health unanimously passed the motion to deny the appeal. Chair Austin then directed staff to operate in accordance and closed the public hearing on this matter. 411 ACTIVITY UPDATE Chair Austin invited staff to add any comment to the materials provided in the packet. Jean Baldwin stated that staff was involved in budget preparations. As a department, they are in the process of preparing 2009 budget proposals. She said a strategic planning process is underway with the intent of determining internal prioritizations before involving the Board of Health. AGENDA PLANNING Jean Baldwin noted that there are a number of items that staff will bring forward in the next few months. She said that staff would like to discuss fees. A cost analysis is underway, by program, by service provider, and by unit. She explained that they can analyze their costs and look at the market rates,but may be not be able to charge accordingly. School-based clinic (general health, family planning and mental health) is another topic for the agenda within the next two months. The next BOH meeting is scheduled for Thursday, August 21, 2008 from 2:30 to 4:30 PM; location (Courthouse) is to be confirmed. • Jefferson County Board of Health Page 10 of 11 July 17, 2008 • ADJOURNMENT • Member Frissell moved for adjournment. The motion was seconded by Member Russell and passed unanimously. Chair Austin adjourned the BOH meeting at 4:30 PM. JEFFERSON COUNTY BOARD OF HEALTH _ Ohl& Excused o Austin, Chair Sheila Westerman, Vice Chair t ; (tvv144 Roberta Frissell, Member uck Russell, Member Excused Phil Johnson, Member David S livan, Fiber ff Absent • Michelle Sandoval, Member • Jefferson County Board of Health Page 11 of 11 July 17, 2008 • Board of Health Old Business .agenda Items # 1"V., 1 • Port Townsend Paper .fir Quality ,agreement .august 21, 2008 • ! !! News Release FOR IMMEDIATE RELEASE—Aug. 7,2008 08-219 Ecology and Port Townsend Paper sign air quality agreement OLYMPIA—The Port Townsend Paper Corporation and the Washington Department of Ecology (Ecology)today announced an agreement calling for the mill to expand its air emissions data collection. The agreement is in response to recommendations from a recent state Department of Health (Health) consultation. Under the agreement, the company will collect air emissions data on additional chemicals, evaluate air emissions around the wastewater treatment lagoon and add an upgraded meteorological center. The agreed order: • Requires the mill to report 18 specific chemicals. • Establishes a meteorological station to track temperature, wind speed and direction, relative humidity and barometric pressure. • • Directs the company to develop a plan for evaluating wastewater treatment lagoon emissions. • Details an enhanced complaint tracking system and follow up procedures. The health consultation released by state Health earlier this year did not connect mill emissions with some chronic diseases experienced by area residents. The information collected under the order will help Health better assess possible impacts. "We now have an agreement in place that helps fill in the health data gaps that have been the subject of much discussion and concern," said Carol Kraege, manager of Ecology's Industrial Section. The order was signed by Ecology and Port Townsend Paper at the end of July, and takes effect immediately. Some of the order's provisions will take three to six months to return information. The order doesn't limit or change any conditions or requirements of Port Townsend Paper's current air operating permit nor Ecology's authority under the Clean Air Act. Ecology can take enforcement actions against Port Townsend Paper if provisions of the order are not met, and the company has the right to appeal any enforcement of violations. ### • Office of Communication and Education;P.O.Box 47600;Olympia,Washington 98504-7600 °printed on recycled paper If you have trouble receiving this fax or have a change in your fax number,please call(360)407-7006. PTPC agreed order- 2 of 2 Media Contact: Kim Schmanke, 360-407-6239 Ecology's Web site: http://www.ecy.wa.gov • Broadcast version The Port Townsend Paper Corporation and state Ecology today announced an agreement calling for the mill to expand its collection of air emissions data. Under the agreement, the company will provide emissions data on additional chemicals , evaluate air emissions around the lagoon and install a new on-site meteorlogical center. The information collected under the order will help Health better assess possible impacts. ### • IIII Board of 3-feaCth Old Business .agenda Item # 1'V., 2 .T4entalHeaCth Consultation � Outreach .access Line .august 21, 2008 1 44 a• • Partnership Access Line "4 Mental Health Consultation Outreach 1-866-599-PALS (7257) -cot chUldYP-`t www.PALforkids.org • PAL is a new program, designed for you. It is funded by the Washington State Legislature and the Department of Social and Health Services. • The Program is offered in: o Southwest Washington: in Clark, Clallam, Cowlitz, Grays Harbor, Klickitat, Lewis, Mason, Pacific, Skamania, Jefferson, Thurston, and Wahkiakum Counties. o Eastern Washington: in Adams, Chelan, Douglas, Ferry, Grant, Lincoln, Okanogan, Pend Oreille, Stevens, Spokane, and Whitman Counties. • Any primary care provider in these counties may call the toll free number (866-599-7257) during business hours (M-F, 9-5) for any type of child mental health advice for any child they see o A program assistant will ask for provider's name and basic patient information o A child psychiatrist then will speak to the provider either immediately, or, if • there must be a call back, it will usually be within 10 minutes. • If child psychiatrist and PCP over the phone determine further consultation is needed, a rapid appointment will be offered with the child psychiatrist for DSHS/Healthy Options clients • Primary care providers can be reimbursed $25.32 for DSHS phone consultations with the PAL psychiatrist (call us for details) PCP has a question PCP calls MD telephone Evaluation Brief note consult line consult provided if fax to PCP \ I DSHS/HO, in 24 hrs may be with telemedicine SW phone consult, Typical resource questions clinical note dictated, then mailed Direct Phone Consultation Consultation Communication IIIA research study,called Child PsychiatryConsultation in PrimaryCare, is being conducted to investigate the effectiveness of the PAL program. You may be contacted by the research team. Your participation in the research is voluntary. You do NOT need to participate in the research to participate in the PAL clinical program. • Board of 3feaCth 0 C Business .Agenda Item # rV., 3 Board of 3feaCth Letter re: • City of'Victoria Sewage treatment .august 21, 2008 JEFFERSON COUNTY BOARD OF HEALTH August 14, 2008 Denise Blackwell, Chair and Directors Capital Regional District PO Box 1000 Victoria BC V8W 2S6 Dear Chair Blackwell and Directors: As members of the Jefferson County Board of Health, we have closely watched the long and heated debate over wastewater sewage treatment by our international neighbor to the north, the City of Victoria. Jefferson County has substantial shoreline along the Straits of Juan de Fuca and a long-range interest in protecting its unique marine environment. We appreciate that the Capital Regional District and British Columbia Ministry of the Environment have maintained their firm commitment to designing and implementing a modern wastewater treatment system for the City of Victoria and surrounding areas. Although the CRD has been unable to meet the June 30, 2008 deadline for submission of the Liquid Waste Management Plan, it appears substantial progress has been made and Minister Penner's decision to extend the deadline is a reasonable one. Our county seat, Port Townsend, faced a similar wastewater treatment dilemma in the 1980's over whether to upgrade its antiquated primary treatment facilities to more modern and environmentally responsible treatment standards. At considerable expense and long-term indebtedness, Port Townsend did the right thing and invested in modern wastewater •atment. Current and future residents are reaping the benefits of this wise but difficult decision. The Jefferson County Board of Health strongly urges you to maintain your current course, mindful of the fact that there will always be dissenting voices and that construction of a modern wastewater treatment facility in the 21st Century is a very expensive undertaking. We hope the CRD users and governmental entities that bear these expenses will do so with the full knowledge that they are not only resolving a serious current problem but are also making an important investment in the protection of the unique marine environment shared by the British Columbia and Washington State. Sincerely, The Jefferson County Board of Health John Austin, Chair Sheila Westerman, Vice Chair Roberta Frissell, Member David Sullivan, Member Phil Johnson, Member Michelle Sandoval, Member Chuck Russell, Member • 615 Sheridan • Castle Hill Center• Port Townsend • WA (360)385-9400 ClaiD Capital Regional District1: 250.360.3000 • Making rsrf,lreren<e 625 fisgare Street, PO Box 1000, F 250.360 3234 Victoria, BC, Canada V8W 256 www.crd bc.ca June 17, 2008 The Honourable Barry Penner Minister of Environment PO Box 9047 Stn Prov Govt Victoria, BC V9W 9E2 Dear Minister P r: RE: CAPITAL REGIONAL DISTRICT CORE AREA LIQUID WASTE MANAGEMENT PLAN—PLAN FOR ACHIEVING OBJECTIVES OUTLINED IN YOUR LETTER DATED DECEMBER 14,2007 The Capital Regional District (CRD) is pleased to submit the plan you requested for achieving the objectives outlined in your letter dated December 14, 2007 regarding the provision of sewage treatment for its core area. The attached report (Appendix A) entitled Core Area Wastewater Management Program — Program Development Phase — Report to Minister of Environment by Associated Engineering/CH2MHiIl/KWL, dated June 12, 2008, describes how the CRD proposes to achieve the six objectives listed in your letter. You directed that this plan be submitted to you by June 30, 2008. Also attached (Appendix B) is a report entitled Market Sounding and Stakeholder Consultation — .Summary of Responses by Ernst & Young Orenda Corporate Finance Inc., dated April 23, 2008. This report summarizes the feedback received from sewage treatment service providers in the industry regarding their preferred procurement approaches. Your letter also directed that the CRD submit a Liquid Waste Management Plan amendment by December 31, 2008, which was to incorporate the seven items listed on page 1-3 of the Appendix A report. For the reasons outlined in Section 4 of the report, it is now apparent that it will not be possible to adequately respond to all of the listed items by that date. The CRD will, however, by this date be able to provide you with a comprehensive progress report on a number of these items, including those listed on Table 4-2 of the attached report. The CRD will continue to work with your ministry staff to meet the timelines shown in this table. It is now expected to take until the end of 2009 to submit a comprehensive Liquid Waste Management Plan amendment, which fully addresses the findings of the provincial Resources from Waste report, describes a successful facility siting program incorporating extensive public input and outlines the initiatives used to fully engage First Nations in the planning of the project. Your approval of an extension to the deadline for the submission of the proposed amendment to the Core Area Liquid Waste Management Plan to December 31, 2009 is, therefore, requested. The CRD remains committed to completing this wastewater treatment project by the end of 2016, as indicated in amendment#6 and approved in your letter dated December 14, 2007. /2 • HOW/243050M The Honourable Barry Penner CRD Core Area LWMP—Plan for Achieving Objectives Outlined in Your Letter Dated December 14, 2007 • June 17, 2008 Page 2 Should you or your ministry have ral manager, Envirronmental Sery ces, by elephoneplease at 360-30 2your staff contact Dwayayne or Kalynchuk, general by e-mail at dkalynchukCa?crd.bc.ca. Yours sincerely, 410, Denise Blackwell Board Chair Attachments: 2 cc: CRD Board of Directors Randy Alexander, Regional Environmental Protection Manager, Ministry of Environment Kelly Daniels, Chief Administrative Officer, CRD Dwayne Kalynchuk, General Manager, Environmental Services, CRD • • HOM#2430501x1 411 • BRITISH Date typed: Jul COLUMBIA ARCS: 280-30 ORCs: 76780- 1 LAne ONALDISTRICT The Best Place on Earth X Ref: 99229 DATE RECEIVED Reference: 99517 JUL 0 8 2008 JULO 8 ZOOS Board Chair P" CAO 'ii GM Corp.Srvcs. II GM Env.Srvcs �� Denise Blackwell, Chair and Directors GM Parks/Comm.Srvcs. II Capital Regional District . GM PI./Prot.Srvcs. 0 PO Box 1000 GM ater Srvcs. Victoria BC V8W 2S6 � . ,(4,3 ' Dear Chair BF 'well and Directors: �� Thank you for your letter dated June 17, 2008 and the attached two reports entitled: Core Area Liquid Waste Management Program—Program Development Phase—Report to the Minister of Environment authored by Associated Engineering/CH2MHi11/KWL, dated June 12, 2008 ("the Report"); and Market Sounding &Stakeholder Consultation Summary of Response - Capital Regional District— Core Area and West Shore Sewage Treatment authored by Ernst & Young Orenda Corporate Finance Inc., dated April 23, 2008. I will limit my response to the report, but I Ill would like to acknowledge the effort carried out by Capital Regional District (CRD) in the market sounding report to obtain input from suppliers, industry experts and other external stakeholders. The report outlines how CRD expects to address six key objectives for moving forward with the provision of wastewater treatment in the Core Area, as required by my letter dated December 14, 2007. The report describes the deliverables and milestone dates to achieve the six objectives. To accomplish this task, CRD has requested a one year extension on the LWMP amendment submission. It is my understanding that the additional year will provide opportunity to complete assessments on options for integrated resource management (IRM), combining IRM options to treatment facility siting, and to complete the public and First Nations FN consultation process. I have reviewed the report and would like to state that your recent work to assess opportunities for integrated resource management,greenhouse gas reduction, smart growth and resource recovery are commendable. I appreciate your efforts to adapt the wastewater treatment strategy to address innovation, resource recovery opportunities and economic benefits. I also recognize the effort made towards both public and FN consultation processes and agree that this is an important part of the project. I encourage you to further investigate and remain committed to these objectives as the planning process progresses. The report is approved in accordance with Section 24(3) (b) of the Environmental Management Act(EMA). Ministry of Office of the Mailing Address: lefephone:250 387-1187 • Environment Minister Parliament Buildings Facsimile:250 387-1356 Victoria BC V8V 1X4 I would like to acknowledge your commitment to maintain the original schedule to complete the • wastewater treatment project by 2016, Based on this commitment and my letter dated December 14,2007,please take notice that in accordance with Section 24(4) of the Environmental Management Act, the submission of a Liquid Waste Management Plan amendment is hereby extended from on or before December 31, 2008 to on or before December 31, 2009. This approval is subject to the submission of a progress report on or before December 31,2008 and a second progress report on or before June 30, 2009. Thank you for the progress made to date on this important project. I look forward to continuing to work with the CRD board as the project proceeds. At this time I would also like to reinforce the importance of our joint objectives, those being to protect our marine environment, to reduce greenhouse gas emissions, and to minimize total cost to the taxpayer by maximizing economic and financial benefits, including beneficial reuse of resources and generation of offsetting revenue. I encourage you to continue to work closely with the Ministry of Environment, Regional En nmental Protection staff through the next stage of this project. 7cly, I , c'"" v Barry Penner Minister • • • Board of Health Wow Business .Agenda Item #17., 1 Nurse Family Partners(ip • Annual2lpdate .august 21, Zoog Jefferson County Public Health — Planned Performance Measures 2009 FAMILY SUPPORT ItuDGET/PRoGRAm: Community Health: Family Support Programs aternal Child Health(MCH) including newborn follow-up, Child Birth education and Breast Feeding Support, Maternity Support Services (MSS)/Infant Case Management,Nurse-Family Partnership (NFP), Children with Special Health Care Needs(CSHCN), Women Infants and Children(WIC), and the Child Protective Services (CPS) Contract Programs: Early Family Support Services (formerly ARS), Early Intervention Program(EIP), and Passport. MISSION: The mission of the Family Support Program is to offer health education and support to all Jefferson County pregnant women and families with young children as they build a secure foundation for a lifetime of health, learning, and community contribution. The Family Support Team consists of public health nurses, registered dietician, social worker, and support staff. Our goals are: -To honor the diversity of all Jefferson County families with young children. -To support and guide families by building on their strengths in order to create a safe, healthy, and hopeful future for their children. -To collaborate with community partners in our shared goal of improving health, preventing adverse childhood experiences and creating a seamless continuum of services. -To provide high quality services through community assessment, commitment to best practices,professional continuing education and program evaluation. GOALS and OBJECTIVES FOR FY2009: Ilkoal: Improve the quality of caregiving for infants and children through support, education, and intervention for parents and caregivers. Objective: JCPH will offer services to all Jefferson County pregnant women, families, and caregivers of young children through an array of programs designed to fit the diverse and complex needs and risks of each child and family. JCPH will work with staff and families in the schools, child care facilities, health care settings, and in the community. Spanish speaking families will receive interpretive services along with forms and educational materials in Spanish. Goal: Prevent harm to mothers, infants, and families at risk for or affected by maternal depression. Objective: Depression screening and education will be offered to all pregnant and parenting women who are participating in JCPH programs and appropriate referrals will be made for those who have a positive screen. Data will be collected by staff and become part of program evaluation and community assessment. Goal: Encourage and support breastfeeding for optimal nutrition and health for infants and mothers. Objective: Provide education and support to all pregnant women and their families about the benefits of breastfeeding. Each woman's decision on how to feed her baby will be supported. Individual office or home. visits will be offered in addition to the group support of the Breastfeeding Tea Party. Ongoing collaboration with Jefferson Healthcare staff for lactation support will help ensure all families receive the services they need. Goal: Prevent nutritional related health problems for pregnant,post-partum, and breastfeeding women and children under five in Jefferson County. Objective: Provide WIC nutrition education and support to all eligible county women and children. 1 OF 3 4 Goal: Prevent unintended pregnancies. Objective: Assist parents in making goals and plans around family size and child spacing through education • and referrals for birth control. Goal: Improve birth outcomes by preventing birth defects, prematurity, and infant mortality. Promote health and development in children with special health care needs. Objective: Provide education and support to women who are or are planning to be pregnant about potential risks, healthy choices and ways to reduce risks to themselves and their fetus/infant. Screening, referrals,risk reduction, and education will include substance/tobacco use, domestic violence, mental health, and health and nutrition. Provide developmental and health screening of newborns and children to identify children with special health and development needs and assist families in getting further evaluation and intervention services. Staff will collaborate with community providers to ensure quality, comprehensive services for each family. Monitor state collected data on first trimester access to prenatal care. Goal: Address child abuse and neglect through outreach, education, collaboration,prevention, and intervention. Objective: Awareness and assessment of, and prevention and intervention in child abuse/neglect is an integral component of all Family Support Service Programs. Referrals to CPS/DCFS will be made as appropriate and services will be provided to families at risk or involved in child abuse/neglect through the EFSS and EIP contracts. Staff will collaborate closely with other providers to develop a comprehensive plan of care to keep children safe. Staff will engage in clinical supervision, consultation, and professional education to ensure high quality care and staff safety. Goal: Maintain program fidelity, quality, and caseload capacity of the Family Nurse Partnership Program as an evidence based best practice. • Objective: Support the Nurse-Family Partnership program capacity and program fidelity by providing opportunities for ongoing support and education to the nurses through weekly clinical supervision, professional consultation and education and participation in the Washington State Consortium for Nurse-Family Partnership. Program and client data will be collected and analyzed by the national NFP office. Quarterly reports resulting from this analysis will guide JCPH staff in program quality control. Goal: Improve quality of services through collecting and analyzing data on health risks and intervention outcomes. Objective: Continue research based programs such as Nurse Family Partnership (NFP) and Promoting First Relationships while developing technology systems to collect and analyze data on promising programs. Collaborate with state and local agencies in collecting, sharing, analyzing data in program design, delivery, and client/program outcomes. Goal: Increase awareness and support of the Family Support Program mission through community outreach, involvement, and collaboration. Objective: JCPH will continue to engage our community partners in exploring the issues of, and finding solutions to, family and community health issues. We will continue to provide education and information to community groups, agencies, and providers through our website, local newspapers, and community forums. 1110 2 OF 3 PERFORMANCE INDICATORS: 2008 2008 2009 1. Number of depression screenings completed PI 90 ed Projected Planned 2. Number of newborn follow up contacts 0 120 120 90 90 • 3. Number of Home and Office visits provided by Family 1150 Support Staff in all programs. 1100 1100 4. Families served annually in Family-Nurse Partnership 20 20 5. Total number of women infants and children served by 870 20 WIC in Jefferson County(from CIMS report) 850 850 6. Number of children with special health care needs Birth 40 through age 18 referred for Public Health Nurse Case 40 40 Management. 7. Number of families served through CPS/DSHS contract. 20 50 50 Discussion: Due to Federal cutbacks, JCPH had a 100%elimination of funds in our Children with Special Health Care Needs (CSHCN)program that targeted prevention services for children birth to three. The annual budget was $25,000 but was heavily leveraged. First Steps revenue is down 20% due to reduced reimbursement rates. We are experiencing a significant increase in the EFSS/EIP (CPS)program caseload and reimbursement. The contract increase covers approximately a .7 FTE PHN. The record high referral rate and complexity of the cases has necessitated increased staffing in these programs including more visits requiring 2 PHN's and a significant increase in collateral contacts and cross agency collaboration. NFP has a full caseload and remains without stable and adequate funding. We remain committed to NFP as a very high priority prevention program. Our Satellite clinics in Quilcene and Chimacum are being heavily utilized. Currently approximately 35 families AN•e served at each site. Utilization has increased as families have increasing financial stress. IIPVe continue to work down one PHN position. We have been unable to nurse. Based on our years of work in the community with a broad spectrum of familnd ies we feel quite attract alified concerned about the very high level of stress families are coping with while they also face an astounding lack of real resources. We have seen an increase in food insecurity as housing and transportation/energy costs increase. We also have seen a huge increase in incidence and severity of methamphetamine use in women and teens. Jefferson County has the highest rate in the state of grandparents raising their grandchildren. These families are struggling to meet the complex needs of their grandchildren with virtually no funding or community resources. JCPH has no funding source to serve this population group. June 26, 2008 i 3 OF 3 r.. • • s Washington State Institute for Public Policy 110 Fifth Avenue Southeast, Suite 214• PO Box 40999• Olympia, WA 98504-0999• (360)586-2677• FAX (360)586-2793 July 2008 EVIDENCE-BASED PROGRAMS TO PREVENT CHILDREN FROM ENTERING AND REMAINING IN THE CHILD WELFARE SYSTEM: BENEFITS AND COSTS FOR WASHINGTON Child abuse and neglect and the out-of-home placement of youth are concerns to both Summary policymakers and society at large. As a result, The Washington State Institute for Public Policy was the 2007 Washington State Legislature directed by the 2007 Washington Legislature to estimate directed the Washington State Institute for whether"evidence-based" programs and policies can Public Policy (Institute) to . . . "reduce the likelihood of children entering and remaining study evidence-based, cost- in the child welfare system, including both prevention and intervention programs." In this report, we study three effective programs and policies to basic questions. Is there credible evidence that specific reduce the likelihood of children programs"work"to improve these outcomes? If so, do entering and remaining in the child benefits outweigh program costs? Finally, what would be welfare system, including both the total net gain to Washington if these evidence-based prevention and intervention programs.' programs were implemented more widely? • This report presents our findings. The "bottom Methods We conducted a systematic review of all research line" goal of the study is to provide policy information to the legislature on well-researched evidence we could locate to identify what works to improve child welfare outcomes. We found and analyzed and cost-beneficial programs and policies that 74 rigorous comparison group evaluations of programs can improve key child welfare outcomes. and policies, most of which were conducted in the United States. We then estimated the monetary value of the We begin by providing background information benefits to Washington if these programs were on the child welfare system in the state of implemented in the state. We examined factors such as reduced child welfare system expenditures, reduced Washington. We then briefly explain the costs to the victims of child maltreatment, and other long- methods we use to determine which programs and policies are effective and we describe our term outcomes to participants and taxpayers, such as approach to measuring costs and benefits. improved educational and labor market performance, and Next, we present results for individual lower criminal activity. programs and policies as well as estimates of Findings the impact on Washington State if a "portfolio" 1) Some evidence-based programs work, some do of cost-effective programs were to be not. We reviewed credible research evidence and implemented more widely. found a number of specific programs and policies that can produce statistically significant improvements in Suggested citation for this report: key child welfare outcomes. Stephanie Lee,Steve Aos,and Mama Miller.(2008). 2) The economics look attractive. Among the Evidence-based programs to prevent children from entering successful programs, we found several that can and remaining in the child welfare system:Benefits and costs for Washington. Olympia:Washington State Institute for generate long-term monetary benefits well in excess Public Policy,Document No.08-07-3901. of program costs. For additional information on this study, contact 3) The potential for Washington appears significant. Stephanie Lee at(360)586-3951 or slee a(�wsipp.wa.gov We estimated the statewide benefits of implementing • an expanded portfolio of evidence-based programs. We found that after five years of implementing such a strategy, Washington would receive long-term net SHB 1128,Chapter 522,§202(17),Laws of 2007. benefits between $317 and $493 million (of which $6 1 million to$62 million would be net taxpayer benefits). Background care for and parent their own children safely, and to provide quality care and permanent • In 2003, the Washington State Legislature directed families for children in partnership with the Institute to conduct a broad review of prevention parents and kin, Tribes, foster parents and and early intervention programs related to youth.2 communities.4 Our 2004 report found that some prevention and early intervention programs can produce positive Before presenting the results of our current study, returns to taxpayers, while others fail to generate we highlight several "big-picture" statistics on more benefits than costs. Washington's child welfare system. The 2004 study reviewed programs that impacted a In Washington State, in fiscal year 2007: wide array of outcomes, including rates of violence ✓ There were 1,566,400 children under age 18 and crime, teen substance abuse, teen pregnancy, living in Washington teen suicide attempts, educational outcomes, and child abuse and neglect. ✓ 42,300 children under age 18 were referred to the Children's Administration and accepted for The 2007 Legislature directed the Institute to update investigation.6 This is 2.7 percent of Washington and extend our previous findings regarding programs State's child population. that specifically focus on preventing involvement, or V After a referral is accepted for investigation by the further involvement, of children and families in the Children's Administration, some children are then child welfare system. placed in out-of-home care. In 2007, about 7,500 The majority of children in the child welfare system children were placed in out-of-home care at least are referred for reasons of suspected child abuse or once. neglect. Preventing abuse and neglect can lead a V On any given day during the year, the better quality of life for children and lower child Children's Administration estimates that 10,000 welfare system use. In addition, research evidence children were living in out-of-home care in the that we review in this study (see Appendix B) shows custody of the state: that children who are abused or neglected are more • Of these, just over a third were living with • likely than their non-abused or non-neglected relatives. counterparts to experience other negative outcomes • About two-thirds were living with non-relative later in their lives. Abused and neglected children foster families or other state-sponsored experience reduced rates of high school graduation, arrangements. greater criminality, lower standardized test scores, increased grade repetition in grades K through 12, About 2,500 children were in formal increased teenage pregnancy, and increased guardianships overseen by the Children's substance abuse. Administration. Guardianships are considered "permanent" placements, so they are not included The legislative directive for this study is to find in the "out-of-home" care numbers. tested and effective policies and programs that V In 2007, the Children's Administration estimates address the involvement of children and families in that 7,200 children left out-of-home care. They the child welfare system.3 report that: • 4,630 children were reunified with their The Child Welfare System in Washington State: biological parents; A Statistical Snapshot • 1,283 were adopted; The mission of the Children's Administration of the • 394 were placed in new guardianships, and; Washington State Department of Social and Health • 808 had "other" exits, which include those Services is . . . who reached age 18, those with a transfer of custody, those with no exit reason, and a . . . first to protect abused and neglected very small proportion that died. children, to support the efforts of families to 2 4 Washington State Department of Social and Health Services,Children's S.Aos, R. Lieb,J. Mayfield,M. Miller,&A.Pennucci.(2004). Administration.<http://www1.dshs.wa.gov/ca/general/index.asp> Benefits and costs of prevention and early intervention programs for s youth.Olympia:Washington State Institute for Public Policy, Total child population(ages 0 to 17)in Washington State in 2007 • Document No.04-07-3901. Available at: according to the November 2007 Forecast of the Office of Financial //www.wsi Management(OFM .Available at: <htt p: pp.wa.gov/pub.asp?docid=04-07-3901>. <http://www.ofm.wa)gov/pop/stfc/stfc2007/stfc2007.xls> 3 The funding for this study was provided by the 2007 Legislature 6 This is an unduplicated number of children. Washington with$50,000 of state funds and$100,000 of matching funds from Department of Social and Health Services(2008).2007 Children's Casey Family Programs. Administration Performance Report. Olympia,WA:Author. <http://www1.dshs.wa.gov/CA/pubs/2007perfrm.asp> 2 What are the characteristics common to There appear to be five broad characteristics effective programs? shared among the majority of these effective • programs. Unlike some other policy areas, there are very few interventions related to child welfare that have 1) Targeted populations. Successful programs been rigorously evaluated multiple times. This tend to be targeted toward a specific group of lack of well-researched programs makes it difficult people who might be expected to benefit the to statistically generalize conclusions about why most from the services provided. For some programs work and others do not." example, the Nurse Family Partnership (NFP) Therefore, while we could not conduct a formal targets low-income, first-time, unmarried analysis of program factors at this time, the mothers; trials of NFP with other populations characteristics listed below are those that we have not been successful. observed most frequently in our readings of the 2) Intensive services. Programs with strong evaluations of effective programs. While we offer impacts on child welfare outcomes tend to these as tentative observations, we recommend a provide intensive services, meaning a high more formal statistical analysis be conducted as number of service hours, often coupled with a an important next step in this process. requirement for a high level of engagement that from participants. For example, the In this review, we found some programs Homebuilders®model of intensive family showed a significant reduction in either child preservation services provides 24-hour staff abuse and neglect or out-of-home placements. availability to families in crisis, small staff Without considering the cost of program caseloads, home-based counseling and implementation, the following programs showed services, and short program duration (four to statistically significant reductions in at least one of six weeks) with a high number of service the two key child welfare outcomes above: hours. • Chicago Child Parent Centers (IL) 3) A focus on behavior. The effective • Family Assessment Response (MN) programs on our list are likely to take a • Healthy Families America behavioral approach (as opposed to an • Intensive Family Preservation Services instructional approach), such as coaching • (Homebuilders® model) parents one-on-one during play sessions with their children as in Parent-Child Interaction • Nurse Family Partnership Therapy (PCIT). This observation is • Other Home Visiting Programs for At-Risk consistent with studies of psychosocial Mothers and Children interventions; one meta-analysis of • Parent Child Interaction Therapy (OK) psychotherapeutic treatments for children Structured Decision Making (MI) concluded that"Behavioral treatments proved • more effective than non-behavioral treatments • Triple-P Positive Parenting Program (SC) regardless of client age, therapist experience, In addition, the following programs showed or treated problem."18 statistically reliable evidence of increasing 4) Inclusion of both parents and children. placement permanency and/or stability measures Many of these successful programs take an approach that acknowledges the central role for children placed out-of-home: DependencyDrugCourts (CA, NV, NY) of the parent-child relationship in child • outcomes. For example, in addition to PCIT, • Intensive Family Preservation Services the Chicago CPCs focus on educating pre- (Homebuilders® model) school age children and preparing them for • Intensive Case Management for kindergarten, but the Centers also work with Emotionally Disturbed and/or Maltreated parents to increase positive involvement and Youth healthy interaction with their children. • Project KEEP 5) Program fidelity. Several of the successful • Subsidized Guardianship programs on our list have demonstrated the Structured Decision Making (MI) importance of maintaining adherence to the • program model. For example, an earlier i "With a larger database,a formal meta-analysis could be 18 J.R.Weisz, B.Weiss, M.D.Alicke,&M.L. Klotz.(1987). undertaken to database, those or fal met that lyem to influence Effectiveness of psychotherapy with children and adolescents:A program effectiveness. meta-analysis for clinicians. Journal of Consulting and Clinical Psychology. 55(4):542-549. 13 • Exhibit 3 • Evidence-Based Options for Reducing Involvement in the Child Welfare System: What Works, and Benefits & Costs SECTION 1: BENEFITS Benefits (Per Participant,Present Value,2007 Dollars) Washington State Institute for Public Policy Estimates as of July 2008 Benefits to Benefits to Benefits to Total Program Taxpayers Others Benefits PREVENTION PROGRAMS Participants Chicago Child Parent Centers $13,427 $12,041 $13,692 $39,160 Nurse Family Partnership for Low-Income Families Parents as Teachers $8,936 $8,112 $9,938 $26,986 Other Home Visiting for At-Risk Mothers and Children see descri tion, 16 $3,153 $1,403 $794 $5,350 ( Healthy Families America p p' ) $2,016 $666 $327 $3,009 Iowa Famil Develo.ment and Self Sufficienc Pros ram $1,697 $520 $220 $2,437 INTERVENTION PROGRAMS $0 $0 $0 $0 Intensive Family Preservation Service Programs(Homebuilders®model)* $2,059 Parent-Child Interaction Therapy(Oklahoma) $4,883 $932 $7,875 $4, Dependency(or Family Treatment)Drug Court(CA, NV,NY) $70404 $1,297 $567 $5,9681 Intensive Case Management for Emotionally Disturbed Youth $1,653 $444 $2,8$0 Other Family Preservation Services(non-Homebuilders®) $0 $0 $0 $0 $0 $0 $0 $0 SAFE Homes Connecticut ADMINISTRATIVE POLICIES $0 $0 $0 $0 Family Assessment Response(Minnesota) $817 Flexible Funding(Title IV-E Waivers in North Carolina and Oregon) $419 $190 $1,425$277 $125 $947 Subsidized Guardianshi. Illinois $50 $0 $0 $ $0 $0 $0 _.. $0.. SECTION 2: PROGRAM COSTS • Washington State Institute for Public Policy Program Costs Costs for Comparison Estimates as of July 2008 (per participant,present Group value. 2007 dollars) (per participant ,present PREVENTION PROGRAMS value,2007 dollars) Nurse Family Partnership for Low-Income Families Chicago Child Parent Centers $8,931 $0 Other Home Visiting for At-Risk Mothers and Children(see description, 16) 5 168 $0 p p. $5,368 $0 Healthy Families America $4,267 Parents as Teachers _.._.._ $0 Iowa Famil Develo.ment and Self Sufficienc Pro.ram^ $3,8$ $8 INTERVENTION PROGRAMS $00 $448 SAFE Homes(Connecticut) $15,631 $9,910 Dependency(or Family Treatment)Drug Court(California) $3,772 _..._. .,.,. Intensive Family Preservation Service Programs(Homebuilders®model)* $3,484 $5 Other Family Preservation Services(non-Homebuilders®) $350 $3,164 Parent-Child Interaction Therapy(Oklahoma) $350 $2,240 Intensive Case Mana.ement for Emotionall Disturbed Youth $1,2$0 $2,120 $0 ADMINISTRATIVE POLICIES Flexible Funding(Title IV-E Waivers in North Carolina and Oregon) $0 Family Assessment Response(Minnesota)^ $9 Subsidized Guardianshi. Illinois^ $3,823 $5,149 ^These programs cost less up front than services as usual $29,773 $34,727 S 10 Exhibit 3(continued) Evidence-Based Options for Reducing Involvement in the Child Welfare System: What Works, and Benefits & Costs • SECTION 3: BENEFITS AND COSTS Total Benefits Washington State Institute for Public Policy Total Benefit-to-Cost Ratio Minus Estimates as of May 2008 (per participant) Costs PREVENTION PROGRAMS (per participant) Chicago Child Parent Centers $4.82 $31,036 Nurse Family Partnership for Low-Income Families $3.02 $18,054 Parents as Teachers $1.39 $1,509 Iowa Family Development and Self Sufficiency Program Not computed $448 Healthy Families America $0.57 —$1,830 Other Home Visiting for At-Risk Mothers and Children(see description,p. 16) INTERVENTION PROGRAMS Intensive Family Preservation Service Programs(Homebuilders®model)* $2.54 $4,775 Parent-Child Interaction Therapy(Oklahoma) $5.93 $4,962 Dependency(or Family Treatment)Drug Court(CA,NV, NY) $0.74 —$970 Intensive Case Management for Emotionally Disturbed Youth Not computed —$2,120 Other Family Preservation Services(non-Homebuilders®) Not computed —$2,814 SAFE Homes(Connecticut) Not computed —$5,721 1,,ADMINISTRAt Poticits Subsidized Guardianship(Illinois) Not computed $4,954 Family Assessment Response(Minnesota) Not computed Flexible Funding(Title IV-E Waivers in North Carolina and Oregon) $2,751 9 ) Not computed $947 SECTION 4: OTHER PROGRAMS FOR WHICH BENEFIT-COST FINDINGS WERE NOT ESTIMATED FOR THIS REPORT Program Comment Abuse-Focused Cognitive Behavioral Therapy(AF-CBT) This program has only one rigorous evaluation that was based on a very small treatment group (n=25). Circle of Security To date,this program has not undergone a rigorous evaluation. Early Hospital Discharge and Intensive In-Home Follow-Up This program has only one rigorous evaluation that was based on a very small treatment group for Low Birthweight Infants(Pennsylvania) (n=39), The authors found no significant effects that we could monetize,although the program itself saves money over standard treatment. Early Intervention Foster Care(MTFC-P) e to This program has only one rigorous evaluation,and we are unable to estimate the cost of its implementation at this time. FamilyConnections(Maryland) ns ft have( �' ) No rigorous evaluations of this program have been published to date,although a randomized trial is currently underway. The Family Connections Study(Canada) This program has only one rigorous evaluation,and we are unable to estimate the cost of its im I�ementation at this time. Familyto Family(New Mexico) We were able to code outcomes for only one evaluation of this program,and we are unable to estimate the cost of its implementation at this time. However,a randomized trial is currently underway. Family Group Conferences This program was evaluated in two very different settings,and we are unable to estimate its cost at this time. Family Group Decision Making(California) This program has only one rigorous evaluation,and Weare unable to estimate the cost of its implementation at this time. Family Therapy This program has only one rigorous evaluation that was based on a very small treatment group r(_118). LEARN(Local Efforts to Address and Reduce Neglect) This program has only one rigorous evaluation,and we are unable to estimate the cost of its implementation at this time. Mockingbird Family Model(Constellations) i No rigorous evaluations of this program have been published to date. Multidimensional Treatment Foster Care(MTFC) Although several evaluations have measured the impact of MTFC on future crime,no evaluations have been published on the program's impact on objective child welfare outcomes. Multisystemic Therapy(MST) Although MST has been evaluated with respect to its effects on crime,child welfare outcomes have not been measured. However,a randomized controlled trial with physically abused adolescents and their families is currentunderway_ Project KEEP This program has only one rigorous evaluation,and we are unable to estimate the cost of its implementation at this time. Project SafeCare/Project 12 Ways Y No rigorous evaluations of this program have been published to date,although a randomized trial is currently underway. Promoting First Relationships No rigorous evaluations of this program have been published to date,although a randomized trial is currently underway. Structured Decision Making(Michigan) This program has only one rigorous evaluation,and we are unable to estimate the cost of its implementation at this time. Triple-P Positive Parenting Partnership(South Carolina) I This program has only one rigorous evaluation,and we are unable to estimate the cost of its I implementation at this time. *We have presented a single benefit-cost analysis for Homebuilders®-style Intensive Family Preservation Service Programs here.In our meta-analytic table,we presented effect size estimates in three ways:(1)for IFPS programs focused on reunification of children already placed out of home,(2)for programs focused on preventing children from being removed from home,and(3)for all IFPS programs. The benefit-cost estimates were nearly identical for the reunification and prevention programs,so we have summarized them here. 11 • s • • Board of Cealth Netiv Business .agenda Item #v, 3 Cyanobacteria (Blue Green .algae) In . Iefferson County Status Report • .august 21, 2008 • fk Y� 3 JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 • www.jeffersoncountypublichealth.org Cyanobacteria/Blue-green Algae Fact Sheet, July 28, 2008 Cyanobacteria (commonly referred to as "blue-green algae") are a diverse family of photosynthetic bacteria with worldwide distribution. Warm temperatures, still waters, and the presence of nutrients (nitrates and phosphates) are known to promote their growth and lead to algae blooms characterized by floating mats of algae ("scum layers"). Five major species of toxin-producing cyanobacteria have been identified: Microcystis aeruginosa, Anabaena circinalis, Anabaena flos-aquae, Aphanizomenon flos-aquae, and Cylindrospermopsis raciborskii. Among these 5 species, about 2/3 of the cyanobacteria sampled produce toxins and the remaining 1/3 are toxin free. Toxins are classified according to whether they have neurotoxic or hepatotoxic effect. In Jefferson County, Microcystis, Anabaena, and Aphanizomenon species have been identified in Lake Anderson, Gibbs, and Leland. Microcystis can produce microcystin toxin, Anabaena can produce microcystin, anatoxin-a, anatoxin-a(S), and saxitoxin, Aphanizomenon can produce anatoxin-a, cylindrospermopsin and saxitoxin. Anatoxin has been detected in Anderson Lake and Gibbs Lake, and microcystin toxin has been found in Lake Leland. • How can people/animals be exposed to cyanobacteria? • Humans or animals can be exposed to cyanobacterial toxins when high concentrations of toxin-producing bacteria are present in lake water. • Health effects can occur when water containing high levels of cyanobacterial toxins is swallowed, toxins contact the skin (as when swimming, wading or showering), or when airborne droplets containing toxins are inhaled (also while swimming, bathing or showering). • Pets that drink from the waters edge (where scum layers accumulate) can be exposed to lethal levels of toxins. Exposure can also occur when dogs have been swimming in an area with an algae bloom and ingest significant amounts of toxins by licking their fur after leaving the water. Please contact Neil Harrington at 360-385-9411 if you have questions. Check our website for Lake Water Quality updates at: http://www.jeffersoncountypublichealth.org • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIESi L�''AYS 11dC�I h�Nt F / . Al�i� NATURAL RESOURCES MAIN: 360-385-9400 MAIN: 360-385-9444 FAX: 360-385-9401 HEALTHIER COMMUNITY FAX:360-385-9401 ,, 4 Cyanobacteria/Blue-green Algae Fact Sheet, July 28, 2008 — page 2 CDC Recommendations • Table 1.Cyanobacterial toxins,effects,signs and symptoms of poisoning,and therapy Toxin Acute effect Signs and Symptoms Therapy Anatoxin-a Neurotoxicity Humans: not documented. Supportive care. Animals: progression of muscle Respiratory support fasciculations, decreased movement, may allow time for abdominal breathing, cyanosis, convulsions, detoxification and respiratory death. recovery. Birds: opisthotonos("s"-shaped neck). Anatoxin-a(s) Neurotoxicity Humans: not documented. Supportive care. Pigs: hypersalivation, mucoid nasal discharge,tremors, fasciculations, ataxia, diarrhea, recumbency. Ducks: regurgitation, paresis, opisthotonos,clonic seizures. Mice: lacrimation, hypersalivation, urination, defecation,death from respiratory arrest. Rats: red-pigmented ears. Cylindrospermopsin Hepatotoxicity, renal Humans: enlarged liver, malaise, Supportive care. toxicity, chromosome anorexia,vomiting, headache. breakage, Mice: huddling, anorexia,slight aneuploidy diarrhea,gasping respiration. Microcystins Hepatotoxicity Humans:elevated gamma-glutamyl Humans: powdered transpeptidase. charcoal,supportive care. Humans, mice:elevated alanine Animals: • aminotransferase. cholestyramine. Rats: embryo lethality, teratogenicity. Mammals:weakness,reluctance to move,anorexia, pallor of extremities and mucous membranes, mental derangement, survivors may be photosensitized. Nodularin Hepatotoxicity Humans: Skin and eye irritation from Supportive care. skin contact. Experimental systems:inhibition of protein phosphatases,tumor-promoter. Saxitoxin, Neurotoxicity Humans: paresthesia and Activated charcoal, neosaxitoxin numbness of lips and mouth within%to 3 artificial respiration. hours after exposure,extending to face, neck, Supportive care. extremities; motor weakness; incoordination; respiratory and muscular paralysis. Animals: incoordination, death by • respiratory failure. Types of illnesses people and animals can get from exposure to cyanobacterial toxins • Getting it on the skin may give people a rash, hives, or skin blisters (especially on the lips and under swimsuits). • Inhaling water droplets from irrigation or water-related recreational activities can cause runny eyes and nose, a sore throat, asthma-like symptoms, or allergic reactions. • Cyanobacteria/Blue-green Algae Fact Sheet, July 28, 2008 — page 3 • Swallowing water that has cyanobacterial toxins in it can cause • o , severe gastroenteritis (including diarrhea and vomiting). o AcuteLiver toxicity (i.e., increased serum levels of liver enzymes). Symptoms of liver poisoning may takes hours or days to show up in people or animals. Symptoms include abdominal pain, diarrhea, and vomiting. o Kidney toxicity. o Neurotoxicity. These symptoms can appear within 15 to 20 minutes after exposure. In dogs, the neurotoxins can cause salivation and other neurologic symptoms, including weakness, staggering, difficulty breathing, convulsions, and death. People may have numb lips, tingling fingers and toes, or they may feel dizzy. Recommendations for Asymptomatic Exposed Patients • If you do swim in water that might have cyanobacteria, rinse off with fresh water as soon as possible. Pay particular attention under bathing suit areas. • If pets (especially dogs) swim in scummy water, rinse them off immediately—do not let them lick the algae (and toxins) off their fur. Pay attention to cleaning their fur when you rinse them off. Use clean water, not the scummy water, to clean them. • Watch for symptoms and report them to your health care provider or Poison Center at 1-800-222-1222. • Sources: http://www.cdc.gov/hab/cyanobacteria/facts.htm http://www.who.int/water sanitation health/resourcesquality/toxicyanbact/en/ http://dhs.wisconsin.gov/eh/Water/fs/Cyanobacteria.pdf http://www.doh.wa.gov/ehp/algae/default.htm • JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 www.jeffersoncountypublichealth.org • July 29, 2008 Dear Lake Leland Resident; Lake Leland continues to have levels of toxin over the recreational and drinking water limits, from a blue-green algae bloom. The toxin present is microcystin which can cause liver damage from repeated exposures. This toxin has also been reported to cause gastrointestinal distress and skin irritation. Jefferson County Public Health (JCPH) is checking the lake weekly for algae and toxin levels. Conditions can change quickly and toxins can form in a short time. We advise you to not drink water from the lake, bathe in it, cook with it, or brush teeth with it. If you currently use lake water in your household, you should stop and switch to bottled water or potable drinking water from another source. Household methods of treating water like boiling, use of faucet filters and/or chlorine bleach do not work. Removal of microcystin from water requires a specialized filtration and disinfection system and equipment available only from water purification professionals. We have posted the following Warning: • Do not drink lake water. Boiling, chlorine, faucet filters will not destroy the toxin. • Avoid visible scums. Algae can concentrate in bright greenish patches or bands, • sometimes looking like a paint spill. These scums can have over a thousand times as much algae. • Do not swim or get water in mouth or nose. Toxins can be absorbed if you swallow the water, and also through the mucous membranes of the mouth and nose. • Do not eat fish from this lake. There is some evidence that toxins can build up in the flesh as well as the organs. • Small children and people with liver problems, such as chronic hepatitis, are most at risk. If you have questions about your water source or using the lake, call 360-385-9444. Our website has current warning levels: http://www.jeffersoncountypublichealth.orq/. Another source of information is the State Department of Health: http://www.doh.wa.gov/ehp/algae/default.htm. Sincerely, °.°".47-2~-'` Tom Locke, MD Health Officer • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES NATURAL RESOURCES MAIN: s 9401 HEALTHIER FOR MAIN: 360-385-9444 FAX: 360-385-9401 Print Story - canada.com network Page 1 of 2 ,ianadacom 18 » 2008 WHERE PERSPECTIVES CONNECT Quebec not coming clean about algae: watchdog BRETT BUNDALE The Gazette Friday, July 18, 2008 Blue-green algae may seem to be under control this summer but that is because the government is camouflaging the truth, said Martine Chatelain, a spokesperson for Eau Secours, an environmental coalition on water issues. "Blue-green algae is still a serious problem, but now we just don't know about it," she said. Quebec's Environment Department decided to "adjust the level of intervention" this summer with a more "targeted" approach and only advise the public of bacteria levels if there is a ban on drinking or swimming. Last year the public was informed and lakes closed whenever a significant amount of blue- green algae blooms appeared. In all, 194 lakes were closed last summer, 83 in 2006 and 45 in 2005. So far this summer only two have been closed: Lac St. Louis in the Mauricie and Lac Bleu in the Monteregie. 110 "It's a camouflage operation. They're hiding the data so they don't hurt tourism or scare people," Chatelain said. A spokesperson for Quebec's Environment Department did not return calls yesterday. Quebec launched a $200-million 10-year blue-green algae plan last fall and "continues to act responsibly to combat blue-green algae," according to a news release this month. Chatelain said she thinks the government has taken some steps in the right direction but that more needs to be done. "It's good that we finally banned phosphates in detergents but it won't go into effect until 2010. We need solutions now," she said. Blue-green algae are a bacteria, known as cyanobacteria, that occur naturally in lakes, said Elena Bennett, assistant professor at McGill University's school of environment and department of natural resource sciences. "But we're definitely making it worse." The blue-green algae explosion is due to a combination of human activity and the right conditions. "It's like a perfect storm," Bennett said. "It occurs when we have a really wet spring, with lots of rainstorms that wash nutrients off the land and into lakes, followed by a hot and humid summer." Lakes surrounded by farmland or cottages often have the most blooms because agriculture • and lawn fertilizers as well as leaking septic tanks feed the bacteria nutrients like nitrogen and phosphorus. "Just like fertilizers make corn and wheat and soybeans grow, it makes the blue-green algae http://www.canada.com/components/print.aspx?id=02d50b 19-82d7-424c-8d3 d-d465b2bb 1... 7/18/2008 print Story - canada.com network Page 2 of 2 grow," Bennett said. Blue-green algae pose a danger to public health because some species of bacteria produce • toxins (like neurotoxins) that can poison the water. "The danger is mostly for children because their bodies are smaller and it's harder for them to process the toxins," Bennett said. Most blue-green algae, however, is not dangerous and some members of the scientific community felt closing nearly 200 lakes last year was an over-reaction, Bennett said. But given that testing bacteria for toxins is expensive and complicated, it is better to err on the side of caution, she said. Quebec should do more to legislate the use of fertilizers and cottage owners should "think twice before putting fertilizers on their lawns and take care of their septic tank," Bennett said. bbundale@thegazette.canwest.com ©The Gazette (Montreal) 2008 CLOSE WINDOW Copyright© 2008 CanWest Interactive, a division of CanWest MediaWorks Publications, Inc.. All rights reserved. CanWest Interactive, a division of CanWest MediaWorks Publications, Inc.. All rights reserved. • • http://www.canada.com/components/print.aspx?id=02d50b 19-82d7-424c-8d3d-d465b2bb 1... 7/18/2008 Board of 3CeaCth Netiv Business .agenda Item #1/., 4 . Tefferson County • Public Health 2009 Budget Planning .august 21, 2008 • 0 JEFFERSON COUNTY PUBLIC HEALTH 2009 DEPARTMENT SUMMARY Jefferson County Public Health (JCPH) provides a wide array of public health and human services. JCPH provides essential programs and services to help protect and improve the health of our community. We are always working to make Jefferson County, Washington, a safer and healthier place to live, work and play. JCPH will continue to focus on different areas in which the community, as a whole, benefits from services provided by JCPH. Focused areas for the Community Health Division include: ❖ Family Support Services offers a number of programs that support families including Women, Infants & Children, maternity support and case management for pregnant high- risk mothers and more. ❖ Communicable Disease provides disease surveillance, investigation and reporting, along with education, and screening. • ❖ Community Support offers a number of programs dealing with population and prevention issues including Child Care, Child Death Review, Health Care Access, Peer Education and School Nursing. ❖ Clinical Community Health offers clinical programs dealing with foot care, family planning and breast and cervical health. ❖ The Developmental Disabilities Division works to assure that citizens with developmental disabilities in Jefferson County have the choice, opportunity and support to achieve full, active, and productive participation in community life. ❖ The Tobacco Prevention and Control Program provides information and education to increase public awareness of harmful effects of cigarette smoking, smokeless tobacco and secondhand smoke. ❖ The Substance Abuse Program provides school and community-based services, literature and lending library materials. • Jefferson County Public Health 2009 Department Summary 1 • Focused areas for the Environmental Health Division include: ❖ Drinking Water programs assures quality drinking water is reasonably available and waterborne diseases are prevented. ❖ Food Safety assures the service of safe food throughout the county and prevents the spread of food borne illness. ❖ Living Environments program inspects and permits pools and spas. ❖ Liquid Waste programs provide education, permitting services for owners of septic systems and certifications for septic system installers, operations and monitoring specialists and septic pumpers. ❖ Solid Waste programs provide enforcement and education of the Washington State and Jefferson County Solid and Hazardous Waste Code and promotes solid waste reduction and recycling outlined in the Jefferson County Comprehensive Solid Waste Management Plan. ❖ Water Quality programs, partnering with the Jefferson County Water Quality • Department, provides education to improve water quality in Hood Canal, Discovery Bay, Mats Mats Bay and Chimacum Creek. JCPH has worked hard to bring value to the general fund dollars it receives by applying for and receiving grants. JCPH will continue to explore funding sources in order to better serve Jefferson County citizens. Looking ahead, JCPH will continue our efforts to make Jefferson County a safe and healthy community for all our residents. • Jefferson County Public Health 2009 Department Summary 2 • JEFFERSON COUNTY PUBLIC HEALTH 2009 BUDGET ASSUMPTIONS Environmental Health fees and permits in the Drinking Water and Liquid Waste programs are projected to be down 50% in 2009. GIS cost will continue to be covered by an operating transfer from the general fund. Union wage increases are reflected in the 2009 Budget. A 3% wage increase for non-union employees has been added to the 2009 Budget. Benefit increases are reflected in the submitted 2009 Budget. The county contribution through operating transfers from the general fund for Substance Abuse Prevention ($48,894), Discovery Bay Grant Match ($55,000), Hood Canal Grant Match ($45,000), and 0 & M Services ($35,000) will remain at the 2008 funding level. • The county contribution for Public Health Services will maintain the 2008 appropriated pp opriated budget level and will be increased in 2009 to cover approximately 75% of the wage and benefit increases. ❖ The Administration Division's budget proposes an operating transfer for 50% of the actual wage and benefit increases due to the inability to collect the majority of its costs in grants. ❖ Environmental Health's budget requests 100% of the wage and benefit increases due to the loss of fee revenue anticipated in 2008 and 2009. ❖ The Community Health Division's budget reflects an operating transfer for 75% of the wage and benefit increase as historic grant funding continues to remain flat with a few being reduced. ❖ 25% of the wage and benefit increases are to be covered by an operating transfer from the general fund for Developmental Disabilities as a portion of salaries and benefits is covered by grants. Additional funding for Solid Waste Enforcement will be acquired in 2008, providing funding through June 2010. This revenue is reflected in the 2009 Budget. • Jefferson County Public Health 2009 Budget Assumptions August 1, 2008 1 • Public Health Emergency Preparedness and Response (PHEPR) federal funding has been reduced, specifically the PAN Flu funding ends in 2008, creating an overall reduction of approximately 40% of the total PHEPR funding. Public Health nurses will decrease attendance in the county emergency exercises. A 10% revenue loss from Department of Health for the Maternal Child Health program is reflected in the 2009 Budget. Family Planning funding, state and federal, are down slightly, but client fees are projected to be higher in 2008 and 2009, balancing the overall funding for this program. HIV Case Management is no longer a service provided by Jefferson County Public Health. Clallam County provides direct service to former JCPH HIV Case Management clients. JCPH continues to provide services to HIV high risk prevention services and testing and counseling. 5930 "Blue Ribbon" funding was allocated by legislators in 2008 to increase the Immunization and Communicable Disease program efficiencies by improving childhood immunization rates and impose communicable disease surveillance and control. The primary focus with 5930 • funding is to evaluate and improve disease reporting, and to promote childhood immunizations. Deliverables are outlined at a state level and revenue is based on actual population. 1 FTE from Community Health is being reassigned to meet these new deliverables. • Jefferson County Public Health 2009 Budget Assumptions August 1, 2008 2 co 0 0 N . 12 • CDCD 7 C N• m = cri Q N st O 3 Q N co > Q RS O cC - V C CD O a) d = Q C (11 cC oCD = 'S0 C w � o) a) o a) I o V N .F o a) ' O rte+ O >, i. d N co N _0 co _N � () Iii jJ a) _ � a�1p E a > o N Q C U a u) (a L 0) v O i >> 41) E R C .N a) ` N ILL .0 U!CtS 1:2 ! O aa //yo�b -a > W Q ' < O co o a) N ,N > ❑ > a < Q • C O *-.7-- E i_ E Q 0,I MIO10'MI M N O i 0 N 0 a 0 1 O 100 1� 0 m ' i ' III I o i l i , i C) 0) CO 0 CY 00 N 4 I I , I I Ql Ol 00 N in I iM co 1�1 I I I I I I 1 1 1� I I CO o .. N — _, oo�- 1 1- ct 000o olo N Ch CO O M M 00 tD i , , O O O O M t0 O 0) u1 m I00 OCr Ct N 'i O 0 u1 LO 0 ' 00 ' t0 N 0 ' ' I i O U M csi I I Ln I 10s--10 m I U ul 001 M 00 N N M 101 d I I I I I I en I I 11L L I I I - _ 1 t T - i ,- m r o i n rn o I 1 1 I o0 r+ o 0 01 N I M Ln �' I I ' 1 I i 1 I t0 lJJ m co m C) tri Ln Crl N �° I I as I cN I a E 0 _Z 0, I of N �, i I 1 � IO , , I CD Q '1" I I ul' �.1 1a I I + 1 I I 1 1 ---- 0 0 m� .4- , t o d' O�o+o O _.. 1 o O .q' CO i o 1 I ..-.-. ' -"- 0 on 0 0 I N I N 01 0 l0 t0 0 O .�-1 1 O O CO t0 O 001 C) O Lmr1 N '0 O O O N l0 U.) l0 c--1 O'...O LI) CD O CT CO l0 C0 O 0 ,-I I O N O = l00 I`Y) N I a 1 1 00 W m c-I Ln co 1 O�oo N O UD N--I Cr) CO VI 1 LU itiN to CT I N CO I 1mi.-i.,1.c-1,�'�'N! CO u1 N. Cr N > 1 t — _I 1 • II I I ,I o 7r 1 I x m o li I �I l 1' I 1 0 I I i 1 1 o I 1 TS 0 1 ci- I C0 03 1 I �I ° w.. O0 ux c ij x 0 co =io o C 0 c aa)) c O 1 p a) in 0 CO '. co C 0 COWo. a) x a) 0 - 5 4- � c O W E — CO O � >, id,Z a co p' COUI X E E , a), <,c' o1— o a? a �' �I0. coU Q a) co o o = 1`0 0 o a v=i co co N j c m _ o = i= a = m y v N U Q v 3 3 0 a) E o o E -0 o ccncn co -0 m0 2 :0 _,-_ C9i= J i10u I-- ma- QUUa. � ppmM Ocnin n I- _1 a LIU r I _ I 1 U a I ) a`�i x C 0 0 0 0 1 0 0 c C C 3 00 "'I m I o zw1 0 U UI U 0'0'0I O 0' CO d I 1 .. I a.!='-oI C C C C C c c I 1 U U', 0 0 0 0 0 0 0 a c I 1 z I a) aL) 1 I 0 0 0 �o O O U 0 �o 0 ,p!�o C c > ' Q 1 u)I 1 1 2 W i z 0 I z z z a) a`) a) Cn U U _ _ _ _ °'. C� 1= .a)i O O O O O O O O ami O)) O aa)) ate) cn co 0 0 m 0 0 0 y 1 _J m 0.00 0 u_ 0 0 0 0 W 0 O W u. 0 Cl 0 0 cc O 0 0 O O O O O O CD 0 CD CD CD 0 0 O _ U = O CD CD.._.... i'.N- .CO O co :(0 COO CO 00 00 0) r CD CD O O O OCD N CD CD CD c0 --.i- - co coN O CO co co co Z0CO CD O H CD x fn y r i z o CD o vi o IT 4m c0 N N N N CO Ln I I` N. _� to 0) rn. Z N .- N I`',, IFI`- CO CD 010)10)I0)IoI� Li) a W.co,co � �'� O' CD M''M1M > • LL 1 w `,.7)1 Z M CO'CO i M!CM M I M I M I M CO CO CO M'CO CO CO CO i M V' V''V' V'• w LLILL 0 0 c7,1,7,--, Ch CO M CO M CO CO CO CO CO CO CO CO CO CO CO CO CO CO a 7 N I I W 1 MIM CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO 1 co Cr) 'm ~ - I I I�', I o N A • 0 N 0 ' N 00 i i Q 00 i i i i i i i i i i i i i 0N1 I i i i i I , 00 O pOp O' V1 M up p 00 N 1 WO 00 co ! ' I1 N O N c0 01100 OI O O 'O O O o, O 01 O 010 O, 00 1 up 0 N LO 0 LO 0 N 0 0 Ill'0 0 0 CO 0 0 0 00 ' ' ' V O N - O M O ' ' ' N , 1'-1 , H-4.1 ' N N m 01 al O M 14 1 N M O Ql N Ol .--1 l0 1 N S ,--I .1 I N cr .-1' Ni �1 I I m m N UI I M e.'--I Ni CO. o 1 1 Pf1 in 1 1 1 1 I I ' 1 00 r. .Ni O O O O m N O N S 'n N l�0 ^' tri N N N• O Oi CT W N\ M c-1 I i I SII I o1 �1 ' I i N i I i �oo j 0 1 tr1in j tot �a 1 1 1 1 I- .--IO N fl O N O N 00C) 00 O N O O Cf7 0 0 0 O O 0 O O O. N Ol 0 0 0 0 0 W d' O 01 N 0 CD 0 N O 0 CO O .1 Ln .i N Lfl 0 0 0 141 u1 O O 00 CO CD 0 0 0 00 A11 CT Vl O Ol 0 Art O N 0 rn O 00 N N s N .1 00 N N N O At I11 I• 01 O rn L.n N - O) p N .-i LA' O 111 M O 0l N 01 .-i Ni Vl CO l0 LI) (-4 N er CO fn N If1 LII U) tri' .--I N 0) 00 D N N CO a�-I .-1 .1 N cr e-1 CO N N N N Cr) 0 .1 0e1 CO Cil .-i .- .-I N `m 1 > I W Cct-- rt r 1 11 I1 o j ,� N 1 a.1 1 I 1 1 1 1 1 1 , I �I I 1 1 ;a I 1 I Ip; 1 I 80 N I 1 1 01 (6 @ C d E O = N' � I �� a' I J = " co Oto a) _)c UG C . " '� Qna c (° °2 Si > U �) a (I) .5 (i) 10 42caCO 8 w E. 0 06 Z o O E N U CO o c v) H c E > U 0 0 .. N O W C O Q m aiS .c to. 0 8 g 0_ 3 , a) > U c WWQ VZi U S CL CL W `� O s w_ a p t- o I-o coo o aci Q O o V 0 a) a+Q_ a-Q U iii'O o f m` O'�lc u Ia -8 . O >' E .c • o U 1 > v) J rn 0 1- � O o � � � CJ t O ._ p p .,... s co U U p � � N 1 U a U m a ' 1 1 1 I � 1 U 1 1 co _ W O cn = y 0) I I TsU 15 o 0 0 U a ; i j 1 I cc c c Y c c. c c c c ami n o o N m lolo' o. o o 0 0 0 0 0 o E o o _c J UiU IU U 0,0,,UIU'U U U, c 0 cn .c cl io m - c c S c C ca c c C' c C C c o E o U U 0 > o os-, 0 o a) 0 0 0 0 0 0 0 0 al c 0 0 0 0 0 v) 0 0 0 0 0 0 0 ' > _c, 0 c c 1 O� O. W W W 2 2 2 2 'pl S S S S S 4? S S 2 S S S S co c ca-) 0 ,O O O v) v) v) co a) v) 0 0 j 0 0 @ 0 0 0 0 0 0 0 c a? F- s '� w Zrt p 0 p p p V) pa p p p co cocoa p 0 p 0 p p U U O- 0 m 0 Y 0 O CC 00 O .O- O O O O NO 0 0 CO CO 0 O 0 0 0 0 0 0 CO CO CO CM 0 0 CO CO CO CO CO 14) 0 N 0 CO CO Cr) CO CO Cr) CO CO CLA MU C 0 0 0 0 0 0 .- N CO I• •- .-- 0p A- N M M co cc) co M t, CO Lo CO 0 0 0 0 0 0 v1 Z •� A- •- A- CO CO CD CD CD CD CD O CO CO W 0) 0) 0) 0) 0) 0) Q) 0) Cr) -) . N . N N N N -X- 0 ._ _ W L co co co •V• V• V vI'a' v- ,a- ,Lt. v 1- v V'V.'V'�'� •d•Iv ',a- N N N N W a 0 0 0 0 0 0 0 0,0 0 0 0 0,0 0 0 0 0 0 0 0 0 0 O 100 CD CO CD CD •M > • LL V' V V 1 4 4 V' V V V V' 4V 4 V' 'V'1 4 V' V V' V' V V 41 V C0 00 00 00 a0 (0 M LU u- 0) CO CO CO CO CO CO M CO M CO M CO CO CO CO CO CO CO CO CO CO M CO CO CO CO CO CO CO CO co O W O co M co co co co co co co co co co co co co I co co co co co co co co co co CO co co co co N 0 N 1 x I i 2 • o N WI IC 1 oo N I it Ln co jo I co I N 0 to N N N O O N Iv n' 00 N 1 0 O r-1 r 1A t\ r r r r , r 1 , • r N O O N 000011 1 ILa m ' Cr CC) V 00 NN a t0 4CIO 00 CP N cr 1 N IN N 1 I m NI N O M M r I I rmi r , I I t0 00 r , r r , I 0 0 O N 2 In ri I .a1 001 I I V 1 -i-I I taO V1 N CI) W 1 In N. N 0 Ln _ , 1 1 I I � I 4 t } l _ - t—t! I g00 O1l'NNo oo Vi 01 o O o O Im o Z r to , , I , 1 ovm CO mI 1vNo0 ryj (V `° rnI 0 '1 I i t1 .-i" '-I N M: oi . N Il 1 'I co I IN ,a, O m O O n 00 N CO O In 1 iO O O O O ct OO m uN O In lD CO 0 0 N CO D M N N 0 0 C0 CT) N 0 N 01 m CT) •--1 0 M 0 CT) - M - lD 00 II Lo N O I-, In 00 CT!o O a, to .-1 '-i Ni- I/) N NiCrl0 N. OO CT •-1 on N ^I N I C O (N .--I Ni N N Co CT M V m ,-1 '-'1 1D N 1 ',cr I N I Ln W I , — — 4 w• } as r+O D o NNy ..ra ` COO) Om c N N Ow !C c!6—'pU OU5 N 'Od ha) ca c . L N= 3 VN Ni0O y I U Y;-c w U �I _C o (T 1 a c 2 m' co 7-Ci a L O NI m 0 ° 0 a) m 0 c I- I = C7 S 2 2 F- 2 In N O «s D mo ` ' o 0 o EcOO o o _—.- 1 —_ o3 a oL oEa 1 E o E E , E, - E E - z E = = o oc o i� > .fl -) 0 : --UwUU >, 5 LUUaa- C -, g1gOL ' (/) a_ f i t W, yI � W U m > L1 LLL 4,4 ILL LLi LL LL — -. Ce c c' c c c O L 7 co 3 m W :� E .. O O O E E E CO 3 y �'� � Ea �,:: c L L L y o 0 0 p_ CL Q Q Q'Q Q,a' n iX c_w c_ou N W I ',.,, w N N N (n w 0 C6 c6 L c0 W Q 1 L N N y y t"/Ll � I d U D Ce o 0 0 o O N A: J: ai L I O ,2 I v°i F- F- f` Z Ll LL LL LL LL W LL LL <L LL LL CO v) O; c . 1 y C7 o COo N CD o ` f o o,o o C9 - 0 O Z al I 0 V < CO CO 00 Z O o 0 I 0 I : __ft __0, • % W N In In , ,cr szrN NO o J -1>11-<1 0 � V V V a Z et L r CVtc) loIo vVvvv .- .-1 -Igooloo Moloo -o W a C N N N N N LL 1 M M IJ Ln O•O OO O o > • LI_ O1 a' ca c0 to cocci rG ai ai ai ai ai ai ai W c\i N: ai W w W _ M (`�') C (( �W., M M M M CC0 M M ' N M M M M = 2 2 2 '1 M ch M V Z I 0 NO C 01 d' I of .i a O c:3 111. U1 01 Ocri t�D CI' N N m 00rnCO CIin oW co ,--I o to tD O '' ' N N to ,JR.1 cr N p 2 m 000 .4 M iri esi m N NV ' 001 M m co LO N .-1 1 i O o u, m 0 I.-i . l .1 O o d''in .--I m N N O O 011.0 0:I IN M M co N 2 Lii m m d' coo m er uJ m o N 1.•1 ia- o .-I .i M CO N tD O!t0 wr I Z . , i N COI .�-I N O N O .-1 o0 01 CJ1 t0 m N o I.0 tD Co N a-1 ID to Q N 01 af1 MN ri I ,---- i1 ' IL ►- O 0 u1 m COI: N tD N CO W 0 0 v .-1 .cr! eti m .-1 0 000, 00 01I M 0I0CD 0) jn Lri CO'm "' 0 CO00 .Q1-�Iv.N 0 I m l la.. 01I tD N M .-I'' M W a' • I W W W W p o d W Z < w N V > Q co c 7 W' X W W 0 W' W � (x> c (n L7 -J J o O c6 0 , < < H C C 0 I- Q LE U (6 N C C' H 8 � o U` 2 u_ W W 0 W f- O oo o 3 J W 2001— I- -J a LU y i U. U L.L. = co 6 c5 C-5 O J m 1 0 0 0 CO w 4- D =L I ! I C CO• CD C >_ >, c c c 0) F— I— I— Z — + 0 I CO I C O O O 1 ZI' x OE -o co --rp — = re w d 0 0 0 > • W o 0 W O M M M n N I i Iili 2 • O coQ ,_ 0 () N • 1,11 — F o' { -4 J I _ co I 1 I 0110 0' l0 0 0 0 0 01010 C)0 0 0 0 0 ol0 01010 0 o 00 1 •1 O• N• O V• O• ID• O'•.C0• 0• 0•.O• V• 0• CO• CD 0• O• Nr:Ln•''(O• 0• •V'•.0• 0 (O O :i ' 00 I� O:co co co r co I` O W ,- N CO I: 0 V Ln V co 1� CO'Ln N N W CO CO CO N 00 N I,- CO (O N CO N N- M (0 V (0 V CO: N. = O:.M CO (0 O O Ln'V CO O CO CO O V Ln O'CO CO V V O M:O O ,r: NI 1 CD V N:.- ,-,N (N .- N1.- •-.N N1•- •- ,-I, I— N I • 1 1 1 I I 1 I CD CD CD CD CD CD r I I 1 � CO OO 1 000000 -- '0 '7' 01(0 OD OD COCD I� CO'OD O I0 CO OD 00 CO N N N CO Ln N '2 I 1 0000000 'CO COO .- co W I N.N N N N ,- ,-i,N'. IO O.O'O O''O O'0 0'. I '0 I t-- O10 O 000 C0 NO V VI I O Z W N.: n co N O) W I- O1 ' ' ' , . . • . 1 , L . . . . 1 . i i . , L 1 . . i , i . I i CO N N CO:4),(D N 0', I I CD, 0 0 O'OD CO CD'N O) (O OD V'' 1 1 W 0 010 O�W CD1CV CD V-'0 O O O O O OV'N O V'O O V CO00 0 CD OV CD CO O O OO.O O CD O O OO O 0 CD O OO V LO QD 000 Cr OO0000 (0 C 00 N N'00 N O):cc; N- O) W 00:00 W 00 N (Ni N N O 00 00 O ,-'r-.. W'N O W N CO N O U') V U) V 00 00 N 0000 CO Q) Q CO N N 00 U) 011T- N 0 W CO CO CO CO N'..0) CO N I,... 00 CO I' (0 N CO N N- 00 CO N'CO N I's M CO Cr (O V00 W N CO ICO Ln 0 -, O DO 00'O'N O).QD CO 1" 000,0000.•- M 00 CD'O 0 1(0''V O O OO CO O V L0'O OO,CO V V O M,O 0'.0.00.0 0 .- O m N .-'N ,- ,- N N NN N .-.N .,- ,-IN N'.. ,- .'N .-- .-- N .- (.4,—.-- ,-- ,--- - - N'.N ,.N'N N a x LU 0_ 0 0 0 0 0 0 0 0 0 0 0 0 0!0'00 010 0 0 0 0 0'0 0 0 0'0 0 0 0 00 0 0 0.0 0'0 0 0'010'010 = 0 0 0 0 0 0 0 0 0 0 0 0 0 l0 0 0,0 0 0 0 0 0 0 0 0 0 0 0 0 0 010 O'LU 0'0 0 0 0 010 0 010 O.UD UD O,V W Ln P..... CD CD O 0 10 Ln N,CO LID N O O N 00 Un O In N O 100 O O,U1 N r- OO O 1,.0.0 0'.Ln O CD OD N W ,VM M -7,N �'.M,M 04,1- ,4- V V'.V M V,N M r) V- V MIN MV,MIMV.1N .- V M M N;N N '..NIV V M V V Q 1 _ I i 1 0 -- • I • I 1 I 1 1 0 t 1 1I 1 I 1 1 I , 1 -O -O 0) N 1 U U ICD 0. O 1 `p I INC , In N Q Q.'. 0 Y CO 'Y_I () Y ( Y I I.: I ! IC.5!1 aoo I 'U U ' ° � °T C N 7 7 C .. ._c 1 EO a) : -a I l 1 i I �', 2 -3c'� _a) L- � Mice 1 . a) us—aa) : a axil 1- N 0c.� cv 15 <4 •- = I= — a _ a) N N ,- - - - = — = Q = = = N — c = = O'° H. N'm m .°'N m m c Q'U) U) C/)'C/)IW U) C',Z Z TL_° -- . 6 Z E Z Z Z Z'1Z `,a E -° z,z N 15 z U of z'E z c Ly-c c: Ni --, - _ - °I2 �: O N1 C= 7 7 CL 0_0 W d 0_ = i LL U LLILL,LL (q 0 W W W W W W1U O i0 J 0 0 0 0 d 0 LL Z 2U 0 0 Z Z 0 H . I 11 11 <, 1 1 j ° N A >, 1LO11 C C IC V 3 c 3' col 1 I = >, a) c N ° ° c ° a) = 1 ° a) a) c mm •3 Z Y L aI c a) ,, Ln L°1 c C ° Y'@ c . c 1•D E ,53 =a) o _c a3i o 6 >,,m W 0 aa) o-o _ .N M y I � � a cm m > � Ya (j = 0 c ,_ cr)— - ? a .cc c• o) @ a) o o � 2 � �'wL o'C .6 d c c 'c L C > > > coQc Y Oc c) •92 2 >'O ' m J N N > > 2 J U = Q D'-_' -°)'� 3 D O '- CO Q N C N L- L- @ .L.. C -O CT= N N .(6 C N N N c s N O` C a) ° T,>.._@ Y .L.. ..., .- C -O M:C Z W , N 0 7 a) M .= L CO CO CO C C C CO 7 7,CO .0 7 N a) f0 CO L0 CO a) 7 L 0 CU N N >r, 7 CO CO LO N C C N 'C N A COULUJQQ (n CONNM.M ell,C0 I>� (00U) O:O >- 00Y U) Q'QN- 0 to m ,�} -)1aCO > CO � . -) . 1 ) -) CO5Y � 00000 > YY2 �, CV CV CO! Olo 0 oO O 00 o O OCO QD 1O O�OO O o,o BOO OO O O O o O 00010.0 C) CD O ~IO,O 1�F0.O X __ u),__ , 0 I O Ln Ln O U) W O M (O I� Ln L0 O O M Ln O '''N O O O L!') M , V N- O OD U V V Nr aD N "crN O I- O • 0) 0 00100 0 0 0 0 0 0 0 0 0 0 Oro O O O O O O O O O O O O O O O O O O O 00.0 CD OD CID CID' N LU 7 O E I 0010 00000 a go � 0 0,0 0 0 0 0 0 N N N N N N N N N N N N N N N N N N N N N N 1N N O O) u.110-. (/) N N N N N N N N N N N N N N N N N N N N N N N N N N N N N.N N N N N N N N N N 0 •- •- : 0 Q' OCO (OWW OWCOI(4 (O (D (000 (O (OWW W (O0W WCID O W W W0OiCO (O (OCO (O (OWW OWCC) j,;I�'I= 0 . LL C Lt) Ln Ln Ln Ln (O Ln to t!) Ln 6() Ln LO (n Ln Ln Ln to Ln to Ln (n Ln Ln in Ln Ln Ln Ln Ln Ln Ln Ln to to Ln u) Ln (() Ln N WO 0 7.,N = 2 000 O M co (o • M N) N 00 O co O•) ON I 0���1.(0 . 0 MN CD U) 000 N000001- (D10 W � 1 CO� ! I(0 N CO O MU) O00 N 0 CO CO 0 CD N- V• (D !co, 000 ! 1 1 N'N O M ,- M0- co .-',r r-r- 0 (O M M OM ODM N _ 1 I((DDM (AChoMM,.N11,U) MU) U0X10) M .,-00M , 0 V M I I co t I0M! 0 0 coO D Ni i i i i i II I i III iIi I iII . i i I i' i 0 N CO ,r ' I I I= O M ,r,r1I N I ' w N ' INN ' O CO � N V CO Co.N- CD'CO 1 I - a 0- R t (D N CO O) CO CO N 1 I I ' I N Z i ' i i e- t- CO Co 6) CD V N- 6 V' V . . . , i . ! . i 1 ( i 0 . 1 . ' i l i l . ( i , . . Ili , ' l . . 1 . ( o 00 O N Co C0 CO I- M M U) I e- I 1 O 0 a) Cb M M Co N '- N N N I'. I I in < J II I- OiOO` __O 0'_. !LOINetCO OD 0- O1 CO Cov; M CO (.0!CO 00 N .- (Dv0 I n coOo 0) 00 O 0) O0 COo ON CO (O wOMO Or CD Ul CD 0 N O 0 CO CO 00 CO O0 (O CD (O N CO O CO CO 000 (00 CO CD 0 CO Co ' (DO000 d• N ((7 O MN ON M0M N00r N OCDMMOM co O) 0 (0NN et () 0N (OCOMf- (DCO (0Ma (O OD000 (OUC'7M0ni(0O (0 .- 00)(f)NCDU V V' coo O N WMM (0N .- NNN (0 (0ete' V• erNM (OCDMMN (OM (O V• (O (OM .- MMNMetN N m N A a I.1.1 -- - I 1 Y a. 0 0 O N V 0 V t- Cn 0) 0 W ,- 0 (D 0 M 0 (O O V• (0 N (0 0 CON (010 O (V�0 U) M V O• (O• O CO OO N r 0- m V• V O M M C10 0 ,- CO 0 000 et 0 CO V• et. ,- 010) 0 CO 0...0 (O O O o) Co co V) UJ OV• '- per)• ' ( (M n N N CD CO CD V Co.N'N 0 N N CO N CO ci M �I� M N N N CO NEIN M V- N V- N CO N 4111 mlO ! I I I 11 , 1----1 _, 1 1 a t 1 N 1 1 1 ' I ! ! 1 1 1 1 I I I I I I 1 I , I ' I j j 1 , 1 I 1 I I , I 1 1 H I 1 ' v v •a . I l ! 1 00 p'o `CI iO I I o 1 1 1 �U U aa) a), I �Ia o 0 oO o �� 5 2i40U ' aU q .. I N - U re 17,-..mo = t -t2 co c 0 anU c`o � vv W � vWaj c a N 0- > > c 0 a N U U - a < 0,...,0, EY 0 •EO 0O <n (nv -o Z 2 -0ww 0 cc °),W a x1 1 117) w co i5 'c 1- 171.1 o 46 ` m o N m (0 (0 'c Q fn U) U) O CO (n N Z Z ° V '5 -5Z 8 CL E Z Z Z Z 1 Z F .5 E =o Z Z . _ - w 01- N .c -E •c c C o = _ _ _ _ _ _ _ _ = 0 N CD a)'W o = _ _ =,2 N a) o N = =i ._ _ . Z wc� (n f- u oJu U (L (Lu_ cnawwwwwwciaaJ2 '¢ c� aaaan z2vaa = H I w I 1 ' _ I , I I I I I h 'c n I a o j T > 40 mU 0 C_ 3 I co C p 1 1 j,,,: T, N C CO ) CD C _) N = O m S ;C •Zptwa > a� � �''F S =apIY (arc = (Yn '� �i) oI=:ot0 o ('r5 >. Cu d' Q N ami 1 v m m (A '-I N a� c a� m :2- .-a� • t �l y m!p m T p�p r o c ) T — > 0 . 9_,, ,,,,m a'y `- = m a �p w m'> S d1 c Y cn = �'s,o o N c — o p C = Uo QQ 2.- CO O 0O O J Y p 1O coE y c >, mmcccc >' TQ@ = c0 c 412T m NN > > 2JU =1Q W C . C m O ... CO N _ - C O 0.._ _ N _ C 0 . , C , C N O" . 0 ,2) = = = ._ -t _, _ >+ >. _ Z CO - 0 O o 7 0 0 .- c m m m C C C CO 7 7 N .o 7 0 0 m N N m N O L m o N m T 71 N > OZ -, OW > WOONCU W J ¢ ¢ f W -) MJW -) -) MSiY2000 W > YY � M >-'Y y O 000 O (0 (00 (000O (000N (0 (0O0M00 0O (0 (0 (O0000OOOOOOI� O X � � � NNNMMO ((') n � 0000OO .- NM00 (f) � NM 0001 V et er et (O N et O N s- ,- etN M • 12 V C NOO rrNN (O (O NN � .- � � rNCO (OO O Z O O O 000000000000000000000000000000000000 M p E . . . .- . a pC en 0i0 010 0.0 0 w T 7 ' -, N (OOD N:CND (ND (ND CND (No (No CND I CND-CD CD CD CD CD CD CD I CND (No CND CND CN�(ND N CND (ND (ND CNN+(No CNo N (ND (No CNo (No CNo (ND N N N N'N M Woo � � � C7 n (n n n n (n (n n (n,u� (n � � n n � (n (nu) n (n n n n (n n (n n 0 n n ° C°r) U)UD N Q -) c4 S I CI O C C 1 N ( C C C C C i C C ` i a o 0 o N M (0 03 0 v N Co 4110 U) 00 O CO U) N.1 CD; CO CO Co f COI 'CO O,O,C 1,-'11)10/ �10)�(D O''C (0 OD CO N- 'CO U)'CO CY CO.Co N O CO'CO '- CODICD ' C o C C C O C CO r- N, CD N'0 Co.CD O CO CD N CD CY NI ',,.= O.Ni co-ILO i0 OD o ,- (O N:cc M,O.�.co-I- I- U) IS N N 0 I !_ I 1 --- I I O M O O 0) CO 00 00) OD O N- r- 1 CO Co CD CY CD 00 CO C M COO N CA' 1 ' ' ' CI" (1) CD CON . M N 1 , 11111 ). . N- COOO 0) CD N ' . C C C C I C C C C C I C C C CY N N co O (O O) I CO N- N- CO CD CD' CNO 1I I IC � Co Cl . N i�I 1 LO 1 I I ` 1 I 1 i I 1 tD CDO _O CD N_ CTN- ----- N CO COa- CO CO ..- 0) OO �- O' ZC Co CD O Ct N OO O ,- N- N- 1 C C C N N N � � '---- OO '- � O co M O Q 1I 1 1 I t I 1 E CD N-'VD N- O C O C CO I M WI CD U) COO CD N "CV N-- C C CO C N- N. CY O C CD N.- N-- M CD COC O OD W Co O'y- N.- U0 CD CA ‘r CD co N CO'c- OO _ CD CO C M COO N OD N- CO N-- CO U) O CY CO M N C COC0 0 CD CO N CY N N O M O M CO CY CD O CY N COO c- N- r- COO CD CO N O N- U) O M M x- O 00 U) N U) V O 0 O CO N- O CY Co N CO-0 c-CO Co N Co N` O CO Co V O CO N-. NJ CO CD U) O x CO N--CO Co ,- CD CO N�NS CD N- N O m N CD CY CD CD Co Co N U) N c- l- c- x- x- N c- x- x- x- c- a- a- c-- c- c- a- a- N CO .,I 0- X ceO'O O O N N- CO CDC CY I O,CDCONI I a ICY:N-I� V''V'IN O,co n'.a'NSI Nom,010 0'N'CO O V'O CD N'CY O CD LO CO 00 CD Nr OD O CY' N co <-'MICY N'O'N- O OICD CO O;CY co'.c- CD,O 0'� V' CO COIN. CCD ' D c-'CY CD - U) ui 1--: M'O ui Cnu) 00,6 Cr OCO N.: OS h h CO N. N (D 00 CO OO N- - CND O) co 0) O N-. (D CD OCO O) 0)00 0000 CAI N N''N'NI N'..N'r- N.� �x- c- 11 0 ' i r r coill 48 0 ! , • , 1 ' '2 -2 (n N I ,0 '.. p � o C6 .�. 0 c a) N a) I :a O to W d O_ p Y Y t6 U c0 c (oU) Y �, UU S U o p U W ( @ p i_ 0_ 0_U (o o a w El.- -c m c O Q a) •- a) a tl c — o 0- 9 0 0' .0 a c C ._ Q C o_ CO p- 7 7 •- C (n CO U U W - O O (n (n E m Z a) -o n a) a) -o E a) -p �' a�6iCC 2 = _ o a) i- Q (a 0-w co ioQ - a' = Q _ o v — ° O — - o Q 0 Q c 0 c c 0 o 0 — m — ='ZIne M M a E _ _ =, __ Q Z U.°� Z Z (n C, 'H N N N C6 f0 NC Q C_n (!) (n (n (n (n'� ZZ.� 'p 'O 'O Z Z Z Z Z Z O 7 = 0,2 = a52 2 _ op' 0, c U'LL w LL'cn a. Lu w w LUAU w UI, a) O 2,2 2 = 2 O 22 = 222 O N a) a) a zaa CL w (..) co CD _J u c c c a a Q U a a a a a I 1 I I I- I 1 , Q, w''�I Au ZIICY c cZii CD J m I ,. a) p p •- C •C .0 N t - a) 0 N W t c •N ,N Y Y - € O = .311_. M d lI (-) W 1 o O X Y LI Q a)I N'', I V N NCO •- co.o N c a) co C ,N Y C r co N y m >, 3 N t a) c 2 rn .N a'C rn �',o ) CO CL',..1..1.', 2.= I CO.M' a Oi (n w W O� Q 2 Y n p 2 a m V O CO I @'I�'0 0I 7 o Y >- a) o > CO �'.�L co Y m e c c -C c aa) >, >,v N!N =,-C c O Y g c 60 -a c >,— (n 0 m -.. . 'w O C -o w c U p C - N C yI pI,_Ic `-- w w clv p).9,�@,u) •- c N co (,) c �.c � � 'c a) c Z CO CO C C N '- CO CO - CO O 0 7 a) (o - .0 coI Co COI C C C'it 7 j (a CO 7 O OI N CO O (0 a) 7 L 0L000 0 � n (no � coO � m � � (noOMuiOCDOT(DCnY � U � C C) N . CA COO C CO c- Yl- NCD 0 CD ODO 0 U Z O � � � O � O U V N M aO N N N MLM CD CO CO 000LO 0 00 O � -p x x- N N CO CO N N ICO - 7 N CO CO (n O fa CO(O CO CO c- ZC O O O O'CD O OHO O 0 C N N C,C'O O O O O O O'O OHO 0 0 0 O 010 O O O O C3CD0 O O 0- L N O;NO, N N NN N.N.c- N NN NN NIN.N_ ,... -._.._. W N N N N N N N N N CC o___ 0000000000000100000004-0,0,000000 I1CD N N N N N N N W CI- N N'N CO - .., Ni N N N N,N N N N N N N N N N N N NININ N N N N N N N N NIC O rn CD D `n CD CO �I� � Z'`CD �,� COOCD CD CO CO CO CO CO CO CO CD CO CD U))I CD U) ((Only CD CD �,� NN wo I I inl :OI0 0 2 0 CO 01 (I) • OI CO CO m M ~ '-r t i� 10) ,0 0001 I `n o 0 0 0 CO tO N r 0 M (00 COODM N. CO 0' I V 0 0 0 If) IO of LO c0 LO N CO O 0 0) O I(() ' M 1 M (O 0 V' 0 10 0 I ' N O 0 = V' M M N V CO M I N CO �n 0 M r' .- I r N N M O co 0 1 , i l II r co �''I 01 Oi0'0 1 O0I. r vmo - 00 - N N. ' 0 ' ' N ' ) M O, RR ' ' 00) O ' O M 0 Oro r U) r N O M N CO .- , (O O 0) 0) N = r O OD r N w r 0 t nein ] 000000 0'0 . t t I 0' 1 Z i i I I I I i I i 1M ' NU) ^ l0 NA O) O i II r i . ii 0 I • I00 c6,--7,v. N N N CO1 ' N ,II M I CO O I r I I I- (O M IN. V' 0 CO M 0 N C O (O M ''.N I 001010 I O O 0 O O 0 0 0 0 0 0 0 0 1 1 1W CO IU)'N 0 0 CO 0 CO I. 0 V M O I� h10IV IC) 10'0I0IU) 0 0 0 0 0 0 0 0 0 0 0.0 0 I I Vr LO CO (O N CO O) 0 O) O) 0 r CO I CO r N V 0 I ' ICA I(0 N:(O m 00 O) O O) O ' 0 0 N 0 0 0 0 O. 13 r MIM N cY CO ^,0 CO CO (Oe-iN. 'V' i M I0 NIN 0 !V'.c N 0 (0 00, O).O) .- N N M O) 0 r r r r r r r r (fl r r N I CO r I r r I W I V' r r 0 CO CO CO I. CO V N ' CO .- N. CO NC O) no 0) r [f 0) 0 O M to V' IN. M O N r M M CO N W N N. N. N. CO CO 'R N 0 0) N 0 CO IN- CO 0 .- N. 0 -r , , • lAli , I ',. I I ` 2 , 0 o a) O a) I c a H m M o M 6-25s5 C) 0 = (0 W o a 0 0 Z M 'O M Z o a) U � J c =' M E ,,, M E .E -. - 8 � o av oo LL w 8 0 om Ea � (o .°� �' •owc ... =�n = Io CD CO ami o m c C 'C) E LU aU .5 V, 5 SIUrz w 0 - P.. cc oce .y o v o. a) 2v m = CD(0 vW v) Ev) .o.d •ct s :° iv 2 - = - c22 013 - F-I = Q J 03 CO •--. J w J m (E, .0 0,mMA o)V ani (OI0 o c E c = = •° 0 .V = O - . Y',o 4 € C0 4 Q M m o c � Q = � (n Olx e 'v E .5ZZ emZU °(fZ EZv) c F- o a) • 21- - coiJ E 3 0 a)1 1 saa'Iia = o 0 0 2 2 = _ = SOS = o = _ -,a) 0 .caO I O, M MIS f o a,E M LL, z2U2aaZzaaOwtaaaw0''V) F- aOO1- I OF- � < w0 - 0 (nwUJZIO I oI I-( m 0 -J u) U O w 1 ! l U) ',, 11 1 o ` cO 0 2 U N �_ Ce) c c 0 U -0 - c a) a) c N U 3 c o 0 Jm o 0 aa) o o c a) c a Cu 03 CO C "C' mo o m 0 ° co o`o c o (moi w (L 1 o m . Q 0 ate) c v) c o as c a3) M o m o E c o m = M co co a) a) u L -o CL c M J U Q M J o 2 31 6 = i a) a) a) E I W o E CO Z w M M v, rn O Z o I C7 0 >. ro m o - 0 > a) 0)1_c m m Y 0 I a a a 0_ U m o o voi o o ° o o U a o CO oI�,o00b'o`o ooLI)00 - 000 0 .hoo (noo,o as0ooZU -5-C F- Q C oL '� co c D M c U c Q Q = c ='la 2 >- Y > Y al ca o › W > X 0 0 000 O N M (O CO M r �' ti O O O 0) t7 N 1 J ((') O V' 0 V' N (O M 00) 0 -o U C 1- 1- 1- N000000 N N CO'(O Q r CM r N N r r N 0 • '.= 000000000000000'000 00000000000000'000 rr M0 :77477;; ; ;: ; 71-1- 7:1: 17 :47 :277fO NNNNNNNNNNNNNNNNIN r W X �Iy01L NNNNNNNNNNO WN Cl) 00 NNNNN U-110 N N N N N N N N N N 0 :- :- :_. . :_, :_. . .41N = = LU N N N N N N N N N N N N 0 LL 1 cn CO 0 M CO 0 CO CO CO CO O i° (n (n CD GO = _ _ _ _ _ = 0.470 a = 4 i° u(Oi i° (n i° (n (n (n (n (n (CO CO CD CI) CD (n° N - WIo 2222222 22 �2 --),N (n W 4 00',0000l000000000 0 0 0 U) 0 00 00 2 0O'O,OO,Oo00000000 0 o '4) Nr• ON o a O ' ' ' 0000o0ot000u OOOO ' ' ' 0 ' ' O Co ' Co (D (0 NN 07 0 i0 Oa- tOa- Na- OMaa co" a00Ma{ (O N M (00 '110 W Na- a- a- a- a- a- Ma- Na- 0 M • t0 SICD I N _ _ I I c0 T- 010000 0 0 0 0 1 0 0 0 0 0 0 0 0 C 0 0I 000 Co 0 t() 0 CO 0 10010 c0 IA 00 00.10 M Oa 00a ' ' ' O Ill NI- U) a r` 1% LO In NI = a- (.4N0 0 ) 00N M C') I N (O O)0) NN N U a- u") I - ; , ! -_., I I } + 1 1-._}- 1O too 4 �.. O o 0'' o o 0 l 1 0' 000 0 0 00' o 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ' O T- O ' i i T O ' M M aT a 00 000 a•- = a N W `- a- tD to 0 0I 0 0 i0; 00'. I 0 O ^ OA ( NOIzi i i i I i i I i i i i 1 1 1 i 1 i 1 i i I i i i I i Nh N 0 0 a- a- ar Q I- O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O O O t0 N 0 0 O O W 0000a000000O0000000000000 0 t0 ) r� r. 00 00 Ur 00 O M O a o 0 0 o_o cl o ) 0 0 10 O O O o 00 N a o ' ' 00 CM a 0 W 101.0 I,- n C) 0 a- N N O Oa- tea- N a- M 00a- 000 -0') O t0 (D (O 10 O) MN trite MM O - t0 N a- a- � a- a- M a- N a- a- M N a- a- - I 10 N 0- 1 I ' 1 l W -t Y re coal • in o aa) o' > Cl) o a) 1 E c V)i W E c c I,Co _1 0 0 aO) . E M O .- ° E U u Q H w' a) c > N 'c c'op 0 m Epp > ,> E O E .„ u u) c 0 Q c O a L 0 T c a') o �j c m-.7,- -.7.- w u U ac) a c '" c N Z _ O� c w v! a) (n �. a) < < -O c c C E a O Z >' Cl) N �j I- c c m m o E 0 E a) '- c c 1001''Cu I a) n a`) E 0 a) � < W 1 0 � .0 o,w = .Va a)� I 0-1c'a:aa E u u W c EQ O 'cic _co Z. ai0 W e .�_ a' i y O ce 00 ~ ` ' � aa))I aa)) o aa)) U 3 w o Q O a) c0Iaa)) m a 1 I a) oc ' (") � f- - Q HiOLJllIhhI a) Cs _ F al- OI- 1- I- I F=-' (n__ ' Q ° c 0 I W I. c m a to 2 2'21 E c c e rn c U .a .,c ! W N N •- •N l a) N 1 0 N N Z i J E-,\I � ._ O. C Lc O O O 0 map y -O o ` cUU a) I U IN 0 v v �p �p �p Ia a) v) Q T V .Orn ` C -o -oa) O -0 U U U ,a) aL v Q 2p m m = E c t m u1ILL E EIm E c O 0 0 0 > > > m >. a) .- 2 _00) - 00� U =,N Y a � - ()co I,N Y Y a) ._ y.,(0 J H E E a) Z x .0.'@ Y 0 0 0 CC � U (n�O:Y Y _� O � L.Ia O ?' 0 E E co a) co W v) � � cn v) UU12Qa a v) v) � (YUtY'IY }- 0 0000 I- I- v, C O OO 0 O t0 I-- O 0 01a- O NN UI N,N Co N_O 0 CO NI _ O O O - O O 0 U N N N (I) a CD I� O) o O I N a- a- .- �� I # ¢ 0 N N i .M. 'O • U N -.-- N (NN N'N O O O O O 0Jo 1,- .,—,- ,- ).- ,-- )-., ,—,- ,)-- v- )- � ,--- a- a a p E a as aarvvvvva'aavarararaavva'ara Varary v Za a L1J re E 01010000000000000,010,000 Z N W 0 0.0.010 010 OO J O) a N N N N N CO 00 00 CO CO O CO CO 00 00 00 CO CO 00 CO :J w. .- O - �, .r, O ry UD (D CO UD CO m CO m 0 UD UD CO UD UD (O UD CO (0 UD o > > o � j W • 0 WIC u� (mtn n � tntn to to Lc) to n n nuoUr> ntn n in Lo 0 22 Q2 ) 2 N SIN 1 ; i Q O0 LO 000'O 0 M CD CO F.3 N CD .- N. t) OC�o °' 1N a O 0 CO CO �- a CD h fD N. M CO Cr") N M co O O (O a- r N of (O N 0r) (p 0 M N tom') M co O co O 00000 N N V 00 e! CO N- Co V1N 1 MN .�' op 0 0 CO 0 0 e- 0 0 O 0 CID (O N. CO N. 0 O M N V ' V 0 CO M N.I. ' ' M ' M Cl.(() N O ' ' N. n N - - CO et : ' U) 0 _ NINOMICCO0ai e- ~ � a- M(D COO CO U X11 1 to e- 'et N et r 1 I 1 _It 1OOOOOI CO CO COO (D ON L. OF N- CO O M M e-i 1 � CD0IDO0 0 0 MCD CO V V V O CO CD PO co V ' N 'Nc- N'V O, ' et ' ' et MN ' U) NO .- C) - V.0 OD e- 00000 N = VIN NIS O; coco (O .- F- .r- M Ci N-.N NIN N N N VI CO1 W N N N U")', I e• MOM 00000 0 0 OO CDOCONONN h 0 .Z N- O N ' ' 0 CO CO 01. O ' ' ' O MN ' ' ' ' CD COO N. M N (NO N ' I e�- O O '.� OV NMS M e- N .- i e- V a O (n N ,-- N CD CA N 0 1 I M CO UJ N O N 0 0 CO - O 0 M O 0 CD N.M. �_ I- I-- M CD O Co O U) CO N 0 CD 0 N- N M C) N C) O) COV O ll) N CO - O) N I V V c- U' ao (O N C)) M O CO 27 M (O M CO aD co p O N (°) (A O (0 CO CD 0 .-M 0) c-- CA (Ni-N N- co O C) (O N N M of V 'Q e- O D V V et CO O CO e- N M CO N .- CO .- M N N CA I 0 NCO j N N N N O) a : I M . IX 1 I I 11 ILI 2 u) 0 7 O Q 0 1 0 CD I 1 1 I I Q W iii a co j u'a LL a) u) CD • Q D t N m LL a) rn v 2 2 v,l I 17 I O Iw I o Z 7 .. I n - - c N •E IOi I LL N d i C C O C N (9 Ce W �Im WI c oZ �I'- Ow t,p o c m W u) cV,'Z, c (D o .6 a • m;- Z , I ..n a Z E N a' c Z 11-1Z .,.-=_ d 0 o 1j7 = C0 l7i dl o t=i o w(L) o E (oi N=i X m �' c rn y N n V t7i :a o a) %I co U 1 > o a o'o 0 2 W m U) m .c c rn0 o c = o W fn J a) W c t',U a) IU X W J Z E O a a) N - fn N .>.''LL Z a) N C ~ ill./ a)1 110, i I i r • F- J�' ot) m a tg -o E 'c c ctZ • Z •UI IJilio o"— III I C9m _ >IU _ _ F- U( I-- co, F- 1 a' ! j j I ' W ..' 11 SI I I I o) I i 8 � � � � � � � � w 7 U) CO CO CO U) CO w w w w CO) C N i 'J m 7 7 7 7 7 7 0111 000000 ' 5 0 0 0 N .+ p (n to U) U) LO 0U)) 0) U) U) 7 a� N (on Wu) voi (°)n I vi uoi coi u) voi 0) N 1 U U C C C C C C Q d I a a I.- O a U a 0 (a 0) CO CO CO CO CO C) N 'o v v v F. o c v Q a)I a) a).a) o a) (Da) a a C C C COCOCO CO CO C) Z c C C C Q J 7 C W J J J J `1\'J J h 0 42 )C N m v) N v) w (n v) �/) a) a) a) a) Z c E o y c c c C c c c c OW _ 5 g � 2g2 2 W cIc c c OAU Q � � � � NY � � � p.z N V as C � N O O (f) O (p 0 (f) 0 0 0 0 1O�N N NSI IW CO 0.0..N 0 �.(O (OO I .._,_ -- X 0 0 11 7 W V V 0Flue 0 M — 000001 r• � Cc t , Q - - OrnOrn 0ol� rnrn, . -.O to � 0 X z ZOOOOI = = c- .-I V OO) OC () (� rnlrn 0 O ,_ Zvvvvvvll O 0 0 i o O o O Z. _ - +.. Z 0 LU R, 0 _� - o .- N0 1 rn W d O: CO CD W = CD ._. .. .. .. W:N N N CD LL - :_. '._. W. N N 17 '._. ._. .«. �. Et N 0 UH O) Z (C) 0 V 7 tC) 7 7 7 W co co co:,.co W C.7 7 CC O O 7 7 7 o W °i o W'oI h � � � � � �; I.&j 222222 ZI �1N1 z Z1 I z z ? 1 I I IC) 1 I -I ) o . iC) UI a d co o 0 N N 0 M CO N 0 0 M co co0 co Co C0 A iI� 1 IO W V Tr 0 NID' DI o 1 1 OI r T 1 1 1 1 0 O i n N _ M m W N I I I ' H- i-- O 0 Ir. et o Z 0' ' ' o 0co in O 1 13 N N CO In Q I LU 0i ) CO eA- N 0 O LO O e- N'�., ,m N N N x LU Y Ce cn I- ce LL D U' O I * 2 1 , - i 1 W 0 z 5 a m 0 z i n •iii -a LL W u_ z Z Z LL t 0 a co 'ii c w Lu I L_ J J j I CO 0 I- I- I 1+- a 0 o' O- JI— �, W'd c c'c. _ COCm CO To To U "0 m m m J v -o -ol c c c CO �I LULL LL d d C, W Z Z ? W I J Ce Ct �,.._ f--- < 0X00. N U ca m "5-"< O dH' 2000; p 0_ ix m .4. 000w u_ 0) 2 0 0 0 0 ` W 0 o in Ln Ln _ 0 CV N LI • JEFFERSON COUNTY PUBLIC HEALTH •.. 2009 Revenue Detail ...7..„..„...„,....,,...:...,..,..,... .7 wus.,vv, fists .w s,..: .. .. -w.; ti t^;ur 's: -. Federal Grants Taxes 635,021 State Grants 41,423 15.86% 945,589 1.03% ' « k• 23.62% Intergovernmental 170,761 General Fund Revenue 4.26% 1,114,853 ``-„ 27.84% Fee for Service 729,357 18.22% g,µ % Interfun. :. . Misc. Service Revenue,Contributions 355,435 11,590 8.88% 0.29% II JEFFERSON COUNTY PUBLIC HEALTH 2009 Expense Detail £ 2,506,176 62.53% ..+u Supplies -''; .......-..„*,,,.,4.k.....,41..... , 143,450 . Y .` : a ,, .., 3.58% G'' A _ .. _ .,........ ... ...,. ... , „. ,........,., ... . , . . ., .... ... ,, . . ,. ..,, ..., ..".„ . . Tools&Equip Int Rents&I. 4,500 234,352 v',. 5.85% 0.11% Prof Svcs 526,890 Int Comm&Prof Svcs 13.15% 251,805 Miscellaneous 6.28% 40,345 Communication 1.01% Insurance Travel 12,875 Advertising 43,235 8,250 10,950 0.32% • 1.08% 0.21% 0.27%o0 • 0 0 o 0 0 0 0 0 0 0 o O 0o '-n o o� 0m N nj c-1 :1598.c'''' o ul o I i 1 01 O o __I i Q H W 6L v _ E E m O . LL o p v a c� v . *% • o O v v V 4'' m o �� N Z 06 N O m CC LLJ U. A U. bC O O N 0 • z CC V) W Z = < V)Z w CC Z CC uJ 1- a Q C9 U- 0 O F- IN ■ I ii- . 00 4:r Cr W I, = m U I I -J W CCI I.- I- W . r • Z2 O Z W o O O . I3C Cil ''''''L4:1:17'v.'.::41..1?-.4*.:-_, -" U. N W ,s ',, ,kms`,. &. tt '1,1,VA. - ., • a -4- CV V W O Jefferson County Public Health 2009 FTE Revenue Source Division Detail ADMINISTRATION • FTE=7.18 0.14 a Grants ■Fees Other a County GF ENVIRONMENTAL HEALTH FTE=10.50 ■Grants •Fees IN Other e County GF • COMMUNITY HEALTH FTE=18.75 •Grants •Fees Other 0.36 •County GF DEVELOPMENTAL DISABILITIES FTE=1.05 0.02 •Grants •Fees • Other ■County GF 8 4:26 PM JEFFERSON COUNTY PUBLIC HEALTH BUDGET/PROGRAM: Public Health • MISSION: To protect the health of all Jefferson County residents by promoting safe,healthy, communities and environments. REVENUE: 2006 2007 2008 2008 2009 Actual Actual Adopted Projected Request Restricted Fund Balance: 253,981 246,014 - 246,014 246,014 Beg. Fund Balance 284,024 443,419 - 220,532 357,945 Taxes 37,736 39,651 39,529 40,656 41,423 Federal Grants 627,943 620,306 628,246 582,386 635,021 State Grants 801,607 800,104 1,067,219 1,054,478 945,589 Intergovernmental 151,065 206,293 119,669 173,108 170,761 Fee for Service 821,474 790,600 833,205 708,065 729,357 Misc. Revenue, Contributions 24,971 27,159 12,350 20,959 11,590 Interfund Chg. For Service 198,741 292,225 350,566 390,679 355,435 General Fund Revenue 653,033 605,608 672,937 967,371 1,114,853 Total Revenue 3,854,573 4,071,379 3,723,721 4,404,248 4,607,988 EXPENDITURES: 2006 2007 2008 2008 2009 Actual Actual Adopted Projected Request Wages& Benefits 2,044,228 2,145,616 2,345,543 2,205,772 2,489,616 Supplies 197,402 135,624 189,979 145,372 143,450 0 Tool &Equipment 18,812 24,513 13,666 10,014 4,500 Professional Services 464,898 582,829 561,986 626,541 526,890 Communication 5,330 18,452 16,549 17,414 12,875 Advertising 14,331 22,832 13,800 10,685 10,950 Travel 23,149 14,849 18,358 7,846 8,250 Machinery& Equipment - 27,000 17,226 - Operating Rents& Leases 3,320 10,330 Insurance 43,929 48,935 43,235 40,735 43,235 Miscellaneous 52,746 100,880 46,460 51,051 40,345 Interfund Comm& Prof Svcs - 224,424 222,763 251,805 Interfund Rents&Leases 197,639 227,276 238,200 228,645 234,352 Interfund Payment for Svcs 124,006 223,499 276,918 216,224 224,843 Sub-Total Expenditures 3,189,790 3,555,635 4,016,118 3,800,288 3,991,111 Adjustment (24,649) 48,837 - - Required Fund Balance 246,014 246,014 246,014 246,014 246,014 Total Expenditures 3,411,155 3,850,486 4,262,132 4,046,302 4,237,125 Balance Forward 443,418 220,893 (538,411) 357,946 370,863 STAFFING: 2006 2007 2008 2008 2009 Actual Actual Adopted Projected Request Annual Hours FTE's 76,340 79,656 81,312 79,291 78,248 36.70 38.15 38.79 37.83 37.48 • JEFFERSON COUNTY WATER QUALITY DEPARTMENT • 2009 Revenue Detail Federal Grants 224,883 23.90% ;f2 General Fund Revenue 152,440 16.20% Interfund Chrg. For Svcs 243,224 25.85% Intergovernmental 8,000 0.85% " .ss-,py ."..s.,+'�La`..r`vb^Sy '4,a'-SMay, .�n'.ae,:3.4Nvx».'r�y5 y.ti.A#R,dr des w.i✓n ur. h ..b;:. U R; " • ,„ , „„ „ , JEFFERSON COUNTY WATER QUALITY DEPARTMENT 2009 Expense Detail Supplies 2,150 0.24% Wages&Benefits r ` 430,292 48.82% Prof Svcs 310,358 35.21% } list,— —„,--.- • , y • Int Rents&Leases " "� - 42617 4.84% Communication 340 Int Comm&Prof Svcs 0.04% 34079 Miscellaneous 3.87% 53,050 Advertising 6.02%0 Insurance Operating Rents& 2,962 Leases Travel 875 0.34% 4,025 650 0.10% 0.46% 0.07% JEFFERSON COUNTY WATER QUALITY DEPARTMENT Wage/Benefit Cost & County GF Trend Wages&Benefits General Fund Revenue 500,000 450,000 400,000 350,000 300,000 250,000 200,000 • 150,000 100,000 50,000 0 2006 2007 2008 2009 • JEFFERSON COUNTY WATER QUALITY DEPT 2009 FTE = 6.93 Grants Other County GF 1.79 .:° . • Board of Cealth .Media Report .august 21, 2008 • - Jefferson County Public Health July/August 2008 NEWS ARTICLES 1. "Jefferson lakes biotoxin levels remain high,"Peninsula Daily News, July 11th, 2008. 2. "Another lake added to toxins list,"Peninsula Daily News, July 13th, 2008. 3. "Bat scratch puts woman in hospital,"Peninsula Daily News, July 16th, 2008. 4. "Jefferson OKs funding for land buy,"Peninsula Daily News,July 16th, 2008. 5. "Conservation Futures money awarded to Finnriver,Tarboo,"Port Townsend Leader,July 17th 2008. 6. "Crocker Lake is contaminated by toxic algae,"Port Townsend Leader, July 17th, 2008. 7. "Apparently no end to poisonous lakes,"Port Townsend Leader,July 17th, 2008. 8. "Swimming holes closed,"Port Townsend Leader, July 17th,2008. 9. "Rabies detected in bat in Ozette area,"Port Townsend Leader,July 17th, 2008. 10. "Guarding against HPV,cervical cancer," Port Townsend Leader,July 17th, 2008. 11. "Public Health always working for a safer and healthier Jefferson," Port Townsend Leader, July 17th, 2008. 12. "Immunization clinics set Tuesdays,Thursdays in PT,"Peninsula Daily News, July 20th, 2008. 13. "Urgent injection of cash,"Peninsula Daily News,July 22"d, 2008. 14. "Vaccinations... Plan ahead for back-to-school needs,"Port Townsend Leader, July 24th, 2008. 15. "Algae still a lake problem,"Port Townsend Leader, July 24th, 2008. 16. "Toxic warning issued for clams,crabs,"Peninsula Daily News,July 30th, 2008. • 17. "Tobacco prevention T-shirt winners lauded,"Port Townsend Leader, July 30th, 2008. 18. "World Breastfeeding Week celebrated,"Port Townsend Leader,July 30th, 2008. 19. "Lake algae is still a health hazard,"Port Townsend Leader,July 30th, 2008. 20. "PT Bay,Marrowstone beaches are closed to public shellfish gathering: crabbing is OK,"Port Townsend Leader online,July 30th, 2008. 21. "Is Peninsula going batty over bats?"Peninsula Daily News, August 13th. 2008. 22. "Use caution with bats to prevent rabies,"Port Townsend Leader, August 13th, 2008. 23. "Sports physicals offered at PT,Chimacum schools,"Port Townsend Leader, August 13th,2008. 24. "Algae is still a problem for lakes,"Port Townsend Leader, August 13th, 2008. • Jefferson lakes • biotoxin levels remain high No algae blooms evels of toxic blue are reported in green algae remain Clallam County elevated at Anderson Lake, Lake Leland and PENINSULA DAILY NEWS Gibbs and Tarboo lakes. PORT TOWNSEND — Test results of samples from in in contact with four Jefferson County lakes g show that biotoxin levels are the water. unchanged from last week, a Anderson Lake State Park, county environmental health near Port Hadlock, remains official said Thursday. open for recreational uses out- Levels of toxic blue-green side the lake. algae remain elevated at Users of Gibbs Lake, near Anderson Lake, Lake Leland Chimacum, and Lake Leland, and Gibbs and Tarboo lakes. north of Quilcene, should not Anderson Lake was closed drink lake water, swim in the three weeks ago to boating. lake, or consume fish from County Environmental them. • Health Director Andrew Moderate blooms of poten Shogren warned against corn- tially toxic blue-green algae are present in Tarboo Lake. Lake water is not safe to drink. It can be used recreation- ally, if small children and pets stay out of the water, and if fish caught for consumption are cleaned in fresh water with the organs and skin discarded. 41f/ No toxic blue-green algae has been reported in Clallam County lakes,said Tom Locke, 0( Y M P 1I C health officer for Clallam and 1.�, i Jefferson counties. RAFT $C KAYAK Clallam County officials do not test for the toxins.Instead, they monitor lakes by visual River Rafting a inspections. Blue-green algae can pro- Sea Kayaking - duce anatoxin-a, which can cause liver damage or nerve 111111(l1�PQ1111C1 impairment. To report an algae bloom in Olympic National Palk a lake in Jefferson County that f01'over 2t)years: is not already listed, phone 3 Public Health at 360-385- 9444. 360.452. 1443 In Clallam County, the Environmental Health office . 123 Lake Aldwell Rd., PA . can be reached at 360-417- www,RaftandKa ak.com 2258. 7/er aei V1 G, 4) T �' c >>•6 0.3 : , 8 tom.. C 3 C 8. o 111! . u 3 � ro 8 N 4 \vim0 G ` .D 8.D y3 Y -vNLC� fs a M cw — . .. w.,_- ,, Y MEM a 3' = 3'3`0`a L \ L •T J J ^ • L_ 'Z C c .r 1 f ^ � c ^ c L a 3 (1) OG d T d f E C 51 ' c9 c 3' A L 4 L L• a0 c.my G L c y °p L(J Ca CUi¢ 8 c c E w a@° x,-2 c 3w¢ 8 7 a ■INIIM .3 U !I !UH O acio > °Y >a . m , s a y • m c u c Elma 3 " oa c a ° a ° or [ v t -� 1 6 , ,.. w „.1.0 E w y E ° ^ , O cc•° 0SE-E, c y m ) h,-. ; SLE c z - GL J J— t. v. y 7,.E y L a y 9 > ; a= c• L E i ! iIJ ! :. i L Ec ; °� ccE to c Os !- J L 2 • u a L ,.3 --0 v a: S cr CD 'Es'-5 ,.,...Q N 7 .J3w q G.-. . 3c" L b y T 1:73 > Y gv � BL� > c 3 L c 8 ir; U.Q. .-7x O..]L c C 8 cr OAC. di 9 4A 1 1 81;8 N 1M. d* co m� 1-w, ez� acs a ° p 0� f4 03 :1,k5,..2 l' .`.s ;3-c▪V.:,...▪...... . ci ° E 2g1� ° jJP Uto ',;').0 • Nc' a ` (1/ .�d 85 •od pmE5 � E.� °S a ^S a c • d CDt.cc° ac_L? �� O d °03t�+' qgb ° °�tc a E a c j� = L �• ' ler •g.G ait°7'�eo g Pi! o'CUvcG ` B � milg R ' ml, p r o Ifi °imit W •L °. ? 8 ,:; QT�jao 0. 1,9cyr06 3 07 L vi w a ,,, 03 L c7 U L., v �1 L ,N y y1Ii �qq � e "�' 3It OLL�'a 3 Lxx la C 6 8 �Ed6y5 1E ggn 424•'� ▪ a _ ^ _thY .� G U.- aY JL^ := ^ ccc LIM > .. G:' C .� .Q :J L'Z' a. 7 LU ctl for Sc L. 0J ai) ,f1t..3 C 'l L J` Y L MC O O` t U x 2 3 a Z z, J c"° •' cO iwMG ELL 0 C Q1J, z3 a > c V. 0G- - • C '-Ua G j 14C + ; - >.cr 7- V � 1:▪ f) 8:5 PENINSULA DAILY NEWS Bat scratch • puts woman in hospital Park visitor to park employees went to get i,it was nota d being treated The stfo Health Depathe bat. ment lab found that the bat had rabies. for rabiesThe woman did exactly the right thing,Locke said. She separated herself from BY PAIGE DICKERSON the bat as soon as possible and PENINSULA DAILY NEWS sought help that resulted in OLYMPIC NATIONAL the being captured for test- ing. PARK — A Seattle-area Anyone observing unusual woman is undergoing preven- or aggressive behavior among tative rabies treatment after park wildlife,including bats or she was scratched by a rabid other mammals that approach bat near the Ozette Camp- or appear fearless of humans, ground last week. should inform a park ranger as Three Olympic National soon as possible,Maynes said. Park employees who retrieved "It's time for us to do the bat on Wednesday also are another education push on undergoing preventative treat- this,"Locke said. ment, said Olympic National He stressed three things: Park spokeswoman Barb •Vaccinate pets, especially Maynes. cats—who are likely to play No one was bitten by the with dead or dying bats. bat,she said. ■Avoid bats that are behav- Maynes said she didn't ing abnormally,including flap- know the name of the 55-year in on the • old Seattle-area woman who flap- ping ground or attack- was bitten, and she did not ing people. identify the park employees. II Treat apparent exposure This marks the second time like a bite. Don't release the in the past 12 months that a bat. Health authorities will rabid bat has been found in the test it. North Olympic Peninsula,said Bats also helpful Dr. Tom Locke, Clallam and Jefferson County health offi- It's important to remember cer. • that although bats can carry "This should not at all be disease, they are also helpful, surprising,"he said. Locke said. "We've known for decades "They are very desirable to that bats have been the reser- have because they help control voir for rabies in Washington insect populations and other state. ' reasons to balance the ecosys- "What we have to remem- tern,"he said. ber is that rabies is about 100 "But when people need to percent fatal in humans,but it get worried is if they see a bat is also about 100 percent pre- that is acting oddly—writhing ventable if we know about it on the ground or being aggres- and can start the vaccination sive, because bats tend to be process,"he said. very shy and not come out all Bat scratch that often." Any contact with a bat The bat alighted on the should be reported. woman at dusk,and when she "We love to test the bats and knocked it to the ground, it find out they are not rabid scratched her,Maynes said; because they you know that Rabies is contracted the person has nothing to through the saliva, either worry about,"Locke said. through a bite or through con- He added that information tact with the mucous mem- about bats and rabies will be branes of the eyes or mouth, posted on the Web sites for However, because bats' both Clallam County, teeth are tiny and often it is www.clallam.net/health difficult to tell whether a bite services,and Jefferson County, . has occurred, the scratch is www.j e f f e r s o n c o u n t y being treated as if it were a publichealth.org. bite,Maynes said. Phone Jefferson County After the woman knocked Public Health at 360-385-9400, the bat to the ground,it didn't and Clallam County Health move. Services at 360-417-2274. "It was still there in the morning,so she thought it was Reporter Paige Dickerson can be P/ITT N dead,"Maynes said. reached at 360-417-3535 or paige. "But'when she reported it dickersonopeninsuiadairynews.com. 1//L'/ i.:J. i.' J92 a I'J:fti,�4�.�i. ... (j' .}NYf�w(ri; ,e.r 9I `I1 !,v/'N '�.1.. efiferson • OKs fundin for : land buy BY JEFF CHEW to the fund. PENINSULA DAILY NEWS For 2007, the conservation PORT TOWNSEND—Jef- futures levy rate is 4.75 cents per $1,000 of'assessed valua- ferson County commissioners tion. The levy raised more on Monday gave the nod to use than$180,000 in 2007. county conservationfutures The county's 'contribution funds to preserve the 33-acre to the Finnriver Farm conser- Finnriver Farm and conserve vatiori easement will be 24 acres of the Tarboo Creek matched by, grants from the watershed. Washington State Farmland Commissioners Phil John- Protection program and the son, D-Port Townsend, and Federal Farm and Ranchland David Sullivan, D-Cape Protection program, plus corn- George, dedicated $207,500 in munity fund-raising. conservation futures'funds to Jefferson Land Trust is the Finnriver, an apple and blue- applicant and sponsor. berry farm off Barn Swallow The.Tarboo Creek Conser- Road in Center Valley,south of vation Project off Dabob Road • Chimacum, to protect it`as a in the Tarboo Valley would be farm in perpetuity matched by a' grant from the Watershed purchase U.S. Fish & Wildlife Service National Coastal Wetlands The commissioners also -Conservation. . program, dedicated$7;500 toward a pur- according to county docu- chase'of part of the creek's . menta.' watershed north of Quilcene. The Northwests Watershed Commissioner John Austin, Institute is the applicant and D-Port Ludlow, was absent stiOnsor. from Monday's meeting. The; county .Cpnservation u. Jefferson County Editor Jeff Chew Futures Oversight Committee can be reached at 360-385-2335 or recommends the county Jeff,.chew@peninsuladailynews.com. expenditures: The county commissioners. established the conservation. Futures Fund by ordinance iri 2002. All properties,,whether in the city or county,'contribute • /c'/N - -• x, ct $c mttCpp..'v�a. . u n> g c v�-' �> [z c Z • ` >b °. ° ° Ee . Eo >°avcDQ -' c3E u4 0so ac! f4' i8 . o ° a a 3 `1S , 'EC - , i:p:nhijliljl;iv or� 2r . cE ' E vQ c.caynic = yLC�T � rEi •o °eCOe •s 2Opi2' g ° 4 w cg 2.vi eo 77*; • ±, OCuNaL 1o Oo ° U o v Ns' 1 � ' C L > O tE �oEoc v ° °n '.P > v c4E0oco"0' ° ° c cws ft ' g .rz $ a E € ° E 54 $ w L o ° E vmg Er- 0 A 2'5u P 9 C s u EN =.i .` r ; P-Txt. - „ 4 p u a v .N m w cA= 3 ` u c 5 Cov g ° c Ni a u c, r 3 Z• +Ks 'E } 'E-01:111.47'..: E' uOLro'' uc..c 5 " 'Eg a+ g sEc oapv$ S Pd.ds _ 3 5 3 E" s "‘?"':'..4 t�' f*. • id; : fit'r q :: u 3 L v aua Qa 3 o $vp U Z`3 U Q = E w.ev V a ..” 1,:14,41;!, 7 >.`o u w 3 �� c •I.y_;'ti<<..e. m.• } y 7_>. ,F .tt .Ys�~ '" . � •>1 :C..,. ., - �. .2. ° c F ,Oc3:o3oE v 4 .. - o? N .J .cY5c, aR � =k $ C 4a07Yµ. { yM oY u cComeoo -v0 ac�at � + .S y,,P:-/- 't' i1] « rv5uc v v,0 m § n; L`N VV v 2_ d� tl i•p d C J ,p u LE 4_RSay 4 k�? i 3 'sr -.• E7 cFDavc •DfuLy>V"' y 1° E-Nvyg 4,r:- s- "o0 i' Z o.'rx} }l eiI t f `tT el ^ N E : us c e a s0 22 ° .. o o w a ' -.22'o c 4J��' S 3. N l i .• i. Y1E u EN Lg mO oU i o 4 g u aV 9 o--554;,----,,,,.; yy K 3r' _ c ° c -- - 5 7° 8 54 . 3 - e>'1.' 5 w u ?� c _ Ef ^a nT. � r v ° uat3> d F }° 8. " o. p ° E ° .oE' �i $ ; �nLpCvuuE ° p; °' � a Oro 15C ac`= _e N °m c 2 5 c F c m c uv e, $ ° c L «z '''5'...J.14'; ' i . ,.t ".tic r 5 voa caa a c , 3scf• E o«°;. 8 s ° >'onuulis � i', :hEc Eau-'' c'o E ` 5 5r ° o " c 0= > E=vi -a.< a T `°1 r �r ` v ` ° .2 o a•v R L gNcom a'-g • 3 8. < -i "ihx. - - " 4. Z ' c ig o ` a,=: ,, 5c ° cc "b ft....cgt..; ` u 7 L 5 "0 ` o •o ° u c $3 . a aii#. zF ` t t anroc4 ,.. 5,o ,a 4 E.c, wao ',k' 4 1Aicc ` O 0o ra = U V :n a o ie x ` ..^ a '"+ ° . ?.B40*LL LLA3Ac yr, eu " § Ugc1I1h1ILIfI11I1IIII1 i5woot a tJv> _ a -J `` x , ' En � illh:IjHi 9vu^A ' t 1uN� w 1LUcDv ='t f. .o£ aYt 'ANd •.-.: �F4,. e tq44t� �K« y g� C sL �Ls dN1vw> C3u o�C4EcL a� 1 1o -' °�1 u* "y�f t �ti � If�i� 4 C vv � o .� yv ° oUE 5� 1Aa �E8 ° U u 2:2.i ��"' � � '0lAY, `A�y' g o � 51 "UA0E vcEooGii« u O - 40L O '�` "'r . A.y � ...4.t e �� � � .� � v V c o y r u« o µv ti� yvcc aa� ) pF ° N Lr.VF� te1? '-"-: :--`$-1\ ;/! � 44"?4 'l'a'vu 10 ` C E ' g g , y�yov 040 '15A-8 r. 3,() u U _ oU . « 3o. I ~ Z14� i ,bc', c0 T su vV U w w w�y. r4t +. + e r,;1'.,,,:'• ,eom g .o mL a`u ' o 7A°t u 1e4s �, . .nt 1 ,irSv 1Eo8a :BZW cL° t.5 g1 • imimm 40 • it • 00 8 bil • 88041 44# [ y { . } �v4'' i2N V § z � tV E �`zctG ;:,*".-:,..?1,.,„ - e e avuo V j 3Exo8 ';--. i;.t, + 'S 71.; �,..fef ; 10 i '° o I . a gv3 Q, n` Uu ` Ewl1 1 ,� � nCavS0y > : it a4 , ,g � .tA L!Uh ` r' Z, C. az1"'. O gRy Y2N4.0 pC uH.,-,I ,.‘"4-t,:•-~,- f ` 4,1, 3. � -R d q. c. 1 �, u O C� r if "• 0<k'+f f��f � :: n .°� . � $ gt7� O . •o 13'111 -2I >� Ai ti . ; +M1te '. 5 i.i� '4 ; 4", V t 3 1 53 L A - +••e a ; Ott ► z F T :o 0 ° �iU O3a1 _'° oYF ,'' », ,L gS Tw. p5gsWoi 5"F' t ti ' ti eX` 4"f6Y���" �Y ''''''-',4;1' ,� TFS - o w , "% C u�} y >) Ou E 'CE- Ug c cer t. a rel + f'' pq . DT .-....,,-,...1. 71--,..-:-- -., t .- '. . 4 > i6h . • - pye , g4O° > -• r1 .. - - °: d ff IflflH o `"S0 ot » F cdoH 8 Q ae ..st +4 ' `:it.4s ~ U U c $L• r� O ..„,,;,.,.........i.‘,.-..0: .— o Q Fr � ~ • EC$ etE , . ° a . �l F0� -.0!-,,..0+,-,f. ✓ - rFg �W .� o d 5a N ,.. = .3 .3 v9r = 5 gZ .w- . pm$«t 8 . ot ' R d5 8 r3. pa^ ,2CcE° a°� � 3� u - = C ° iF 2 QC0wg y5 p, 5pyLi "` `L/ oL > cYgm0� d 4p: 5 U p w o'C v 'o .0. .4 u ovu �- _m ou m5mpro•pysgEgpvftCw > rH 5pJaE9$ c4'" cuo�v u iL tCp, o ,vLNn. L vC_ z, EEtc z 7 0 = o tm�yc5v ° Oo � °.Z ,oocoCT a u E c gv 5o id � $ g0 ° 5CnSu �� > ."- ga tfi �tc , Q a°y/1 d F.cc...,), 5 ,.',.3 c,n .�voN° oe 613(3 N2� ° O g v5t.� > t yz6.3 o f. v `� m! 8 o- 3 U! 8. c o 3a g ` 88ran c .1) a o u A `p . vfiv' 3 'a " t il]ritV - ,, " 11 CCi E. • Zrrc 4 1ol d , N _. 9 � 2 505ig o ` -O v4sZwu .og � ❑v EU$' U g r4 ? 0p ^ ^ o � « Sg. � wo � € g �aa fi + ° � m v p v '4'g . v °v o. < aw Cm) Ct F5I w= 9 A ALa ,a`oFu �.5.� � e 0 • Crocker Lake • • is contaminated • byalgaetoxic By Patrick J.Sullivan A. This means the traditional Leader Staff Writer public swimming holes at Leland and Gibbs are closed.Anderson Crocker Lake is the fifth Lake State Park is open, but not freshwater lake in Jefferson the lake. County to be hit with a public The lakes with blue-green health warning due to toxic blue- algae are closed to swimming, green algae. and pets should not be allowed Jefferson County Public Health to drink the water.No fish caught on Friday,July 11,posted a warn- in the lakes should be eaten. ing advising against humans or Tarboo Lake has a caution pets swimming in Crocker Lake label. The lake is not safe for or drinking the water. drinking water. Small children • Crocker Lake,which is along and pets should stay out of the U.S. Highway 101 south of water. Fish caught for consump- Discovery Bay, has been closed tion should be cleaned in fresh permanently for fishing by the water and the organs and skin state Department of Fish and discarded. Wildlife. Teal Lake and Sandy Shore Neil Harrington,county water Lake are reported to be clear as quality manager,said people may of July 7. boat on Crocker Lake,but contact Current lake status and more with the water is not advised. detailed recommendations can Health contamination warn- be found on the Jefferson County ings remain in place at Anderson Public Health website at www. Lake, Gibbs Lake and Lake jeffersoncountypublichealth.org. Leland due to high levels of the (Staff writer Allison Arthur powerful neurotoxin Anatoxin- contributed to this story.) • • P7-.eat 72/�2/oe Apparently no end � top oisonous lakes It now appears to be routine that our lakes are closed to most forms of recreation because of potentially toxic blue-green algae blooms. Crocker Lake on July 11 became the fifth freshwater lake in Jefferson County to be hit with a public health warning due to toxic blue-green algae. The lake has been closed permanently for fishing by the state Department of Fish and Wildlife, and while people may boat on Crocker Lake, contact with the water is not advised. Health contamination warnings remain in place at Anderson Lake, Gibbs Lake and Lake Leland due to high levels of the neurotoxin Anatoxin- A.The lakes with blue-green algae are closed to swimming, and pets should not be allowed to drink the water.No fish caught in the lakes should be eaten. This now annual event is becoming quite troubling.We know algae blooms occur when the weather warms and when high concentrations of nutrients are present in the water. Two important nutrients algae require for growth are phosphorous and nitrogen,and these are found in animal and human waste and in fertilizers. So while pollution is one probable cause, it isn't the only one. In • Lake Erie,non-native zebra mussels are being examined as a possible factor in increased toxic algae blooms. There have even been reports of Saharan Desert dust clouds traveling thousands of miles and fer- tilizing the water off the West Florida coast with iron, which causes blooms of toxic algae. Whatever the cause here, it is a problem that seems to be worsening. The Washington Department of Ecology has a new website tracking outbreaks of toxic algae in state lakes and beaches. It sure would be nice to get a handle on what's feeding all this toxic algae so we could cut off the food supply. It would be nice to get our summer swimming holes and fishing spots back again. • —Fred Obee • /2//3/o2 Pert Townsend&Jefferson County Lead, III ...,,,-- -..-,-,...„:„.„:„...,,,,..., :,....,....,,,,„,,,..,,,,,,,,,,...,,..„.,.,- ..:,--- - - .,...,,,...,„...........,..,,,..,.„...,....„,-,,;... ....•...,v44..t.;+....:,...4.,.. ..',,-,/..",...-.41i,... ...•-•;:v-... . ;: tC y '"r A r n.4,3,4‘,,.'-;t:'..:w r 14 1 ;f s# tt 'A v y�. xt ,ii ,i%. � e s + w��M • x y;�x�uy�t*Ya 1 t + fif lir :fir M �'3,;rnr " S huYbie 'i2 ,4` 6 + V ^� j, T6 � r � �tu 1� $�iw � i'� 1t i V�� j dx �4�rC0114 1 Pr r111..1 a zr° �. 1F4 . .Ak 4Q e1,4 ? �,.r y , 4'� hg6 \ aV nq s yd ' 'T°t4"Ad i ' a Sy ,\ yed r . 7 t u..�..." .... .71. .. ..'^'••-� .??'.s'"'".. k,z Fe.:� it° .� S ' yhfi bx° Ft S�° ��4'w?�r•e5V .!�' Swimming holes closed Jefferson County lakes contaminated with blue green algae Anderson(pictured),Leland,Gibbs and Crocker-are • closed to swimming,and pets should not be allowed to drink the water.No fish caught in these lakes should be eaten.Tarboo Lake has a caution warning.The only freshwater swimming hole still open is at Sandy Shore Lake. Photo byJefferson County Public Health • �/7/off • Rabies detected in bat in Ozette area A 55-year old Seattle area woman is undergoing The only other known case of rabies in Olympic rabies prevention treatment after being scratched National Park was recorded 33 years ago in July by a bat in the Ozette campground in west Clallam 1975,when a child was bitten by a bat in the Elwha County late last week. Three Olympic National Valley. Park employees who responded to the incident are The risk of acquiring rabies is extremely low, also receiving treatment. but the disease is fatal if not treated early after The bat approached the visitor unnoticed while exposure, making it vitally important to treat any she was in her campsite around dusk. When she possible threat of exposure seriously. found the animal, she knocked it to the ground, Anyone observing unusual or aggressive behav- receiving a scratch in the process. The bat was for among park wildlife, including bats or other stunned and remained on the ground in her campsite mammals that approach or appear fearless of until the next morning, when she reported the inci- humans, should inform a park ranger as soon as dent to park employees. The employees removed possible. the bat and packaged it for transport and rabies test- Bats are important and enjoyable parts of the ing.The rabies virus was found in the bat,and pre- Olympic ecosystem, where they are often seen as ventative treatment began for all persons involved. ,they feed on insects after dark.Worldwide,they are "We're very glad that this incident was reported major predators of night-flying insects, including to us and that the people involved are receiv- pests that cost farmers billions of dollars annually. ing treatment," said Olympic National Park More information about bats and rabies expo- . Superintendent Karen Gustin. "Rabies exposure is sure is available at the Centers for Disease Control extremely rare,but it does underscore our standard website, www.cdc.gov/rabies/bats.html, and the precaution—to never approach or allow yourself to National Park Service Public Health Program web- be approached by,a wild animal." site,www.nps.gov/public_health/index.htm. • • Guarding against HPV, cervical cancer . , Recommended Gardasil vaccine helps prevent cervical cancer By Blythe Lawrence since May 2007,but may be just — f . —— — -'-- — Leader Staff Writer starting to go mainstream. Among girls ages 10-15, the 1 HPV V b" the numbers The latest must-have amongst nator at Jefferson County Public Health Department averaged ; i the teen set this season isn't a Health. about 10 doses per month in ( 3 -Number of shots required for the HPV vaccine PradaskirtorGuccibag-it'sthree Some strains can cause genital 2007.McKenzie said.But during pokes in the arm with potentially warts, which can be uncomfort- the past three months,the average { 6-Number of months between the first and last life-saving implications, able but usually not dangerous, has gone up to about 27 doses shot The vaccine is called Garda- Other strains may go completely per month. sib, and although it's been avail- unnoticed. Still other strains can The shots are recommended 33 Maximum number of dollars women 18 and able for less than three years, its cause cervical cancer. Gardasil for girls as young as 9 and as old I younger will pay per shot at the Jefferson County u success rate at preventing infec- protects against two of the most as 26,McKenzie said.It is recom- Health Department tions caused 'four types of gen i- potent cancer-causing strains. mended that girls have the shot 1 (lt)0 Numberot women killed by cervical tal human papiliomavirus tHPb1, "HPV is the roost common before becoming sexually active, some of which can lead to cervi- ST! [sexually transmitted infec- in order to reduce the risk of { cancer per year in the United States cal cancer,has been nothing less tion). and they figure more than contracting HPV at all. ; 10,000-Number of women who develop cervical li than perfect. half of people sexually active will Even it the patient does have. Cance_rp er year in the United States According to literature from be infected with it sometime in HPV, the shots arc still recon- ` the Vaccine Education Center at their lives," McKenzie said.The mended, because it is possible a ; 2,000,000-Number of people in the United States The Children's Hospital of Phila- U.S. Centers for Disease Control woman with HPV has only one who have some strain of HPV, as of 700 delphia, in studies of more than estimates that 20 million people ' strain and can stili be protected 20,000 young women, Gardasil in the United States had HPV in from the three others, McKenzie r _ has been 100 percent effective 2005. said. Those who have had the at preventing infections caused While HPV does not necessar- vaccine are still recommended to by four of the most common ily cause cervical cancer, those have regular pap tests and annual strains of HPV,a virus transmitted who are infected with it are more physicals. Gardasil FAC:6 through sexual contact. likely to get cervical cancer at Although Jefferson County has j'if "Vaccines usually work in some time in their lives. McKen- some of the state's highest rates of , zie said. parents • who choose to sign w'aiv- Q: Should mmore than 95 percent of people, I have.the vaccine if I m not sexually but 100 percent is very unusual,' While the vaccine prevents ers so their children don't have I active? said Jane Kurata, immunization only tour of the 40 or so HPV to receive vaccinations to attend A:If you ever plan on becoming sexually active, coordinator at Jefferson County strains, two of those four are school, Kurata has not seen this the answer is yes.You cannc t get HPV without Public Health. responsible for about 70 percent attitude applied to Gardasil. beingIl sexually active, however. Unlike the human immunode- of cervical cancers.The other two "For most cases, I've been } ficiency onus tHIVI, HPV is not cause about 90 percent of cases really impressed with how ac_cept- necessarily deadly. But cervical of anal and genital warts,one of ing people are.' Kurata said. "It ''{ Q:Can I get HPV if my partner wears a condom? cancer,which can develop from the ways HPV manifests itself. prevents a certain type of cancer. ; A:Yes.The condom does not prevent certain form. some of the roughly 40 HPV Gardasil is a three-dose series Who would not want that for their I of skin-to-skin contact that can transmit i iP1`. strains, is common enough to be of shots given within six months. : daughter?" scary - about 4,000 women in The second dose is given two ' the United States die of it each months after the first,and the third Q: Could I get HPV and/or cervical cancer from year,and another 10,000 develop dose given four months after that �§ the HPV vaccine? it, said Lisa McKenzie, Commu- The vaccine has been available �: a fr A:No.T evaccine is a"killed"vaccine,said Lisa sic tble Disease Program coorcii- at Jefferson County Public Health '.:- `- `�" " 1'' �": Mr_Kenie,t:ommunieal�le.Disease Program coordinator at Jefferson County Public l lealth. _ _.....,,„,,,,.,,,,,.„__,,„. ..,,,,t7.,,,,,,,,,i.:_....„.„,:::.,..,' That means it cannot cause HPV or cervical -..--,-,,,,,,,,f, cancer. -, Q: Do women who have the HPV vaccine need - - to worry about other sexually transmitted " -�' l infections? I A_Yes.The HPV vaccine protects against HPV only. a - 1� 3 Q:Are there side effects to getting the shots? ° 2 A:Some patients complain of pain or tenderness Y x at the injection site a few days atter getting a ', '- ,-" I dose of Gardasil, McKenzie said.There is also - • -� "' -""`- I the possibility of a mild lever during the first few t days as the immune system kic:Ls into gear and if -.- I the body builds up antibodies.Those who are I allergic to 'east should check with their doctors ' := I before having the shots. .t4 Sources Jefferson County Public Health and the Vaccine Education Center at The Children's Jefferson County Public Health has noticed an increase within recent months in the number of women I Hospital or ?1711 ClClpfaia getting vaccinated for human papillomavirus. Submitted photo 6 R 2008 Health&Wetlness - Port Townsend&Jefferson County Lender 411 pTd2ek- J 1//2/0 7 • r1.. _ .' Al',< I":le";4643, s'.•lN,1.M: Of A 5-"i<A- R ANa» • ., y `„"„r/j1 4s„ az,c$rtlE�. JEF ERS t -zr:: ", 4.= • ON'TSTARTUSINGTOBACCO - , . HPVVACCINE Tobaccouse:thenation`snumberonecauseofpreventabledeatht 45 WA youths begin smoking everyday.Surveys of adult smokers in WA State show that PREVENTS CANCER! half of them had first tried cigarettes by age 14,and 70 percent of those were regulars �\ 3 shots canprotectyou against the smokers before theyleft high school*The youngeryou are whenyou start smokingA,- 9 9 Y 9 viruses that cause 70%of Cervical cigarettes,the more likely you are to become strongly addicted to nicotine. - cancer&90%of Genital warts. Jefferson County adults are motivated to quit.76%of everyday adult smokers in Recommended for all girls and Jefferson Countytried toquit smokingfor one or more daysduringthepast 12 months.' _. -�. ; young women ages 9 through 26. Increase your chances of quitting: wer.per 4"'P,...«..aw.. 111111111111111111111111111111 Ft Low cost or free children's vaccine •Call the WA State Quit Line:1-800-Quit-Now 1-80 ...ourr4U Mavailable for ages 9 through 18 on Most effective strategies include: Illailillaiillital a sliding scale. •Talk to your doctor about medication that may help you quit Free vaccine now available for •Seek support through tobacco cessation classes or social low-income women ages 19-26. Learn how to talk to loved ones who smoke: Call Jefferson County Public www.doh.wa.goviTobacco/quitiquit.htm Ar �. Health 360-385-9400 Jefferson County Tobacco Prevention&Control Program 360-385-9417 'Stopping the Safe of Tobacco to lids,WA DOH fact sheet'"Health of Jefferson County DON'T LET ILLNESS RUIN YOUR TRIP! ARE YOU AT RISK FOR HEPATITIS A OR B? Jefferson County Public Health Travel Clinic offers: =; You May Qualify for FREE VACCINE •Vaccines for international travel Have You: •Malaria prevention information •Had more than 1 sex partner in the last 6 months? , •Precautions to avoid travel-related diseases •Injected or snorted street drugs? •Been diagnosed with a sexually transmitted disease See us6toa or Hepatitis C? ` weeks before FREE HEPATITIS C TESTING your trip. .. Many people who are infected don't know it. • Cail for an Risk factors include: ' ` Appointment. •Exposure to someone else's blood - •:,, Insurance •Injecting or snorting street drugs .�, can be billed. •Having sex with someone who has Hepatitis C - 360-385-9400 'Getting tattoos or piercings from a non-professional : ` For more information on testing,call Jefferson County Public Health,360-385-9400. • THE KEY IS EARLY DETECTION THROUGH REGULAR SCREENING TESTS. • k 4§#,, , � �: g ,'''''Alr f mi':-; 3 Breast Cancer is more common in women over 40. Colon Cancer- Over 90%of colon cancer is curable 1 c?J '• However,75%of women with breast cancer are over when caught early.Colon health screenings can find L . ap ,'xe age 50, and remove growths before they develop into cancer. .i F i ' Beginning at age 40._ •Start colon health screenings at age 50. _ r t tt •Have a mammogram(x-ray of the breast)every year. •Find out your family history and discuss this with A / y Have a clinical breast exam hyo hearth care provider your health care provider.You may need to start ��! '''1 4 ° every year: screening tests at an earlier age. • - •Do a breast self-exam every month. - ` �' Regular cervical and colon cancer screening £ CoLCervical Cancer is preventable.The Pap test can find can stop cancer before it starts.Regular main �. ,-.`t cell changes before they become cancer; mograms can fiind cancer when it is the size of aa •Most changes are easily treated. For Women Over SO •Have a Pap every I to 3 years.Ask your health care small Seed Treatment is most provider about how often you need a Pap test, successful at this early stage. ., Have Peace of Mind! Take good care of yourself.Be your own best advocate.Get regular health screenings. Regular cancer screenings can help &cost or ladteflrealth insurance keeps you from getting care Or if You&net have a health care provkierl rail 385'940° you keep healthy as you grow older. and ask about the Washington Breast and(Andra!Health Program.For the Washington Colon Health Program call 1-800-756-5437. Putt Tumuend&Jeffersen Coady Leader 2008 Health&Wellness R t 9 • r2A 7/op Immunizat ion clinics set in PT Tuesdays, Thursdays PENINSULA DAILY NEWS and rubella vaccines; two hepatitis B requirements as PORT TOWNSEND —' chicken pox vaccines or medi- above for kindergarten. cal provider verification of I All other students — Walk-in immunization clinics disease, or a blood test show- Three doses DTaP,DTP or Td, are held at Jefferson County ing immunity to chickenpox. with the last dose on or after Public Health, 615 Sheridan II First grade-One chick- fourth birthday; three polio St.,from 1 p.m.to 4 p.m.Tues- enpox vaccine or a history of vaccines, with last dose on or days and Thursdays. the disease;a parent's report of after fourth birthday; two To make an appointment, disease history; three DTaP doses measles, mumps and or for more information,phone vaccines, with last dose on or rubella; three doses hepatitis 360-385-9400. after fourth birthday; polio, B vaccine. The health department measles, mumps and rubella Hepatitis B vaccine is not says that requirements for and hepatitis B requirements required for high school school vaccinations have as above for kindergarten. seniors, but Centers for Dis- changed since last year. ■ Sixth grade — One ease Control and the health U Kindergarten — Four chickenpox vaccine or a history department recommend that DTaP vaccines,with last dose of the disease;a parent's report all students are immunized. on or after fourth birthday; of disease history; one dose of Chickenpox vaccine is not three polio vaccines, with last Tdap if it has been at least five required for students in most dose on or after fourth birth- years since the last tetanus- grades,but two doses are rec- day; three hepatitis B vac- containing vaccine;polio, mea- ommended by the health cines; two measles, mumps sles, mumps and rubella and department. • • 7/82o%F. +' a C wb O m c p E t0. to >, , aO b m 0.a d o " c - a�")y<ci 0 0 o ti 2 0'1 d • igy!12 v,4g o a a VD y E .0'' 1aZto > w Cl) 0 A.2 R Er. 8 0 A.5'-''k),, c 0 [ 8 as .4 3 6' ° 20 2 3 a-g i.v'-0" ••tea oo ® aa) ad Il °'-' 8 g g 24+'' eljl El f -§ Ea-4q 8i a i °bis- 8 8 c ..,. .a .� < c „” A k _ 1, OA 4~ to g01 >-, O - . o •E,flJ1IUF 5 ec2 O ° G roa � W'm v y a. a a V N p oA 6 m m 0 8 =..5 U "� V,� 5'u 0 ; �.m ° ro w a d o "� Cl) a� 000 = �o o 8:c 0 -a .a m 2v„. as 3$ ?'�nm �- 4° oc� a d 80 +>.o a) 0. 1 - a.S' 3 ai v0 N S:1' U a o o.�3 a) 0 0 0 o o ‘.-.-,T fe 0,•o, ,.... 0 &,,D 0 0.1:4 0 2,1 •R,.... A Eb4 11 t m m > x Gao v 2 o ° 8 g 1j ; a) a.a a 0F+'" 5S r, a a 1-, G •0 w••-, VI m x,o.' d.5 y > 8 o.A.0 Ts 8 8 '''0" y a) y o _ - °) meo aA T Egp.,' °'0 °) a.-t,ac aa7 a ai a m o . .41,5—2 o m w 8 7.-2, • NEI § E 2 i+' - g 1 8 k ta : 0 as �� q0o '`° ao �n �'� 8�°t�: �osv �: x„� ti,.-0 s >bU y� W o.�•� �E. . o d a Iii1 a•0.r w'p RhiHf oID! 1111 o oai a'bo0 ow"mm ° yw% � o ,A ° >,V $. a - aa •° r,' de , .,.. � -0y • g ,.' ° fAM a y,= U�W d Oco miC �O --( 4., co O (`/ � � e C� > • O >,y O .°.V.C . 1. O8 ',.aa^ od � 4)•�o ° � T. .oa1 ° � � a c° be• �MOM 0 N LC. �' p01 'm.0 .' U1 cH 0 G' Oy ° �� O'ty ° >,^ , a 52 >.m � a ,o Mg. > ym .0 0.) a � a-�� �+o oo o ° 0o a 0al) ehtill C13 C'd ,_ .' v 9R9I;q 1040 ‘11# w co..., CI) C) z °0 1.'- -,.>3 3" a... >.. a o av 3 3 E o O `a a d �� d. � a a o > 16 • O I Ca E--- g-go '" " y A •ti M •P.`"b >,v S.•� d a) • 1 ^�l U y . o Ca P. ° `"&`' ;� cV 1 a�Qa ›. m 0 °m)8 .j °.-'y•5 II IMMI O "' >.., mo W A .. 4) Oma^ P®W ?/0102/ Vaccinations . ic :1!ian ahead • - nee s or ac o s c o� As families enjoy warm sum- •Two doses measles, mumps may have,more doses of some Vaccines are available free or mer days, most parents don't &rubella vaccine(MMR) vaccniei thOri aro listed. at low cost for students younger think about back-to-school vac- • Two doses chickenpox vac- Hepatitis B vaccine is not than 19. Ask your healthcare cinations. cine or medical provider verifi- requited fo•r,high,school seniors, provider or Jefferson County But waiting until late August cation of disease, or a blood test ,' bite `tete r-Ve'titera -for Disease Public Health about HPV, hepa- to get children's shots can leave showing immunity to chicken- Control (C'1)C) and Jefferson titis A and meningococcal vac- parents and students facing long pox. This is a new requirement County Public Health strongly cines as well as an annual flu waits at the health department or this year. reconunetld-that they be inunu- shot. Meningococcal vaccine is their doctor's office. Jefferson nized,, a1hst,,this'potentially especially important for fresh- County Public Health encour- First grade cancer-catling disease. men entering college. ages parents to get their students' • One dose of chickenpox Chickenpox vaccine is not Jefferson County Public shots early to avoid the rush. vaccine or a history of the dis- required for``students in most Health has walk-in immuniza- Although exemptions are ease.A parent's report of disease grades, but`two doses are rec- tion clinics every,Tuesday and allowed for medical, religious history is adequate at this grade ommended, especially" for Thursday, 1-4 p.m. at 615 or personal reasons,the best dis- level. teens who.have not yet had the Sheridan St., Port Townsend. ease protection is to make sure • Three doses of DTaP vac- disease. Chickenpox can be a Call 385-9400 for more infor- children have all recommend- cine with the last dose on or after severe disease 'leading to hos- mation. Call your medical pro- ed immunizations, emphasize the fourth birthday pitaliiation in teens and young vider to ask about getting school health department spokesper- • Polio, MMR and hepatitis adults. immunizations by appointment. sons. Children who are not fully B requirements as above for kin- All teens who have not had immunized may be excluded dergarten a tetanus-containing vaccine in from attending school,preschool the past five years are strongly • or childcare if a disease outbreak Sixth grade encouraged toget the Tdap vac- occurs. • One dose of chickenpox cine The requirements for shots vaccine or a history of the dis- Other vaecuies are available for school have changed slightly ease.A parent's report of disease and'ceded for children since last year.Minimum required history is adequate at this grade and tee,by'the`CDC but are not immunizations for the 2008-09 level. 'fotschool attendance. ,._ school year are as follows: • One dose of Tdap if it has been at least five years since the Kindergarten last tetanus-containing vaccine • Four doses of DTaP vaccine • Polio, MMR and hepatitis with the last dose on or after the B requirements as above for kin- fourth birthday dergarten • Three doses of polio vac- cine with the last dose on or after Other students the fourth birthday All other students should •Three doses hepatitis B vac- have had the minimum of: cine • Three doses DTaP, DTP or Td with the last dose on or after the fourth birthday • Three doses polio with the last dose on or after the fourth birthday •Two doses MMR •Three doses hepatitis B vac- cine . These requirements are the III minimum vaccines that school students should have. Children Algae still , a lake problem • There has been no change in The lakes with blue-green dren and pets should stay out Anderson,Leland and Gibbs the number of Jefferson County algae, which contains the pow- of the water. Fish caught for are being sampled each week, lakes put off-limits due to toxic erful neurotoxin -Anatoxin-A, consumption should be cleaned usually on a Monday. Other blue-green algae. are closed to swimming, and in fresh water and the organs public-access lakes in the coun- Jefferson County Public pets should not be allowed to and skin discarded. ty are sampled less frequently, Health has posted a `warning" drink the water.No fish caught Teal Lake and Sandy Shore when visible blooms are seen. advisory against humans or pets in the lakes should be eaten. Lake are reported to be clear as of To report an algae bloom in a swimming or otherwise cora- Tarboo Lake still carries a the report posted July 14. Sandy lake not listed above,call Public ing in contact with the water "caution" label.The lake is not Shore,located just south of State Health at 385-9444. at Crocker Lake, Lake Leland, safe for drinking water,accord- Route 104, is the only viable For more info see www.jef- Gibbs Lake and Anderson Lake. ing to the county. Small chil- freshwater swimming hole. fersoncountypublichealth.org. • prdiadez._ 2/12(7/a loic warning .. .. , dniss.ued for 3a ,. ... 3oiclams crabs • -73 no. nu! risk from crabs, especially'if 9fi:Cl(.4 L ' health guts—also knownas"butter" 3o p —.are consumed. Official advises Although crab meat shows vhi • lower levels of PCBs and lii.against eating .dioxin, it still exceeds levels -ii ' , recommended for unlimited . aii. .,human consumption, Locke ae'FFNixsuia D,unx NEws said. Jd Clallam County Health Further evaluation of the Officer Dr. Tom. Locke on 2006 data continues by the Tuesday advised against con- state Department of Health, wer, uming,.clams'or,crabs from and a final health advisory will ,o Port Angeles.Harbor. 1be issued when the process is Also.Tuesday, state health complete. authorities closed all beaches Locke's order specifically in.Port Townsend Bay,Kilisut says: Harbor,'and Mystery Bay to ■No clams should be har- the.recreational harvest.of vested .from the tidal or shellfish.because.of paralytic marine waters of the Port shellfish poisoning. Angeles Harbor for consump- en' In Port Angeles, tests on tion,primarily because of con- nwhorseclams and Dungeness taminants from sewage that .9 crabs that were collected in overflows during rain storms. autumn 2006 have shown ele- ■ Recreational crab liar- vated levels of polychlorinated venters should avoid consuming .�i,biphenyls — an industrial caughtannD within the rockness or crabs Jni chemical—and dioxin. Flatfish and rockfish .loi As for the Jefferson.County caught within,the Harbor also get,be'destroyed by cooking,(shellfish haiardy`Pokingor cannot may g contain contaminants but r114,freezing. little specific information is The poison produces tin- available. od:gling sensations in the lips and ' The state Department of . mtongue at the outset, spread- Health advises that consump- tion of Puget Sound rockfish bri. In severe cases,it can para- should be limited to one meal diilyze breathing,causing death, per week. - Recreational beaches For other Puget Sound 913 affected by PSP are Fort Fla- seafoods, consumption advice m1gler, Mystery Bay, Old Fort can be found at www.doh. bfLTownsend, Chimacum Beach wa.goulehploehasl/ish/ps.htm Sc(Irondale Co unty Park) and or by phoning 877-486-7316. lo beaches in'Port Townsend and Some places safe stilt Port Hadlock. 1 Dungeness crabs caught in no,From Rayonier waters Freshwater Bay and Dunge- an' The Port Angeles crabs and ness Bay at the same time as 9Jc clams were taken from waters the Rayonier-site sampling surrounding the former Ray- were found to be safe for JE(onier pulp mill site east of the human consumption. -75 downtown area,said.Locke in But in Jefferson County, a RO a written statement. harvest advisory remains for a'fc Both PCBs and dioxin build .Mats Mats Bay and Port Lud- I IS/up tissue and can accu- low for the recreational har- p in vest of all species of shellfish ga'mutate inhumane. due to continuing high levels of Pregnant women can expose children to the`chemi-'�'9f people also"are advised not cals. Mn the womb, and the ,to butter. ...clams -- .which HBs -can produce•learning retain the toxin longer than and behavior problems later in other species — taken from life. the Discovery Bay and Oak PCBs also .can cause Bay areas. immune system effects and For the health status of impaired reproduction, Locke beaches on the Outer Coast said. and all western Washington Dioxin has been found to marine counties, visit cause a wide array of health www.doh.wa.gou and click on problems in animals, includ- "Beach Closures:Shellfish"on ing cancer, and the Environ- the right side of the page. mental Protection Agency lists From there, Web site visi- them among probable causes tors can click on a map to of cancer in humans. check beaches in their areas or III Port Angeles Harbor has click on"NEW: County Beach been closed to commercial and List" for the specific status of recreational clam harvests for locations by county. 77�� years. Clicking on a listed beach �2)/1/ The new data reveals the reveals a map with more possibility of a human health details. 7 \f'Oc g xt r aarxa, �:r,� Ss �reaa� „. 3 f� 7 '. ,,,, ,,,,,,,,,:„ +� �r j ,tea,, �� ��+„,:,,, �,.,,,,, : ` �' ��, � ��j.: . ilikiV\I(‘ k.,))0 .: Ili ., B S me 'r , Cq{ "s°3"j'�`a Cf .� t ®y0.y��”"'y,' "v ` '°,moo '.•'''.. , . , �+,,, ''.�T� :,'s l ,: vi,} • € r .,: ,•:,1,,,,,,%:‘,1,.,¢q• 3§f3.y .nr i< / ., +t.i .r `. 1j,9�'fMit. Winners of the Tobacco Prevention T-Shirt design contest are(from left)Heather King,wearing her"Killing You Heather King's slogan for her Slowly"design,Helen Pilling,tobacco prevention intern and contest organizer,and Emily Rose Strickland,wearing winning design was "Killing You her"Tobacco facts"winning shirt.Both winners display certificates of recognition. Submitted photos Slowly." Tobacco prevention T-shirt winners lauded Heather King and Emily Rose Program, The Boiler Room, & Pilling,the county Public Health shirts are distributed free to Strickland of Port Townsend BaDd Habit Screen Printing and summer intern who coordinated Jefferson Countyyouths at The are the winners of the Tobacco Embroidery. the project. Boiler Room and at Jefferson Prevention T-shirt Design con The local project was The winning designs are being County Public Health. test. inspired by NoStankYou.com, printed by BaDd Habit Screen For additional information King's T-shirt slogan was a Washington state prevention Printing. All other entrants will about tobacco prevention efforts 'Killing You Slowly," and program. receive an iron transfer of their in Jefferson County, contact Strickland's T-shirt featured More than 30 designs were design to put on their own T- Obermeyerat385-9417orkober tobacco facts. submitted,and two winners were shirt. A limited number of the mbenneyo.jefferson.wa.us. The contest was sponsored chosen by public vote. by the Jefferson County Tobacco "I had a lot of fun working Prevention and Control Program on this project. We received so and was aimed at encouraging many great entries it would have county youths ages 12-18 to been impossible to pick a win create and submit tobacco-pre- ner, which is why I was glad vention messages with words or that part was left up to the com- images. munity to decide," said Helen "Across Jefferson County, youths were thinking of tobac co prevention messages," said Karen Ohermeyer of the county Tobacco Prevention and Control • //ee/ei' World Breastfeeding • Week celebrated • Support breastfeeding in lete needs a healthy start in life. the community and celebrate Optimal infant and young child World Breastfeeding Week on feeding are essential for the best Wednesday, Aug. 6 by joining possible growth and develop- _ the Breastfeeding Tea Support ment,experts say. Group for a picnic at Chetzemoka World Breastfeeding Week Park in Port Townsend. celebrations recognize the Bring family, children, importance of supporting moth- friends, neighbors and a lunch ers so they can achieve the to the park at 1 p.m., say offi- gold standard of infant feed- cials at Jefferson County Public ing: breastfeeding exclusively Health, which sponsors the pic- for six months and providing nic in conjunction with La Leche appropriate complementary League. - foods with continued breast- La Leche League in the feeding for up to two years or United States joins organizations beyond. around the world in celebrat- La Leche League advocates ing 2008 World Breastfeeding creating optimal conditions for Week,Aug. 1-7. mothers in several critical areas In conjunction with the of support, including family Olympics in August, "Mother and social networks, healthcare, Support: Going for the Gold" workplace and employment, is this year's theme for World government and legislation, and . Breastfeeding Week. An ath- crisis or emergency response. • ir)jOf�a � g • Lake algae ae is. still a health hazard There has been no change in water. Fish caught for consump- the number of Jefferson County tion should be cleaned in fresh lakes put off-limits due to toxic water and the organs and skin blue-green algae,based on water discarded. quality tests made July 21. Teal Lake and Sandy Shore Jefferson County Public Lake are reported to be clear as of Health has posted a "warning" the report posted July 21. Sandy advisory against humans or pets Shore, located just south of State swimming or otherwise corn- Route 104, is the only viable ing in contact with the water at freshwater swimming hole. Anderson Lake, Lake Leland, To report an algae bloom in a Gibbs Lake and Crocker Lake. lake not listed above,call Public The lakes with blue-green Health at 385-9444. algae, which contain the power- Current lake status and more . ful neurotoxin Anatoxin-A, are detailed recommendations can . closed to swimming, and pets be found on the Public Health should not be allowed to drink website, www.jeffersoncounty- the water. No fish caught in the publichealth.org. lakes should be eaten. Tarboo Lake still carries a "caution" label. The lake is not • safe for drinking water, accord- ing to the county.Small children and pets should stay out of the • 'T0/.-2 r aS- v+;4-1 W 1� � F 4. 9:k�,F,11- 6 b ° 0- $ x The LEADER home'daily news flash:daily news flash July 30,2008 - 7/29/2008 6:38:00 PM Email this article•Print this article PT Bay, Marrowstone beaches are closed to public shellfish gathering; crabbing is OK Marine biotoxins that cause paralytic shellfish poisoning(PSP)have led to the closure of public shellfish gathering on Marrowstone Island, Indian Island and Port Townsend Bay beaches. The Washington State Department of Health ruling on July 29 affects Fort Flagler State Park,Mystery Bay,Old Fort Townsend State Park,Chimacum Beach(Irondale County Park),and beaches in Port Townsend and Port Hadlock. Closure to"all species"means clams(including geoduck),oyster,mussels and other mollusks such as moon snails.These advisories do not apply to shrimp.Crab meat is not known to contain PSP toxin,but the guts can contain unsafe levels.To be safe,clean crab thoroughly and discard the guts("crab butter"). Commercially harvested shellfish are sampled separately,and products on the market should be safe to eat. A harvest advisory remains for Mats Mats Bay and Port Ludlow for the recreational harvest of all species of shellfish due to continuing high levels of PSP found in shellfish samples taken from these areas.Do not eat butter dams from Discovery Bay and Oak Bay areas. Marine biotoxins,such as PSP,are not destroyed by cooking or freezing and can be life-threatening.People can • become ill from eating shellfish contaminated with the naturally occurring marine algae that contain toxins that are harmful to humans. Symptoms of PSP can appear within minutes or hours and usually begin with tingling lips and tongue.The tingling moves to the hands and feet,followed by difficulty breathing and potential death.Anyone experiencing these symptoms should contact a healthcare provider.For extreme reactions call 911. In most cases the algae that contain the toxins cannot be seen and must be detected using laboratory testing. Therefore,recreational shellfish harvesters should check the DOH website at www.doh.wa.gov/ehp/sf/biotoxin.htm or call the DOH Biotoxin Hotline at 800-562-5632 before harvesting shellfish anywhere in Washington state. • a >+C+° aya N. 4 3 0O= 00 00 • ° .O au, pnn m '4&,„.,-41:� � T Y1OVO a°)i � ° III � bn.0R u e a .;° a) 4"_3• S t , - .�y as m +� n .,(;.3-- "z ',,,, �� 2 * 4: a d-o..,°;, iOD 4o.4' Lei +' .... - = L=.4-- , _ Art,„)...,,, .).1 --, _ ;:- -_ 'tre,'1,4fgt.'t'L 0"ice . ,tti; ' �, no 0, t)a o ,. o .. i. O -*- ....,-!-- to**5,*,:!,.".1,',:„.."--- -,T44,,,.ce.r.., .S. ''') , i .,*-4, -7,;,.-1.,%,e'.-'0 4) 0 0 Itt 0.4.,4-4-,9,g; cri m Oo s�y40 rd 2 O l + 0kw—,_. . c„-,,,,,,, ,, xy, .-..%ti +a O •7 rrrncis .---1--, s a R # O • E. -.ia` _ 'tOO V d3 � � r , cete ° Q .a ,,,,....,,, , „,„, t re - - • w -. } i" r" 4"t-I - O`s,,t R4... y3, - r ;3L c. g. • `. - _ f#4. fir lift-4z--' '-'--'-',', ...:.'. -,' .. -,-..,-, ----Z4-. - ; -,,,,: -. -1,'".4, ° g 1 t' 'Ci,„ .44 st , f ht o ° a� a•., b, y o ' - *--, -xi:,,-.- , ' 't '-'•'s '-'no @I':""p 4• - . mv " ami rnaui1 ›' a4)�� a a a' c�i0,4 to 0 0 Cep' 00 ® �� �� �� '�wv° wo• 80' 8 � R a�ia°i ,- a�"i � O,� `�-o = sipor :,-,70:35 t,:ra E-. . E ..) c),c4) O 0,44 14 0tao Oro c 3 ��v 3 0 cg IiiiP .14 E _c, . , th " C N �� �, 'a >, " fix. 0,0404;1 - ° o.a �4.c s.�af„, a� fl .1:2 2 4. co 4.7..4.a•-c1 cp 0 d ,, d•= • cr 0 CO 3a�! w ' at°0 ) 0 0 > +�-° �•aF0a „ a) : 0,. Pcb 0 . $. A 3a' [ °- •� c � � w 0 ViL 7 ° 0 0.,,.2..4. Ef., 9:4 71: >47 °-c J.PI: : a.zate � °� !`� . �S-- 3 '4narq a.•.) a0 a' nb., -jf ...O ai. m rz.'O CI) CO) NA at° 0 C) 1 0,0 p,E°4 0„ce , trJ. ..), a) 00 .+' 0) 0 c4 Z t2 ›, y W ° a'A ° a�iE+IS oa`�i� �'E"' ozwy � • 0 iz to o ° oq -8 '~4 . .0 •> o � aC4" co c0 )• o § ,irl I 1 8 O . ill (*1-112"-. ilu o.oE,1 •!'�4 a7 .0A, § --, p t*".4 ..0 =• a! ' ^484 4-3-•-•tai a ( 13 a:1 o 6 g 8 `)aU • .44 a'0 0.• WyawQ-0 a v OF oabo 6 ,Qw • g 1 o il .1 •j' 8 ��4. .5,Q) � da8'tiq • o +) 0 � 4 r4' .ad . H A•° >2to0 ''x fpoa• U 4 2 os �� US a 3 �..� 111 * 111.ate a' 3 3 $ ?o•,.,. al g .I o ai co ■ ■ " . Wit .. gb t24-� , 401 .a,ta42 S us g �ta �� So. $ - o.� .4 w a� �:.� t 7S. CM tv +, 8' o o;,� • o CC :•, -4.,0.; 2 g m 8'n 4' ; + 8 CIO CA & Fp 8 OSE gg 8 ob '4.) cd.o •-+AE.roa8 4 0.. .35 (9 _.843 . . Use caution . • with bats t 0 prevent rabies Reports of human and pet open wounds or mucous mem- contacts•with bats have been on branes by an infected animal's the increase this summer,reports saliva. In Washington, bats are the Jefferson County Public the animal of most concern for Health Environmental Health rabies—about 7 percent of those Department. tested in the past 20 years were Bats are not aggressive main- rabid, including bats from the mals and generally do not attack Olympic Peninsula. humans, note department offi- Dogs and cats can also get cials, and avoiding bats can pro- rabies, so keep their vaccina- tect people from rabies. tions up to date,recommends the "With hot summer days, department. Call your veterinar- many people are cooling off at ian if your pet has had contact night by leaving doors and win- with a wild animal. If you are dows open. Even with screens, bitten by an animal — wild or bats are able to squeeze through domestic—wash the wound well very small openings and find and call your doctor and the their way into houses, said Dr. health department immediately, Tom Locke,public health officer urge officials. of Jefferson County. • "Rabies exposures can occur Bat behavior when a bat that is infected with Bats can be found throughout rabies is directly handled," he the state;they are not aggressive continued."Any bat that is found animals and most of them don't on the ground, has been caught have rabies.Those seen flying at by a pet, or is found in a house dusk and feeding on insects are might have rabies and should be usually healthy and will avoid avoided." contact with people. However, If you find a bat in your any bat that is flying during the house, call the department at day or appears sick and unable to 385-9444 to discuss the situation fly is more likely to be rabid.All and determine whether the bat wildlife should be avoided and should be tested for rabies. never handled. "It is important that anyone While bats are migrating in who is directly exposed to a bat the spring and fall, they may safely capture the bat sb that it temporarily rest in unusual plac- can be tested,"urged Locke: "If es, such as attics. If you'find the bat is released, there is'no a bat in the house,'the health way to determine whether it was department recommends follow- healthy or rabid." ing these steps: Close the doors and windows to the room, wear Rabies leather or other thick gloves, Rabies is a viral disease that capture the bat in a can or box attacks the central nervous sys- without touching it,seal the con- tem in mammals.Symptoms can tallier and call the health depart- take weeks to months to devel- went. Officials there will help . op, and once the disease has you determine if any people or occurred,it progresses rapidly to pets in your home may have death.People exposed to a rabid been exposed and can arrange to animal must receive anti-rabies test the bat for rabies,if needed. treatment to prevent the disease. "Bat proof'.your home by P Jew The virus can be transmit- making sure that open windows �%) ted after a bite from an infected have screens and that other small animal. It can also be spread to entry points are sealed. Wednesday,August 13,2008.13 7 physicals S orts offered • p at PT, Chimacum schools Jefferson County Public Health offers sports phys- A signed parental medical consent form is icals to students at Port Townsend and Chimacum required for each physical for students 17 and high schools in preparation for fall sports. younger. Students 18 and older can sign their own The program is offered as a partnership between form. the schools, Jefferson Healthcare Hospital and the For students unaccompanied by their parents at health department in anticipation of a new school- the clinic site,the forms are available at the health based health center opening in the future. department, 615 Sheridan St., or online at www. Sports physical clinics are from 1 to 4:30 p.m. jeffersoncountypublichealth.org. Monday, Aug. 18 at the Gael Stuart Building at Cost is$45 for a physical.Medicaid and private Port Townsend High School and from 8:30 a.m. insurance can be billed. to noon Tuesday, Aug. 19 next to the library at No student will be turned away because of Chimacum High School. inability to pay, according to public health nurse Appointments are recommended. Students who Yuko Umeda. don't have an appointment can walk in but might For more information or to make an appoint- have to wait. ment,call 385-9400. • • Ri,ciaedez Algae is still a • problem for lakes There has been no change in Lake are reported to be clear. the number of Jefferson County Sandy Shore, located just south lakes put off limits due to toxic of State Route 104, is the only blue-green algae. viable freshwater swimming Jefferson County Public hole. Health has posted a "warning" advisory against humans or pets swimming or otherwise com- ing in contact with the water at Crocker Lake, Lake Leland, Gibbs Lake and Anderson Lake. The lakes with blue-green algae, which contain the power- ful neurotoxin Anatoxin-A, are closed to swimming, and pets should not be allowed to drink the water. No fish caught in the lakes should be eaten. Tarboo Lake still carries a "caution" label as of Aug. 4. The lake is not safe for drink- • ing water, according to the county. Small children and pets. should stay out of the water.Fish caught for consumption should be cleaned in fresh water and the organs and skin discarded. Teal Lake and Sandy Shore • ,2 .god (rte/42 • Board of Health August 21, 2008 Sign In Sheet NAME PHONE NUMBER EMAIL ADDRESS Gr gt.-.—PC6Ery A.) • JEFFERSON COUNTY PUBLIC HEALTH r 615 Sheridan Street • Port Townsend •Washington • 98368 .«�sS • www.jeffersoncountypublichealth.org Status of Jefferson County Lakes: Anderson: 134 pg/L microcystic and 200 pg/L of anatoxin-a 460,000cells/ml (10% Ocillatoria, 9% Anabaena, 31% Microcystis, 50% Lyngbia) Anderson Lake continues to be toxic and be predominated by various species of toxic cyanobacteria. It was closed to recreational use in late April after the first scums formed. This scum proved to be contain both microcystin and anatoxin-a. Since this spring bloom the algal population decreased for some time and then spiked again in early June, by late June the concentration of anatoxin-a was 172,640 pg/L! The bloom was probably starting to senesce at that point. The bloom is currently dominated by Anabeana, Microcystis and Lyngbia. An interesting note is that the bloom really got going in early June at almost the exact date as the previous two years. An'CkrocAi{st Leland: 191 pg/L;,100,0O0cells/ml (96% Microcystis, 4% Aphanizominon) This year has seen Leland be at a warning status since April. In the spring it was dominated by a mixed bloom of Aphanizomenon, Anabeana and Microcystis. But since late June has been dominated by a Microcystis bloom that has produced documented toxin (microcystin) twice: once July 7th (12.8 ppb) and also on August 11th (191 ppb). An interesting thing • about the August 11th result is that it confirms our concern that 100,000 cells/ ml be our trigger for a warning versus a caution- the lake being well over the 6 pg/L draft guidance by WDOH. Gibbs: no toxin 170,000cells/mL (17% Microcystis, 46% Aphanizomenon, 37% Anabaena) Gibbs Lake has had a cyanobacterial bloom just over the warning criteria for most of the summer. Some samples have been in the cautionary criteria (30,000 to 100,000 cells/ml) but the population has not dropped for a sufficient time to lower the warning. Crocker 160,000cells/mL (100% Aphanizomenon) Sandy Shore 11,000cells/mL (100% Microcystis) Genera of blue green algae and the known toxins they can produce: Microcystis: microcystin Anabaena: microcystin, anatoxin-a, anatoxin-a(S), and saxitoxin, Aphanizomenon: anatoxin-a, cylindrospermopsin and saxitoxin. Oscillatoiria: microcystins and anatoxin Lygbia: Saxitoxin (the paralytic shellfish toxin) • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES ���IAY �r"CORKING','OR WATER QUALITY FAX: 36(}385-94000 HEALTHIER COMMUNITY MAIN: 360-385-9444. FAX: 36Q 379--4487