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Home My WebLink About2010- May File Copy • Jefferson County Board of 3-Cealth .agenda Nlinutes • Nlay 20, 2010 • • JEFFERSON COUNTY BOARD OF HEALTH May 20,2010 Jefferson County Public Health 615 Sheridan Street Port Townsend, WA 2:30—4:30 PM DRAFTAGENDA I. Approval of Agenda II. Approval of Minutes of April 15, 2010 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. Annual Review Jefferson County Shellfish Growing Areas 2. State Vaccine Program Update V. New Business • 1. H1N1 Pandemic Response—After Action Report 2. National Health Reform Legislation: Impact on Public Health and Prevention Activities 3. Draft Invitation Letter: Jefferson County Community Health Assessment Data Steering Committee 4. National Accreditation of State and Local Health Department 5. Interlocal Contracting for Environmental Health Director Services VI. Activity Update VII. Agenda Planning Calendar VIII. Next Scheduled Meeting: June 10, 2010 2:30—4:30 PM • r I JEFFERSON COUNTY BOARD OF HEALTH • MINUTES ® Thursday, April 15, 2010 2:30 PM—4:30 PM Mountain View Commons, Conference Room, 1925 Blaine Street, Port Townsend, WA 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, County Commissioner,District#3 Julia Danskin,Nursing Services Director Kristen Nelson, Vice Chair,Port Townsend City Council Sheila Westerman, Chair, Citizen at large(City) Chuck Russell, Chair,Hospital Commissioner,District#2 Roberta Frissell, Citizen at large(County) Chair Chuck Russell called the meeting of the Jefferson County Board of Health to order at 2:37 PM. A quorum was present. Members Present: John Austin, Phil Johnson, Kristen Nelson, Chuck Russell, David Sullivan, Sheila Westerman Members Excused: Roberta Frissell Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin, Veronica Shaw APPROVAL OF AGENDA Member Nelson moved and Member Westerman seconded for approval of the agenda. The agenda was approved unanimously, as written. APPROVAL OF MINUTES Member Austin moved for approval of the March 18, 21010 BOH meeting minutes; Member Nelson seconded. The minutes of March 18,2010 were approved unanimously. PUBLIC COMMENTS (None) • NEW BUSINESS • 2010 Public Health Heroes Awards Jean Baldwin introduced Julia Danskin and Lisa McKenzie, and provided a brief history and background information on the Public Health Heroes Awards. The awards recognize community members whose efforts positively impact the health of the community. She noted that in keeping with the 2009 annual theme of the national American Public Health Association, "One Community at a Time", the Jefferson County BOH had decided to recognize those involved in H1N1 planning and prevention, which was of significance to the whole community. She provided a brief overview of the BOH, their role and responsibility within the community and explained where the Health Department and other providers/agencies fit into the overall health care system. BOH members and Dr. Locke introduced themselves and their individual roles on the BOH. Member Westerman noted that Roberta Frissell, who could not attend, represents the citizens of Jefferson County. Ms. Baldwin noted that the H1N1 preparation and response required the support of the entire community, and that a great deal had been learned in that process. She expressed her appreciation that, despite the complexity and compressed time frame, the overall outcome had been so successful. Julia Danskin described the H1Nleducation/awareness efforts that had been made beginning in the spring of 2009. She said she and other staff had visited tens of community sites, schools and organizations to discuss H1N1 preparation, prevention and protocols, as information evolved, as well as having provided training to providers and other health care professionals. Jean Baldwin noted that she and Dr. Locke had also worked with school superintendents and principals regarding tracking/reporting of absenteeism and virus transmission prevention. Lisa McKenzie discussed surveillance and epidemiology. She noted that at least 10 different guidance updates from national and state centers had to be shared with providers and agencies over the period of the pandemic. This related to who, when and how suspected cases should be tested. The Jefferson Health Care lab was extremely busy with rapid flu testing, and with weekly reporting on positive tests for types A and B. For example, in October there were 178 of these lab tests. Schools reported whenever the absentee rate exceeded 10%. There were 5 different updates to guidelines for hospitalization case reporting, which mainly affected Jefferson Health Care. In addition, Ms. McKenzie noted that the anti-viral treatment guidelines had changed many times and had been disseminated rapidly to providers. Ms. McKenzie also reviewed the federal vaccine requirements for contracts and reporting. Jefferson County coordinated signing of 13 different contracts among providers, pharmacies, the hospital and Kah Tai Care Center. She described how vaccination plans had to be periodically adjusted because of delays and shifts in the types and amounts of vaccine received. Clinics had to stay abreast of shifting target groups and vaccine target groups, as well as communicate with concerned patients about those f changes. She said that considering the lack of control over many factors,the response worked out very well. By February, over 6000 doses had been administered throughout • the County. Jean Baldwin then asked those representatives present to receive awards to introduce themselves and their organization. Dr. Locke noted that planning for an influenza pandemic had been underway for over 5 years, beginning with the first warnings that H5N1 Avian flu had the potential to become the first pandemic of the 21st century. Unexpectedly, H1N1 suddenly came into the picture in April of 2009. He noted that, fortunately, the elderly were not as susceptible as the general population; that there was not panic among the population; and that that there was time for planning and vaccine production. Although illness from H1N1 was relatively mild for most people, there were at least 12,000 deaths and over 200,000 hospitalizations nationally. He said that this is not likely to be the only pandemic of the 21St century, and that there is no guarantee that the next occurrence will be as mild. It is necessary to pay close attention and improve upon any aspects of prevention/response that did not work well. Jean Baldwin expressed her appreciation to all those involved. She mentioned surveys that had been sent out to providers etc. to collect feedback and suggestions for improvement. She said the responses affirmed that there had been good teamwork and communication, despite challenges and constrained resources. BOH member Westerman said she was thankful that this pandemic did not necessitate quarantine; she acknowledged that much more work would be needed to prepare • adequately for such a situation. Member Austin added that Jefferson is a relatively small, isolated county, which increases the need for the community to work together in these types of emergencies. He expressed his thanks for all that everyone had accomplished. Chair Russell said he was particularly proud of how well everyone had responded to rapidly changing demands and circumstances and expressed his appreciation to all. Member Nelson said she was impressed with the number of individuals and agencies involved and with the breadth and depth of participation in this community wide issue. Member Sullivan noted the ever increasing challenges to each of our systems and the demonstration of our ability to meet these challenges by working together. Member Johnson said that, in addition to all that had been said,he simply wished to thank all the Health Heroes. Julia Danskin then acknowledged each of the particular individual contributions and presented each representative with a Health Heroes certificate. BOH member Sullivan presented Jefferson County Public Health with their certificate. Group photographs were taken following the awards. "Our Kids, Our Business" JCPH roles Kelly Matlock presented information on the Our Kids, Our Business program. Written • packets containing the history of the program, participants, highlights for the preceding years, event announcements, call to action and pledge statement were distributed. This is the third year for the Our Kids, Our Business Campaign. April is national Child Abuse Prevention and Sexual Assault Awareness month. The Health Department partners with the Jefferson County Community Network to develop this program. The campaign has several integral parts. Each year, the BOCC and Port Townsend City Council proclaim April as Child Abuse Prevention Month. There is a call to action to community members to take at least one intentional action within the year to make Jefferson County a safer and more nurturing place and to sign a pledge. There are trainings and educational events around related to child abuse and its prevention, and celebrations of existing services and agencies in this regard. Ms. Matlock briefly described the role of businesses, organizations, schools and the media in this campaign. She pointed out two events in particular. The PTHS Student Task Force is putting on a Town Hall meeting about alcohol/substance abuse, which is made possible by a small grant from SAMHSA (Substance Abuse and Mental Health Services Administration). A Food Coop event celebrates the resources and services that are available for kids. BOH members were invited to sign pledge statements and to attend both events. Jean Baldwin mentioned that the Health Department has recently placed a food collection bin in the department; all are invited to participate in making food donations to local food • banks. Chair Russell added that Valley Tavern has donated more than 1.5 tons of food in the past year. Member Nelson offered to bring copies of documents and Our Kids Our Business promotional items to the next City Council meeting. Public Records Requests Veronica Shaw reported to the BOH on the process and activity of Public Records requests. She and Cathy Avery have recently attended two training sessions related to this function. Veronica said there been enhancements made to the County's records system over time. Although one of the training sessions addressed electronic records systems, she said that the County is not yet ready to implement a fully electronic records system. Veronica referred to the packet document entitled "What are Public Records?" She wrote this policy document to assist staff in understanding the definition of public record and what constitutes a public record. The document is based on input from David Alvarez and the State's Public Records Act. It is part of the Procedures Manual and the orientation materials for all new employees. Jean Baldwin noted that Health Department policies and procedures are accessible only to departmental personnel, are less formal • than County personnel procedures and are frequently updated. She affirmed that this policy has been checked for consistency with the County's "Record Access Policy". • The second document, prepared for the BOH, is a summary of the procedure followed for p processing a request for Public Records. The third document is the actual procedure from the Procedures Manual. There was a brief discussion about the need for employees to recognize and follow through on all requests, even those received orally and/or outside the office. Veronica Shaw noted that the departmental process is very effective, but expensive in terms of staff time. To date in 2010, more than 200 hours have been spent on Health Department public record requests; program codes are used to track the time. She noted that a multi- step process is usually needed to first list the range of possible documents that the requestor desires and then to work with them to identify the small subset actually needed. For example, a recent request was successfully narrowed down to 2 documents from an initial possible list of over 600 e-mails. Jean Baldwin noted that when individuals wish to debate/question County policy or decisions in connection with a records request, she invites them to make public comment during a BOH or BOCC meeting. Mystery Bay Shellfish Growing Area Now Approved Neil Harrington provided an update on the Mystery Bay shellfish growing area. He reported on the recent reclassification by the State Department of Health of the Mystery • Bay shellfish growing area from Conditionally Approved back to Approved, as it was classified prior to August 2009. A letter from the State Department of Health outlining this action dated March 25, 2010 is included in the packet. Mr. Harrington also distributed copies of maps and the Executive Summary from the newly developed Management Plan. In the spring of 2009, the Department of Health closed the outer portion of Mystery Bay to shellfish harvesting. The primary issue was that the number of boats moored there caused it to be considered a marina, where shellfish harvesting is prohibited by the National Shellfish Sanitation standards. This led to a conditional closing; it was not based on water quality testing. In response, a large ad-hoc group of stakeholders including local Tribes, shellfish growers, DNR, Jefferson County DCD and Health Department, Marine Resources Committee, Army Corps of Engineers, Marrowstone residents, and the National Northwest Fisheries Commission was brought together under the Governor's Office of Regulatory Assistance (ORA) as facilitator. Mr. Harrington explained that the ORA assists businesses in navigating the regulatory environment of Washington State. One outcome was the development of a management plan. Under that plan, DCD has adjusted its permitting process; implementation of the updated SMP ordinance will also help to limit the number of mooring permits. Illegally moored boats and buoys are being removed by DNR and Jefferson County. Mooring buoys require permission from the • ti Army Corps of Engineers, a DFW hydraulic permit to work in the aquatic environment, a building (shoreline)permit from DCD and permission from DNR to anchor into the bedlands of the Bay. The State Department of Health is allowing certain mooring buoys • and boats located along owners' shoreline properties (approximately 20)to be exempt from the boat counts in the Bay and marina, provided that owners sign an affidavit regarding proper waste discharge. This is the first instance of such an arrangement in this State. Member Sullivan noted that there is a great deal of monitoring and scrutiny at this time, with property owners participating in that. Mr. Harrington showed an aerial view diagram/inventory of all the objects (boats, buoys, etc.) in the Bay and pointed out the marina, State Park and outer bay areas. Along with this plan, there will be a voluntary no-anchor zone established, based on the Port Townsend eel grass zone model, with transitory boats directed to the State Park area. This will be implemented by the Marine Resources Committee via a grant from the Northwest Straits Commission for marker buoys, signage and education/outreach. There is potential for this multi-party collaborative endeavor and process to become the model for other areas in Puget Sound. The next step will be a memo of understanding stating that the Health Department has participated in this process and will exercise regulatory authority to further this plan. However, there is no new ordinance or regulatory change. Mr. Harrington noted that the State Department of Health will monitor the situation carefully and is likely to initiate further remedies if this solution does not continue to work as planned. Mr. Harrington announced that he will be leaving his position with the Jefferson County • Health Department on April 17, but will be assisting with transitional matters beyond that date. BOH members thanked him for his years of service and wished him well in his future endeavors. Data Steering Committee Workgroup Report from Healthcare Access Group Jean Baldwin reviewed the composition and purpose of this workgroup. Participants include Vic Dirksen and Paula Dowdle from Jefferson HealthCare, Dr. Locke, Jean Baldwin, Julia Danskin, Sam Markowitz from Mental Health, and representatives from Olympic Area Agency on Aging, OlyCap, and Domestic Violence. The group meets informally to discuss mutual challenges and concerns, such as budget constraint impacts on programs and services. She mentioned that a new working group is being formed to address emergency mental health issues and access to mental health services. In the past, the Data Steering Committee had developed a series of priorities through a vetting process based on shared data. The Committee had then met with a group of about 30 community leaders to prioritize that list. She said that the Committee believes it is time to re-examine the data in order to understand what has shifted or changed in the community. Is there a homeless problem? Do the aged have sufficient resources and • health care access, including mental health? Is there a hunger problem and how serious is • it? Ms. Baldwin recommended a workgroup be formed to gather information and present reports under the authority of the BOH for prioritization and action. She said that the Hospital, the Health Department and other agencies have all expressed interest; an epidemiologist will also be involved. Ms. Baldwin said she plans to begin a gradual, long term process of updating the demographics and analyzing health risks. BOH members viewed preliminary statistical reports that are examples of the type of information to be examined in depth by the steering committee. In response to a question about cost, Ms. Baldwin said that, for the Health Department, the cost would be covered by the current budget. She said that she would shift focus from evaluating internal programs to better understanding community characteristics and needs. She invited BOH members or representatives from City Council or City staff to participate, or asked for suggestions on potential representatives from the community or other agencies. BOH members expressed their support for going forward with this workgroup. Legislative Update/Wrap Up The Special Legislative Session ended on Monday, April 12. Maternity Support appears to have survived expected cuts. Child care oversight services have been transferred from DSHS to the Department of Early Learning; details are not yet known. Jean Baldwin said • that currently there is a nurse assigned to licensed child care centers for inspections and support of the staff of child care centers. It is also unclear what will happen with the child abuse prevention part of this program. The impacts of the DSHS reorganization are not yet known. A number of proposed Environmental Health related programs did not pass. Member Austin noted that in the future the State Board of Health will not pay for travel for Board members. As a consequence, most meetings will be held via teleconferencing. NEW BUSINESS Green Business Award: Wandering Wardrobe Wandering Wardrobe, 936 Washington Street, Port Townsend has earned Green Business certification. A copy of the notification letter from Lori Clark is included in the packet. Letter to Senator Hargrove re: Immunizations Waiver A letter to Senator Hargrove from Dr. Locke regarding the immunizations waiver bill, • approved by the BOH at the March meeting, was sent; a copy is included in the packet. Dr. Locke said that there has been no response as yet, and that he would check on the outcome of this bill before the next meeting. Newsletter: Hood Canal update on projects A copy of the Spring 2010 Jefferson County Water Quality Newsletter was included in the packet. ACTVITY UPDATE The Health Department is in the process of interviewing candidates for the Environmental Health Director position. AGENDA PLANNING CALENDAR The next BOH meeting is scheduled for May 20, 2010 in the Health Department Conference Room. There was a brief discussion about the June meeting, which had been previously • rescheduled to June 10, 2010. Jean Baldwin will verify that the change of date has been property publicized. ADJOURNMENT Chair Russell adjourned the meeting at 4:30 PM. • 4 f JEFFERSON COUNTY BOARD OF HEALTH MINUTES • Thursday, April 15, 2010 2:30 PM—4:30 PM Mountain View Commons, Conference Room, 1925 Blaine Street, Port Townsend, WA 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, County Commissioner,District#3 Julia Danskin,Nursing Services Director Kristen Nelson, Vice Chair,Port Townsend City Council Sheila Westerman, Chair, Citizen at large(City) Chuck Russell,Chair,Hospital Commissioner,District#2 Roberta Frissell, Citizen at large(County) Chair Chuck Russell called the meeting of the Jefferson County Board of Health to order at 2:37 PM. A quorum was present. Members Present: John Austin, Phil Johnson, Kristen Nelson, Chuck Russell, David Sullivan, Sheila Westerman Members Excused: Roberta Frissell Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin, Veronica Shaw • APPROVAL OF AGENDA Member Nelson moved and Member Westerman seconded for approval of the agenda. The agenda was approved unanimously, as written. APPROVAL OF MINUTES Member Austin moved for approval of the March 18, 21010 BOH meeting minutes; Member Nelson seconded. The minutes of March 18, 2010 were approved unanimously. PUBLIC COMMENTS (None) k NEW BUSINESS •2010 Public Health Heroes Awards Jean Baldwin introduced Julia Danskin and Lisa McKenzie, and provided a brief history and background information on the Public Health Heroes Awards. The awards recognize community members whose efforts positively impact the health of the community. She noted that in keeping with the 2009 annual theme of the national American Public Health Association, "One Community at a Time", the Jefferson County BOH had decided to recognize those involved in H1N1 planning and prevention, which was of significance to the whole community. She provided a brief overview of the BOH, their role and responsibility within the community and explained where the Health Department and other providers/agencies fit into the overall health care system. BOH members and Dr. Locke introduced themselves and their individual roles on the BOH. Member Westerman noted that Roberta Frissell, who could not attend, represents the citizens of Jefferson County. Ms. Baldwin noted that the H1N1 preparation and response required the support of the entire community, and that a great deal had been learned in that process. She expressed her appreciation that, despite the complexity and compressed time frame, the overall outcome had been so successful. Julia Danskin described the H 1 N 1 education/awareness efforts that had been made beginning in the spring of 2009. She said she and other staff had visited tens of community sites, schools and organizations to discuss H1N1 preparation, prevention and protocols, as information evolved, as well as having provided training to providers and • other health care professionals. Jean Baldwin noted that she and Dr. Locke had also worked with school superintendents and principals regarding tracking/reporting of absenteeism and virus transmission prevention. Lisa McKenzie discussed surveillance and epidemiology. She noted that at least 10 different guidance updates from national and state centers had to be shared with providers and agencies over the period of the pandemic. This related to who, when and how suspected cases should be tested. The Jefferson Health Care lab was extremely busy with rapid flu testing, and with weekly reporting on positive tests for types A and B. For example, in October there were 178 of these lab tests. Schools reported whenever the absentee rate exceeded 10%. There were 5 different updates to guidelines for hospitalization case reporting, which mainly affected Jefferson Health Care. In addition, Ms. McKenzie noted that the anti-viral treatment guidelines had changed many times and had been disseminated rapidly to providers. Ms. McKenzie also reviewed the federal vaccine requirements for contracts and reporting. Jefferson County coordinated signing of 13 different contracts among providers,pharmacies, the hospital and Kah Tai Care Center. She described how vaccination plans had to be periodically adjusted because of delays and shifts in the types and amounts of vaccine received. Clinics had to stay abreast of shifting target groups and vaccine target groups, as well as communicate with concerned patients about those • changes. She said that considering the lack of control over many factors, the response worked out very well. By February, over 6000 doses had been administered throughout • the County. Jean Baldwin then asked those representatives present to receive awards to introduce themselves and their organization. Dr. Locke noted that planning for an influenza pandemic had been underway for over 5 years, beginning with the first warnings that H5N1 Avian flu had the potential to become the first pandemic of the 21St century. Unexpectedly, H1N1 suddenly came into the picture in April of 2009. He noted that, fortunately, the elderly were not as susceptible as the general population; that there was not panic among the population; and that that there was time for planning and vaccine production. Although illness from H1N1 was relatively mild for most people, there were at least 12,000 deaths and over 200,000 hospitalizations nationally. He said that this is not likely to be the only pandemic of the 215t century, and that there is no guarantee that the next occurrence will be as mild. It is necessary to pay close attention and improve upon any aspects of prevention/response that did not work well. Jean Baldwin expressed her appreciation to all those involved. She mentioned surveys that had been sent out to providers etc. to collect feedback and suggestions for improvement. She said the responses affirmed that there had been good teamwork and communication, despite challenges and constrained resources. BOH member Westerman said she was thankful that this pandemic did not necessitate quarantine; she acknowledged that much more work would be needed to prepare • adequately for such a situation. Member Austin added that Jefferson is a relatively small, isolated county, which increases the need for the community to work together in these types of emergencies. He expressed his thanks for all that everyone had accomplished. Chair Russell said he was particularly proud of how well everyone had responded to rapidly changing demands and circumstances and expressed his appreciation to all. Member Nelson said she was impressed with the number of individuals and agencies involved and with the breadth and depth of participation in this community wide issue. Member Sullivan noted the ever increasing challenges to each of our systems and the demonstration of our ability to meet these challenges by working together. Member Johnson said that, in addition to all that had been said, he simply wished to thank all the Health Heroes. Julia Danskin then acknowledged each of the particular individual contributions and presented each representative with a Health Heroes certificate. BOH member Sullivan presented Jefferson County Public Health with their certificate. Group photographs were taken following the awards. ID "Our Kids, Our Business"JCPH roles Kelly Matlock presented information on the Our Kids, Our Business program. Written • packets containing the history of the program, participants,highlights for the preceding years, event announcements, call to action and pledge statement were distributed. This is the third year for the Our Kids, Our Business Campaign. April is national Child Abuse Prevention and Sexual Assault Awareness month. The Health Department partners with the Jefferson County Community Network to develop this program. The campaign has several integral parts. Each year, the BOCC and Port Townsend City Council proclaim April as Child Abuse Prevention Month. There is a call to action to community members to take at least one intentional action within the year to make Jefferson County a safer and more nurturing place and to sign a pledge. There are trainings and educational events around related to child abuse and its prevention, and celebrations of existing services and agencies in this regard. Ms. Matlock briefly described the role of businesses, organizations, schools and the media in this campaign. She pointed out two events in particular. The PTHS Student Task Force is putting on a Town Hall meeting about alcohol/substance abuse, which is made possible by a small grant from SAMHSA(Substance Abuse and Mental Health Services Administration). A Food Coop event celebrates the resources and services that are available for kids. BOH members were invited to sign pledge statements and to attend both events. Jean Baldwin mentioned that the Health Department has recently placed a food collection bin in the department; all are invited to participate in making food donations to local food • banks. Chair Russell added that Valley Tavern has donated more than 1.5 tons of food in the past year. Member Nelson offered to bring copies of documents and Our Kids Our Business promotional items to the next City Council meeting. Public Records Requests Veronica Shaw reported to the BOH on the process and activity of Public Records requests. She and Cathy Avery have recently attended two training sessions related to this function. Veronica said there been enhancements made to the County's records system over time. Although one of the training sessions addressed electronic records systems, she said that the County is not yet ready to implement a fully electronic records system. Veronica referred to the packet document entitled "What are Public Records?" She wrote this policy document to assist staff in understanding the definition of public record and what constitutes a public record. The document is based on input from David Alvarez and the State's Public Records Act. It is part of the Procedures Manual and the orientation materials for all new employees. Jean Baldwin noted that Health Department policies and procedures are accessible only to departmental personnel, are less formal 0 than County personnel procedures and are frequently updated. She affirmed that this • policy has been checked for consistency with the County's "Record Access Policy". The second document, prepared for the BOH, is a summary of the procedure followed for processing a request for Public Records. The third document is the actual procedure from the Procedures Manual. There was a brief discussion about the need for employees to recognize and follow through on all requests, even those received orally and/or outside the office. Veronica Shaw noted that the departmental process is very effective, but expensive in terms of staff time. To date in 2010, more than 200 hours have been spent on Health Department public record requests; program codes are used to track the time. She noted that a multi- step process is usually needed to first list the range of possible documents that the requestor desires and then to work with them to identify the small subset actually needed. For example, a recent request was successfully narrowed down to 2 documents from an initial possible list of over 600 e-mails. Jean Baldwin noted that when individuals wish to debate/question County policy or decisions in connection with a records request, she invites them to make public comment during a BOH or BOCC meeting. Mystery Bay Shellfish Growing Area Now Approved Neil Harrington provided an update on the Mystery Bay shellfish growing area. He reported on the recent reclassification by the State Department of Health of the Mystery Bay shellfish growing area from Conditionally Approved back to Approved, as it was classified prior to August 2009. A letter from the State Department of Health outlining this action dated March 25, 2010 is included in the packet. Mr. Harrington also distributed copies of maps and the Executive Summary from the newly developed Management Plan. In the spring of 2009, the Department of Health closed the outer portion of Mystery Bay to shellfish harvesting. The primary issue was that the number of boats moored there caused it to be considered a marina, where shellfish harvesting is prohibited by the National Shellfish Sanitation standards. This led to a conditional closing; it was not based on water quality testing. In response, a large ad-hoc group of stakeholders including local Tribes, shellfish growers, DNR, Jefferson County DCD and Health Department, Marine Resources Committee, Army Corps of Engineers, Marrowstone residents, and the National Northwest Fisheries Commission was brought together under the Governor's Office of Regulatory Assistance (ORA) as facilitator. Mr. Harrington explained that the ORA assists businesses in navigating the regulatory environment of Washington State. One outcome was the development of a management plan. Under that plan, DCD has adjusted its permitting process; implementation of the updated SMP ordinance will also help to limit the number of mooring permits. Illegally moored boats and buoys are being removed by DNR and Jefferson County. Mooring buoys require permission from the Army Corps of Engineers, a DFW hydraulic permit to work in the aquatic environment, a building(shoreline) permit from DCD and permission from DNR to anchor into the bedlands of the Bay. The State Department of Health is allowing certain mooring buoys • and boats located along owners' shoreline properties (approximately 20)to be exempt from the boat counts in the Bay and marina, provided that owners sign an affidavit regarding proper waste discharge. This is the first instance of such an arrangement in this State. Member Sullivan noted that there is a great deal of monitoring and scrutiny at this time, with property owners participating in that. Mr. Harrington showed an aerial view diagram/inventory of all the objects (boats, buoys, etc.) in the Bay and pointed out the marina, State Park and outer bay areas. Along with this plan, there will be a voluntary no-anchor zone established, based on the Port Townsend eel grass zone model, with transitory boats directed to the State Park area. This will be implemented by the Marine Resources Committee via a grant from the Northwest Straits Commission for marker buoys, signage and education/outreach. There is potential for this multi-party collaborative endeavor and process to become the model for other areas in Puget Sound. The next step will be a memo of understanding stating that the Health Department has participated in this process and will exercise regulatory authority to further this plan. However, there is no new ordinance or regulatory change. Mr. Harrington noted that the State Department of Health will monitor the situation carefully and is likely to initiate further remedies if this solution does not continue to work as planned. Mr. Harrington announced that he will be leaving his position with the Jefferson County • Health Department on April 17, but will be assisting with transitional matters beyond that date. BOH members thanked him for his years of service and wished him well in his future endeavors. Data Steering Committee Workgroup Report from Healthcare Access Group Jean Baldwin reviewed the composition and purpose of this workgroup. Participants include Vic Dirksen and Paula Dowdle from Jefferson HealthCare, Dr. Locke, Jean Baldwin, Julia Danskin, Sam Markowitz from Mental Health, and representatives from Olympic Area Agency on Aging, OlyCap, and Domestic Violence. The group meets informally to discuss mutual challenges and concerns, such as budget constraint impacts on programs and services. She mentioned that a new working group is being formed to address emergency mental health issues and access to mental health services. In the past, the Data Steering Committee had developed a series of priorities through a vetting process based on shared data. The Committee had then met with a group of about 30 community leaders to prioritize that list. She said that the Committee believes it is time to re-examine the data in order to understand what has shifted or changed in the community. Is there a homeless problem? Do the aged have sufficient resources and S health care access,including mental health? Is there a hunger problem and how serious is it? Ms. Baldwin recommended a workgroup be formed to gather information and present reports under the authority of the BOH for prioritization and action. She said that the Hospital, the Health Department and other agencies have all expressed interest; an epidemiologist will also be involved. Ms. Baldwin said she plans to begin a gradual, long term process of updating the demographics and analyzing health risks. BOH members viewed preliminary statistical reports that are examples of the type of information to be examined in depth by the steering committee. In response to a question about cost, Ms. Baldwin said that, for the Health Department, the cost would be covered by the current budget. She said that she would shift focus from evaluating internal programs to better understanding community characteristics and needs. She invited BOH members or representatives from City Council or City staff to participate, or asked for suggestions on potential representatives from the community or other agencies. BOH members expressed their support for going forward with this workgroup. Legislative Update/Wrap Up The Special Legislative Session ended on Monday, April 12. Maternity Support appears to have survived expected cuts. Child care oversight services have been transferred from DSHS to the Department of Early Learning; details are not yet known. Jean Baldwin said that currently there is a nurse assigned to licensed child care centers for inspections and support of the staff of child care centers. It is also unclear what will happen with the child abuse prevention part of this program. The impacts of the DSHS reorganization are not yet known. A number of proposed Environmental Health related programs did not pass. Member Austin noted that in the future the State Board of Health will not pay for travel for Board members. As a consequence, most meetings will be held via teleconferencing. NEW BUSINESS Green Business Award: Wandering Wardrobe Wandering Wardrobe, 936 Washington Street, Port Townsend has earned Green Business certification. A copy of the notification letter from Lori Clark is included in the packet. S t Letter to Senator Hargrove re: Immunizations Waiver A letter to Senator Hargrove from Dr. Locke regarding the immunizations waiver bill, • approved by the BOH at the March meeting, was sent; a copy is included in the packet. Dr. Locke said that there has been no response as yet, and that he would check on the outcome of this bill before the next meeting. Newsletter: Hood Canal update on projects A copy of the Spring 2010 Jefferson County Water Quality Newsletter was included in the packet. ACTVITY UPDATE The Health Department is in the process of interviewing candidates for the Environmental Health Director position. AGENDA PLANNING CALENDAR The next BOH meeting is scheduled for May 20, 2010 in the Health Department Conference Room. There was a brief discussion about the June meeting, which had been previously rescheduled to June 10, 2010. Jean Baldwin will verify that the change of date has been property publicized. ADJOURNMENT Chair Russell adjourned the meeting at 4:30 PM. • 0 JEFFERSON COUNTY BOARD OF HEALTH 4/ -/'''' 4 ' /if) '// /1----- tit l/ 6l 1 uck .ssell, Chair Phil Jos son, Member E "Or \Y\ L ,i) �', (21/7/1 Kristen Ne son, Vice-Chair Jo Austin, Member Excused ��'^ Roberta Frissell, Member David Sull van, Member -.DLO;IL5,/ W )`fir Sheila Westerman, Member • 0 • Jefferson County Board of aCealth OCdBusiness & Informational Mems ,Agenda item # fl/, 1 • Annual Review Jefferson County Shellfish Growing .areas NLay Zo, 2010 • STATS Off, .4 74o 18890 • STATE OF WASHINGTON DEPARTMENT OF HEALTH OFFICE OF SHELLFISH AND WATER PROTECTION PO Box 47824 • Olympia, Washington 98504-7824 (360)236-3330 • TDD Relay Service: 1-800-833-6388 April 8, 2010 RECEIVED Susan Porto, Environmental Specialist APR 12 2010 Environmental Health&Natural Resources .teffersOn CoHu Jefferson County Public Health environmental linty 615 Sheridan Port Townsend, Washington 98368 Dear Ms. Porto: Our office has completed its annual review of the classification of Washington's shellfish growing areas. Two areas in Jefferson County are threatened with a downgrade in classification. We have enclosed the annual reports and early warning system summary reports for these areas. The reports for the other growing areas in your county are available on our • website at www.doh.wa.gov/ehp/sf/growreports.htm. We call an area threatened when a water sampling station passes the national water quality standards but shows bacteria levels that are near the limit of the standard, or when a shoreline survey identifies pollution sources that threaten the area's classification. The threatened designation usually does not mean that the classification of the entire shellfish area is at risk. We are notifying the Tribes, shellfish growers, Conservation Districts, the Department of Ecology, and the Puget Sound Partnership. We want all affected parties to be aware of the threat and we want to encourage work to identify and correct the pollution problems before downgrades are required. We would be pleased to meet with you or your staff to discuss the problems in this area. If you have any questions, please contact Bob Woolrich at 360 236-3329 or bob.woolrich@doh.wa.gov. Sincerely, )444A,Nr. Maryanne Guichard Office Director • Enclosures Washington State Department of Health 2010 Early Warning System Summary for ' WashmgtanstateDepartmertrof Shellfish Growing Areas in Jefferson County IHealth • The Department of Health(DOH)places shellfish growing areas in a"Threatened"or "Concerned" status based on our assessment of threats to the growing area's classification. This assessment is currently based on the identification of pollution sources that may impact public health, and/or how close a water sampling station's bacteria_levels are to the National Shellfish Sanitation Program's (NSSP) standards. The latter has been the most common and is described below. The NSSP prescribes twoutatotheate4embooliteanAeloels at water sampling stations to classify growing areas: WourTfinB(SRS) and Atia (APC). Both use a minimum of the last 30 samples. With the SRS method, the 90th percentile cannot exceed 43 fc/100mL. With the APC method, no more than 10% of the samples can exceed 43 fc/100mL. If any of these standards are,exceeded, no shellfish can be directly harvested from the area of that station. A Threatened status is assigned in SRS growing areas when a water sampling station's 90th percentile is between 30 and 43 fc/100mL. In APC growing areas, a Threatened status is assigned if more than 6.0% of the samples have exceeded 43 fc/100mL. A Concerned status is assigned where a water sampling station's 90th percentile is greater than 20, but less than 30. The DOH is providing this information to county governments so that corrective actions can take place before water quality at the listed stations fails the shellfish standards. • DABOB BAY RECEI V Station Number 296 Concerns due to water quality I+CCW F HOOD CANAL #3 1-1-c W P APR 12 2010 Station Number 136 Concerns due to water quality Station Number 137 Concerns due to water quality Jefferson County Station Number 140 Concerns due to water quality Environmental Health Station Number 143 Concerns due to water quality MATS MATS BAY olioP Station Number 10 Concerns due to water quality MYSTERY BAY Station Number 27 Threatened due to boat moorage Station Number 28 Threatened due to boat moorage Station Number 29 Threatened due to boat moorage Station Number 30 Threatened due to boat moorage PORT TOWNSEND Station Number 33 Threatened due to boat moorage •. Public Health-Always Working for a Safer and Healthier Washington—April 2010 f 2010 Shellfish Areas Listed as Threatened or of Concern (Based On 2009 Water Quality Data) m • 144-4iltrrAVAUFW -4;irlii‘ift9„,,,,Ptigi: P4,.,l'A,,,•,;;,,przl, ,I, ,ffsstrAW,C,F219 "OBtfiNT‘K5' ::4Ira:!,:''tkl*‘;.t.4, Anderson Island 625 Mark Toy (360)236-3321 Annas Bay 195, 197 Lawrence Sullivan (360)236-3320 Bay Center 112, 113, 134, 137, 138 Scott Berbells (360)236-3324 Burley Lagoon 337, 340, 339 (Failing) 331,333,336,338,342,343 Greg Combs (360)236-3308 Dabob Bay 296 Bill Cleland (306)236-3306 Drayton Harbor 3,4, 5 12 Greg Combs (360)236-3308 Dungeness Bay 115, 106 Greg Combs (360)236-3308 471, 472 Mark Toy (360)236-3321 Dyes Inlet 480,481,482,483,491,655 Eld Inlet 160, 161, 171Lawrence Sullivan (360)236-3320 Grays Harbor 35, 36 Jule Schultz '(360)236-3349 Henderson Bay 299 Greg Combs (360)236-3308 Henderson Inlet 190, 191 Lawrence Sullivan (360)236-3320 Hood Canal 2 87 Scott Berbells (360)236-3324 Hood Canal 3 136, 137, 140, 143 Lawrence Sullivan (360)236-3320 Hood Canal 6 218 Lawrence Sullivan (360)236-3320 Jamestown 102 Bill Cleland (306)236-3306 Mats Mats Bay 10 Mark Toy (360)236-3321 � 'steal y ' ; -- �� r� Mark Toy (360)236 3321 NaseileRver 152, 161, 162, 187 153, 156, 157, 158, 160 Scott Berbells (360)236 3324 4110 Nisqually Reach 709 Lawrence Sullivan (360)236 3320 North Bay 1, 575, 7 Scott Berbells (360)236-3324 Oro Bay 555 Bill Cleland (306)236-3306 Pacific Coast 11, 196, 197 6, 195 Scott Berbells (360)236-3324 Pickering Passage 52, 57 Lawrence Sullivan (360)236-3320 Port Blakely 418 Scott Berbells (360)236-3324 • � Mark Toy (360)236-3321 Portage Bay 272 Greg Combs (360)236-3308 Reach Island 17 Bill Cleland (306)236-3306 Rocky Bay 22 Bill Cleland (306)236-3306 Sam ish Bay All Stations Greg Combs (360)236 3308 South Skagit Bay 192 183, 184, 185, 186 • Scott Berbells (360)236-3324 Vaughn Bay 613 Bill Cleland (306)236-3306 Threatened or Concerned status is generally based on marine water quality but may also be based on the presence of potential pollution sources that, if not managed, may cause a downgrade in classification f s: g cg ®wtnga �, to �4 � r, � , tr W mt � °-4 � �°� Concerned status is asslgne• where a wa er sampling stats percentile is greater than 20, but less than 30. • APR 12 2010 • Jefferson County Environmental Health WASHINGTON STATE DEPARTMENT OF HEALTH OFFICE OF SHELLFISH AND WATER PROTECTION • ANNUAL GROWING AREA REVIEW PREPARED BY: Lawrence Sullivan,Public Health Advisor AREA: Mystery Bay YEAR ENDING: December 31,2009 CLASSIFICATION: Approved,Conditionally Approved ACTIVITIES IN THE GROWING AREA IN 2009: • Samples were collected from the growing area six times during the year using the systematic random sampling method. The"conditionally approved" area was closed from May 1 through September 30 in accordance with the management plan and was sampled three times while in open status. The outer portion of Mystery Bay was downgraded from Approved to Conditionally Approved due to an increased number of boats moored in this area. A stakeholder group has been meeting since April 2008 to resolve the boating issues and is in the process of developing a management plan to allow the upgrade of the outer bay back to Approved by May 1,2010. A shoreline survey of the area was completed in 2009. ANALYTICAL RESULTS OF WATER SAMPLES: Table 1 summarizes the results of all samples collected from the area. This summary shows that all stations in the • area pass the NSSP water quality standard. CHANGE IN ACTUAL POLLUTION SOURCES THAT IMPACT THE GROWING AREA: We currently have no information indicating that the area has new sources of pollution. CLASSIFICATION STATUS: ❑ Well within the classification standards ❑ Meets standards but some concerns ® Meets standards but threatened with a downgrade in classification ❑ Fails to meet classification standards REMARKS AND RECOMMENDATIONS: Table 1 shows that all stations meet the NSSP water quality standards for an Approved and Conditionally Approved classifications and the area is correctly classified. The area is listed as"Threatened"due to the potential for pollution from large numbers of boats that moor in Mystery Bay. RECEIVED APR 1. 2 2010 Jefferson County Environmental Health WASHINGTON STATE DEPARTMENT OF HEALTH OFFICE OF SHELLFISH AND WATER PROTECTION ANNUAL GROWING AREA REVIEW • MANAGEMENT PLAN EVALUATION—BRIEFLY DESCRIBE THE FOLLOWING COMPONENTS: 1. Have all parties involved complied with the conditions in the management plan Yes 2. Has reporting been adequate to manage the conditional area Yes 3. Does the area consistently meet approved area criteria when it is open for harvest Yes 4. Has a field inspection of critical pollution sources been conducted Yes • RECEIVED APR 12 2010 Jefferson County Environmental Health! t TABLE 1 0 SUMMARY OF MARINE WATER DATA(SRS) Growing Area: MYSTERY BAY Classification: Approved,Conditionally Approved From 02/17/2005 To 11/19/2009 FECAL COLIFORM ORGANISMS/100 ML Station Number Range Geometric Est. 90th Meets Std. Number Classification of Samples g Mean Percentile 27 Approved 30 1.7 -23.0 2.0 4.0 Yes 28 Approved 30 1.7-13.0 2.1 4.0 Yes 29 Approved 30 1.7 -4.5 1.8 2.0 Yes 30 Conditionally 30 1.7 -33.0 2.1 5.0 Yes Approved 31 Conditionally 30 1.7 -4.5 1.8 2.0 Yes Approved All tides information is presented • The standard for approved shellfish growing waters is fecal coliform geometric mean not greater than 14 organisms/100 ml and an estimate of the 90th percentile not greater than 43 organisms/100 ml.The above table shows bacteriological results in relation to program standards. RECEIVED . APR 12 2010 Jefferson County Environmental Healm! • .,„ ..,..ek.''''P•'$4'7,:.'4.7,1 ...-''' -,--4',V7 • ,...-4,' .,- 'S.'"i` 2:4' ' '''''''''''4Ali`41.4 m' " ''),P'''1 e,...ri, - ,..4...1,4.V,I. •-,4.. .'",, 4-'4.4-4, ,,,,' ,t'ae.-4r.-4., . 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P.:1-0,-.WA4,A 4+o ,4i !,>•:tfo, A ti tifitt„ •k",,,,4,%$w.I!',37,70"',:ve6.,4""„`,s,tx,.,--4: ,t7i-x"-,-, -* -,,4 io: 1.f4r 341 qi;Cr'iria 3,tyl ;',,Z4fik,,,Igkr.v616,,•.,,,,sg,ragr--77''''..wmffaft e-, k 4,414 ,yy",i t ,2,. -,4,--- . ,",•'',,---- .),-,,,,,r410 - ,Y,,,*,,,,:v ,7,110}7,a.,", ';.,::,,,,,,,,1,--._4.140, ,,,,o,„i.g.: ,,,,,. ,,L,j...,,. ..•,0741..•4,4 4:1;,''',11.• , rviAr,,.,,),40..:!--''''Mr,' Tet,' stVi.;:(Ik'''',TA:Eak I, fin.,,*'•et:ftle.}4.4Qatil 444,4,I,,, 4' ; -- -0° •AA'5,_,--.. 4,4 cl.,-.• • 4.,..?:'. z.,,..„,,rei.7ik.,&a-ir•„o4.tke7,,,z 4c.-,-,iI''.. uvviTV 4V,I1% .f.AH1,. ,rVrtlA ytirkg,"• .'I...'.APiI! ,.-r,ItP$11,`r./.t3,,,,',-...0*-,-‘'1,K- 1 k..`,'- , 28 It : 0,..Av ,i,,, ..,410,,N,,,•-,,,.; ;:-.1q.:114,11 1,7:m,,Ti.grlip:. - , " Iforgt --- 4 -..:„,,,,i,c,' %,, *is&) 1,4„----,',i,Li, -,1/4,',1)...';',1, r .:'-'.,'$..,-4kqe,i!mi- " •1 ) '- '411:i, v10 31,, ,,,;(4t..4 dle'i; ,;:,,,,tit,lmilit,,,,,„" L ,,:, ,:.,,:y• •Y „ , ; 1 r ',.:-lit' 4 -,-,.it 1, 44,4,_•',,, ---4,tr, kolg rv,...z4gr --,. - - . ':,-'',4,-,' i ':'"'''z i AI% tc%"t 4 ,r/t‘,. ,3 •••...4,47, ',`.%%fa .34,-4t,..1.4.4•4, .4,.' ', • ' •c., --..; ., , - •44-,,•,, ' F'4,'s' • 1` ',',,,. ''•'i,11‘,V4',4'-I.AI wir,,A4.,, , * ', .,-. : . , 1 Ge IF,,,,c1•11 Ir.0 '''.'0,,k% ,,14..;. C-14,.:4,-1.1 ''. :21. . 411?-1;V G200 71 Nabona ,. ., .i,,,........„.se..'4"r" • Mm.,4tia',:p114,,le.reliatecliwititir,(42:Pc;.,'!..,:°?...49 ;.-.... _ geCe\\I EP kvDR 2, /A COONIW tl iietS°° 1 kAea" le its, In •e $1411°11 0 WASHINGTON STATE DEPARTMENT OF HEALTH OFFICE OF SHELLFISH AND WATER PROTECTION ANNUAL GROWING AREA REVIEW PREPARED BY: Clyde T. Bill,Environmental Specialist AREA: Port Townsend YEAR ENDING: December 31,2009 CLASSIFICATION: Approved,Prohibited and Unclassified ACTIVITIES IN THE GROWING AREA IN 2009: Samples were cQllected from the growing area six times during the year using the systematic random sampling method. ANALYTICAL RESULTS OF WATER SAMPLES: Table 1 summarizes the results of all samples collected from the area. This summary shows that all stations in the Approved portion pass the NSSP water quality standard. CHANGE IN ACTUAL POLLUTION SOURCES THAT IMPACT THE GROWING AREA: A liveaboard boat was moved out of the southwest part of the growing area. The number of boats moored in that • part of the growing area threatens the Approved classification. CLASSIFICATION STATUS: ❑ Well within the classification standards ❑ Meets standards but some concerns ® Meets standards but threatened with a downgrade in classification ❑ Fails to meet classification standards REMARKS AND RECOMMENDATIONS: Table 1 show that all stations meet NS SP water quality standards for an Approved classification and the area is correctly classified. Chimacum Creek,which discharges near sampling station 32, is on the 303D list for fecal coliform. RECEIVED APR 12 2010 Jefferson County Environmental Health M Table 1 • Summary of Marine Water Data(SRS) Growing Area: Port Townsend Classification: Approved,Prohibited,Unclassified Fecal Coliform O ganisms/100 ml Station Sample Date Classification Number of Range Geometric Est.90`h Meets Number Range Samples Mean Percentile Std. 33 11/23/04-11/19/09 Approved 31 1.7-11.0 2.5 5.0 Yes 34 11/23/04-11/19/09 Approved 31 1.7-4.5 1.7 2.0 Yes 35 11/23/04-11/19/09 Approved 31 1.7-4.0 1.7 2.0 Yes 38 11/23/04-11/19/09 Approved 31 1.7-7.8 1.9 3.0 Yes 39 11/23/04-11/19/09 Approved 31 1.7-33.0 3.3 9.0 Yes 32 11/23/04-11/19/09 Approved 31 1.7-13.0 2.4 5.0 Yes 40 11/23/04-11/19/09 Approved 30 . 1.7-49.0 3.1 10.0 Yes • 44 2/17/05-11/19/09 Approved 30 1.1-350.0 2.7 11.0 Yes 45 3/2/05-11/19/09 Approved 30 1.7-2.0 1.7 1.0 Yes 41 9/4/02-11/19/09 Unclassified 30 1.7-4.5 1.8 2.0 Yes 176 11/23/04-11/19/09 Approved 30 1.7-17.0 2.0 3.0 Yes 179 11/23/04-11/19/09 Approved 31 1.7-14.0 2.0 3.0 Yes 180 11/23/04-11/19/09 Approved 31 1.7-7.8 1.8 2.0 Yes 181 11/23/04-11/19/09 Approved 30 1.7-2.0 1.7 1.0 Yes 177 11/23/04-11/19/09 Prohibited 31 1.7-170.0 4.3 21.0 Yes 178 11/23/04-11/19/09 Prohibited 31 1.7-110.0 2.7 8.0 Yes 186 9/7/05-11/19/09 Unclassified 27 1.7-13.0 2.4 5.0 *N/A 187 9/7/05-11/19/09 Unclassified 27 1.7-11.0 2.4 5.0 *N/A 188 7/27/05-11/19/09 Unclassified 27 1.7-70.0 2.1 5.0 *N/A • 191 6/18/08-11/19/09 Unclassified 11 1.7-11.0 2.0 4.0 *N/A The standard for approved shellfish growing waters is fecal coliform geometric mean not greater than 14 organisms/100 ml and an estimate of the 90`h percentile not greater than 43 organisms/100 ml. The above table shows bacteriological results in relation to program standards. *N/A-SRS criteria require a minimum of 30 samples for each station. PteGet Nil 0-) SPR12 (L' • • Jefferson County Board of 9-feaCth OCdBusiness & informational items Agenda item # 117, 2 • State 'Vaccine Program Update _May 20, 2010 • Washington State Department oNews• 1 For immediate release: May 5, 2010 (10-076) Contacts: Michele Roberts, Immunization Program CHILD Profile 360-236-3720 Allison Cook, Communications Office 360-236-4022 Childhood vaccine program to continue after previously being cut All Washington children will again have access to HPV vaccine OLYMPIA—Washington's program that buys vaccine for all kids in the state has been saved thanks to timely new funding from health plans. Some state funding for the program had been cut last year, with the rest scheduled to end May 1, 2010. A public-private partnership has closed that budget gap and restored the program. The cuts last year eliminated funding for human papillomavirus (HPV)vaccine for children with private health insurance.Now that the program has been saved, HPV vaccine is back and all kids age 11-18 years can once again get it from the state program, along with all other vaccines. • Under the innovative public-private partnership, state funds that had been cut have been replaced with an assessment to the state from health plans. Now, some kids will be covered by federal funds and other kids will be covered with state funds through this assessment. Health insurers and self-insured plans will be assessed for vaccines given to the children they cover. This commitment to "universal childhood vaccine" ensures that all kids have access to vaccines they need to protect them from disease. It also keeps things simple for health care providers and families, because providers won't have to purchase and manage a separate vaccine supply for children with private health insurance. One change with the new funding is that vaccinators must track vaccine given to kids with private insurance. "Vaccinating children is one of the best ways to keep them healthy," said Secretary of Health Mary Selecky. "This new partnership means kids have continued access to vaccines that prevent disease, and it's seamless for parents—that's why we got together with our partners in the private sector to make this change." —More— Washington's Childhood Vaccine Program saved May 5, 2010 Page 2 "The good news is that families can continue getting immunized in their regular health care • provider's office," said Dr. Beth Harvey, president of the Washington Chapter of the American Academy of Pediatrics. "This is the start of a long-term plan for improving immunization rates in our state. This is a positive outcome for children, physicians, the state, and insurers." The legislation that saved the vaccine program also created the Washington Vaccine Association. The association will manage payments from the health plans to the state. "The health plans and other payers recognize the importance of childhood vaccinations and responded to the providers' desire to maintain the state's system of universal purchase,"noted Fred Potter, Washington Vaccine Association executive director. "We will be working hard over the coming weeks and months to make sure the system works well for everybody, providers, payers, and the State of Washington. But the true beneficiaries of this program are our state's kids." Despite funding challenges over the past year, childhood immunizations remain a public health priority. Recent outbreaks of measles and chickenpox in our state show more must be done to • protect our children and communities. Partnerships between state and local health and the private health care community are more important than ever. More information about the Washington Vaccine Association (www.wavaccine.org) is available online. Call the local health agency (www.doh.wa.gov/LHJMap/LHJMap.htm) or the WithinReach (www.withinreachwa.org) Family Health Hotline at 1-800-322-2588 for help finding a health care provider or an immunization clinic. ### Photo opportunities in Group Health Cooperative clinics are available on request. Contact Joe Turcotte at 206-448-7301 or turcotte.j@ghc.org. Visit the Washington Department of Health Web site at http://www.doh.wa.gov for a healthy dose of information. • • Jefferson County Board of Health Netiv Business .agenda Item # IV, 1 311LNi Pandemic Res_ponse— • .after .Action Report .May 20 2010 • H1N1 After Action Report • Jefferson County Public Health April 23, 2010 INTRODUCTION The following After Action Report is for the Jefferson County Public Health (JCPH) response to H1N1 2009-2010 Pandemic between May 16, 2009 and April 2010. A separate After Action report was written for JCPH activities conducted between April 26, 2009 and May 16, 2009. The overarching goal JCPH H1N1 Pandemic response after May 15, 2009 was to prevent the transmission of H1N1 Flu through (1)tracking cases of influenza-like illness in hospitals, schools, and other facilities; (2) educating the community on ways to prevent H1N1 flu; (3) preparing for and conducting community vaccination campaign; and (4) distribution and tracking of the Strategic National Stockpile of Antivirals. EXECUTIVE SUMMARY Information about H1N1 flu was constantly changing. JCPH kept current on local, statewide, national and international disease trends,treatment guidelines and vaccines concerns and shared this information with Health Care community. JCPH worked with local hospital, schools and other agencies • to maintain surveillance and provide up to date information for the public. JCPH received information from several conference calls per week from the Department of Health. Regular email updates were received from the State DOH and the Center for Disease Control. JCPH disseminated information to Medical providers via Fax and email. JCPH web site was updated with information frequently. The first documented positive H1N1 case in Jefferson County was reported in Late May 2009.The Strategic National Stockpile (SNS)of Antivirals arrived in May of 2009 and were distributed to local pharmacies and the hospital. Information on how physician could order the Antivirals was provided via fax, on JCPH web site and at a meeting with the medical community in June 2009. As of April 2010, 196 courses of Tamiflu have been dispensed from the SNS in Jefferson County. Summer and fall of 2009 JPCH worked with schools, summer camps, community groups, agencies and businesses providing information on "Preventing the Spread of Disease", including flyers and posters. H1N1 Vaccine finally started arriving in October 2009. JCPH Immunization staff worked with the local hospital and medical community to initially focus on Health Care workers, pregnant women and young children to get the vaccine. By mid-October JCPH started offering regular H1N1 clinics for clients who met the current guidelines to receive the vaccine.JCPH Public Health Nurses started routinely offering the H1N1 Vaccine to WIC clients and pregnant women who were in the office for other services.JCPH staff worked closely with Jefferson Health Care to get the Vaccine to pregnant women and young children through their medical providers. JCPH conducted a School based Vaccine clinic after school • with a focus on young children and preschool age children. On December 12th the Health Officer lifted the restriction on the H1N1 Vaccine. Pharmacies started providing the H1N1 vaccine before Christmas. As of February 2010 almost 6,000 H1N1 vaccines were administered in Jefferson County. There were no • reported deaths caused by H1N1 in Jefferson County as of April 2010. TIMELINE OF MAJOR EVENTS May 2009 Received antivirals and personal protective equipment (PPE)from the Federal Strategic National Stockpile (SNS) Created contracts with 2 pharmacies to distribute SNS Antivirals and created SNS Prescription forms for Medical Community to use to access SNS Antivirals. First case of H1N1 documented in Jefferson County. Jefferson County Public Health implemented Incident Management system (light). Director became Incident Manager. Health Officer agreed to be Public Information Officer and take press calls. JCPH staff communicated information on surveillance and lab testing for H1N1 almost daily to Health Care providers. Local Hospital Lab created procedures for testing and sending specimens to state Lab. June 2009 Provided information to Health Care providers on how to access Antiviral and current recommendations for treatment. July 2009 Sent information to Summer Camps about H1N1 Surveillance and keeping sick kids home. Also, JCPH staff provided information on respiratory etiquette to Summer Camps. JCPH staff started planning for storage of large quantities of Vaccine. Received a donated Refrigerator, arranged secure space and insured temperature control of refrigerator. August 2009 Developed community information materials "Preventing the Spread of Disease" Scheduled Community Education trainings on "Preventing the Spread of Disease" • Contacted local School Districts to provide information on H1N1 and Preventing the . Spread of Disease. JCPH School Nurse met with School Staff including school Secretaries to review Communicable Disease Prevention in the Schools. JCPH scheduled Health Officer meeting with School Superintendents. Met with Jefferson Health Care Medical Providers and scheduled larger meeting with Medical Community to review H1N1 surveillance and treatment interventions September 2009 JCPH staff started a modified "Incident Command light" structure with weekly meetings to update each other on what was going on. Health Officer presented at Medical Providers meeting Sept. 10 and 18, 2009 providing up to date information on surveillance and treatment of H1N1. Continued Community meetings providing information on "Preventing the Spread of Disease" Constance communication with Jefferson Health Care regarding H1N1 testing and surveillance and treatment interventions • Weekly contact with schools on absenteeism rates Several Conference calls a week with the anticipation of H1N1 Vaccine to arrive in October 2009. JCPH started pre-registering medical providers and pharmacies to provide H1N1 vaccine. October 2009 Started planning mass vaccination clinics at school sites with Department of Emergency Management but canceled plans when the initial vaccine amounts were reduced radically. Sent out information to all Medical providers on information on H1N1 Vaccine, consents, Adverse Reporting (VARS) procedures, weekly tracking and reporting Jefferson County started receiving H1N1 vaccine. All vaccine was delivered to JCPH and JCPH immunization staff divided vaccine and delivered to local hospital and medical providers since Jefferson County's allocation was too small to ship to multiple providers. Daily and weekly tracking and reporting started of H1N1 Vaccine allotted and distributed in Jefferson County. JCPH Immunization and Communicable Disease staff met face to face weekly with clinics administering H1N1 Vaccine, delivering shipments and answering questions. • JCPH started offering H1N1 Vaccine through WIC clinic and to all pregnant women and young children through Maternity Support Services. Set up Communication plan to provide public information on who could get the H1N1 vaccine and where they could get it. Reassigned JCPH staff to answer phone calls. Provided information to Statewide Web site with information on where to get H1N1 Vaccine. JCPH received more SNS antivirals and JCPH staff distributed antivirals to local pharmacies. JCPH staff received faxes from pharmacies on antivirals prescribed and distributed. JCPH staff sent weekly reports done to Department of Health. Region 2 H1N1 epidemiology report launched and distributed to medical providers including surveillance data from local schools. JCPH set up scheduled and walk-in H1N1 Vaccination clinic. Reassigned RN staff and Registration staff and brought in on-call RN to help administer H1N1 vaccine. November 2009 Continued ordering and distributing H1N1 Vaccine in community. • Continued Community Education "Preventing the Spread of Disease". Continued Surveillance and received weekly absenteeism reports from Schools Continued Vaccination clinics Continued updating information on Web site, Press releases and emails and faxes to Medical Providers. December 2009 Continued conducting H1N1 Vaccination Clinics, Distribution of Vaccine to providers and tracking Vaccine and Antivirals. On December 12th, lifted restrictions on H1N1 Vaccine so that everyone was eligible to receive Vaccine. Delivered H1N1 Vaccine to 3 local pharmacies so they could start distributing H1N1 Vaccine. • January 2010 • Continue weekly "walk-in" H1N1 Vaccination clinic Continue tracking H1N1 Vaccine and SNS antivirals March 2010 Sent survey to community partners via email, fax and mail to Health Care providers, Pharmacies and schools requesting feedback on H1N1 response and JCPH. 10 of 14 Health Care Providers responded 1 of 4 school districts responded 4 of 4 pharmacies responded Responses were positive, constructive with some great ideas. Providers universally felt heard, supported and knew they were working as part of a local team. KEY ACTIONS, OBSERVATION, AND RECOMMENDATIONS Epidemiology and surveillance • Schools There are five school districts in Jefferson County, none of these employ their own school nurses. The two smaller districts have ESD school nursing services. The two largest districts contract with us, JCPH, for part time school nursing services to cover the mandated services. The limited nursing hours for each school meant working with the school secretaries to collect absenteeism data. The JCHP Director spoke to each superintendent by phone, discussing the updated absenteeism reporting system. All four superintendents agreed to have their staff participate in the surveillance system. We emailed the new absenteeism reporting form and instructions to each principal and attendance secretary. The attendance secretaries at each school building reported absenteeism at once it reached 10% by faxing the form to JCPH. Some schools called in reports. Observations: Most of our schools participated in the absenteeism reporting system using the new form. Recommendations: • Healthcare Community JCPH Communicable Disease nurses faxed recommendations on testing for H1N1 and the • criteria for testing at the State Public Health Lab to the hospital and all provider clinics. Case reporting requirements were faxed to the infection control nurse and lab at the hospital. New recommendations were faxed out as the testing criteria changed. Information on H1N1 transmission and infection control was sent to the one nursing home in county and all assisted living facilities. Region 2 Epidemiologists produced regional H1N1 surveillance reports that were disseminated bi-weekly to healthcare partners via e-mail. These reports included viral trends, influenza hospitalizations, and influenza deaths from sources such as the DOH communicable disease epidemiology report, regional hospital reporting, and the University of Washington virology Lab. Observations: The offer to sign up for the Region 2 H1N1 report was faxed out to all hospitals, clinics and pharmacies, which needed to send a response back to be added to the list. JCHP did not know which local providers had signed up until late in the outbreak when we requested this information from the Region 2 staff at Kitsap County Health District. We • found that only 5 local providers and 1 pharmacy had signed up, none from our largest clinics, and no key hospital staff. Jefferson Healthcare ER Visit data was not available for the Region 2 H1N1 Report. Recommendations: In the future, if this e-mail list system is used again to distribute reports, we will find out who is receiving the report and follow-up with providers who did not sign up. We need to follow up on the issue of Jefferson Healthcare ER Visit data not being available for this report. We need to find out what needs to be done to make this data available. Identify vulnerable populations early in Communicable Disease incident with the help of surveillance and tracking. By focusing initial education and outreach efforts on most vulnerable groups we may prevent transmission or initiate treatments interventions early preventing complications and hospitalizations. Communication iHealthcare Community During August- October of 2009,JCPH CD/Immunization staff with the Jefferson Healthcare System COO, MD team leaders and Clinic Managers five times. We discussed H1N1 lab testing guidelines, antiviral recommendations, the federal H1N1 vaccine program and plans for vaccine distribution, infection control, surveillance and communication methods. Dr. Locke gave a H1N1 education presentation to the local providers on 9/10/09. He covered the H1N1 vaccine, target groups, H1N1 diagnosis, treatment and infection control. JCPH provided local and Region 2 updates and alerts to medical providers via blastfax, and email system. Alerts covered topics such as lab testing guidelines, use of antivirals, H1N1 rumors, the Vaccine Adverse Event Reporting System (VAERS), and H1N1 Vaccine. JCPH received many phone calls from providers with questions about vaccine, diagnosis and treatment recommendations.These calls were prioritized so that they always went to an available nurse and not to voice mail. Survey results: see summary Observations: Web site updating was sometimes complicated Recommendations: revised web site School Communication JCPH School Nurse met with School staff including School building Secretaries before School started to review information on Preventing Spread of Disease and when to students should stay home from school. As new State and Federal information for schools was published JCPH e-mailed these out to the principals and superintendents. JCPH Communicable Disease Nurse worked with schools to identify the easiest way for them to communicate their absenteeism rates weekly. Health officer met with School Superintendents and Kitsap County Health officer On Sept. 25, 2009 to review issues on infection control and school closures. It was decided that school closures were not necessary in this situation to prevent the spread of disease. • Observation; JCPH long history of working with Jefferson County Schools with School Nursing and • other prevention Programs created a strong foundation for dealing with H1N1 response. Recommendations; Continue annual meeting with school personnel regarding infection control issues. JCPH Staff Communication JCPH H1N1 team including Director, and Communicable Disease Team and Immunization Coordinator and Chief Operation Officer met as needed and at least every two weeks. Notes from H1N1 team meeting were email to the rest of the department staff. Updates on H1N1 were presented at the General Staff meeting. Nursing and Medical Records staff were reassigned to assist with H1N1 Vaccination clinics. Observations;JCPH staff worked well together communicating both formally via email, meetings and meeting notes and informally as needed Recommendations; no changes Community Communication Director and Health Officer were lead Public Information Officers for Newspaper and other Media. JCPH did press releases and the local Newspaper did articles almost every other week after talking to Director or Health officer about current situation with H1N1. Nursing, Medical Records and Administration staff assisted with phone calls from the public regarding who, when and where the H1N1 vaccines were available. Nursing staff was available to answer medical questions and refer to medical providers or information available on the Web. JPCH updated Web site with news releases weekly JCPH Community Liaison staff, Public Health Nursing Director and Environmental Health staff, conducted Community Education meetings on "Prevention the Spread of Disease" including: Jefferson County Departments, City of Port Townsend, Port Townsend Chamber of Commerce 8/17, Gardner Community Center 9/13, Food Coop 9/24, Cape George Emergency Preparedness group 10/7. Jefferson County Emergency Preparedness meeting 9/25, Adult Care Facilities and Agencies Serving Vulnerable Populations and Emergency Preparedness meeting 10/5, and Neighborhood Emergency • Preparedness meeting 10/15. Environmental Health Public Health Food Service staff did • Pan Flu outreach to restaurants. Sept. 5, 2009 JCPH staff provided 5 Red Cross RN Volunteers H1N1 Preventing the Spread of Disease material. Red Cross RN Volunteers did training with 5 churches, YMCA, Fitness center, Garden club and others. September 17, 2009 JCPH staff presented information at Jefferson County Board of Health on H1N1 Observation: Community was very receptive to information from Public Health. There was some controversy over Vaccines by alternative community. JCPH used CDC and State Web sites as references for additional information. Consistent messages was a challenge when priorities changed as more H1N1 Vaccine became available Recommendations: Continue efforts to maintain consistent messages through Region 2. Vaccine Distribution and Tracking During August- October of 2009,JCPH CD/Immunization staff met with the Jefferson Healthcare System COO, MD team leaders and Clinic Managers five times. We educated • this team about the H1N1 vaccine,the federal program, and updates. We discussed vaccination strategies for our community. We planned to use a combination of mass vaccination clinics and vaccine in the provider clinics. The vaccine shortage required a change to having vaccine in provider and JCPH clinics only, since the vaccine supply was not adequate for a mass clinic until much later. In early November the 4 Jefferson Healthcare clinics decided to create a joint H1N1 vaccine clinic to serve their patients. We were invited to a planning meeting for this clinic. JCPH held 2 H1N1 immunization clinics per week from October through January, focusing on those without healthcare insurance and those without a local provider. Dr. Locke gave a H1N1 education presentation to the local providers on 9/10/09 and 9/18/10. He covered the H1N1 vaccine,target groups, H1N1 diagnosis, treatment and infection control. We used our provider fax system to provide medical providers and their office staff with local and Region 2 updates about H1N1 issues, including the vaccine process. We also received many phone calls from vaccine providers with questions. These calls were prioritized so that they always went to an available nurse and not to voice mail. Nine medical providers, two pharmacies, one hospital and one long term care facility signed contracts with DOH to provide H1N1 vaccine. JCPH facilitated the signing of •these contracts and trained all vaccine providers. Beginning October 1st JCPH Immunization Nurses made weekly deliveries of H1N1 vaccine to all of the clinics and provided education on the vaccine presentation target groups. For the first several weeks the clinic staff had questions for the nurses when they arrived, so these face to face visits were helpful. By November we were using support staff to make the deliveries. Since the Jefferson County allocations were very small until late November, we had to have almost all of the allocations shipped to JCPH. We split the allocations and delivered vaccine to the clinics according to the presentations available and their patient population. JCPH provided two H1N1 vaccine allocations of 100 doses each for the Queets Tribal members living in Queets. We did this by transferring our dose allocations to Grays Harbor Health department so that they could order it for the Tribe. Observations: Initially it was confusing to the public who and where they could get the H1N1 vaccine when there was limited supply Recommendations: • Uncertainties regarding vaccine supply will likely be a feature of future pandemics. Antiviral Distribution and Tracking The Federal SNS Antiviral arrived in May 2009 and some of the antiviral were distributed to two local pharmacies who agreed to take it and the local hospital. For Jefferson County Public Health to become a licensed Emergency Pharmacy warehouse was not practical for the small amount of antivials in its allotment. Most of the antivirals were delivered to the local pharmacies and the rest were moved to Kitsap County where their Kitsap Health District has a licensed Emergency Pharmacy warehouse. By September 2009 the 3rd pharmacy in Jefferson County signed a contract to take SNS antivials and all 3 local pharmacies had signed contracts to store and distribute the SNS. 196 Courses of Tamiflu were given out as of March 2010 of the SNS through the local Pharmacies. Observations; Pharmacies were receptive to accepting the SNS and distributing. S Health Care System Coordination • JCPH started working with Jefferson Health Care and the local providers very early in the Pandemic starting in May 2009. Coordination was by phone, email, meetings, and faxes. Observations: According to the Survey sent out March 2010 all the 10 out of 14 medical Providers who responded to the Survey said they received adequate and timely information. Recommendations: JCPH created a Medical Provider section to the JCPH web site. Web site continues to be updated and revised. JCPH will work with Jefferson Health Care (JHC) Information Technology department to figure out ways to connect to JHC internal email and medical records system to assist with communication, surveillance and lab reporting. Regional Coordination From Kitsap Health District Region 2 Lead for Public Health Emergency Response and Preparedness. • • The Health Officers from Kitsap County, Clallam County and Jefferson County (Dr. Locke and Dr. Lindquist) participated in regular conference calls with other Washington State health officals. In addition,they talked regularly with each other regarding regional information and ensure consistency in key issues. • The Kitsap Emergency Response Coordinator, who also works on regional response, communicated regularly with the emergency response coordinators at Clallam County Health and Human Services and Jefferson County Public Health. They shared press releases and information on major strategies or epidemiology. • Observations: Counties in Washington State varied in their approach to vaccinating their residents. The Health District works closely with Clallam County Health and Human Services and Jefferson County Public Health in emergency planning; however, each county modified their approach to H1N1 vaccinations to best match the local health care delivery systems' capabilities. The public health agencies were able to identify two areas where regionalization would work: public information (press releases, messaging, etc) and surveillance. • Recommendations: o Region 2 Response Coordinator(Kitsap Health District)will work with Jefferson County Public Health and Clallam County Health and Human Services on a definition of regional response (especially pertaining to public information and surveillance) and update regional response plan • Conclusion JCPH received 15 responses to the survey sent out March 2010. See attached summary. • Overall response was very positive regarding JCPH. At the April 15, 2010, Board of Health Meeting Jefferson Health Care, a local pharmacy and nursing home all made positive comments regarding JCPH staff's assistance, information and support through H1N1 response and vaccine distribution. Community partnerships were a key component for Jefferson County Public Health's H1N1 Response. JCPH worked very closely with Jefferson Health Care, local medical providers, pharmacies and schools. Jefferson County Department of Emergency Management was available but was not needed since the H1N1 Vaccine came into Jefferson County in small allotments and JCPH and Jefferson Health Care was able to distribute H1N1 vaccine to the initial priority groups without additional staff/support from DEM. Local media, businesses, agencies and community groups were very receptive to Public Health message on "Preventing the Spread of Disease" and respiratory etiquette posters. 3 local pharmacies signed contracts to distribute Antivirals from the SNS and 196 courses of Tamiflu was dispensed. Over 6,000 H1N1 Vaccines were dispensed by a combination of JCPH clinics, JHC clinics, medical • providers and pharmacies. There were no reported deaths from H1N1 in Jefferson County. In April 2010 Jefferson County Board of Health gave Public Health Hero Awards to the local partners listed above. Action Plan Issues Recommendation Staff/program Target date responsible for for resolution recommendation or completion Communication: JCPH Web site wasn't easy to Assess Web site and work Director with help from Initiated navigate and/or find needed with Web Master to Admin staff and update of information for the public and update and rework support from program Web site health care providers headings and links staff February 2010 and on going JCPH doesn't have direct email Work with JHC to create IT Director will contact July 2010 communication to JHC medical link that will assist with JHC Administrator to providers emails making is communication directly make connection with difficult to get information to with JHC Medical IT Department • them quickly providers(might be through their EMR) • Constantly changing messages Continue efforts to Health officers and LHJ Ongoing and and information on maintain consistent leadership, RERC, with each priority/vulnerable populations, messages throughout LERCs incident disease,vaccines distribution, region 2 through current testing and treatments communication methods, conference calls,face to face meetings and emails Epidemiology and Surveillance: Providers were required to In the future, if this e-mail Communicable Disease During next respond to an invitation to be list system is used again to Program Coordinator incident in added to the list to receive the distribute Region 2 which this Region 2 H1N1 Report.JCHP did reports, we will find out system is not know which local providers who is receiving the used had signed up until late in the report and follow-up with outbreak, and then found that providers who did not sign few providers were on the list. up. Jefferson Healthcare ER visit Follow up on issue of Communicable Disease Assess issue data was not available for the Jefferson Healthcare ER Program Coordinator May 2010 Region 2 H1N1 Report. Data visit data not being and Region 2 from other hospitals in Region 2 available to Region 2 Surveillance Staff was available and was included Surveillance Staff for the • in the report. surveillance reports. Limited vaccine supply required Identify vulnerable Communicable Disease During any prioritization of vaccine target populations early in team future groups, according to CDC Communicable Disease incidents, prioritization and specific incident with the help of ongoing vaccine presentation availability. surveillance and tracking. By focusing initial education and outreach efforts on most vulnerable groups we may prevent transmission or initiate treatment interventions early, preventing complications and hospitalizations. In this outbreak JCPH administered vaccine as soon as possible to pregnant women, parents and young children in our WIC clinic and our MCH program. • Vaccine Distribution Uncertainties regarding vaccine Address vaccine supply Health officers, LHJ Ongoing and supply will likely be a feature of issues early leadership, at the future pandemics Department of Health, beginning of future incidents Response Planning JCPH and Region 2 needs JCPH will work with Local Emergency Started updates to Emergency Plan Region 2, Kitsap Health Response Coordinator March 2010 District to identify needed and Regional and on-going updates to Emergency Emergency Response Exercise Plan Coordinator January 2011 Contact person: Julia Danskin, Local Emergency Response Coordinator Jefferson County Public Health jdanskin@co.jefferson.wa.us 360-385-9420 • • s Jefferson Count Board of 3-Cealth Wow Business .Agenda Item # 1"V, 2 • NationalHealth Reform Legislation: Impact on Public 3-featth and Prevention .activities iVlay 20, 2010 • TrIt for /00. 4044 / menca's Hea th WWW.HEALTHYAMERICANS.0RG Patient Protection and Affordable Care Act (HR 3590) Selected Prevention, Public Health & Workforce Provisions Selected Prevention and Public Health Provisions Essential Health Benefits Requirements (Sec. 1302) —Includes an essential health benefits package that covers essential health benefits defined by the Secretary and limits cost-sharing. Included in the general benefit categories are preventive and wellness services and chronic disease management, maternity and newborn care, mental health and substance use disorder services, and pediatric services, among other things. Coverage of Preventive Health Services (Sec. 2713)— Stipulates that a group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage for and shall not impose any cost sharing requirements for: (1) evidence based items or services that have in effect a rating of'A' or `B' in the current recommendations of the US Preventive Services Task Force (USPSTF); (2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the CDC with respect to the individual involved; (3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by HRSA; (4) with respect to women, additional preventive care and screenings not described in paragraph (1) as provided for in comprehensive guidelines supported by HRSA; States that for the purposes of this Act, and for the purposes of any other provision of law, the current recommendations of the United States Preventive Service Task Force regarding breast cancer screening, mammography, and prevention shall be considered the most current other than those issued in or around November 2009. States that nothing in this subsection shall be construed to prohibit a plan or issuer from providing coverage for services in addition to those recommended by United States Preventive Services Task Force or to deny coverage for services that are not recommended by the Task Force. Medicare Coverage of Annual Wellness Visit Providing a Personalized Prevention Plan (Sec. 4103)—Provides Medicare Part B coverage, with no co-payment or deductible, for personalized prevention plan services. Personalized prevention plan services means the creation of a plan for an individual that includes a health risk assessment and may include other elements, such as updating family history, listing providers that regularly provide medical care to the individuals, BMI measurement, and other screenings and risk factors. The personal prevention plan would take into account the findings of the health risk assessment and would be completed prior to or as part of a visit with a health professional. The personalized health advice and referral may include community-based lifestyle interventions to reduce health risks and promote • self-management and wellness, as well as lists of risk factors and a screening schedule. t Directs the Secretary to establish publicly available guidelines for health risk assessments, standards for interactive telephonic or web-based programs to furnish health-risk assessments and a health risk assessment model. Removal of Barriers to Preventive Services in Medicare (Sec. 4104)— Waives coinsurance requirements for most preventive services, requiring Medicare to cover 100 percent of the costs. Services for which no coinsurance or deductible would be required are the personalized prevention plan services, an initial preventive physical examination and any covered preventive service if it is recommended with a grade of A or B by the USPSTF. Clarifies that cost sharing for colorectal cancer screening services would be waived. Evidence-Based Coverage of Preventive Services in Medicare (Sec. 4105)—Provides the Secretary with the authority to modify coverage of existing preventive services, consistent with USPSTF recommendations. It would allow the Secretary to withdraw Medicare coverage for services not rated as A, B, C, or I by the USPSTF. Improving Access to Preventive Services for Eligible Adults in Medicaid (Sec. 4106)—The current Medicaid State option to provide other diagnostic, screening, preventive, and rehabilitation services would be expanded to include: (1) any clinical preventive service recommended with a grade of A or B by the USPSTF and (2)with respect to adults, immunizations recommended by the Advisory Committee on Immunization Practices and their administration. States that cover these additional services and vaccines, and also prohibit cost- sharing for such services and vaccines, would receive an increased Federal medical assistance percentage (FMAP) of one percentage point for these services. Coverage of Comprehensive Tobacco Cessation Services for Pregnant Women in Medicaid (4107) - States would be required to provide Medicaid coverage for counseling and pharmacotherapy for tobacco cessation by pregnant women. Prohibits cost-sharing for these services. Incentives for Prevention of Chronic Diseases in Medicaid (Sec. 4108)—Directs the Secretary to award grants to States to carry out initiatives to provide incentives to Medicaid beneficiaries who successfully participate in a healthy lifestyles program and demonstrate changes in health risk and outcomes. The program shall be comprehensive, evidence-based, widely available, and easily accessible and shall be proposed by the state and approved by the Secretary. It shall be designed to address the needs of Medicaid beneficiaries to achieve: ceasing the use of tobacco; controlling or reducing weight; lowering cholesterol; lowering blood pressure; avoiding the onset of diabetes or improving management of diabetes. The programs shall last for 5 years. The section includes impact assessments, evaluation and reporting requirements. The section appropriates $100 million for the program, out of any funds not otherwise appropriated in the Treasury. National Prevention, Health Promotion & Public Health Council (Sec. 4001) —Creates a Council within HHS to provide coordination and leadership at the Federal level, and among Federal departments and agencies, with respect to prevention, wellness and health promotion • practices,the public health system and integrative health care in the U.S. &to develop the National Prevention Strategy. The Council shall be composed of departmental Secretaries from • across the federal government, with the Surgeon General serving as Chair. National Prevention and Health Promotion Strategy (Sec. 4001)—Tasks the Council with creating a national strategy to: set goals and objectives for improving health through federally- supported prevention, health promotion and public health programs, establish measurable actions and timelines to carry out the strategy, and make recommendations to improve Federal prevention, health promotion, public health and integrative health care practices. Prevention and Public Health Fund (Sec. 4002) Establishes a fund, to be administered through the Office of the Secretary at HHS, to provide for an expanded and sustained national investment in prevention and public health programs (over the FY 2008 level). The Fund will support programs authorized by the Public Health Service Act, for prevention, wellness and public health activities, including prevention research and health screenings and initiatives, such as the Community Transformation grant program,the Education and Outreach Campaign for Preventive Benefits, and immunization programs. Funding levels: FY 2010 - $500 million; FY 2011 - $750 million; FY 2012 - $1 billion; FY 2013 - $1.25 billion; FY 2014 - $1.5 billion; FY 2015 and each fiscal year thereafter- $2 billion. Community Health Centers and the National Health Service Corps Fund (Sec. 10503) - Creates a Community Health Center Fund that provides enhanced funding for the Community Health Center program, the National Health Service Corps, and construction and renovation of community health centers. Fund totals $10 billion over 5 years. **Of note,the President's • proposal would invest $11 billion in Community Health Centers over five years. Clinical and Community Preventive Services Task Forces (Sec. 4003)—Defines, clarifies duties of, and provides better coordination between the U.S. Preventive Services Task Force and the Community Preventive Services Task Force. Education & Outreach Campaign Regarding Preventive Benefits (Sec. 4004) - Directs the Secretary to provide for the planning and implementation of a national public-private partnership for a prevention and health promotion outreach and education campaign to raise public awareness of health improvement across the lifespan. Requires the Secretary, acting through the CDC Director, to establish and implement a national science-based media campaign on health promotion and disease prevention. Directs the Secretary, acting through the CDC Director, to enter into a contract for the development and operation of a Federal Internet website personalized prevention plan tool. Funding for activities authorized under this section shall take priority over funding provided by CDC for grants with similar purposes. Funding for this section shall not exceed $500 million. Directs the Secretary to provide guidance and relevant information to States and health care providers regarding preventive and obesity-related services that are available to Medicaid enrollees, including obesity screening and counseling for children and adults. States shall design • a public awareness campaign to educate Medicaid enrollees regarding availability and coverage of such services. The Secretary shall report on the status and effectiveness of these efforts. School-Based Health Centers (Sec. 4101)—Directs the Secretary to award grants to support the • operation of school-based health centers, with an emphasis on communities with barriers pp access to health services. Out of any funds in the Treasury not otherwise appropriated, there is appropriated for each of the fiscal years FY 2010-2013 $50 million for expenditures for facilities and equipment or similar expenditures. Authorizes the Secretary to award grants to pay the costs associated with expanding and modernizing existing buildings for use as a School-Based Health Center. Oral Health (Sec. 4102) Directs the Secretary (subject to the availability of appropriations) to establish a 5-year national public health education campaign focused on oral healthcare prevention and education. Establishes demonstration grants to show the effectiveness of research-based dental caries disease management. Includes various oral health improvement provisions relating to school-based sealant programs, oral health infrastructure, and surveillance. Community Transformation Grants (Sec. 4201)—Authorizes CDC to award competitive grants to State and local governmental agencies and community-based organizations for the implementation, evaluation, and dissemination of evidence-based community preventive health activities in order to reduce chronic disease rates, prevent the development of secondary conditions, address health disparities, and develop a stronger evidence-base of effective prevention programming. Eligible entities shall submit to the Director a detailed plan including the policy, environmental programmatic and as appropriate infrastructure changes needed to promote healthy living and reduce disparities. Activities may focus on creating healthier school • environments, creating infrastructure or programs to support active living and access to nutritious foods, smoking cessation and other chronic disease priorities; implementing worksite wellness; working to highlight healthy options in food venues; reducing disparities; and addressing special population needs. The section includes evaluation and reporting requirements. Healthy Aging, Living Well; Evaluation of Community-Based Prevention; and Wellness Programs for Medicare Beneficiaries (Sec. 4202) -Authorizes the Secretary, acting through the CDC Director, to award competitive grants to health departments and Indian tribes to carry out five-year pilot programs to provide public health community interventions, screenings, and when necessary, clinical referrals for individuals who are between 55-64 years old. Grantees must design a strategy to improve the health status of this population through community based public health interventions. Intervention activities may include efforts to improve nutrition, increase physical activity, reduce tobacco use and substance abuse, improve mental health and promote healthy lifestyles among the target population. Screenings may include mental health/behavioral health and substance abuse disorders; physical activity, smoking and nutrition; and any other measures deemed appropriate by the Secretary. The section includes an evaluation component. The Secretary shall conduct an evaluation of community-based prevention and wellness programs and develop a plan for promoting healthy lifestyles and chronic disease self- management for Medicare beneficiaries. The evaluation shall include programs sponsored by S the Administration on Aging that are evidence-based and have demonstrated potential to help Medicare beneficiaries reduce their risk of disease, disability and injury by making healthy • lifestyle choices. CMS and AOA shall also conduct an evaluation of exiting community prevention and wellness programs. The Secretary shall submit a report to Congress on recommendations to promote healthy lifestyles and chronic disease self-management for Medicare beneficiaries; relevant findings; and the results of the evaluation. Removing Barriers and Improving Access to Wellness for Individuals with Disabilities (Sec. 4203)—Requires the establishment of standards for accessible medical diagnostic equipment for individuals with disabilities. Immunizations (Sec. 4204)—Authorizes states to obtain additional quantities of adult vaccines through the purchase of vaccines from manufacturers at the applicable price negotiated by the Secretary and authorizes a demonstration program to improve immunization coverage. Reauthorizes the Immunization Program under Section 317 of the PHSA. Requires a GAO study and report on Medicare beneficiary access to vaccines and coverage of vaccines under Medicare Part D. Nutrition Labeling of Standard Menu Items at Chain Restaurants (Sec. 4205)—Establishes nutrition labeling of standard menu items at chain restaurants (20 or more locations doing business under the same name). This includes disclosing calories on menu boards and in a written form, available on request, additional information pertaining to total calories and calories from fat, amounts of fat and saturated fat, cholesterol, sodium, total and complex carbohydrates, sugars, dietary fiber, and protein. • Demonstration Project Concerning ning Individualized Wellness Plan (Sec. 4206)—Directs the Secretary to establish a pilot program to test the impact of providing at-risk populations who utilize community health centers funded under this section an individualized wellness plan designed to reduce risk factors for preventable conditions identified by a comprehensive risk- factor assessment. Reasonable Break Time for Nursing Mothers (Sec. 4207)—Requires employers to provide reasonable break times for nursing mothers and a place, other than a bathroom, which may be used to express breast milk. Employers with less than 50 employees shall not be subject to this requirement if it would impose an undue hardship by causing significant difficulty or expense. Research on Optimizing the Delivery of Public Health Services (Sec. 4301)—Directs the Secretary, acting through the CDC Director, to fund research in the area of public health services and systems. Research shall include examining best practices relating to prevention, with a particular focus on high priority areas identified by the Secretary in the National Prevention Strategy or Healthy People 2020; analyzing the translation of interventions to real-world settings; and identifying effective strategies for organizing, financing or delivering public health services in real world community settings, including comparing State and local health department structures and systems in terms of effectiveness and cost. • Understanding Health Disparities: Data Collection and Analysis (Sec. 4302)—Requires the Secretary to ensure that any ongoing or federally conducted or supported health care or public health program, activity, or survey collects and reports, to the extent practicable, data on race, 11 ethnicity, gender, geographic location, socioeconomic status, language and disability status, in addition to data at the smallest geographic level. The Secretary shall analyze the data to detect and monitor trends in health disparities and disseminate this information to relevant Federal agencies. Employer-Based Wellness Programs (Sec. 4303)—Directs CDC to provide employers with TA, consultation and tools in evaluating wellness programs and build evaluation capacity among workplace staff. Directs CDC to study and evaluate employer-based wellness practices. Clarifies that any recommendations, data or assessments carried out under this part shall not be used to mandate requirements for workplace wellness programs. Grants for Small Businesses to Provide Comprehensive Workplace Wellness Programs (Sec. 10408) - Directs the Secretary to award grants to small businesses to provide employees with access to comprehensive workplace wellness programs. Pain Management (Sec. 4305)—Calls for an IOM Conference on Pain and includes various provisions relating to pain research and pain care education and training. Funding for Childhood Obesity Demonstration Project(Sec. 4306)—CHIPRA established a Childhood Obesity Demonstration Project and authorized $25 million for FY 2009-2013. This section appropriates $25 million for the Secretary to carry out the demonstration project in FY 2010—FY 2014. • Effectiveness of Federal Health and Wellness Initiatives (Sec. 4402) -Requires the Secretary of HHS to evaluate all existing Federal health and wellness initiatives and report to Congress concerning the evaluation, including conclusions concerning the reasons that such existing programs have proven successful or not successful and what factors contributed to such conclusions. Better Diabetes Care (Sec. 10407) -Directs the Secretary, acting through the CDC Director,to prepare on a biennial basis, a national diabetes report card. Directs the Secretary and the IOM to study the impact of diabetes on the practice of medicine and the level of diabetes medical education that should be required prior to licensure, board certification and board recertification. Cures Acceleration Network(Sec. 10409) - Requires the NIH Director to establish a Cures Acceleration Network to accelerate the development of high need cures, including the development of medical products and behavioral therapies. Centers of Excellence for Depression (Sec. 10410) - Establishes a Network of Health Advancing National Centers of Excellence for Depression. Programs Relating to Congenital Heart Disease (Sec. 10411) - Authorizes the Secretary, acting through the Director, to establish programs relating to congenital heart disease, including the formation of a National Congenital Heart Disease Surveillance System. Young Women's Breast Health Awareness and Support of Young Women Diagnosed with Breast Cancer(Sec. 10413) - Establishes a public education and a healthcare professional education campaign regarding women's breast health. National Diabetes Prevention Program (Sec. 5316) - Creates a CDC National Diabetes Prevention Program targeted at adults at high risk for diabetes, which entails a grant program for community-based diabetes prevention program model sites. • • Selected Workforce Provisions National Health Care Workforce Commission (Sec. 5101)—Establishes a commission to serve as a national resource for Congress, the President, States and Localities, determine whether the demand for health care workers is being met, identify barriers to coordination and encourage innovation. It shall disseminate information on retention practices for health care professionals and shall review current and projected health care workforce supply and demand and make recommendations regarding healthcare workforce priorities, goals and policies. The Commission shall communicate and coordinate with a variety of federal agencies and departments. Specific topics to be reviewed include health care workforce supply and distribution, health care workforce education and training capacity; existing education loan and grant programs, the implications of federal policies; the healthcare workforce needs of specific populations, and recommendations creating or revising loan repayment and scholarship programs. Public health professionals are included in the definition of health care workforce and the definition of health professionals. Public health workforce capacity is also included in the high priority areas list. State Health Care Workforce Development Grants (Sec. 5102)— Establishes a competitive healthcare workforce development grant program to enable State partnerships to complete comprehensive planning and to carry out activities leading to coherent and comprehensive health care workforce development strategies at the State and local levels. Authorizes $8 million for planning grants and $150 million for implementation grants for FY 2010 and such sums for each subsequent year. Health Care Workforce Program Assessment (Sec. 5103)—Codifies the existing National Center for Health Care Workforce Analysis to provide for the development of information • describing the health care workforce and the analysis of related issues and collect, analyze and report data related to programs under this title. The National Center and relevant regional and State centers and agencies shall collect labor and workforce information and provide analyses and reports to the Commission. Public Health Workforce Recruitment and Retention Programs (Sec. 5204)—Establishes a public health workforce loan repayment program to eliminate critical public health workforce shortages in Federal, State, local and tribal public health agencies. Individuals receiving assistance must work at least three years in these agencies. In FY 2010, $195 million is authorized to be appropriated for this program, and such sums as necessary for FY 2011-2015. Sec. 5205 creates allied health workforce recruitment and retention programs. Training for Mid-Career Public and Allied Health Professionals (Sec. 5206) -Authorizes the Secretary to make grants or enter into contracts to award scholarships to mid-career public health and allied health professionals to enroll in degree or professional training programs. Authorizes $60 million for these programs in FY 2010 and such sums as necessary for FY 2011-2015. Elimination of cap on Commissioned Corps (Sec. 5209) This section strikes the required cap of 2,800 for members of the Regular Corps. Establishing a Ready Reserve Corps (Sec. 5210) -Assimilates active duty Ready Reserve Officers into the Regular Corps & establishes a Ready Reserve to participate in training 101 exercises, be available and ready for involuntary calls to active duty during national emergencies and public health crises, be available for deployment and for backfilling positions left vacant during deployment of active duty Corps members, and be available for service in isolated, hardship & medically underserved communities. This section authorizes $5 million for FY 2010 —FY 2014 for carrying out the duties and responsibilities of the Commissioned Corps under this section and for recruitment and training; and $12.5 million for the Ready Reserve Corps for FY 2010—FY 2014. Grants to Promote the Community Health Workforce (Sec. 5313)—Directs the Director of CDC to award grants to promote positive health behaviors and outcomes for populations in medically underserved communities through the use of community health workers. Epidemiology-Laboratory Capacity Grants (Sec. 4304) Directs the Secretary (subject to the availability of appropriations)to establish an Epidemiology and Laboratory Capacity Grant Program to award grants to eligible entities to assist public health agencies in improving surveillance for and response to infectious diseases and other conditions of public health importance. Authorizes $190 million for each year of fiscal years 2010-2013 to carry out this section. Fellowship Training in Public Health (Sec. 5314)—Authorizes funding for fellowship training in applied public health epidemiology, public health laboratory science, public health informatics, and expansion of the epidemic intelligence service in order to address documented • workforce shortages in State and local health departments. Authorizes, for each of fiscal years 2010 through 2013, $5 million for epidemiology fellowship training programs, $5 million for laboratory fellowship training programs; $5 million for the Public Health Informatics Fellowship Program; and $24,500,000 for expanding the Epidemic Intelligence Service. Training in General, Pediatric and Public Health Dentistry (Sec. 5303)—Authorizes the Secretary to make grants to, or enter into contracts with, a school of dentistry, public or nonprofit private hospital or a public or private nonprofit entity to plan, develop and operate or participate in an approved professional dentistry program; to provide financial assistance to dental students, residents, practicing dentists and dental hygiene students, and for other purposes. United States Public Health Sciences Track(Sec. 5315) Authorizes the establishment of a United States Public Health Sciences Track with authority to grant appropriate advanced degrees in a manner that uniquely emphasizes team based service, public health, epidemiology, and emergency preparedness and response. Students receive tuition remission and a stipend and are accepted as Commissioned Corps officers with a 2-year service commitment for each year of school covered. Included among the graduates shall be 100 public health students annually. Includes a provision that would develop elite federal disaster teams. Preventive Medicine & Public Health Training Grant Program - Directs the Secretary to award grants to or enter into contracts with eligible entities to provide training to graduate medical residents in preventive medicine specialties. • Jefferson County Board of 3-dealt(. Netiv Business Agenda Item # IV, 3 • Draft Invitation Letter Nlay 20, 2010 • JEFFERSON COUNTY BOARD OF HEALTH • Re: Jefferson County Community Health Assessment Kick-off Date Place Dear Much has changed in Jefferson County since the last Jefferson Community Health Assessment. A national economic recession has forced deep cuts in the Washington State budget and Jefferson County services. Health care costs continue to rise at double digit rates and health insurance is increasingly unaffordable. Sweeping federal legislation, passed in March of this year, envisions extending the benefits of health insurance to an additional 32 million Americans while improving the quality and controlling the costs of this medical care. Accomplishing these extremely ambitious goals will take an unprecedented level of community leadership, wise allocation of limited resources, and careful management of public health and medical care services. The Jefferson County Board of Health has a broad statutory mandate to supervise "all matters pertaining to the preservation of the life and health of the people within its jurisdiction". Gathering and analyzing relevant health data and using it to help inform the decisions of community leaders is one important way the Board of Health works to improve the health of Jefferson County residents. We are inviting you, as a community leader, to join us in this important work group. • With the initiation of national health reform, community health assessment process has taken on a critical role. We have long known that prevention of illness and injury is much less costly than their treatment. As we invest in prevention and community health improvement, we have some hope of reigning in the runaway costs of health care and extending its lifesaving benefits to all citizens. The Jefferson County Board of Health invites you to become part of the Data Steering Committee to take a first look at Jefferson County's most up-to-date community information and guide the process of interpreting and prioritizing this data. Our goal is to set a process in motion that identifies priority community health problems, targets them for organized, multi-agency action, and allows health care and social service providers to evaluate the effectiveness of their efforts to address these problems. Our ultimate goal is a healthier community. And to do this, we need your help. Our first kick-off meeting will be for two hours in June, and then a smaller work group of interested partners will work with the data analysis professionals. Sincerely, Chair, Jefferson County Board of Health 615 Sheridan • Castle Hill Center• Port Townsend • WA• 98368 (360)385-9400 • Jefferson County Board of Health New Business gen&I Item # 117, 4 • NationalAccrecfitation of State and LocaC3-fealth Department _May 20, 2010 • Public Health Performance Review in Washington State . 2010-2011 FREQUENTLY ASKED QUESTIONS Have the Standards been The 2010-2011 Washington Public Health Standards have been substantially revised revised? from the last cycle.A review of the National Public Health Accreditation Board (PHAB)standards showed that approximately 80%of them corresponded to the Washington standards. We received permission to use the PHAB standards for the Washington performance review.This means that any local health agency interested in accreditation will get information from the performance review that will help them apply for accreditation. For local agencies not interested in accreditation,the standards and measures that were not part of Washington 2008 set are optional for the 2011 Review. Because the State Department of Health is participating in the beta test of the PHAB standards,all measures will be reviewed at the state level. There are two parts to the standards: Part A includes the administrative standards and Part B includes the standards that pertain to the public health work.You will notice that Domain is used as an organizing framework and follows the structure of the 10 Essential Services.There are now 10 Domains with 2-4 standards and 2-12 measures each. The standards (including printable copies for local and state agencies)can be found at the Public Health Standards website www.doh.wa.gov/phip/PerfMgmt/10- llstds/overview.htm Please note that a reverse look-up to the 2008 Washington Standards is displayed in a column alongside the current standards (where • applicable). LHJ Guidelines, Glossary of Terms and Local Health Applicability Table are also available on the Standards website(www.doh.wa.gov/phip/PerfMgmt/10- 11stds/resource.htm) Why conduct an Measuring the performance of the public health system according to standards is assessment of our required by state law(RCW 43.70.520 and.580). performance? Continuing to measure the performance of our public health system is critical to our future success.The 2002 Baseline and the 2005 and 2008 Performance Reviews provided site-specific reports on performance and identified local and statewide areas for focused improvement. This cycle will measure system changes since the 2008 Review and provide information about the strengths and opportunities for improvement. This continues our process of continuous quality improvement. Who are the reviewers? For local health,the reviewers are Marni Mason and Diane Altman Dautoff of MCPP Healthcare Consulting as well as trained reviewers from DOH. MCPP consultants served as the reviewers in 2002, 2005 and 2008.The Standards Workgroup of the Public Health Improvement Partnership (PHIP)again selected this team based on their expertise in quality improvement, surveying, statistical measurement, and the prior standards evaluation process. For the State Department of Health, the PHAB will send a team of reviewers to • review and score the PHAB standards and measures and Marni and Diane will review the specific Washington measures that are not part of the PHAB set. 1 What process will be The review process has been streamlined to have an off-site document review phase used to conduct the LHJ and an on-site review phase. Prior to the site visit,the reviewers will review the performance review and documentation you have gathered and score the documents. If there are any the site visits? questions about the documentation,you will be notified prior to the site visit. During the site visit the reviewers will discuss these questions with you (and your managers if you choose) and complete the review process. Depending on the size of your LHJ,this will be the same day. NOTE:For the 2010-2011 Review cycle your documentation must be submitted electronically, unless otherwise stated in the LHJ Guidelines document.There are just a handful of measures that allow for hard copy documentation to be provided to the reviewers during the site visit. Directions on how to submit electronically your documentation will follow in a few of weeks.At least 60%of the required Washington measures must have electronic documentation submitted in order for the agency to have a performance review in this cycle. When will the off-site The off-site review and the site visits to each local health jurisdiction (LHJ) and the performance review and State Board of Health will be done in the spring of 2011.The Department of Health site visits occur? will be reviewed in June of 2010. MCPP will contact LHJs in the Fall of 2010 to schedule the date of the site visit for the spring of 2011.A new feature of this review will be the submission of documents electronically which will be reviewed remotely. The site visit will be used for questions and clarifications. How can we get some An updated online orientation to the public health standards process will be help preparing for the available in 2010 for new staff or as a refresher to staff that has been through the site review process? process before. In addition,training will be provided in the Fall of 2010 to prepare • agencies for the on-site visits.The schedule for this training will be sent out in mid- 2010 to allow sufficient time to schedule your staff and managers for the training sessions. Will I receive material in The LHJ Guidelines for Performance Review are available on the Standards website. . advance?Will I have to Local health agencies should use these guidelines and an electronic submittal tool to gather documents ahead prepare for their review and to submit documentation. of time? An LHJ Applicability Table is also available to indicate which measures apply to the program/activity level. For the review process,you will use the LHJ Guidelines to gather and organize your documentation electronically for your submittal.The thoroughness of your preparation for the submittal will support a valid, meaningful performance review. The guidelines and applicability are available on the web at www.doh.wa.gov/phip/PerfMgmt/10-11stds/resource.htm How will the results of This review cycle will provide performance information to compare against most of this process be used? the previous results. It will help us continue to improve our processes and outcomes and help us target future resources. Results will be reported to the legislature as required by law. • 2 What if I don't like a Your opinions are critical to this process.At the end of your site visit, let the standard or measure? reviewers know if you have ideas about how to improve a standard or measure.The • responses you provided in the past site visits were utilized to refine many of the measures,and we will use your input again to continue to improve. Will I know how my The reviewers will provide you information about your overall strengths and scores relate to others'? opportunities for improvement at the closing interview of the site visit. Later you will receive a performance report that provides site-specific information and a summary for all LHJs and DOH/state level programs. These reports will be distributed at the close of the 2010-2011 cycle,after review of the findings and recommendations by the Standards Workgroup.A summary of the findings will be included in the next Public Health Improvement Partnership report. What about" Exemplary During each site visit,the reviewers will ask for electronic copies of material that Practices?" could be added to our online Exemplary Practices Compendium to help you in adopting or adapting proven tools or processes. Until then,you may find helpful documentation in the current Exemplary Practices Compendium to improve your performance in the coming year. With the changes, how A crosswalk to the previous set of standards is imbedded in the 2010-2011 can you compare items standards,so some of the 2008 review results could be used to help you prepare. If from one year to the you want to improve your score on a particular item from the last performance next—and how can we review,you can check the crosswalk to see how and where that item shows up in the use Exemplary Practices? revised standards. 4111 You can view related materials to the 2008 Exemplary Practices and use the crosswalk references to see how those items might be useful with the revised standards.www.doh.wa.gov/phip/documents/PerfMgmt/08EP/EPcompendium.pdf More Questions?The following people could help... Susan Ramsey, Co-Chair, Performance Management Committee susan.ramsey@doh.wa.gov Torney Smith,Co-Chair, Performance Management Committee tsmith@spokancounty.org Allene Mares, Department of Health allene.mares@doh.wa.gov Rita Schmidt, Department of Health rita.schmidt@doh.wa.gov Jane Lee, Department of Health jane.lee@doh.wa.gov Simana Dimitrova, Department of Health simana.dimitrova@doh.wa.gov • 3 Jefferson County Board-of Cealth Nledia Report • .7 /lay 20, 2010 • Jefferson County Public Health • April/May 2010 NEWS ARTICLES 1. "County reaps `found money'," Peninsula Daily News, April 7th, 2010. 2. "State lifts 23-year shellfish sanction near Dosewallips," Peninsula Daily News, April 7th 2010. 3. "Sexual assault, child abuse spotlighted by area events," Peninsula Daily News, April 9th, 2010. 4. "Breastfeeding good for baby, community," Port Townsend Leader, April 14th, 2010. 5. "Fight is on for king of the rock," Peninsula Daily News, April 18th, 2010. 6. "Results of toxic algae test due," Peninsula Daily News, April 18th, 2010. 7. "Landmark receives group's blessing," Peninsula Daily News, April 20th, 2010. 8. "New shoreline regulations taking effect," Port Townsend Leader, April 21s` 2010. 9. "Anderson Lake fishing season a go," Peninsula Daily News, April 22nd 2010. 10. "Family Fun Fest scheduled in PT," Peninsula Daily News, April 23rd, 2010. 11. "Algae an issue at Anderson Lake," Port Townsend Leader, April 28th, 2010. 12. "Smokes to cost a buck more," Peninsula Daily News, April 30th, 2010. 13. "Deadly fungus spreads to state," Peninsula Daily News, April 30th, 2010. • 14. "Please support your local Green Businesses," Port Townsend Leader, May 5th 2010. 15. "EnviroStars Certified Businesses," Port Townsend Leader, May 5th, 2010. 16. "Seminar on septic system TLC," Peninsula Daily News, May 10th, 2010. 17. "Taking on underage drinking," Port Townsend Leader, May 12th, 2010. 18. "Septic system class set for May 15," Port Townsend Leader, May 12th, 2010. 19. "Women turn dream to reality," Peninsula Daily News, May 14th, 2010. L • County 'found money' BY CHARLIE BEJu,tAN'r ble-murder trial of Michael fall and retain our projected However, he said he is PENINSULA DAILY NEWS J.Pierce. year-end fund balance," monitoring these situations Morley said. and will implement them if PORT TOWNSEND— Cut postitions in 2009 Morley said even if the needed. Jefferson County needs to county continues to hold the watch its costs, but the In 2009, the county cut line,it still could fall into a Volunteers for parks receipt of$500,000 in antic- the equivalent of 10.5 full deeper deficit in 2012 with ipated, unexpected pay- time positions,and now hasout additional revenue Moreley said that some ments could prevent any a staff of 287.The lost poli- sources. cost-cutting measures,such more cuts,County Adminis- tions have not been "We are restricted from as requiring citizens to trator Philip Morley said restored. raising property taxes more maintain parks,will be per- this week. The county additionally than 1 percent a year and manent. "The [sales tax] revenue shortened the work week of that does not cover infla- "We no longer have the we are getting for the first most general fund employ- tion,"Morley said. staff to mow the lawn in our part of 2010 is less thanees to 37.5 hours from May Morley said that the 1 to Dec. what we projected,"Morley county needs to monitor 31 2009, but public w, Morley said. "The ll need to continue missionersi parks" told the three county com- restored them to 40 hours cash flow each month. doingthis." on Jan. 1. He advised the commis- "Buttinn Monday.the end we are Morley did not antici- sinners to "be prepared, The county has a pro- almost exactly where we pate any more cuts"as long develop strategies and con- jetted annual budget of thought we would be." as.we can keep expenses tinue to work with all $52.8 million, with a gen- The"found money"comes down." branches, departments and eral fund balance of $15 from late payments from Both sales tax and unions,as appropriate." million, and is one of the investment revenue in Moreley doesn't think smaller counties in the jail invoices from the Port March were low,decreasing the county needs to impose region. Townsend Police Depart the overall 2010 projection. radical cost-cutting mea- ment as well as reimburse- "if revenues do not dete- sures such as those that ment for"extreme criminal riorate further, other pro- have been used by Kitsap, Jefferson County reporter Char- ", justice expenses" incurred jetted general fund reve- King and Snohomish coun- lie Bermant can be reached at 360- by the Jefferson County nues currently appear suf- ties — for instance, closing 385-2335 or at charlie.bermanf@ Superior Court for the dou- ficient to backfill the short- offices one day each week. peninsuladailynews.com. el . State lifts 23-year • shellfish sanction near Dosewaflips Official cites fewer "There used to be 300 seals on tidelands [seals] up there. I can't say that they're gone, but. BY TOM CALLIS there's certainly a lot less." PENINSULA DAILY NEWS GREG COMBS BRINNON — The state state public health adviser Department of Health has declared a portion of the Dose- wallips State Park tidelands safe tanks,Combs said. for shellfish harvesting after it Seals contribute to fecal coli- had been under a health advi- form bacteria contamination sory for the last 23 years. through their waste, and the Seventy acres of tideland, area was a popular spot for them marked by orange plastic stakes, until about five years ago when were taken off the health advi- orcas began hunting more in the sory list March 31 after water Hood Canal,Combs said. samples showed the area to be "There used to be 300 [seals) safe for harvesting under all con- up there," he said. "I can't say • ditions, the Health Department that they're gone, but there's announced Tuesday. certainly a lot less." The Health Department used The area near the river's 30 water samples taken over the mouth remains a problem, last five years to warrant the Combs said, because of bacteria move. washed downstream from leak- The rest of the park's tide- ing septic tanks. lands, particularly near the He said he doesn't think that Dosewallips River's mouth, any more of the park's tidelands remain under an advisory, said will be taken off the advisory list Greg Combs,state public health in the next couple of years. advisor. Shellfish licenses can be pur- Water quality in the tidelands chased at sporting goods stores, has improved because it now has Combs said. fewer seals than it once did, a decline attributed to hunting by Reporter Tom Callis can be reached at orcas, as well as because of less 360-417-3532 or at tom.calis@peninsula pollution from. nearby septic dailynews.com. • /4/ • //f%i%r • SeXuaIassault child abuse spotlighted b area events PENINSULA DAILY News both venues. child-identification and strategies to reduce under- The tragedy of sexual Today's reading will be DNA kits,and treats will be age drinking. assault and child abuse,the at 6:30 p.m. the Port Ange- provided. The meeting will be at 6 courage of those who sur- les Senior Center,. 328 E. The following day, Sun- p.m. at the Port Townsend vive it and possible ways to Seventh St. day, April 18, The Food High School cafeteria, 1500 Saturday's event will be Co-op and Sound Experi- Van Ness St. prevent it will be high at 6:30 p.m. at the Sequim ence will host "Our Co-Op I Dove House Advocacy lighted during presenta- Faith Lutheran Church, Kids,"an Earth Day festival Services will sponsor a tions across the North 382 W.Cedar St. celebrating boats, planes, "Walk a Mile In Her Shoes" Olympic Peninsula this Both are sponsored by worms and fish. event at 6 p.m. on Wednes- month, with three events . Healthy Families of Clal- The festival will be from day,April 28. set for this weekend. lam County. Both are free, 1 p.m.to 4 p.m.in the Food The walk will attempt to Jefferson County Public but donations will be Co-op parking lot,414 Kear- bring awareness to the Health, and several com- accepted. ney St.,Port Townsend. issues of sexual assault and munity partners, have . Healthy Families also Also participating will be rape. developed "Our Kids: Our will sponsor the screening representatives of the It will begin at Rotary Business," a social aware- of the documentary "Rape Northwest Maritime Cen Park, next to US Bank, ness and prevention cam- Is" and a follow-up ques- ter, Wooden Boat Founda- which is at 1239 Water St., paign featuring measures tion-and-answer session tion, Port Townsend Sea Port Townsend. individuals, organizations, with Healthy Families ther- Scouts,Northwest School of Men are encouraged to agencies and businesses apist Ann Marie Emineth Wooden Boatbuilding, Port walk in women's shoes. can take to prevent child on April 27. Townsend Marine Science1110 Women and children can abuse and sexual assault. The screening — which Center, the schooner Mar- take part as well. Events are planned is free, with donations tha, Community Boat Proj Preregistration forms throughout the month. accepted—will be at 6 p.m. ect, Port Townsend Aero are available at the Food at Healthy Families, 1210 Museum, Tri-Area RC Fly- Co-op,Jefferson Healthcare History Hunt E.Front St. ers Club and the Tri-Area and Dove House. On Saturday, the Jeffer For more information or School Garden/Compost Sponsors of the walk are to RSVP, phone 360-452- Program. Jefferson Healthcare hospi- son County Historical Soci- 3811. tal,the Food Co-op and the ety will host a Museum His- Other events Northwest Maritime Cen- tory Hunt from 11 a.m. to East Jefferson County ter. 3:30 p.m. ■ Crime Victims Service The Port Townsend Light Prizes will be given forNext weekend,on Satur- Center will host a free Fam- House Lion's Club will pro- completing the history`' day,April 17, the Jefferson ily Fun Fest at the Moun- vide refreshments. game.The event is free for County Sheriff's Office and tain View Commons, 1919 This event is part of a children. Jeffcom 911 Dispatch Cen-. Blaine St., Port Townsend, national men's movement In Port Angeles and ter at the Justice Center at on Saturday,April 24. to bring an end to sexual Sequim, members of Read- 79 Elkins Road in Port Had- The festival will be from violence. ers Theater Plus will read lock will host an open house 10 a.m.to 3 p.m. ■ The Boiler Room will excerpts from two Sequim from 1 p.m.to 3 p.m. Children and families feature events throughout authors today and Satur- Visitors will be able to will be able to learn about the month of April. day. meet Sheriff Tony Hernan- health and safety and com- For detailed information. Barbara Richard,author dez and the deputies,check munity resources. visit w w w.p t b r.o rg l of the trilogy Dancing on out the emergency vehicles, Free child identification calendar or phone 360-379- His Grave, Walking dust for fingerprints and kits will be available. 8247. Wounded and Chasing tour the Sheriff's Office and ■ Port Townsend High Events in both counties Ghosts, along with Dauna Jeffcom 911 Dispatch Cen- School Student Task Force are in recognition of Cole, author of A Shattered ter. will sponsor a Town, Hall National Child Abuse Pre- Mind,will answer questions Balloons, badges, age- Meeting on Tuesday, April vention and Sexual Assault and autograph books at appropriate coloring books, 27, to address community Awareness Month in April. • breastteea i ng In Jefferson County we have high I munityreeing su pp rtstes mo nsatoebreastfeed. good for baby, Jefferson County exceeds the state goal • for breastfeeding. As the nutritionist for community the Jefferson County WIC Program, I have heard of businesses that will allow In the state of Washington there is moms to work part time and encourage breastfeeding moms to bring their babies a law against harassing breastfeeding moms, and harassment is considered ,I. to work or provide a place where they can pump Way to go! discrimination. It is legal to breastfeed— We also milk. n beto thankful for partners in public, in restaurants, in the park, in.!Z such as Jefferson Healthcare and the the grocery store, anywhere. It is not a"::: lactation consultants and staff that help crime. women overcome difficulties with breast- fortable,It may make us individually uncom- feeding. La Leche League and the WIC but these moms are doing a Breastfeeding Tea help breastfeeding great job. Moms may feel embarrassed women support one another. Jefferson about breastfeeding their babies instead County Public Health WIC Program and of thinking:"Wow,look at me.I'm doing the Public Health nurses, through pro- the bestt thing for me, my baby, and the grams such as Nurse Family Partnership communityand Maternity Support Services, offer Breastfed babies are healthier.One of the many reasons that breastfed babies breastfeeding education before and after the baby comes.Together, these groupsare healthier is that breast milk contains work with the doctors and the midwives cells that fight infection. This healthy to help have positive outcomes for the start will last a lifetime for the child in breastfeeding mom and baby. ongoing health benefits. It also benefits Moms, keep up the good work. all of us in lower medical costs, since Community, keep up the good work. breastfed babies are hospitalized less Everyone say thank you to those moms often,have fewer upper respiratory infer- and families as well o to our partners tions and fewer ear infections as well as who help make a healthier community in many other health benefits.These health Jefferson County. benefits are long lasting for babies, as THY ANDERSON they remain healthier throughout their coordinator • lives. Babies who are breastfed have T Nutritionist,urson County WIC coordinator inator higher IQs. Breastfeeding also protects lth moms in many ways. Moms who have breastfed have less chance of getting breast cancer. f m ;�" 4 « a �ti 3 �` ems,.` 4� ,� e rg AO M � � 5 t ' 4111 _ •-,' --,:::::: R �� ' � •y+ to '4 � �' - .' lad nes ^' .„,..,-:°..-, - sap i. . a •? • , $ t• w ' 9ry i s ..Ar� - e 1.. -€.*s7,- fr '$`''6 .s `rix M«,r _ 4. k' m t. vor _ tiR } , 5-- t.4 tic .t a a .,,,C, ,,f,ti; t ..,j fv �+ a`,»'` ' s -.. JEFF Cxsw(3)�ENI':SLI.A RAIL,NeN� Once atop Tamanowas Rock east of Anderson Lake os Park,climbers get a a panoramic view to Hood Canal Bridge on a clear day,south,and to the Canadian C ,_. ;„„,r, to -1., ascades,north. to Fight Is on .........„...,:,„„„, „„_.,.,.5_,. ,,r for king :, ,,1 , .,..,,,inir....t .. ,,,,,„„;-:,7'.';,-1- ,i-,..1. ,--,,::4' \-,.°'-'-!"-._10C-- vi;-'4:-.4 of the rock g `,�.� 3 • Future of Tamanowas preservation worries groups `y • $� BY JEFF CHEW The property on which ; ^r�+ • a, €{ ' PENINSULA Dnns NEWS Tamanowas Rock sits is �� " ,' '4•`,4:-",':',',11..,,,•„,° ' now going.through the ,:t " + ,; , HIMACUM — Tamanowass ;�$ .,•,,,,,,,„: C}p a geological icon that juts preservaton process. s,a .4, up out of the forest east of .,:44,-;„.„1,—,- � 3 � �� Anderson Lake State Park C -ter '>I means a lot of things to a lot of people # "- '' - r - ! � To Northwest Native Americans such t ` ,*� a � ' ,* {' as the Jamestown S HIallam tribe,the ' ' ` more than 100-foot-tall monolith ist a '� r 5L€ 1e � ' cultural and spiritual symbol—a sacred -..,,, x, ,..4. :-,,,,-t, i place of worship. ^ The tribe, Jefferson Land Trust a ,, Northwest Watershed Institute and oth '^�� ; ers have worked for more than 13 yearsl'''''''' ' t- to protect the rock and the surrounding ,,E area from development. K Special place for climbersi*C.''''''''kt-..,,,77' + �', _e„,:,, ;' To veteran rock climbers Stewart :.,,,...t31,-;,--;,,,,_,, Matthiesen and Martin Mellish, the , , rock is also a special place where they i w have long scaled its gnarled brown-grey '',..,t40,'. � -"II' ' - walls dimpled with hollows. « The climb ends with a panoramic s t viewpoint towering over the China s a.w . - .. �*` Valley and Hood Canal to the south and • well into the Northern Cascades. Longtime Port Townsend-area rock climber Martin Mellish practices m,pu m�T .,,.,navealA4 nart of Tamanowas Rock. A4 SUNDAY,APRIL 18,2010—(J) Peninsu Iallorthwest Tamanowas: Land trust ownslot Tamanowas p Rock part • CONTINUED FROM Al 14t-. t 7 1 , of land buy "I don't think anybody wants r ° t to knock it down,just preserve it � *• - r `a * JEFFERSON COUNTY once and for all," Mellish said ., ,< after coaching a Peninsula Daily - CONSERVATION Futures News reporter-photographer up P�QT C F Citizen Oversight Committee the steep cable climb on the rock's Ig�� EQ will consider a two=year west side to take in the view. RBr $200,000 application toward Mellish and Matthiesen said .4 the purchase and perpetual includ- they know of nontribal individu• t ' protection of 129 acres,als and groups that consider the ung Tamanowas Rock east of ?'� Anderson Lake State rock a spiritual place. Park, I have a friend who comes rilkksoN when it meets Monday. here and she prays here and kris VD The committee of eight makes an offering,"said Mellish, Lmembers will meet at 3 p m a Port Townsend-area resident, >«;: in the Pacific Room,the main Tai Chi teacher and former t< ..,„„....‘ii',,‘,:, conference room at Jefferson Microsoft database design con- �y �" ` ...,,,,,,4„,,,,..:?„, CountyPublic Health,615 tractor. "' Sheridan St in Port He wants to get county youths Townsend's Castle Hill QFC involved in climbing the rock and a' t v ' shopping center , helping to keep it pristine, Jeer Leek Pevms ia DAILY Nrw, The makes instead of a place to drink beer g funding recommendations to commission- and party,which sometimes has Jefferson Land Trust now owns acreage off Anderson Lake Road with an entry and the three county road leading to Tamanowas Rock. e been the case. em The Jamestown S'Klallam Worry about agreement • Jefferson Land Trust is the She said there have been con- of their ceremonies,"county Com- tribe and Washington State "bridge"owner of the 63 acres servation easements allowed by missioner David Sullivan said. Parka aro project applicants Mellish and Matthiesen,who that surround Tamanowas Rock, the county that don't necessarily "That is something that has to Jefferson Land Trust is the grew up on Marrowstone Island a trust official said. allow public access. be worked out and we'll continue sponsor. and has rope-scaled the rock for The land trustpurchased the "The program wasn't specifi- to work on it.There are ways to The Tamanowas Rock about 20 years since he was 10, 63-acre rock property in Decem- cally design to provide access," rock climb and be respectful and application will be considered worry that public access could be ber 2009 for$600,000,and will she said. ways to avoid damage." along with a proposed Conser seriously restricted or closed off remain the owner until the tribe Sullivan said that, with an vation Futures funding appli- under a conservation easement and state parks officials come upLand purchases Olympic Discovery Trail route cation for$63,394 toward a agreement in the works among with the money to purchase the The tribe in 2005 obtained proposed from Four Corners to Salmon Creek riparian con- Washington State Parks, the Property and land adjacent to loans to purchase 86 privatelythe head of Discovery Bay, an servation easement acquisi- Blyn-based JamestownS'Kjallam Anderson Lake State Park. east-west trail spur needs to be lion on 160 acres off West and Port Townsend-based Jeffer- Jefferson Countycommission- which acres adjacent to the rock, considered.It would connect the 'Uncal Road near Discovery son Land Trust. era later this year will consider which otherwise might have been Discovery Bay-area to the Port ,Bay. "It would be unfair if itgoes the request from the tribe and developed as home sites. Jefferson County's Hadlock-Chimac area. Committee members ill from land trust protection to not state parks for $200,000 in "We'd like to seeee another trail discuss,rate and formulateto allowing anybody to access the county Conservation Futures tion Fund partially funded pur- go to Anderson Lake State Park," recommendations for the area,other than for tribal use," Fund dollars generated through chase of a conservation easement he said,and then on to the Tri- county commissioners The said Matthiesen,who likens his countytaxes. of the tribe's property just north Area's urban growth area. meeting is open to the public relationship to the rock as "a The eight-member Conaerva- 2008e rock,a deal completed in County Commissioner John The Conservation Futures communion with nature" tion Futures Citizen Oversight In November 2008,Washing- Austin said he supports preserve- 'Fund,established by the When living on Marrowstone Committee will meet Monday toton g" tion of the Tamanowas Rock site. countycommissioners in 2002, Island,he said he used to climb consider the application span- purchase State Parks entered into a "The question that is still is derived from a tax levy of the rock monthly before moving cored by Jefferson Land Trust, 'Purchase agreement for 63-acres unresolved is the question of justmore than 4 cents per to work in Seattle three years which now owns the property but of the Tamanowas Rock prop- access and can there be some $1,000 of assessed property ago.Now he encounters the rock does not restrict access other erty' sort of compromise where people valuation and a fraction of the maybe twice a year. than all terrain vehicles. State Parks then transferred who use the rock to climb can timber tax receipts the county "My dad took me up there The committee is expected to that agreement to Jefferson Land still use it,"Austin said,adding receives. when I was a little kid and we make its recommendation for Trust, and last December the he views rock climbing as another The amount of funds gener just scrambled up the cable on funding to the county commis- land trust purchased the p;op- form of tourism,which has eco- ated through taxation has the back side,"he said."I thought scoffers. erty for$600,000—$480,000 of g which came in a two-year loan Creating a nature sanctuary nomic value as well - . been running at least that was the grehtest thing." Y Austin lauded the land trust, $180,000 a year. Some 20 years later he has around the rock is keyto its pro- ..,from The Bullitt Foundation, calling its leaders "heroic" in The Conservation Futures"?. climbed on Mount Rainier and lection,those wishinto preserve documents show. their efforts to preserve the Fund balance was atmore. locations around the world. the site said. The tribe came up with the rock. than$700,000last year funding "I just hope we can work out a Sarah Spaeth,Jefferson Land balance through loans "They assumed a financial The program's purpose is to solution that maintains access Trust executive director and a from community members. liability as a gift to the commu- provide public open spaces for everyone," said Matthiesen,.member of the Conservation nity,"he said. and to improve the county s who has e-mailed notices to area Futures Citizen Oversight Corn- May or June "I hope we can achieve some qty o ,Program infor- rock climbers to support access mittee,said access is certainly an The county commissioners in solution in which the Native =,mat=states to the rock and share their feel- issue,but that it was too early in late May or early June will con- American interests and the The program requires the ings with those who will decide the conversation to know where Sider final approval of.the key sports interests can respect each .> participation of both an appli- its fate• and how much access would be $200,000 Conservation Futures other's rights." cant land owner and a project Attempts last week to contact allowed. funding to preserve Tamanowas sponsor,such as Jefferson tribal leaders involved in the "The tribes wants to be able to Rock. Land Trust. Tamanowas Rock preservation conduct sacred rituals," Spaeth "I think they'll probably have Port Townsend-Jefferson County Edo- Peninsula Daily Nerve project for comment were unsuc- said."They.may want to close it some kind of accessplan where for Jeff Chew can be reached wpe nsulada5 • - cessful. news or al Jeff chew®Oeninsulatlaily off some times." they want some privacy for some news.com. • • . IL.. Nesul Lb r% _ ___ • Algae: Toxins kept Anderson . . , oxIC -‘ closed last April . . CONTINUED FROM Al ae.. .,,,,.. . Lae state Id ' including fishing and iwim- rus—Anderson Lake has ming. , more than other East Jef- • Thursday's water qual-' ferson County lakes—but Park'and ity sampling are taken to a'the origin of the phosphorus PubliHealth . lab and tested for toxins is unknown. c •officals will conclude a year of regu- Toxic blue-green algae elected to.keep the lake lar sampling,which Jeffer- levels were first discovered dosed to recreation last son County Public Health in Anderson Lake in May April for the opening of fish- will study to try to deter- 2006 after two dogs died tug season because of toxins mine what is causing alter drinking water from AndersoriLa1e.. in the water. increases in toxins year- Anderson Lake. The lake round. was closed. , • Lowland lake fishing Although the county No toxic blue-green algae fishing season is _season opens stateWidePil•- health department has has been reported in sampled lake lake water since lam County, where health 2006,it received a$42,000 officers visually monitor Lake Leland, north of to 'open Satur da.y Quilcene, Gibbs Lake in grant froth the stateDepart- lakes for signs of algae .. • men of Ecology in October bloom. Chimacum and Sandy , . 2008—augmented by some Jefferson County PublicShores Lake,which is the county funds — to fund By JEFF CHEW. ', ' PE Health toxic blue-green AILY headwaters of Thorndyke MSOLA DNEWS . , '- ' - ' Creek, could be opened to data collection for the algae reports can be found Y d PORT TOWNSEND —Water quality fishing also if blue-green stuat http://tinyurl.corn/ lab results this week are expected to deter- algae toxins fall below theYYernib• mine if toxic-algae-plagued Anderson Lake allowable threshold. Toxic algae Algae blooms in chdiani , will open Saturday for the annual state- Water samples were Blue-green algae is a Countylakes should 'he' lake fishing season. . ,, ,1%,, taken from those lakes common fresh-water scum reported to Clallam County *It did look — '- • Thursday,'Hanington said. that can, at times — for Department of Health and really bad,"Neil lue-green Lake Leland and Gibbs reasons researchers don't Human Services environ- Harrington, Jef- understand — begin pro- mental health division at ferson County algae,is 4 , Lake were closed in Sep- during toxins that can dam- 360417'22M- water quality,,4 .common.,- tember after blue-green age human and animal liv- algae toxin levels soared era or neurological systems. Port Townsend-Jeff n :440 thick ., -water scum beyond public safety levels. The cause of algae cty Editor jeff chew can be ,with algae' in that'can at'tunes' Those bakes as well as blooms is considered to be reached at 360-385-2335 or at jet 0 ladaplaces,.,, where _, inr rpnqms ,, • Anderson Lake,were posted high amounts of phospho- chewOpentasuilynews.corn. N samples• were — .---•:. 1.., .with red warning signs ban- taken last Thins- researcligs.ciqn , ning public use. daY• ',.. ' Understand.-- A red warning sign Harrington benlii.ArMlicina0 means that the lake is said the county - or r."'" liPltetiltk thItthS that can dosed to recreational use, department will damage human consult this ,i ;,„•„1 11,,,,,„ Thursday with ""•, "a""`" state parks offi- or neurological . dais to deter- systerns„ mine if Anderson -'— • macuin aid Discover Bay,is safe to open • A decision is exPeCtedo be Made tOn..; When is ft safe;when is It not? , i •' The most recent tests fii mid-March found 60;000 cells per milliliter of ana- baena toxin;which can cause brain and liver damage and burn skin. ' •''''."- '' That level is low enough to be safe for fishing,public health officials say,although the fishahould be cleaned,the lake water should not be consumed and children and small pets should eta),out of the lake. • Fishing or other recreational uses of the lake,once popular for trout-fishing,will be banned if the count exceeds 100,000 cella per milliliter. Uses of the land around the'lake in Anderson Lake State Park;such as hiking and horseback riding,could be permitted. . When the level of toxins in a lake are at • or below the allowable threshold,caution signs are posted asking that,fishermen clean fish before eating them and that oth- ers avoid water contact,especially where . . • •Tow TO Awas/A4 , ' 7 LandmarkCID 0 a) I1) c) 1fli;1 g °' o' o Oil • receives a,im•J �Q group'sIiI9t4i! 'iIilhI1d q � 5L3 a'8g-E,ccli U m c, ' o ° o oxB p x •-, 5 E 4-b,.. 0.5 iu o blessing wt. al o.dG � > Nrob� � w �-8° ..6;11 °).' 2 3 " a 0 ! !!jLjU � mdm �. �$ �•moConservation panel l b i . •c a,yII; "F Cs �x� y wants county to ante 4i 8:a 2 2, a A '5, -IE . 00.-.-3,„E A -8`6°07352 for Tamanowas Rock W ` yb BY JEFF CHEW '--J ex . ee ° v rd gi PENINSULA DAILY NEWS O . Y W {,y $ til PORT TOWNSEND—The eight-member Con- < 342.1Z-,ON- Z F al 1 servation Futures Citizen Oversight Committee a '� voted unanimously Monday to recommend that1,4 14 ' - Jefferson County commissioners fund$200,000 in 'a i z �' Conservation Futures dollars toward the purchase V.1 • 2 d 0 and ultimate preservation of Jefferson County -r , ' Ca icon Tamanowas Rock. '''..i70,4,,„,1) 3 Jefferson County commissioners are expected * - ,.' $s ? d 4 this year to consider the Jamestown S'Klallam „ a 'ii t:6 , Tribe and Washington State Parks'request for the •ifI • $200,000 in county Conservation Futures Fund .0 �' 4 t4 a, m dollars generated through county property taxes. .'...1 d : 03 eo 013 2 Bridge'owner (f, 4;.;-:,f,, . '" "g. 800 Jefferson Land Trust purchased the 63-acre n ) `° iA rock property in December 2009 for$600,000 and VV�.// vv' -4 "5 ad = o will remain the"bridge"-owner until the tribe and m os F state parks come up with the money to purchase the property and land adjacent to Anderson Lake .3• d,g S log m1 d 4 ^qq. 2 a� a' p„ '�a-m .a 8 State Park � �' lis/17:16" E' Y, 3 `�' 8 Creatinga nature sanctuaryaround the more 5 �+ a' " than 100-fot rock, a spiritusymbol to North- S a 1 a E$. m 1 4 w �'.,I . a west tribes and others, is key to its protection, .d„ „ 'd a 'a those wishing to preserve the site said. ''1"'{ � a� e. g -g c m" a a p.A. o y After ranking the proposal highly for funding -a`--g .as•q8 " m w �, uE and discussing it,the eight-member Conservation -g o, g .B, ' v 8 E 8 y a Futures Citizen Oversight Committee voted 8-0 in 0 S$ a c 3 " favor of advising the county commissioners to b U m 6 a approve the$200,000 funding when they consider y 1 y � o q `� o*f- it in late May or early June. o. 4.2 8 0 2 1 on a.v5 <22i - "'a + a a) al a) . . a) � ••C ...VCS ,0"0 > Tum To RoCx/A6 d o: q a a� 4oa Z8 §,e d o g . 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VwV o°) V .?' , 6 t. ¢tiV VAaa V v c s. � o �;- > c� d ati0 o w O .r^ 0 t -06asOOV .74 -c VyyQacoc .0vi goV s 3' o co- � v, a�C tko�-1 c • Uaio •E0 00c.) c•I,bo0 > Oc0ivOC . aiVV OV0. cd ti. y Oco c c . -. cvv � coco- ,a>> a''no(– ° 0 ^ ic)wacoW .-cav cn c > ,c y... o s. co a .w g V wv, V.c O,.d ca U ... c.. O a cd 0-% a o0 o c. oo .4..•+wad 00 ti c v, .. -c V > • y i •' o. 3o ioc ° teco !4.!I Jeij o '� cAc ��cd � �Uab �'�-Q � as 1,2�wn�,E C >E c `o c o •c -atao v, 3 5 �a •y ccs ai, co 0.E >; >'r. 0 › ,.,�-o-C 0.) >,:a o > 0 1.. v, c.)E...., a >b acp 3 o Q c?: ,,,•d.aE" c a •rl Loi vooaa' V cOa c-3c° cv to F........4 �,, v .8 c A A V co 5 .° c u cc 2 co V 2 co as �. . o c c y .b V O _ - upC 00 i.. •.a 4V, 6. ri p..---iy U4 a rf� >^ a' c= 3 ° 0rocQ & 2 °° �Z 7 cau �:o 2? ° E LD >.� � 3 . i • .. . , Anderson . .�v - _..., .7,,,:. Na E dW�°c o c coS ao �j do_ oncaacO I t T !fo� �Un Lake fishingE'..,.,2-' N no o° Eas �,v wA, season ago ...._. 0 '.11.7;,tylg.U_d.271c . a�L 2- Ern-a o4 U c=i ' /� \ C E.w:' pE N C-si 2 a ISI✓/ -4. yVj "' a'-O '.. O L'`-2 a O gig W c, roO Toxic algae threatened ° E ��p . '''''''': '9 q u 7 r� t o I C o V•K `.q� cCn.-0 to close destination again c . a E a r '-� _ § " �,CC - ° O y C� Q d._ a, nE Vz BY JEFF CHEW M o c '� 4, ",'' d m, eo m PENINSULA DAILY NEWS "I know we've had to hold. CU S 6 e. E v m iv x7,1:. a CHIMACUM — Anderson off the fisherman for some (/) . .y. o .5 Lake will open for the start of time. But we feel O ..,, o• ° V^a a-c ° . a, the state lowland lake fishing comfortable enough that �.f a,21 0.0 °a . c.o d c az i° . season on Saturday. ,S a "y•;, d° 3 ° a, It will be the first time the were going to open it up (, C e. `. lake has been open for fishing in until Mother Nature says i9 "gto o nearly two years. otherwise." -1--) . g ". '6'2 �'�8.' P V v w>42..2-'�, Water quality samples taken MANv J E 3 C.. a a ea °.a o c o April 15 found moderate levels of MIKE manager of Anderson Lake State Z/--1 -6/ a °0 E•` '°° ° d--4'-t:5-a v iu blue-green algae toxins in the :B °y,-E c c a id y ° a, ? -g lake near Chimacum and Dis- 3 r.E E ",w ° .e m`B E V ti .5 cover Bay. should stay out of that lake,but . o g'" a,o `1541 .2:_8 -N o The levels fell short of being that fish can be eaten if they are n l T§ F so dangerous that Jefferson cleaned well,with the guts dis- �/ ° E� , ; 3 c v " County Public Health and state carded . 1-22 °, a eo° �o parks officials would have to Samples taken from Ander- ``� -c n,g a3,60 a >, 3). E close the well-known fishing spot son Lake last week showed b,13 .�D ; o m v [ • in Anderson Lake State Park 53,000 cells per milliliter of " a ,�x a0-'13 a-o tri.,-�,3 near Chimacum. microcystis, a liver toxin. That �� $ m b�° ° „$ y :,-2 "I'm pretty excited,"said Mike was below the 62,000 cells per r , 5-41 0a ' ° a 2 Zimmerman,who manages Fort milliliter measured in mid- m ,- E -7) ..-4 Flagler,Mystery Bay and Ander- March. ( ° ^y' son Lake state parks. Fishing or other recreational �/ 3 3 a O 3 3 "I know we've had to hold off lake uses are banned if the tox- • to a ya E a 8 .E the fisherman for some time.But ins count exceeds 100,000 cells eu v& ,a w 78 • ° we feel comfortable enough that per milliliter.Closure of the lake " fl ° x were going to open it up until does not affect land-based recre- O g 8 c q c 8 a� Mother Nature says otherwise." ation such as hikingand horse- r •� ° ° 3 B Zimmerman said that means back riding. r"1 '' ° ° 00...d... °' a EA W m N U .E a, C42 -• C the popular trout-fishing lake N •C Y o a•m^°,C7 ' E will be closed to fishing if levels Open briefly In 2008 • • ,4 g 2 E E a a a 2 a a+ T d A b - V rise again to dangerous toxic Anderson Lake was last = E a ~ e a..t' N E a, a,m 2' E levels. opened in April 2008 for fishing 8 a c i - ti aiv T x o .c The gate to Anderson Lake 0 a-a.c..)-1 0 x e.a-1 ca c State Park will be opened at 5 season but was shut down after a.m. Saturday, Zimmerman .lust three weeks when toxin lev- tA c o o T mp 3 a x els shot up as the weather •O a7 in a a said. warmed. o a 3 0 3 v as t°2 a. a N = Yellow caution signs will Anderson Lake State Park i w o 4 en ai ° > ° E replace the red closure signsyJeffersona d °, m ,--f. ° y posted last year at Anderson and c al elected Public w E ° a a o T x a 'o g `v c Lake State Park's entrance and Health officials elected to keep ° Z - v .3 the lake closed to recreation last .>.6 a, $ 3.1 E•1 C''d-o at the boat ramp at the lake. April for the opening of fishing ° ,.' E n .-,E,D EE ° 3 no one yeThe llow llold iggnsmean c thew thatter, season because of a high level of U °4 a as m_° m E B toxins from algae. ", n E x v ~, m ° v areas of scum should be avoided Q a a.v 8 . 0 8' and pets and small children TURN TO ANDERSON/A8 3 3 v,. ' E 2 x E 3 •• • , • • / /)/V , . FamilyFun Fest _ , _ . • scheduled in PT PENINSULA DAILY NEWS PORT TOWNSEND—The Jefferson County Fest■ Ari Crime Victim Service Center will host its first Al 1 y ever Family Fun Fest:Community Health and Safety Fair from 10 a.m.to 3 p.m.Saturday. • The free event will be held'at the Mountain Mackie display View Commons gymnasium, 1925 Blaine St. There will be giveaways,information and ,J hands-on activities. Kids of all ages will be able to participate in CONTINUED FROM Cl Families also can learn a hula-hoop contest,face painting,art projects, about after-school and sum- cakewalk and more. Children will be able to mer camp programs avail- explore law enforcement able in Jefferson County. Gift certificate giveaway and firefighting vehicles, Participating agencies Attendees can enter to win gift certificates to and there will be informa- include the Port Townsend local businesses by visiting every booth and get- tion about fire safety. Police Department, Jeffer- ting a raffle ticket stamped. Andy Mackie will have son County Sheriff's Office, The Port Townsend Police Department will instruments on display;the , East Jefferson Fire-Rescue, give away child ID kits,and the Jefferson Port Townsend Marine Sci Andy Mackie Music Foun County Sheriff's Office will teach kids how to lift ence Center will show items dation, Jefferson County fingerprints off of dishes. like shark jaws, shells and Family YMCA, Jefferson teeth; and the Recyclery County Parks and Recre- TURN TO FEST/C2 will have several unique ation, Port Townsend bicycles as well as informa- Marine Science Center,Jef- tion, about the positive ferson County Public Health • effects of bike riding. Department, Recyclery, Boiler Room, Make Waves, Tobacco awareness National Alliance on Men- Also to be offered are tal Illness, Safe Harbor tobacco and substance abuse Recovery Center,Pregnancy prevention and awareness, & Family Resource Center, and information on healthy Jumping Mouse, Jefferson relationships and teen dat- County Literacy Council, ing violence, crime preven- Lutheran Community Ser- tion and victim services, vices Northwest, Dove mental health awareness House Advocacy Services and support,the importance and the Jefferson County of reading, how to find a Crime Victim Service Cen- child care provider, medical ter. insurance options and For more information, resources for pregnant phone Nicole Barnard at women. 360-302-0952. • • B 2•Wednesday,April 28,2010 - • Algae an issue -at Anderson Lake Toxic blue-green algae has Lake drew a"caution" label.That Park, had the park open to the been a growing issue in Jefferson means it is OK to eat properly public 4t 6 a.m. on April 24 for County.In late May 2006,two dogs cleaned and cooked fish.However, the season. quickly died after drinking from pets and people should stay out of Health department tests on Anderson Lake.The problem has the water. the lake will continue,and if toxic also occurred in other lakes here, Washington State Parks man- algae becomes more of a problem, but usually in later May or June ages Anderson Lake State Park, the lake will be closed. when the weather is warmer. popular for easy shoreline fish- Clear of algae so far are Sandy Jefferson County Public Health ing access. Mike Zimmerman, Shore, Teal, Crocker, Tarboo, said as of last week that Anderson manager of Fort Flagler State Leland and Gibbs lakes. • • Smokes to cost a buck more• .. Tobacco users urged to quit dates later in the year — "Quitting smoking also are temporary. improves a person's health PENINSULA DAILY NEWS Out-of state companies within hours and saves "Quitting smoking also.were targeted for more money,too. Although the state Leg- revenue, either by recalcu- "A pack-a-day smoker islature raised the tax on improves a person's lating how taxes are charged who quits will save nearly tobacco products in hopes of health within hours or shrinking certain exemp- $2,500 a year. Our tobacco gaining additional revenue, tions in response to courtuit line is there to help." the state Department of and saves money, too. rulings. Smaller loopholes q The free state tobacco Health predicts the addi- A pack-a-day smoker and other exemptions also quit line — 800-784-8669 tional $1 per pack expense who.quits will save were closed or downsized. — received an unprece- that comes into effect Sat Gregoire, a second-term dented number of calls after urday will persuade many nearly $2,500 a year. Democrat, said the tax lastear's federal tobacco to quit buying cigarettes. • Our tobacco quit line Y The Campaign forpackage was a reasonable tax increase, increasing Tobacco-Free Kids and iS there t0 help." response to the estimated threefold in one month. other public health organi- MARY SELECKY $2.8 billion budget deficit• The agency expects to zations estimate the state's State Secretary of Health, that the Democrat con see a similar spike when tobacco tax increase will trolled Legislature con- the new state tax takes prompt about 19,000 adultsseveral on convenience= fronted in its recently con- effect Saturday. to quit smoking. store favorites — such as cluded special session. Callers can talk to And the groups said thesoda, major brand beer, coaches who help them additional tax could prevent candy and bottled water— Urges smokers to quit develop plans to quit. about twice as many young- as well as on service busi- The state Department of All state residents can sters from taking up the nesses and in other areas Health uses the eve of the receive some level of free habit. that Gov. Chris Gregoire tobacco tax increase to support by calling the quit Tax on other tobacco estimated would netrou hl line. Medicaid subscribers products goes up by similar g Y encourage smokers to quit. • amounts. $780 million. "Raising tobacco prices can receive additional help, Higher taxes on service is one of the most effective including prescription med- Health care savings businesses from attorneys ways to reduce smoking," ication,if appropriate. and lobbyists to hairdress- said Secretary of Health Online,the quit line is at The expected decrease in ers and janitors also will Mary Selecky. or www.quitline.com. use of tobacco products come into effect Saturday. could save more than $854 Those taxes are temporary, million in health care costs, lasting through June 2013. the state Department of Taxes on soda, beer and Health said in a written bottled water—which will statement. take effect on staggered The tobacco tax is one of II Deadly . fungus • cm .. ,. ` a ,. 2qv rd.. .. % O � 3 k g: , ao-spreads 82„m asohm ji'2 �� Y w §�140 SC", -40i3�IO Fagg 'io3 tO state UtGiqfl �dhi; g%Ob 4—'1 Ucgi No confirmed yggr1pC . � , � ' 2c,0E o.� gg � �E ao �•d '3.3SSGo.g2'�•^ 0, cases reported ` -' as _,•� .•5a 84.-Ex ggo� E on N. Peninsula 4) �a � ` �B e4 .�y. y a 11 g e 5G °'U3 v 0 8� aaAo > �3 1.t, °� O §,F a 8¢ 25 'G al i~ o o b td S z i BY ROB OLLIKAJNEN J qq PENINSULA DAILY NEWS Ct 111-t-0 C iV N �.'^ o t' W y sl.,p ez It sounds like a villain from a science 2 b f3 I '° t.'n > 8 b . . �' fiction film. °°° z . d s y t - 'b o '$ ^ � " E a 8TE S m that appearedpr oni—an ver Island sladun- Q..4 e 4,.' - "1 2 m ... 58' ''' gus that Vancouver Island in c a. ..>:11,1j . �l a 3 � � a " � the late 1990s—is real,and it's gathering strength as it spreads to the south. -0,6" a e. ° .9'" w 2 a1 . 9 ii~ Though rare, the (I ) fig o, 0 1 '60 "' a 6 00 d o.3 potentially spore-forming fungus is x V/ a ,- ? g T - x potentially deadly.to q i c�' 3 W EMI . A.a 1 a o] humans and animals. t It has mutated into • ti9A.:-4.).6 o h a h �% a more lethal strain a ¢, a 2 g a eg00 1 d i l t c G W • ',3' since it moved Into Ore # 0 3 „ a 2 pq"' _ • gon, according to 8 b 8 w° ,, d E a ° research published c t K '.' - i a c N e April 22 in the journal ��"k ,, rc." a• a0 o 0.11>a d . rc m v Public Library of Sci- I4I' t x.As11 ° 8 ° .....1 o °:" ence Pathfiir,ogens. IS One 2 o o � ••4).6 v v . a S "So" .C.gattn`----This 14 d g g."� E� d r"- ta' m, is y 5• �. which has been reported we expect to g s9' •. x 2' incases in whatcum, be WatGhin B .o o 9 2 ..55 i�'o V 2•� a. King and San Juan g � ...I counties—has made no for a long 'k"' c o y o[•� .E 1.t.l'inroads on the North time," 0 8 d 8. a y a ,, I Olympic Peninsula.evaluated TOM LOCKE someVepeople've and ani- Jefferson .. u c fi a b c , 4 �',, . o a t County ^+1 public health p ti o ,. m.9 m g '" a1 d� w•� t .9. mals but have yet to > ° 03 confirm a definite officer i6. ° gc a1 >aD a r d 1•i N � 0."" x.e`� �" human or animal case," ', .x.c'b,a-'8.c 1.0.0 v "'S "b.a.,c.,a 3 said Dr.Tom Locke,public health officer for o a " ' o°,2 v1 3 co '9 g o ='o Clallam and Jefferson counties. g01.2 •c 6 ' A d-, 1 x a2oV o 0 §. 6,.. cP,2aNro.c 2.a ag 2eo8m-� "It's probably just onea matter of timeo °-'•2 90.'o 860.-.SO 3'm ., a though. . . .This is we expect to be o watching for a long time" a ' a • o.' a a gs a .a�5. 10 Cryptococcus gattii can cause symptoms Y 60 c 0S 2 -°_ �' . a > .d, in people and animals—including short- � __a cam-o-g- mit $ 7c1 o •� ,. '--"' e ness of breath, chest pain, long-lasting ''m v ra El" o $ „ p 4'.2 8 .y a " coughs,fever and headaches—even weeks ‘04) t fam c 2 y ,- A d . g' after exposure. z w 8 N N °,oD a a^❑.c° E c 2 e m $.5. .>,23 5.9 u . a 'b 9. Like pneumonia c ,.22 :,1 -...A 8.3 .c.BaE g , . „ Most cases are like a pneumonia that ro' ' 5a j,E'° y s o'1 g „ 8 W slowly gets worse and worse. U o w c 8 8 9 c;a 15 , 2 8 o ,2, Spores are inhaled and colonize the lungs before they spread throughout the body. Treatment involves six to eight weeks of intravenous antifungal medications fol- lowed by months of pills. • "Overall,I don't think it is a large threat at this time,"molecular biologist Edmond J.Byrnes III of Duke University Medical Center,the lead author of the report,told the Los Angeles Tint TURN TO FUNCUs/A6 BID/1/ EnviroStars Certified Jefferson County Public Health would like to extend a special Businesses • rthaRiC YOU AUTO SHOPS V vv Auto Works to the following businesses: 2313 3rd St. Port Townsend,WA 98368 Pe t yco e 1,' 385-5682 GGiiYG �` you"(lend ,t� Circle&Square Auto Care 109Yee t guesses Port H Rhody Drive Cl Port Hadlock,WA 98339 Annapurna Center for Self Healing 385-2070 Auto Works Jefferson Transit Blue Heron Middle School 1615 West Sims Way Charles Kanieski,CPA Port Townsend,WA 98368 Circle and Square 3854777 Computer.Fix Satch Works Inc. The Food Co-op 670 Nesses Corner Road Jefferson County Public Health Port Hadlock,WA 98339 Department 379-0706 Lehani's DENTISTS Matthew Berberich Professional Dentistry Northwest Gardening Service Box 428 Monroe Street Clinic Port Hadlock,WA 98339 Monsoon 3851000 Naturally Green Cleaning Uptown Dental Clinic Pan d'Amore 642 Harrison St. Printery Communications Port Townsend,WA 98368 PT Computers 385-4700 Quilcene Schools DRY CLEANERS Silverwater Cafe Dockside Cleaners Saint Paul's Episcopal Church 1213 Water St. SOS Printing Port Townsend,WA 98368 Wandering Wardrobe 3854585 Wholistic Skin Therapy Center MARINE • Wild Sage World Teas,Tonics&Herbs Port Townsend Rigging For additional information on becomingan 290 10th St.Suite R Port Townsend,WA 98368 EnviroStars or Green Business,please contact • 385-6330 Lori Clark at Jefferson County Public Port Ludlow Marina Health:360-385-9444. 1 Gull Drive Port Ludlow,WA 98365 437-0513 Port Townsend Boat Haven 375 Hudson St. Port Townsend,WA 98368 385-0656 Point Hudson Marina 103 Hudson St. Port Townsend,WA 98368 385-0656 Pleasant Harbor Marina 308913 U.S.Highway 101 Brinnon,WA 98320 796-4611 • PRINT SHOPS Printery Communications 631 Tyler St. Port Townsend,WA 98368 385-1256 or 800-339-1256 SOS Printing 2319 Washington St. Port Townsend,WA 98368 385-4194 • • 4� ENVIROSTARS • The PortTownsend&Jefferson County Leader / / f/- Seminar on septic system TLC BRINNON—Linda Atkins of Jefferson County Public Health will present "TLC for Septic Systems: Protect your Investment and Health"at Olympic Canal Tracts,310703 U.S. Highway 101,from 10 a.m. to noon Saturday. Atkins will cover opera- tion,maintenance,land- scaping without interfering With the operation of the septic system,garbage dis- posals and the impact of failing systems on drink- ing,ground and surface water. For more information, phone 360-385-9400. • „v tc., B 2 •Wednesday, May 12,2010 Port Townsend&Jefferson County Leader • - . ,,,,,/ „-..1 ,4-,;''' tti FDR LFE ; „!;,..,:,,,,e,..,,;., } ilik r e,., ruin .: 4. t ,, 4 .,, �@ ” rr. r lxz sill bl" V_ '''',c.';''",,'': a, .><„ Taking on underage drinking Students at Port Townsend High School hosted a town hall forum recently on underage drinking.It was attended by 40 teens and 15 adults in late April. � On the PTHS Student Task Force to Prevent Underage Drinking are, from left to right, Angel Shafer, • James Campbell,Jake VonVolkli,Todd Maegerie,and Jason Noltemeier,with Barbara Hansen, student assistant professional and task force adviser,in the center. Funding for the town hall came from grants and was a collaboration with the high school, Olympic Educational Service District 114, the Jefferson County Community Network and Jefferson County Public Health. For more information,go to starttalk- ingnow.org. • . . /-)7-„,/,„..,„,!,,, ,/;,,,tic Septic system class set for May 15 Linda Atkins, registered • sanitarian of Jefferson County Public Health, is presenting "TLC for Your Septic System" from 10 a.m. to noon on Saturday, May 15. The class. includes discussion about the day-to-day operation of septic systems,issues about part-time usage and how people can pro- tect their investment in their septic system.The class is held at the Olympic Canal Tracts, 310703 U.S. Highway 101 in Brinnon. S • • :, r 2 , 1 a ' . 4 'ft Ia" � r f I. !--.-- r { ,... -..—#F"-F°.t"_...-..- ... �"£.. f ..'«_^ 3` tii .'nom. 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"n`lti --.."." - T ' • �fM .F. a t, .. • Women turn dream to reality Foundation's newest fund focuses on education and opportunity • BY JENNIFER JACKSON donations,most from first-time donors. Women and Mayer said.,, PSNINSULA DAILY NEWS "Probably 90 percent of the people We are looking Girls up to Others donated products and ser- PORT TOWNSEND—When Debbi In the room were new to the founda- �fQC Changes that $10,000. vices to the kickoff event,which was Steele cameTupW with an idea for a way tion,"Mayer said.;Donations ranged are sustainable That chal- sponsored by local businesses. to make the lives of women and girls in from rm$2,000 to$10 cash in an enve- lenge was met The next step:to define how the areas her county better,she didn't envision lope." and systemic,. Monday night, of focus will be addressed,then put out a the response she would get from her meaning they get Mayer said. request for proposals,which will probe- friends and neighbors. Limited to women We have bly happen next fall,Mayer said. to the root of the raised nearly Guests also responded to a request On Monday night,Steele stood and The guest list was intentionally lim- for volunteers,offeringto helpwith thanked the people who helped make it iced to women,Mayer said,many of PI'Oblelll." $31,000,count —100 women who attended a ANNE SCHNEIDER ing pledges," events,fundraising,education and out- possiblewhom wrote checks for$250. Mayer said."I reach,as well as on the grant advisory kickoff event at the Northwest Mari- An incentive to give generously: member of fund's time Center to raise moneyfor the Jef- keynoteY steerin committee 'was stunned committee. advice from Barbara 8 that so many "I was overwhelmed when I opened ferson County Community Founda- Stanny,who writes books and gives people gave." the envelopes that so many people tion's newest component,the Fund for seminars on financial empowerment wanted to help,"Mayer said. Women and Girls. for women. A consensus is drawn "Who's going to help us make this Stanny,who lives in Port Townsend, "Everybody wants to roll up their dream a reality?"Steele asked the spoke on the power of philanthropy Each table also was given$10,000 sleeves and go to work." women assembled."Every single one of and how to use it to leave a lasting leg- in play money and asked to allocate it Jefferson County Community Foun- d acy in the community. to two areas out of six to focus on the dation is a tax-exempt,nonprofit phil- Steele is a board member of the "More women give than men,but first year. builds pie organization with the goal of community foundation,a nonprofit give in smaller amounts to twice as The consensus:educational and building endowed funds for the charita- organization that oversees 10 charita- many organizations,"Stanny said, training for school-age girls and eco- ble benefit of countresidents. ble funds that benefit Jefferson County "This is not powerful philanthropy.' nomic opportunities for women of all Contributions to-the Fund for Women residents. Women often suffer from"bag lady ages. and Girls can be sent to JCCF,P.O.Box The Fund for Women and Children syndrome,"Stanny said,meaning they "We are looking for changes that are 1955,Port Townsend,iWAon 98368. is not only the foundation's first"field fear they'll outlive their money and end sustainable and systemic,meaning For more information,go to en an • of interest"fund,meaning it serves a up living on the street. they get to the root of the problem," Girlsues.org and click nn Maya and specific demographic,but also the first, Women also tend to have"bake sale" said Anne Schneider,a member of the Girls Fund"or phone Kris Alayer,360- other than the original endowment mentality,she said,thinking in terms fund's steering committee. 379-3667. drive,to have its own kickoff event, of raising a few hundred dollars. The first donation to the Fund for said Kris Mayer,the foundation's philTo put her"give big advice into Women and Girls was a matching Port Townseno/Jetterson County reporter-con- -anthropic consultant. practice,Stanny announced that she grant from steering committee member umrsst Jennifer Jackson can be reached at The result:more than$30,000 in would match donations to the Fund for Carol McGough and Marilyn Penitsch, jjackson®olypen.com. .y7 ,-..57,43/,e-