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Home My WebLink About2011- October File Copy Jefferson County Boardof Health Agenda .Minutes October 20, 2011 • JEFFERSON COUNTY BOARD OF HEALTH October 20, 2011 Jefferson County Public Health 615 Sheridan Street Port Townsend, WA 2:30—4:30 PM DRAFT AGENDA I. Approval of Agenda II. Approval of Minutes of September 15,2011 Board of Health Meeting III. Public Comments IV. Old Business and Informational Items 1. Correspondence—Department of Health 2. Regulation of E-Cigarettes and Single Cigarettes 3. 2011 Girls Night Out Report IP4. Kitsap Public Health District Strategic Plan at a Glance 5. Staff Stars 6. Port Townsend Paper Company Solid Waste Permit Update V. New Business 1. Proposal to Combine City and County Solid Waste Enforcement 2. WA State Public Health Indicators 3. EPA Homeowner Process Report 4. Environmental Health Time Study Report 5. Environmental Health Fees 6. Nurse Family Partnership—Regional Approach VI. Activity Update VII. Agenda Planning Calendar VIII. Next Scheduled Meeting: November 17, 2011 2:30—4:30 pm Jefferson County Public Health 1111 \)4%° JEFFERSON COUNTY BOARD OF HEALTH • MINUTES Thursday, September 15, 2011 - 2:30 PM—4:30 PM Public Health Conference Room, 615 Sheridan Street, Port Townsend Board Members Staff Members Phil Johnson, Vice Chair, County Commissioner District#1 Thomas Locke,MD,MPH 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 Roberta Frissell, Citizen at large(County) Stuart Whitford,Environmental Health Services Director Kristen Nelson, Chair,Port Townsend City Council Sheila Westerman, Citizen at large(City) Jill Buhler,Hospital Commissioner,District#2 Chair Kristen Nelson called the meeting of the Jefferson County Board of Health to order at 2:35 PM. A quorum was present. Members Present: Phil Johnson, David Sullivan, John Austin, Kristen Nelson, Sheila Westerman, Roberta Frissell Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin • Members Excused: Jill Buhler APPROVAL OF AGENDA Member Johnson moved to approve the agenda for the September 15, 2011 BOH meeting; Member Austin seconded. The motion passed unanimously. APPROVAL OF MINUTES Member Westerman moved to approve the minutes for the August 18, 2011 BOH meeting; Member Johnson seconded. The motion passed unanimously. PUBLIC COMMENTS None OLD BUSINESS and INFORMATIONAL ITEMS Family Planning and WIC Outreach Julia Danskin reported that in an effort to increase the WIC case load numbers there have been several outreach attempts made, which have included posting fliers at several businesses and organizations in the community, sending a packet of information to local health care providers, • as well as some families that are WIC recipients doing interviews with the Leader. 1 BOH Minutes September 15,2011 ` 1 Chair Nelson recommended that JCPH ask permission to post the fliers inside women's restrooms of local businesses for a limited period of time. • A brief period of questions and answers followed regarding tobacco use and the laws regarding public tobacco use. Chair Nelson raised a question regarding steam cigarettes and if they are legal or fall under Initiative 901. Ms. Baldwin will do some research and follow up with an answer as to whether the use of steam cigarettes is legal in public places. In addition, Member Westerman voiced her concern over tobacco use at The Uptown Pub in an outdoor area. Ms. Baldwin recommended that she call and place a formal complaint. Ms. Baldwin concluded the discussion by reminding the Board that community norms must change because community education is no longer funded. Diphtheria, Pertussis - Give Immunity,Fight Transmission (The G.I.F.T. Program) Ms. Baldwin mentioned that another outreach program that JCPH is involved with is getting the Diphtheria and Pertussis vaccine to low income,uninsured adults, and all adults who have direct contact with infants, since Pertussis is the second most vaccine preventable disease. The G.I.F.T. program assists with the cost of the adult vaccine for low income or uninsured. NEW BUSINESS Preparation for the 2011-12 Influenza Season Dr. Locke updated the Board on the 2011-2012 Influenza season which typically occurs some • time between October and May. The priority group for flu vaccine this year is any one over the age of 6 months,with the greatest danger of complications of the flu being to the very young and very old. Dr. Locke reported that the majority of hospitals in Washington are requiring health care workers with direct contact to patients be vaccinated. He also mentioned that this year there is a new vaccine delivery system available called the intradermal injection which uses a smaller dose of the vaccine delivered by a very small needle into the skin and is as effective as the conventional injectable in healthy adults. A recommendation was made that at the next Board of Health meeting in October,the Board members receive their flu vaccine and invite the Leader to be at the meeting. Finally,Dr. Locke reported that there is a new H3N2 variant of the swine flu has surfaced in Ohio. At this point the virus has not posed a serious pandemic threat and is being closely monitored. State DD and DSHS Cuts Ms. Danskin updated the Board on State Developmental Disability cuts that are taking effect immediately. She reported that the state funded Disability Lifeline program has been eliminated, but there have been 3 new programs created to help low income individuals without dependents who are elderly or cannot work due to incapacity or disability. These people will continue to • 2 BOH Minutes September 15,2011 receive health care benefits from the state but will lose assistance for housing and food. These • changes will affect 137 people in Jefferson County. Secondly,Ms. Danskin reported there have been changes to the Medicaid laws which limit the amounts of non-emergent emergency room visits to 3 per year. Dr. Locke pointed out that the change to this law may be problematic to hospitals because it is not until after the patient has been evaluated that they know whether the condition is non-emergent. Finally, Ms. Danskin stated that the Washington State Economic and Revenue Forecast was released, at this point it is unclear where the Governor will make cuts,but all state dollars for flexible programs are on the table and could impact JCPH's budget. JCPH, County Budget Update Ms. Baldwin presented several graphs which outlined the JCPH 2012 budget. The first graph showed the percentage of money from the county general fund that goes back to the county for rent/leases and the amount remaining for services for both JCPH and Water Quality. The second graph that Ms. Baldwin presented was Community Health Fees which shows that client fees have stayed about the same over the past year; Medicaid showed a large drop,which is due to a change in Medicaid's billing system causing a delay in their bills being paid and Private Insurance dropped as a result of approximately 550 people who were on Basic Health losing their benefits. Environmental Health fees show a large drop. As the fees drop staff is being moved to other positions that have funding. The third graph that Ms. Baldwin reviewed showed • changes to FTE's for JCPH and Water Quality. Overall the graph shows that staffing is down. Also reviewed was the Revenue Source Trend for both Environmental Health and Water Quality. Revenue and Program changes in 2011-2012; Tobacco, Child Care, Communicable Disease,Dental,Foot Care,Environmental Health Fees,BCHP,Drinking Water(Group B), Family Planning and PHEPR Ms. Baldwin explained the spreadsheet that was included in the agenda packet which showed current State budget cuts and how they will affect JCPH 2012 Budget. Several programs including Tobacco Prevention, Oral Health, and Healthy Child Care have been eliminated. The programs that will be seeing reductions in their funding are Family Planning, HIV Prevention (which funds the syringe exchange program), Blue Ribbon(which fund Communicable Disease and Immunizations), Breast and Cervical Health Program, Early Intervention Program, Early Family Support Services Program, and Medicaid fees. The only program seeing an increase is WIC. Ms. Baldwin also mentioned that JCPH is trying to build up a Communicable Disease emergency fund of$400,000.00 or 15% of the budget so that the money is available for surge capacity. The goal for 2013 is to put in$150,000.00 to begin phasing in funds. This has been included in the budget. • 3 BOH Minutes September 15,2011 ACTIVITY UPDATE • Ms. Danskin announced that Girls Night Out is October 6th. She will be focusing on prevention by placing brochures that focus on prevention in all the packets that will be handed out at the event. AGENDA PLANNING CALENDAR Ms. Baldwin announced there is another 0 &M installment in October. Ms. Baldwin stated that she will come back to the Board with outreach programs for vaccine hesitant parents. Member Austin mentioned that after being at a public health meeting it was brought up that it may be beneficial for the BOH to be accredited. Ms. Baldwin responded that at some point the Board may want to look at JCPH also being accredited. Ms. Baldwin stated that the flu vaccine will be available to Board member at the October BOH meeting. The next scheduled BOH meeting will be held Thursday, October 20, 2011 from 2:30-4:30 PM at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT IP Member Austin moved to adjourn the September BOH meeting; Member Johnson seconded. The motion passed unanimously. Chair Nelson adjourned the September BOH meeting @ 4:26 p.m. JEFFERSON COUNTY BOARD OF HEALTH Kristen Nelson, Chair Phil Johnson,Vice-Chair Jill Buhler, Member John Austin, Member Roberta Frissell, Member David Sullivan, Member Sheila Westerman, Member • 4 BOH Minutes September 15,2011 • JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, September 15, 2011 - 2:30 PM—4:30 PM Public Health Conference Room, 615 Sheridan Street, Port Townsend Board Members Staff Members Phil Johnson, Vice Chair, County Commissioner District#1 Thomas Locke,MD,MPH 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 Roberta Frissell, Citizen at large(County) Stuart Whitford,Environmental Health Services Director Kristen Nelson, Chair,Port Townsend City Council Sheila Westerman, Citizen at large(City) Jill Buhler,Hospital Commissioner,District#2 Chair Kristen Nelson called the meeting of the Jefferson County Board of Health to order at 2:35 PM. A quorum was present. Members Present: Phil Johnson, David Sullivan, John Austin, Kristen Nelson, Sheila Westerman, Roberta Frissell Staff Present: Dr. Thomas Locke, Jean Baldwin, Julia Danskin . Members Excused: Jill Buhler APPROVAL OF AGENDA Member Johnson moved to approve the agenda for the September 15, 2011 BOH meeting; Member Austin seconded. The motion passed unanimously. APPROVAL OF MINUTES Member Westerman moved to approve the minutes for the August 18, 2011 BOH meeting; Member Johnson seconded. The motion passed unanimously. PUBLIC COMMENTS None OLD BUSINESS and INFORMATIONAL ITEMS Family Planning and WIC Outreach Julia Danskin reported that in an effort to increase the WIC case load numbers there have been several outreach attempts made, which have included posting fliers at several businesses and organizations in the community, sending a packet of information to local health care providers, • as well as some families that are WIC recipients doing interviews with the Leader. BOH Minutes September 15,2011 Chair Nelson recommended that JCPH ask permission to post the fliers inside women's restrooms of local businesses for a limited period of time. • A brief period of questions and answers followed regarding tobacco use and the laws regarding public tobacco use. Chair Nelson raised a question regarding steam cigarettes and if they are legal or fall under Initiative 901. Ms. Baldwin will do some research and follow up with an answer as to whether the use of steam cigarettes is legal in public places. In addition, Member Westerman voiced her concern over tobacco use at The Uptown Pub in an outdoor area. Ms. Baldwin recommended that she call and place a formal complaint. Ms. Baldwin concluded the discussion by reminding the Board that community norms must change because community education is no longer funded. Diphtheria,Pertussis - Give Immunity,Fight Transmission (The G.I.F.T. Program) Ms. Baldwin mentioned that another outreach program that JCPH is involved with is getting the Diphtheria and Pertussis vaccine to low income, uninsured adults, and all adults who have direct contact with infants, since Pertussis is the second most vaccine preventable disease. The G.I.F.T. program assists with the cost of the adult vaccine for low income or uninsured. NEW BUSINESS Preparation for the 2011-12 Influenza Season Dr. Locke updated the Board on the 2011-2012 Influenza season which typically occurs some • time between October and May. The priority group for flu vaccine this year is any one over the age of 6 months,with the greatest danger of complications of the flu being to the very young and very old. Dr. Locke reported that the majority of hospitals in Washington are requiring health care workers with direct contact to patients be vaccinated. He also mentioned that this year there is a new vaccine delivery system available called the intradermal injection which uses a smaller dose of the vaccine delivered by a very small needle into the skin and is as effective as the conventional injectable in healthy adults. A recommendation was made that at the next Board of Health meeting in October,the Board members receive their flu vaccine and invite the Leader to be at the meeting. Finally, Dr. Locke reported that there is a new H3N2 variant of the swine flu has surfaced in Ohio. At this point the virus has not posed a serious pandemic threat and is being closely monitored. State DD and DSHS Cuts Ms. Danskin updated the Board on State Developmental Disability cuts that are taking effect immediately. She reported that the state funded Disability Lifeline program has been eliminated, but there have been 3 new programs created to help low income individuals without dependents who are elderly or cannot work due to incapacity or disability. These people will continue to 2 BOH Minutes September 15,2011 • receive health care benefits from the state but will lose assistance for housing and food. These changes will affect 137 people in Jefferson County. Secondly,Ms. Danskin reported there have been changes to the Medicaid laws which limit the amounts of non-emergent emergency room visits to 3 per year. Dr. Locke pointed out that the change to this law may be problematic to hospitals because it is not until after the patient has been evaluated that they know whether the condition is non-emergent. Finally,Ms. Danskin stated that the Washington State Economic and Revenue Forecast was released, at this point it is unclear where the Governor will make cuts,but all state dollars for flexible programs are on the table and could impact JCPH's budget. JCPH, County Budget Update Ms. Baldwin presented several graphs which outlined the JCPH 2012 budget. The first graph showed the percentage of money from the county general fund that goes back to the county for rent/leases and the amount remaining for services for both JCPH and Water Quality. The second graph that Ms. Baldwin presented was Community Health Fees which shows that client fees have stayed about the same over the past year; Medicaid showed a large drop,which is due to a change in Medicaid's billing system causing a delay in their bills being paid and Private Insurance dropped as a result of approximately 550 people who were on Basic Health losing their benefits. Environmental Health fees show a large drop. As the fees drop staff is being moved to other positions that have funding. The third graph that Ms. Baldwin reviewed showed • changes to FTE's for JCPH and Water Quality. Overall the graph shows that staffing is down. Also reviewed was the Revenue Source Trend for both Environmental Health and Water Quality. Revenue and Program changes in 2011-2012; Tobacco, Child Care, Communicable Disease,Dental,Foot Care, Environmental Health Fees,BCHP,Drinking Water(Group B),Family Planning and PHEPR Ms. Baldwin explained the spreadsheet that was included in the agenda packet which showed current State budget cuts and how they will affect JCPH 2012 Budget. Several programs including Tobacco Prevention, Oral Health, and Healthy Child Care have been eliminated. The programs that will be seeing reductions in their funding are Family Planning,HIV Prevention (which funds the syringe exchange program), Blue Ribbon(which fund Communicable Disease and Immunizations), Breast and Cervical Health Program, Early Intervention Program, Early Family Support Services Program, and Medicaid fees. The only program seeing an increase is WIC. Ms. Baldwin also mentioned that JCPH is trying to build up a Communicable Disease emergency fund of$400,000.00 or 15%of the budget so that the money is available for surge capacity. The goal for 2013 is to put in $150,000.00 to begin phasing in funds. This has been included in the budget. S 3 BOH Minutes September 15,2011 ACTIVITY UPDATE • Ms. Danskin announced that Girls Night Out is October 6th. She will be focusing on prevention by placing brochures that focus on prevention in all the packets that will be handed out at the event. AGENDA PLANNING CALENDAR Ms. Baldwin announced there is another 0 & M installment in October. Ms. Baldwin stated that she will come back to the Board with outreach programs for vaccine hesitant parents. Member Austin mentioned that after being at a public health meeting it was brought up that it may be beneficial for the BOH to be accredited. Ms. Baldwin responded that at some point the Board may want to look at JCPH also being accredited. Ms. Baldwin stated that the flu vaccine will be available to Board member at the October BOH meeting. The next scheduled BOH meeting will be held Thursday, October 20, 2011 from 2:30-4:30 PM at Jefferson County Public Health, 615 Sheridan Street,Port Townsend, WA. ADJOURNMENT . Member Austin moved to adjourn the September BOH meeting; Member Johnson seconded. The motion passed unanimously. Chair Nelson adjourned the September BOH meeting @ 4:26 p.m. ETFE ON COUNTY B ARD OF HEALTH N\\ rk\: Kristen Nsonr. e C\air Phil Johnson, ice-Chair , Excused , I CifrAZ, Jill Buhler, Member Jo 1, Austin, Member f/1-41-6- Roberta Frissell, Member David Sulliva ,Member tiL_ UJ 4-1 et4 Sheila Westerman, Member • 4 BOH Minutes September 15,2011 Board of 3feaCth OCdBusiness & Informational Items .agenda Item # IV, 1 • Correspondence October 20, 2011 • RECERI �yy4 C% OCT��STATO 122011 Jefferson Count 1989 a° Public Health STATE OF WASHINGTON DEPARTMENT OF HEALTH OFFICE OF COMMUNITY HEALTH SYSTEMS Post Office Box 47853 • Olympia,Washington 98504-7853 DATE: October 5, 2011 TO: Jean Baldwin, Jefferson County Public Health Bob Perna, Washington State Medical Association Kathie Itter,Washington Osteopathic Medical Association Mary Looker, Washington Association of Community and Migrant Health Centers Kathy Schmitt, Community Health Systems Sam Watson-Alvan, Primary Care Office Christina Hulet, Office of the Governor • FROM: Laura Olexa, Health Care Access Analyst SUBJECT: Renewal as a Geographic Primary Care Health Professional Shortage Area Designation: Jefferson County—Port Townsend/Quilcene; Federal ID 53G7 We are pleased to inform you that federal officials have approved the renewal request to designate your area as a geographic primary care health professional shortage area. This is a renewal of the previous designation. Enclosed is the federal designation approval letter. The effective date for this designation is August 30, 2011. This designation establishes initial eligibility requirements for the following programs: • National Health Service Corps:This program recruits providers for areas in need. It offers loan repayment or scholarships. Recipients serve at least two years in a shortage area. It is available to primary care,dental and mental health providers.Not all applicants are eligible or receive an award. For more details,please call (360)236-2814 or visit our website at http://www.doh.wa.gov/hsga/ocrh • Rural Health Clinic Program: A clinic cannot be in an urban area. It must also be in a current shortage area to receive certification. A Rural Health Clinic receives better reimbursement for Medicare and Medicaid patients than standard. It can take up to a year to complete the process. • For details about the Rural Health Clinic program,please call(360)236-2811.You can also email crhmail(idoh.wa.gov to request a packet about the program. October 5, 2011 • Page 2 • J-1 Visa Waiver Program: Our state has up to 30 visa waivers a year to offer to international medical graduates.They must be willing to serve at least three years in a shortage area. If you would like to recruit a foreign physician who needs a visa waiver to practice,please call (360)236- 2814. You may also visit our website at http://www.doh.wa.gov/hsqa/ocrh/R&R/jihtm. This program is on a first come first serve basis. • Medicare Incentive Payments: In certain types of shortage areas Medicare will pay more for care. The bonus payment amount is 10 percent or it can be as high as 15%if a Physician Scarcity Area also exists.The following website must list your area in order for you to bill for a bonus payment, https://www.noridianmedicare.com/p-medb/news/hpsa psa/index.html. If this process is new to you,we encourage you to review the website or contact Noridian for more details. If you have questions on this designation or eligibility for federal programs,please contact me. Shortage area information is also available at http://www.doh.wa.gov/hsga/ocrh/HPSA/hpsal.htm. Laura Olexa, Health Care Access Analyst Office of Community Health Systems PO Box 47853 • Olympia, WA 98504-7853 laura.olexa@doh.wa.gov (360) 236-2811 (360) 236-2830 FAX Enclosure: Federal Designation Letter CC: Jefferson Healthcare Madrona Family Medicine Melanie McGrory MD PS Monroe St Medical Clinic Quimper Family Medicine R Lynn Clinic • 1 - S4RVICps 1 / Y DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services o Administration dWda'vdaa • Bureau of Health Professions Rockville,MD 20857 August 30, 2011 Ms. Laura Olexa Health Care Access Analyst Office of Community and Rural Health Department of Health P.O. Box 47834 Olympia, Washington 98504-7834 Dear Ms. Olexa: We have reviewed your application dated May 25, 2011,requesting designation of one or more health professional 51rtage area(s)(HPSA). Based on the information received or otherwise available,we have made a determination about your request(s),which is displayed on the enclosure. If the enclosure shows a new,continued,or reinstated designation,we have determined that your request(s) met the established criteria for this type of designation. The designation of these are effective as of the date of this letter. If the enclosure shows a designation that has been proposed for withdrawal, we have determined the • designation no longer meets the established criteria. The withdrawal of these will not be effective until the date of the next Federal Register publication listing designated HPSAs. If the enclosure shows that a designation has been replaced,this is effective as of the date of this letter. We appreciate your cooperation in this joint effort. If you have any questions,please contact Mr. Melvin Whitfield of my staff at 301-594-0816. Sincerely yours, 111) Andy Jordan Director Office of Shortage Designation Enclosure cc: Office of the Governor, Washington Washington State Primary Care Association Washington State Medical Association co g Sg) 531' co Nea`Itn hcti tom Sm Ss s - �oe.618t Lt.9‘.0"1\' Page l of l Washington- PRIMARY MEDICAL CARE HEALTH PROFESSIONAL SHORTAGE AREAS Update HPSA Designation HPSA Name Port Townsend and Quilcene HPSA ID 15399953G7 HPSA Name Port Townsend and Quilcene HPSA Component Type County Parts HPSA Service Code 53G7 Population 28612 HPSA Type Area FTE Primary Care PHYS 6.7 Ratio 4270:1 Component: Jefferson C.T. 9502 01 C.T. 9502.02 C.T. 9503.00 C.T. 9504.00 C.T. 9505.00 C.T. 9506.01 C.T. 9506.02 • • https://asaps.hrsa.gov/dbw_hpsa_frmReplace.asp?hpsalD=15 3 9995 3 G7&CaseID=201161... 8/30/2011 if. rage 1 or G P � Cathy Avery From: Teresa Wirth [teresaw@safeharborrecovery.org] nt:li Wednesday, October 12, 2011 12:37 PM o: Julia Danskin Cc: Cathy Avery Subject: RE: Board of Health packet Attachments: BOH copy.10-11.doc Hi Julia, Here is a template of the letter we sent minus names and addresses. We sent copies to: Governor Gregoire Rep. Hans bunshee Senator Ed Murray Senator Jim Hargrove Rep. Kevin Van be Wege Rep. Steve Tharinger Thanks for the reminder email. Teres W firth' Administrator Safe Harbor Recovery Center, Inc & Beacon of Hope, Inc. 686 Lake Street Ste 400 Port Townsend, WA 98368 360-385-3866 4111r . . om: Julia Danskin [mailto:jdanskin@co.jefferson.wa.us] Sent: Wednesday, October 12, 2011 12:22 PM To: Teresa Wirth Cc: Cathy Avery; Tom Locke Subject: Board of Health packet HI Teresa, Can you send a copy of the SAAB letter that they are sending to the legislature to both Cathy Avery and me? Also a list of everyone who was sent the letter. I know Fran asked that this be put in the BOH packet. We can let Tom Locke decide how he wants this listed on the Agenda. It is regarding proposed DSHS cuts to Drug Treatment services and Mental Health Services. CAckt Oa S'eff Public Health Nursing Director Jefferson County Public Health 615 Sheridan Port Townsend,WA 98368 Ph: 360-385-9420 email: jdanskin@co.jefferson.wa.us www.jeffersoncountypublichealth.org Confidentiality Notice: Thise-mail message,including any attachments,is for the sole use of the intended recipient(s)and may contain confidential and previleged information. Any unauthorized review,use,disclosure,or distribution is prohibited. If you are not the intended Olecipent,please contact the sender by reply e-mail and destroy all copies of the original message. All e-mail sent to this address has been eceived by the Jefferson County e-mail system and is therefore subject to the Public Records Act,a state law found at RCW 42.56. Under the Public Records law the County must release this e-mail and its contents to any person who asks to obtain a copy(or for inspection)of this e- mail unless it is also exmpt from the disclosure under state law,including RCW 42.56. 10/13/2011 I J 14,FF N;RSON COUNTY SUBSTANCE ABUSE ADVISORY BOARD October 11, 2011 Dear Representative : We are respectfully requesting that the current recommended budget cuts not be implemented for essential substance abuse and mental health services.With the cuts that have already been imposed on treatment services, this additional cost cutting will undermine treatment to the point of seriously eroding the stability of local and state government. Funding Alcohol/Drug Treatment is an Investment in Health Care Cost Containment and has been verified by numerous studies conducted in Washington State that show significant medical cost savings resulting from public- funded alcohol/drug treatment. Defunding treatment programs for indigent defendants basically destroys the rehabilitative model for the criminal justice system in the State of Washington.The majority of defendants in the criminal justice system suffer from chemical dependency. Their use of drugs and/or alcohol is usually an underlying cause of their criminal behavior and most of the defendants are indigent and cannot afford to pay for treatment. If there is no funding for treatment, defendants will not obtain treatment[the court cannot sanction a person who fails to obtain treatment because he is indigent and cannot afford to pay]. • Alcohol/Drug Misuse and Addictions are Widespread • 13% of adult population 200% Federal Poverty Level and below have a problem • 8+%of youth population 200% Federal Poverty Level and below have a problem • 80%of youth in Juvenile Rehabilitation Administration institutions have a problem • 60-80%of child protective service cases(accepted referrals)at least one parent has a problem • 70+%of state prison inmates have a problem • 70+%of Jefferson county Jail inmates have a problem • 60-80%of hospital emergency department trauma patients have a problem • A significant number of Disability Lifeline, SSI and TANF clients have a problem • Alcohol/drugs play a major role in traffic fatalities,fires, accidents and poisonings • 60+%of Mental Health Clients have a co-occurring substance abuse issue Negative Consequences of Untreated Alcohol/Drug Misuse and Addictions • Poor school and work performance • Child abuse/neglect • Increased acute and long term care medical issues/costs • Increased accidents, injuries, poisonings and death rate • Poor birth outcomes • Increased crime Substance Abuse Advisory Board Members Frances Joswick,Chair -- Chief Conner Daily, Vice-Chair Sheriff Anthony Hernandez — Raymond Hunter • Sam MarkowN — Kay Pownell HarGopal — Chase Glennl rnie Danberg Michael Phirnister — Anne Dean — Coleman Riddle David Sullivan,Jefferson County Commissioner — Catharine Robinson,Port Townsend Cit'Council 615 Sheridan --Castle Hill Center- Port Townsend- WA---98368 (360)385-9400 JEFF FRSON COUNTY SUBSTANCE ABL,S F ADVISORY BOARD Page 2 The proposed reductions present numerous problems in a plethora of areas for both State and Local services. Some of the problems created include the costs of not treating an estimated 55,000 patients over an 18-month period will likely be transferred, at a higher cost to: county jails, state prisons, hospital emergency departments, Medicaid medical, employment security, and child welfare. Being able to serve youth and Pregnant and Parenting Women (PPW) patients in rural areas will be close to impossible with the proposed cuts. These proposed cuts also place DBHR Federal Grants in jeopardy. Also in jeopardy are the Prevention, Intervention,Treatment and Recovery support services if treatment agency capacity cannot be maintained and/or federal agencies pull back their grants. Childhood experiences will be negatively impacted (child abuse and neglect)by children who live with adults that do not have access to treatment and recovery planning for their addiction. There will most likely be an increase to property crime and also homelessness. Individuals not obtaining substance abuse treatment likely will suffer more catastrophic injuries and incidents of infectious diseases resulting in increased medical utilization. The chronic physical disease progression will result in qualification for disability-related Medicaid coverage. By not having detoxification services available, individuals inebriated in public will place a strain on limited public safety personnel. The Diversion programs in Washington State will not be able to place residents in treatment who cannot afford to pay for it. This will cause increasing court and jail costs. Low-income, non-Medicaid adults who receive dependency treatment earn more, experience lower medical costs, have fewer arrests and have a lower risk of dying. Last,but not least, it is expected that many of the 500-plus certified chemical dependency treatment agencies in the state will go out of business. This will likely result in hundreds, if not thousands, of jobs being lost in every • Washington State county. Most of these positions will be from community-based treatment agencies. Sincerely, Fran Joswick, Chair Jefferson County Substance Abuse Advisory Board Substance Abuse Advisory Board Members Frances Joswick,Chair — Chief Conner Daily, 6'ice-Chair Sheriff Anthony Hernandez -- Raymond Hunter Sam Markow .- Kay Powttell _ HarGopul — Chase Glenn e trnie Danberg — Michael Phimis'ter — Anne Dean — Coleman Riddle David Sullivan,Jefferson County Commissioner -- Catharine Robinson,Port Townsend City Council 615 Sheridan -Castle Hill Center- Port Townsend--WA-98368 (360)385-9400 I JEFFERSON COUNTY SUBSTANCE ABI F, ADVISORY BOARD • Substance Abuse Board Members Chief Conner Daily, Co-Chair Sheriff Anthony Hernandez Councilwoman Catharine Robinson Commissioner David Sullivan Sam Markow HarGopal Boyd Chase Glenn Anne Dean Ray Hunter Arnie Danberg (On holiday) (Not available for signature) Kay Pownall Michael Phimister • Substance Abuse Advisory Board Members Frances Joswick,Chair -- Chief Canner Daily, Dice-Chair SheriffAnthony Hernandez -,. Raymond Hunter S Sam MarkowN — Kay Pownell HarGopal — Chase Glenn Arnie Danberg Michael Phemister — Anne Dean •- Coleman Riddle David Sullivan,Jefferson County Commissioner -- Catharine Robinson,Port Townsend City Council 615 Sheridan -Castle Hill Center- Port Townsend --WA--98368 (360)385-9400 • Board of CeaCth Old-Business & Informational-Items .agenda Item # IV., 2 Regulation of E-Cigarettes • and Single Cigarettes October 20, 2011 • Jefferson County Tobacco Awareness • : October 2011 Smoking in Public Places Smoking in Public Places (SIPP) at a glance It's the responsibility of the business owner or person in charge to: • Prohibit Smoking indoors. • Post no smoking signs at entrances & exits. • Prohibit smoking within 25 feet of entrances, exits, windows that open, & air intake vents. • E-Cigarettes are NOT covered under current law in WA except in King co. TO REPORT VIOLATIONS: Call 385-9400 For further information on SIPP see: www.smokefreewashington.com/laws/ For latest Foods Safety News mailed to all food service establishments in Jefferson Co. see: www.jeffersoncountypublichealth.org/index.phOfood-safety Sale of Single Cigarettes • Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Pro- tect Children and Adolescents: A FDA rule, restricts the sale, distribution, and promotion of these products to make them less accessible and less attractive to kids. Effective on June 22, 2010, and has the force and effect of law. For complete FDA rule see: http://www.fda.gov/TobaccoProducts/ ProtectingKidsfromTobacco/RegsRestrictingSale/default.htm FDA prohibits the sale of cigarette packages with fewer than 20 cigarettes. How will FDA enforce the regulations? In addition to doing inspections on its own, the Tobacco Control Act requires FDA to contract with states to inspect retail establishments within the state, to the extent feasible. Washington's contract with FDA is through WA Liquor Control Board. To Report Violations : Letty Mendez at LCB LAM( lig.wa.gov or FDA http://www.fda.gov/TobaccoProducts/default.htm E-cigarettes What are electronic cigarettes? B itery Vaporizer Cartridge • Battery-operated devices deliver nicotine vapor to mimic cigarette smoking \ Nicotine is the highly addictive substance in tobacco Indicator fight Mouthpiece • • Made of a cartridge filled with flavoring and various strengths of liquid nicotine • Can cost as little as $10, but a starter kit is typically available for$50 to $100 • Not regulated or approved for use in tobacco cessation by the FDA continued from page 1 '0. • Why should we be concerned about e-cigarette sales to youth? --- E-cigarettes may appeal to youth because of: • High-tech design • Placement in mall kiosks, convenience stores & online • Wide array of flavor cartridges, including fruit punch, chocolate and Regular Vs.E-Cigarettes mint • Use of e-cigarettes among youth can increase nicotine addiction and may lead to use of conventional tobacco products Why e-cigarettes are NOT a safe alternative to smoking? Testing by the FDA found products that: • Contained diethylene glycol, an ingredient used in antifreeze that is toxic to humans • Contained human carcinogens (half of the samples tested) • Labels misrepresentation nicotine level • Had poor product quality control • Companies continue to claim that e-cigarettes are a safe and effective way to quit using tobacco, without FDA approval or product testing • Most e-cigarettes don't have health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes For more information, call 385-9400. • E-cigarette information adapted from Seattle&King County materials King County WA Adopts e-cigarettes Rules On 12/16/10, the King County Board of Health passed an ordinance making it illegal to: • sell e-cigarettes to minors • Sell e-cigarettes via a machine • Offer free or discounted e-cigarettes • Use e-cigarettes in any area where smoking is prohibited by law. This county-wide ordinance titled "ELECTRONIC SMOKING DEVICES AND UNAPPROVED NICOTINE DELIVERY PRODUCTS" went into effect on 1/15/11, will promote the public's health by preventing youth from nicotine addiction and preserving our public spaces as smoke-free. Other States with e-cigarette rules: Massachusetts, ,Minnesota, New Hampshire, New Jersey, New York, Oregon K. Obermeyer October 2011 • • Board of 3-fealth Old Business & InformationaCltems .agenda Item # 1V., 4 Xitsap Public 3-fealth District Strategic Plan at a Glance October 20, 2011 • O o, m tD v �o n O v m < O v coo O DJ •* to o, ^" to +, fl7 '"h to 07 .*fD vmi CU CO M ay. OD tri CD M C W v CD N C N1.1.1111111111111111C in tn y M CU * C, `° 3 CD _ -v G z G O. G 7 0 0 °• o o — ° ° = 0 0 0 • 13 TS o rD GZ Cro w r-- �' O n• p fll Q C rt. 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E ' a) U @ = > ca 73 �C L E QJ p a)co o E a c F°— > °U 3 3 Q. o ° 3 N H V. • _Q _ 0 in N H c'C) a) ai a) C) of d — �+ — v UU) = d Z;) Lfl 5. •Q 5 •a 5 'C) L •� OO L a) C0 ca ��., t0 4p.• L Q) 11,3 >- >- L. >- 4, 4, 4.. 4, 4.. 0 ,n n N N N N N in N • Board-of gCeaCth Old Business & Informational Items .agenda Item # 117., 5 • Staff Stars October 20, 2011 Jean Baldwin aubject: FW: from Robert Anda ttachments: Family Health Program Assessment Questionnaire Results Aug 2011.docx; Assessment form 8-17-10.doc From: Robert Anda Sent: Friday, September 23, 2011 1:06 PM To: Quen Zorrah Cc: Lisa Cook; Sandra Mintz; Nicole Sherren; Laura Porter; SashaSilveanu Subject: Fw: Jefferson Co WA, ACEs use of ACE history in your clinic population Hello Quen: Thank you so much for this information. This is amazing and so well laid out! I would like to talk with you next week about your experience with adding the brief ACE histor. Is there a time on Monday or Tuesday that looks good? Congratulations on the great work! I have cc'ed Lisa Cook and Sandra Mintz who also is interested in this issue. Lisa, Sandra and I have talked about piloting your type of approach in the Chinook Primary Care Network (Alberta). Your experience with this will be valuable for an upcoming meeting funded by the Norlien Foundation to discuss your type of applications of ACE concepts in the clinic setting. Nicole Sherren, PhD, the Science Director at Norlien is also on the list. sour Washington colleagues who told me about your adaptation of ACE work are also cc'ed. Best regards, Rob Anda, MD, MS ACE Studies --- On Fri, 9/23/11, Quen Zorrah <gzorrah(&,,co.jefferson.wa.us>wrote: From: Quen Zorrah <gzorrahnco.jefferson.wa.us> Subject: Jefferson Co WA, ACEs To: "Robert Anda" <robanda cr bellsouth.net> Date: Friday, September 23, 2011, 2:17 PM Hello Dr Anda, Thanks for your interest in our work with bringing ACEs into clinical practice. As public health nurses with many years of experience in maternal child health, our team was relieved and excited to learn about the ACEs research. It helps us promote our work with families as science based. • On intake into our MCH programs we screen pregnant and parenting clients for health risks. We revised this screen to include the short form of the ACE questionnaire. We received a small community grant to fund using an expanded questionnaire and analysis by our epidemiologist. We have a small population-200 births per year, our N for this project was 98. We are currently using the ACE questionnaire in a condensed screening tool. I'm attaching the original screen we developed as well as the analysis. We have learned a lot about the process of asking the ACE questions. My • thought is that offering the information and asking the ACE questions is the critical intervention and the answers or score is not as important. Some clients are not ready or don't feel safe in disclosing their ACE history. For some clients the information and learning their score has been very powerful. I look forward to talking to you about our work. Quen Zorrah PHN Infant Mental Health Specialist 360-385-9424 • • 2 CDC -ACE Study - Publications by Year - Adverse Childhood Experiences Page 1 of 6 F Centers for Disease Control and Prevention irt CDC 2417 Savtng Lives Protecting Peoplo.Saving Money through Prevention. tion. Major Findings By Publication Year Following is a comprehensive list of ACE publications by publication year. 1--Select Publication Year-- Go! 2010 1. Hillis SD,Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Macaluso M, Marks JS. (2010). The Protective Effect of Famil Stren_ hs in Childhood against Adolescent Pregnancy and Its Long- Term Psychosocial Consequences § .Permanente Journal,Vol. 14, No. 3, pp. 18-27. 2. Anda R,Tietjen G, Schulman E, Felitti V, Croft J. Adverse childhood experiences and frequent headaches in adults f. Headache. 2010 Oct;5o(9):1473-81. 3. Anda RF, Butchart A, Felitti VJ, Brown DW. Building a framework for global surveillance of the public health implications of adverse childhood experiences V .AM J Prey Med. 2010 Ju1;39 (1):93-8. 4. Brown DW,Anda RF, Felitti VJ, Edwards VJ, Malarcher AM, Croft JB, Giles WH. Adverse • childhood experiences and the risk of lung cancer§ .BMC Public Health 2010;10:20. 2009 1. Anda RF, Dong M, Brown DW, Felitti VJ, Giles WH, Perry GS, Edwards VJ, Dube SR. The relationshi. of adverse childhood ex.eriences to a histo of I remature death of family members v . BMC Public Health 2009;9:106. 2. Dube SR, Fairweather D, Pearson WS, Felitti VJ,Anda RF, Croft JB. Cumulative childhood stress and autoimmune disease §. Psychom Med 2009:71, 243-250. 2008 1. Anda RF, Brown DW, Felitti VJ, Dube SR, Giles WH. Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients v . BMC Public Health 2008;8:198. 2. Anda RF, Brown DW, Dube SR, Bremner JD, Felitti VJ, Giles WH. Adverse childhood experiences and chronic obstructive pulmonary disease in adults§ .Am J Prey Med 2008;34 • (5):396-403. 3. Corso, PS, Edwards,VJ, Fang, X, Mercy, JA. Health-related quality of life among adults who http://www.cdc.gov/ace/year.htm 10/14/2011 CDC - ACE Study - Publications by Year - Adverse Childhood Experiences ?age 2 of b experienced maltreatment during childhood .Am J Public Health 2008;98:1094-1100. IP 2007 1. Anda RF, Brown DW. Root causes and organic budgeting: funding health from conception to the grave. Ped Health 2007;1(2):141-143. 2. Anda RF, Brown DW, Felitti VJ, Bremner JD, Dube SR, Giles WH. Adverse childhood experiences and prescribed psychotropic medications in adults § .Am J Prey Med 2007;32 (5):389-94. 3. Edwards VJ,Anda RF, Gu D, Dube S R, Felitti VJ.Adverse childhood experiences and smoking .ersistence in adults with smokin_-related s •toms and illness rY . Permanente Journal 2007;11:5-7. 4. Brown DW,Anda RF, Felitti VJ. Self-reported information and pharmacy claims were c0m arable for lipid-lowering medication exposure .J Clin Epidemiol 2007;60(5):525-529. 5. Chapman DP, Dube SR,Anda RF.Adverse childhood events as risk factors for negative mental health outcomes.Psychiatric Annals 2007;37(5):359-364. 6. Edwards VJ, Dube SR, Felitti VJ,Anda RF. It's OK to ask about past abuse .American • Psychologist 2007;62(4):327-328. 2006 1. Dube SR, Miller JW, Brown DW, Giles WH, Felitti VJ, Dong M,Anda RF. Adverse childhood ex•eriences and the association with ever usin: alcohol and initiatin: alcohol use durin_ adolescence v . Journal of Adolescent Health 2006;38(4):444•e1-444•elo. 2. Anda RF, Felitti VJ, Brown DW, Chapman D, Dong M, Dube SR, Edwards VJ, Giles WH. (2006) Insights into intimate partner violence from the Adverse Childhood Experiences (ACE) Study. In:PR Salber and E Taliaferro, eds. The Physician's Guide to Intimate Partner Violence and Abuse,Volcano, CA: Volcano Press; 2006. 3. Anda RF, Felitti VJ,Walker J,Whitfield, CL, Bremner JD, Perry BD, Dube SR, Giles WH.The enduring effects of abuse and related adverse e demiolo�e� eEuropean Archriences in hyes of Psychiatry and ood: a convergence of evidence from neurobiolo and Clinical Neurosciences 2006;56(3):174-86. 2005 1. Dube SR Anda RF,Whitfield, CL, Brown DW, Felitti VJ, Dong M, Giles WH. Long-term • , cone•uences of childhood sexual abuse b :ender of victim. § Am J Prey Med 2005;28:430 http://www.cdc.gov/ace/year.htm 10/14/2011 • Board of Cealth Odd Business & Informational Items ,agenda Item # nV, 6 • Port Townsend Paper Company Solid Waste Permit Update October 20, 2011 • ,o, co • \ JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend•Washington •98368 . -''fir o`° www.jeffersoncountypubtichealth.org October 13,2011 Port Townsend Paper Corporation 100 Mill Road Attn: Ms.Eveleen Muehlethaler Port Townsend,WA 98368 Dear Ms.Muehlethaler: Thank you for your time during the past few months in meeting with Jefferson County Public Health(JCPH)staff to discuss the Port Townsend Paper Corporation's(PTPC) Inert Waste Landfill Permit and characterization of your lime grit and boiler ash waste. As you are aware,the Department of Ecology is recommending that your current permit as an Inert Waste Landfill be changed to a Limited Purpose Landfill. As Jefferson County Health Officer,I concur with the Department of Ecology's assessment that the lime grit and boiler ash waste generated by the PTPC does not meet the criteria for classification as inert waste and that the current waste disposal facility should be permitted as a Limited Purpose Landfill. WAC 173-350-990(2) specifically lists types of waste considered to be inert(cured • concrete,asphaltic materials,brick and masonry, ceramic materials, glass and stainless steel and aluminum). These"listed"wastes share the characteristic of having originally been used for structural and/or construction purposes. WAC 173-350-990(3) establishes criteria for determining if a solid waste not listed in WAC 173-350-990(2)is an inert waste. In order to be considered inert,a non-listed solid waste must have"comparable physical characteristics and comparable or lower level of risk to human health and the environment"as a listed waste type. Lime grit and boiler ash waste do not meet the standards outlined in WAC 173-350- 990(3). This waste stream does not have the physical characteristics that are comparable to the"listed"wastes. The"listed"wastes are all hardened materials with comparably little surface area available for interaction with ground or surface waters. Lime grit and boiler ash waste are not hardened,have exponentially greater surface area available for contact with ground and surface waters than do the listed wastes, and have no relation to construction or structural purposes. To meet the determination as inert waste established by WAC 173-350-990(3)the waste must meet all the criteria contained in subsections(a)and(b)of this code,including those that require that the waste not be capable of producing a leachate or emission that negatively impacts soil, groundwater,or surface waters AND that the waste not pose a health threat to humans or other living organisms through direct or indirect exposure. C• DEVELOPMENTAL HEALTHDIPUBLIC HEALTH ENVIRONMENTAL ATERHEALTH QUALITY MAIN:EVELOPMENTAL DISABILITIES ALWAYS WORKING FOR A SAFER AND MAIN: (360)385-9444 (360)385-9400 FAX: (360)385-9401 HEALTHIER COMMUNITY FAX: (360)379-4487 The waste produced by the PTPC fails both of these criteria. The high pH and large amount of surface area of this waste stream promotes dissolution when exposed to ground and/or surface waters,creating a potential leachate which can negatively impact soil, groundwater,and/or surface waters. Additionally,the high pH of this waste stream creates a higher level of risk to human health and the environment than do the"listed" wastes. In fact,the lime grits must undergo a"washing"process that removes calcium carbonate and reduces the pH of the waste stream below 12.5,which is the limit for designation as a hazardous waste under WAC 173-303-090. Similarly,the bottom and fly ash wastes are washed to lower alkalinity and reduce dust. After washing,the pH of both materials is below the dangerous waste criteria,but typically higher than 11.0. Alkaline materials similar to lime grits and boiler ash are known to cause chemical burns to skin at a pH of 11 or above. This means that the lime grits and boiler ash represent a health threat from direct contact,even after being washed to reduce the pH. Due to the joint determination of JCPH and the Washington State Department of Ecology that the lime grit and boiler ash produced by the PTPC does not meet the criteria required to be classified as inert waste,the PTPC 2012 permit must be changed to a Limited Purpose Landfill permit in order to be approved. Groundwater monitoring data are needed to determine what,if any,impacts the ash and grit waste are having on surface and/or groundwater. JCPH and the Department of Ecology are willing to consider a variance of the Limited Purpose Landfill Permit liner requirements as long as an approved groundwater monitoring program is in place and ongoing monitoring results show that surface and ground water are not impacted. We look forward to assisting in the transition from the 2011 permit for Inert Waste • Landfill to a Limited Purpose Landfill in the upcoming months. Please do not hesitate to contact me or JCPH staff with any questions regarding your permit. Sincerely, Thomas Locke,MD,MPH Jefferson County Health Officer COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH • DEVELOPMENTAL DISABILITIES ALWAYS WORKING FORA SAFER AND WATER QUALITY MAIN:360-385-9400 HEALTHIER COMMUNITY MAIN:364385-9444 FAX:3643859401 FAX:360-379-4487 Board of Health Mew Business .agenda Item #Y, 1 • Proposal to Combine City & County Solid Waste Enforcement October 20, 2011 • wV� 13 JEFFERSON COUNTY PUBLIC HEALTH . "� 615 Sheridan Street • Port Townsend •Washington • 98368 sS11 nct�c> www.jeffersoncountypublichealth.org September 19, 2011 City Council City of Port Townsend 250 Madison Street Port Townsend, WA 98368 Dear Council Members, In the last few weeks Jefferson County Public Health (JCPH) has received several calls from City residents seeking JCPH assistance and enforcement action regarding rats, solid waste, and even squatters. JCPH would like to clarify our understanding of the current solid waste enforcement jurisdictions between the City and County, to clarify the current scope of our authority and work, and to propose a combining of City and County solid waste enforcement efforts as a cost saving measure. In 2005 Jefferson County Board of Health adopted the Solid Waste Code. At that time JCPH and the City Council staff held discussions about the Solid Waste Code as it applied to the City of Port Townsend. The outcome of these discussions was the decision that the two entities would continue to conduct their own solid waste enforcement as there were and continue to be differences in solid waste and zoning codes. (Zoning codes often times deal with solid waste • including junk vehicles and garbage) Currently, solid waste complaints concerning properties outside of City limits are handled by JCPH, while those inside the City limits are handled by the City Building Department. Junk Vehicle Affidavits are provided in PT by Police Department volunteers, while those in the County are provided by JCSO volunteers and JCPH. There are currently many environmental health and solid waste services provided by JCPH that benefit both City and County residents including: • Permitting and regulation of facilities such as the Transfer Station, Recycling Center, Closed Municipal Landfill, Moderate Risk Waste Facility, and Port Townsend Biosolids Facility • Local Source Control Program: providing free technical assistance to businesses to ensure use of best management practices for proper handling and disposal of hazardous waste • EnviroStars Program: Working with businesses to reduce their use of hazardous materials and to ensure the proper handling and disposal of the ones they do use, and promotion of those environmentally responsible businesses • Solid waste education: providing information on the proper handling and disposal of solid waste, from what can and cannot be recycled to how to deal with rats, and to the correct way to dispose of syringes. Information is mailed out, provided by phone, in brochures, i COMMUNITY HEALTH NVIRONMENTALHEALTH DEVELOPMENTAL DISABILITIES PUBLIC HEALTH WATER QUALITY MAIN: (360)385-9400 ALWAYS WORKING FOR A SAFER AND MAIN: (360) 385-9444 FAX: (360) 385-9401 HEALTHIER COMMUNITY FAX: (360)379-4487 provided to Public Works for posting on their solid waste web page, and posted on JCPH's solid waste web page. JCPH also works with other community organizations such as WSU and Beach Watchers to work in the schools. • We would like to quickly clarify a few specific items: • Rats: There are no laws specific to rats. JCPH does offer homeowners/ renters/complainants visits, educational material about how to deter rats, including rat- proofing their homes, eliminating food, water, and shelter for them; and we recommend people contact professional exterminators. We offer this information to all people irrespective of whether they live in the city or county. Rats are frequently a symptom of a larger issue. If there are solid waste issues, callers are referred to the appropriate agency. • Solid waste: JCPH solid waste enforcement includes, first, seeking voluntary compliance from the property owners and renters. If this fails, civil remedies are pursued including tickets and, occasionally, warrants of abatement through Superior Court where JCPH is authorized to hire a contractor to remove solid waste from a property. Cost of the clean- up and court costs are then placed as a lien against the property and tied to property taxes. • Junk Vehicles: Are part of the County's definition of solid waste. JCPH and JCSO assist county residents with junk vehicle affidavits (JVAs) upon request. JCPH also enforces solid waste code in the County which limits junk vehicles to two (2) JVs per property. JV requests in City are handled by PTPD volunteers. • • Vagrants/squatters: JCPH has no authority with regard to people living in abandoned homes. • Hoarders: JCPH enforces solid waste code on the outside of buildings. JCPH does not have authority regarding solid waste inside buildings. If the City of Port Townsend would like JCPH to assume responsibility for solid waste code enforcement within City limits, we would be interested in discussing this. If this were to happen, it would likely be necessary to modify one or both sets of solid waste codes to make them parallel. Additionally, JCPH's solid waste enforcement program is paid for by a State contract with 25% local match funds. Funding covers the cost of services in existing service areas. If the City would like JCPH to assume the City's solid waste enforcement role, JCPH would request that the City provide its proportional part of the 25% required match. Please notify me if there is interest in having JCPH assume the responsibility for solid waste code enforcement in Port Townsend. Thankyou.J-an Baldwin, Director, Jefferson County Public Health COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES WATER QUALITY • MAIN: 364385-9400 ALWAYS WORKING FORA SAFER AND MAIN: 364385.9444 FAX: 364385-9401 HEALTHIER COMMUNITY FAX: 364379-4487 Board of 3feaCth Netiv Business .agenda Item #17., 2 • 1/17.A. State Public 3-fealth Indicators October 20, 2011 • • WASHINGTON STATE LOCAL PUBLIC HEALTH INDICATORS Jefferson County Public Health Communicable Disease Reported Chlamydia infections Treated Chlamydia infections Influenza vaccination(18 years or older) Child immunizations reported to the Child Profile Immunization Registry Prevention and Health Promotion Years of healthy life expected at age 20 Adult cigarette smoking Adult physical activity Adult obesity Adult fruit/vegetable consumption Adult binge drinking Adults with diabetes Adult poor mental health Hospitalization for falls in older adults • Environmental Health Food service safety On-site sewage system corrections Air pollution-Particulate matter(Coming Soon) Maternal and Child Health First trimesterprenatal care Maternal cigarette smoking Teen pregnancy Low birth weight Teen physical activity Teen cigarette smoking Teen overweight and obesity Teen alcohol use Childhood unintentional injury hospitalizations Teen sad or hopeless Access to Care • Adults with unmet medical need Adults with personal healthcare provider Adult dental care Adult preventive cancer screening-Breast Adult preventive cancer screening - Cervical Adult preventive cancer screening-Colorectal Adults with health insurance Children with health insurance Community Context Poverty (Coming Soon) • Page 3 of 4 'indicator.Teen pregnancy 2006-2007 S Rate per 1,000 C 20 40 60 80 100 Jefferson(11)- • Island(16)- —H. Klickitat(1_ I Asotin(17 - I Thurston(2v - •-- Northeast Tri(21)- --�� Kitsap(21)- Clark 21)-Clark(21;- -j-� IUttitas(221- Spokane 221- Spokane(22,- ~� Snohomish(24,- Seattle-Kng(25,- Whatcom(26)- Lewis (27,- Clal lam(27,1- State(28)- Grays Harbor(29)- Tacoma-Pierce arbor(29)-Tacoma-Pierce(30)- Pacific 30)-Pacific(30)- Walla Vh/alla(34 - 30)- WallaVh/alla(34?- I . Mason(35)- I ' • Okanogan(36)- Chelan-Douglas(40)- Grant 40)-Grant(411- Benton-Franklin 41 -Benton-Franklin(42•- Cowlitz(42.- Skagit(46,- Yakima(57 - A,dams(65)- 1 1 I Indicator Definition: Pregnancy rate per 1,000 women ages 15-17 Key better than state* similar to state state worse than state* Statistically significant difference(p<.05)(/doh/Iphi/#) 1110 https://fortres s.wa.gov/doh/lphi/LPHI/RecordS et.mvc/DetailsForindicatorWithChart?recordSetId... 10/14/2011 Page 4 of 4 9s'Comparison NA • Missing Data(#) t10%-19% missing data tt20%-30% missing data Suppressed Data(#) Data for the following health jurisdictions were suppressed due to small numbers(less than 5 records per year or relative standard error>30%): Columbia , Garfield , Lincoln, San Juan, Skamania ,Wahkiakum ,Whitman . Sources (#) State and Local Data: DOH,Birth Certificates National Data: CDC,National Vital Statistics System Technical Notes(http://www.doh.wa.qov/phip/products/phi/doc/TechNotes.htm) Print(/doh/Iphi/LPHI/RecordSet.mvc/PrintForindicatorWithChart?recordSetld=45) 41110 • https://fortre ss.wa.gov/doh/lphi/LPHI/RecordSet.mvc/DetailsForIndicatorWithChart?recordSetld... 10/14/2011 Page 3 of 4 Indicator:Teen alcohol use 2010 • c: C L 4C 6 C Whitman(2"- Island(24:- --�� Skamania - Pacific(25:- --1 Snohomish(2c.- Kitsap(25;- Seattie-King(26.- �-J Lewis(27)- -�� Skagit(27}-_ —{ Thurston(28)- -{ Tanana-Pierce(28)- -I State(28)- Krttitas(28} San Jtran(28)- Clark(28)- Grays Harbar(28}- Cowlitz(25:- '— Benton-Franklin(25;- Klickitat(25 - --� Spokane(25 - Asotin(X;- --�� Yakima(3':- -i Adams(32;- `{— Chelan-Douglas(32;- —� • atco n(3t;- • Whatcan(32;- Grant(33;- Mason(33) Okanogan(341- F—� Walla Walla(34;- I—� Northeast Tri(3.:- --�— Columbia(3::- J Jefferson(37 - Garfiec`_ - Indicator Definition: Percent of 10th graders who report alcohol consumption in the past 30 days Key better than state* Elsimilar to state state worse than state" Statistically significant difference(p<.05)(/doh/Iphi/#) • https://fortre ss.wa.gov/doh/1phi/LPHI/RecordSet.mvc/DetailsForIndicatorWithChart?records etI d... 10/14/2011 Page 4 of 4 US Comparison 40.6% (2009) • Missing Data (#) t10%-19% missing data tt20%-30% missing data Suppressed Data (#) Data for the following health jurisdictions were suppressed due to small numbers(less than 5 records per year or relative standard error>30%):Wahkiakum . Data for the following health jurisdictions were suppressed due to low survey response rate(<40%): Clallam . Sources (#) State and Local Data: DOH,Healthy Youth Survey National Data: CDC,Youth Risk Behavior Surveillance System Technical Notes(http://www.doh.wa.qov/phip/products/phi/doc/TechNotes.htm) Print(/doh/Iphi/LPHI/RecordSet.mvc/PrintForindicatorWithChart?recordSetld=72) • • https://fortre ss.wa.gov/doh/lphi/LPHI/RecordSet.mvc/DetailsForIndicator WithChart?recordSetld... 10/14/2011 Page 3 of 4 Indicator:Years of healthy life expected at age 20 2006-2007 S Years C 20 4C CC CC . San J uan(58)- —I-- Whitman(55)- '-F-' Jefferson(55)- -I- . Seattle-king(54) I - Seattle-King(54)- Kittitas(54)- ÷ Island(54)- + Garfield(52)- '+ • Whatcom(52)- `♦-' Thurston(52)- + State(51)- Chelan-Douglas(51)- -I- Snohom is (51)- 'f' Kitsap(51)- •{-' Walla Walla(51)- --H Clark(51)- + Klickitat(51)- --I-' Lincoln(51)- -�� Spokane(50)- .4-• Skagit(5C'- `I- Benton-Franklin(.:.- '-f-- , taltam(SG)- '-I-- Columbia(49)- '-)-J • Pacific(49)- --l-- Tacoma-Pierce(49)- + Asotin(49)- '-�-` Skarn ania(48)- • Lewis(48)- -I-' Northeast Tri(47)- + • Okanogan(47)- "-I- • (47)- '—H• Mason(47) '-1--' Wahkiakum(46)- --I Yakima(46)- + • Grant(46)- `+-' Cowlitz(45)- '+- Grays Harbor(45)- I '-f•-• Indicator Definition: Additional years a 20 year-old is expected to live in good,very good, or excellent health Key better than state* similar to state state worse than state* Statistically significant difference(p<.05)(/doh/lphi/#) III https://fortress.wa.gov/doh/1phi/LPHI/RecordSet.mvc/DetailsForIndicatorWithChart?recordSetId... 10/14/2011 r Page 4 of 4 US Comparison 48 (2004) 41 Missing Data(#) t10%-19% missing data tt20%-30%missing data Sources (#) State and Local Data: DOH,Behavioral Risk Factor Surveillance System,Death Certificates National Data: CDC,Behavioral Risk Factor Surveillance System,National Life Expectancy data Technical Notes(http://www.doh.wa.gov/phip/products/phi/doc/TechNotes.htm) Print(/doh/Iphi/LPHI/RecordSet.mvc/PrintForindicatorWithChart?recordSetld=33) • • https://fortress.wa.gov/doh/lphi/LPHI/RecordSet.mvc/DetailsForIndicatorWithChart?recordSetId... 10/14/2011 • Board of Health .New Business Agenda Item #17., 6 • .Nurse Family Partners y - Regional Approach October 20, 2011 • JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 • www.jeffersoncountypublichealth.org October 4, 2011 Nurse Family Partnership (NFP) Supervisor Role: Time and Costs draft 1 Hours are for adding 1 new nurse home visitor to the Jefferson County NFP team Monthly Supervisor hours: Team case 2 Half in person, half via telephone/video _conferences Team meetings 1 Half in person, half via telephone/video 1:1 Supervision 4 Half in person, half via telephone/video Field 8 supervision Data 6 Conference 2 calls Consortium 1 mtg Annual Sup 3 training Prep for 1:1, 4 team mtg Travel time 8 For supervision and community meetings Advisory 4 board/Tribal board, community meetings Total monthly hours: 43 hours Quen or Yuko are about $49.50 an hour, mileage and a few other cost may be there for a contract. The hours and need for support from JCPH will decrease after the first few years so costs will then decrease. • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES „ r MAIN:360-385-9400 ` MAIN: 360-385-9444 FAX: 360-385-9401 HEALTHIER COMMUNITY FAX: 360-385-9401 f)` i JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street • Port Townsend •Washington • 98368 www.jeffersoncountypublichealth.org • Initiating Nurse Family Partnership is an important community investment of resources in families and in the staff and agency providing the intervention. Learning the model and becoming skilled in delivering an evidence based program is time intensive, especially in the beginning. Supporting the new nurse home visitor and the agency through this process is critical for maintaining fidelity to the model. Maintaining fidelity to the model is required for funding sources and to ensure ongoing community support. Importantly, fidelity monitoring assures the community that the program will deliver long term positive outcomes similar to the research trials. Nurse Family Partnership Model Elements provide guidance for program structure and activities. Our performance around these elements is assessed constantly for fidelity to the model. This provides assurance that we can expect similar long term outcomes as the clinical trials. Our contract with the National Service Office specifies the model elements and requires that we adhere to the model elements. NFP Model elements around Program Supervision include the following: •Each nurse will participate in 1 hour per week of reflective supervision with supervisor •The supervisor will lead weekly team meetings: 1 hour twice a month for team building • and program issues, 1 1/2 to 2 hours twice a month for case conferences -The supervisor will accompany the nurse on home visits for field supervision for a minimum of 2-3 hours every 4 months NFP Model elements of Program Monitoring and Use of Data include the following: •The supervisor collects, enters, and reviews data for quality assurance program fidelity. (this is in addition to the data entry clerk's role) NFP Model elements regarding the Agency include the following: •The supervisor participates in the NFP community advisory board (Jefferson Community Network) to build support for sustainability. •The supervisor provides advocacy for the NFP program to the community and within the implementing agency. 'The supervisor participates in regional/state and national service office meetings and conference calls for program support, advocacy, and program fidelity. COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL AL HEALTH • DEVELOPMENTAL DISABILITIES NATURAL MAIN: 360-385-9444RESOURCES MAIN. 360-385-9400 HEALTHIERCOMMUNITY FAX 360-385-9401 FAX 360-385-9401 • Board of Health ivledia Report October 20, 2011 • • Jefferson County Public Health September/October 2011 NEWS ARTICLES 1. "All Jefferson lakes open for recreation," Peninsula Daily News, September 11th, 2011. 2. "Just for the Girls," Port Townsend Leader, September 14th, 2011. 3. "Algae toxin levels unsafe in Gibbs Lake," Peninsula Daily News, September 19th, 2011. 4. "Toxin level falls below dangerous in Gibbs Lake," Peninsula Daily News, September 27th, 2011. 5. "King County Farmers Markets Tighten Food Safety," KUOW News, September 27th, 2011. 6. "Pertussis returns: vaccinate your children," Port Townsend Leader, September 28th, 2011. 7. "SmileMobile heads to Chimacum," Port Townsend Leader, September 28th, 2011. 8. "Boiler Room garners interest from Issaquah public officials," Port Townsend Leader, September 28th, 2011. 9. "Does Your Child Need Dental Care?" City of Port Townsend Newsletter, October 2011. 10. "8th Annual Port Townsend Main Street's Girl's Night Out," City of Port Townsend Newsletter, October 2011. 11. "Breastfeeding Tea," City of Port Townsend Newsletter, October 2011. • 12. "Flu vaccines now available," Port Townsend Leader, October 5th, 2011. 13. "Girls' Night Out-a stress reliever," Port Townsend Leader, October 5th, 2011. 14. "No time for a mammogram?," Port Townsend Leader, October 5th, 2011 15. "Girls' Night Out: Award-winning event that supports women, PT," Port Townsend Leader, October 5th, 2011. 16. "Spots and stripes for a cause," Peninsula Daily News, October 6th, 2011. 17. ""Discovery Bay water quality report public," Port Townsend Leader, October 12th, 2011. • a) O �J j Q ° P.d `� y m J c GD P.° m ° $ a Co\ 5d m a O o y b cd •�, ,L °� m 0. a3i is 0 ap . -0 60 0 °•2 ho 0 � ° _ p = v a LIJ ..ti -2V N 0es �- t4 Ayvi . tbWto gag m . pd•W0B >,'b2,006e0.d 4. 0 _ v W wp'gyceIDS 110 S.0 cy N3 2 0 c $ Nocoo° cmr oo �U 'i6A" 4 ' 8'ttl o . 6, .6 ec =' to. 8 °' 2' U d w.m c°) w m _pi CO"' Ds. o m CI) 0 .5 m d Y .. m 0 y ''-' .e F., 0'o_ w C ai o x CA'i '[n m 4 ..' ai a0i..' 0...b.-' 0 -'i '50 am) .k Ft A Wp h0 ami = y y ciC m ,-60 • UN m ..0 °)'�.0•0 P.•O ..w 0 ° ci n 8 0 x 3 „ as-0C 0 m 0.0 O V o'o .5 a6i c5 - 5 5 m 5 0 0 0 m cd ° p.,y o b 0wy.c00�.day bo a til . ani q G.s°.m.o.2w V.D N"• c0 a1 Act N !+' Cl y•'.b W.5]0 3 O'kw.. 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CO-J0 iC .gc0 c>• ^ 0 •,i:-.--,,---,1.-fr,"'-i. -'"_''''''."."'-'"--; , ,, --7, .. r 9,„'4:- a101 4111PP .......,,,,,,,,,,,y,,,,,,-..45 0 xti S N•' N. k r 4 ' is =xI',.- .._ IP i 'tip ---- , 1,,.,.1---Zr Thursday. 't* `h ,>Pa OctoherB.201T z ,,...,•:-. ..5:„.•,,,;.,;„ a �.� 11 a.tn.to rikru- ,y ::.,,a' y k ; ;A day&night of . . girlfriend Um& a'' • .4 shopping In dozens of Port Townsend m a stores! ': ., , }s �. Special sales& ` • . treats5 a Wear year s , k . wildest hail it S , Promotion Committee volunteers help stuff over400 goodie bags for Main Street's Girls'Night Out . 110 JUST FOR THE GIRLS Main Street's"Wild About Girls'Night Out”is Thursday,Oct. 6,11 a.m.—8 p.m.and is sponsored by Jefferson Healthcare and participating businesses. Join us for a day and night of girlfriend fun and shopping in the historic districts! Merchant deadline to sign up for this promotion is Sept. 16.Special sales and treats,in-store events,plus a wrap up party.Goodie bag sales benefit the Jefferson County Health Department Breast and Cervical Cancer screening fund for local women in need and PT Main Street Program,a 501c3 nonprofit. Coordinated by the Main Street Promotion Committee. • 9/�5j/// III . .< u.) ~• o w e P 05•_, x pw v .� 30 .bo-^ ✓� -ZGo ° �yN8a � a 2 aca pc c m m 3 Gr.+ CYo_ v c.. m C • 1.N N WN COr 8 NK m.= - aC ° - vo I u as vo H .94 flhiV1II1 er"w. m m ' O � m 0 i Levels: Other INC2 -C._� y _ r lakes' statuses III® t.„0 c5 Vin, ^o---a CD •P 3 i G c�• G i v J c c = ^_, CONTINUED FROM Al understand why some spe- cies of blue-green algae will -n'Cj Y begin to produce toxins,nor C 5 ^ m a, d to r-^ The lake near Berson G c,- 0 - 3 —I ° cum,which is in Anderson what fuels increases in the ® y o c Lake State Park, was amount of toxins. 3 0 co a. y g r� reopened Aug.27 after hav- Shallow,aging lakes are y -ta m m c 1 ing been closed since June more likely to become over- ', r, al C112 E. N ti -x I 10 because of high levels of grown with algae and con W 1 " tain toxins. Q anatoxin-a,which can cause convulsions and death by Warning,caution 411111111 20o y ' respiratory 3, bo P IY paralysis. 9� Anderson Lake State 0 0 - 3 Q 0 The "warning" level N G J E E Park, which is around the means people should not j m j o a , lake,has never been closed swim •in the lake or drink J �r C.c- ^ • 5 _ :- y r to recreation. its water,that pets and live- W , c 0 5 i stock should be kept away o' Other lakes from it, boaters should °„ co x ti i. ,> Lake Leland north of avoid scums and fish should -� e C7 -- °» y � c W Quilcene remains posted be well-cleaned, with the . o -o ; c y-0 y with a "caution:" sign guts discarded. o c. a a.a, w-_ a because of a slight algae The "caution" recom- ® w 7 E' 3 `U°, 3 g c U bloom and because small mendations are the same amounts of toxins and toxic except swimming should be species are present there. avoided only in areas of Silent Lake on the Toan- scum. o I v g . -, j dos Peninsula is posted Clallam County lakes, ;^ ^ o with a "caution" sign most of which are deep and .. c an because of algae in the lake. relatively free of algae, are o s y g ' c, Sandy Shore Lake south not tested for toxins. NMI '° c).-c g .�- of Port Ludlow remains clear. To report algae blooms in c 5 b ^ Z , I Blue-green algae growth Clailam County,phone 360- R, v o- d f itself is thought to be 417-2258. m m=F 0 m .° Information about Jef- ferson _ o I encouraged by warm,sunny ■ y rn weather when sufficient ferson County lake quality m y " a nutrients, such as is posted at http://tinyurl. > y phos- phates,are present. corn/6z64oi5' O ^ But researchers don't To report blooms in Jef- ferson County, phone 360- , , 1 .6 - .. a> 385-9444. o i o a r m • C)o rn-.^. rte+ c Y '4- ;3 u m o F c� m Managing Editor/News Leah m.x^ ^o y Leach can be reached at?- 3 >c�a 1-, 1m, 0 m s o y N a„ a-� 360-417- 3531 or leah.leach®peninsula OS M Z .7. p 0 3 ^ dailynews-com. 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U •2 ,,, ,,a.ct, ..,cJ bn 0,0 3 p....,.0 R g - .0 0 p ° p ° 4."C" MINIM "o § 2 >00.NA o oay.0 a ms'a0'° a • b » O O .,. FD - b0j A •C -. sA Q) ',117s) V, ,CD G.O_c y.. 'O O p 't:' Cnaj a.b v ., 3 a cr.) . w• a a F v m▪ sLI'nro 0 'U a)-O .. a) , ^ 0 � '°y oA iniiMi .4 a c0� 2al � n Uc . ° 3 "ma � . 0 Fa O� � Z Uo ' s a) � zd ° o . on . 0ym a ai ai 3 c)cn aO "■ 6 -- 3 ) " . cu raq:14 Ca . '73a) i Xw ¢ ° Yaamo E» '� u, Ma)o `. .1o N c-1' p o . a ® '� ` H y c• 2 z • 2 DC7 ox_. a) ol-0 m��.�.S �� ? 3p — • M W >, W o F•^ F•--� a) be EJ v, o • c ". W a U.0.0n 5 0 w v)w y 3 .0 R'.,71 c� a °U. . • • King County Farmers Markets Tighten Food Safety • Sprince Arbogast 09/27/2011 KUOW news: Food safety concerns in King County's Farmers Markets have attracted the attention of the Health Department. KUOW's Sprince Arbogast visits the Ballard Farmers Market for a closer look into food handling safety precautions. TRANSCRIPT From KUOW 94.9 Seattle, I'm Sprince Arbogast. There are concerns these days about food safety at local farmers markets. The Ballard Farmers Market is one of the most popular in Seattle. I went on a recent Sunday morning. The stalls are piled with fresh produce: mounds of leafy green vegetables, baskets full of beans and carrots, fruit layered into pyramids, the sizzling aroma of food on the grill. A couple walks by, nibbling out of a paper bag. Arbogast: "What did you buy?" Couple: "I bought some blueberries and some golden raspberries." • Arbogast: "And you are just eating them out of the bag?" Couple: "We sure are." Arbogast: "Do you know if they've been washed?" Couple: "No we don't. I was thinking to ask, but I kind of assumed that maybe they would be. Probably not though, huh?" In fact, there have been many safety violations found at the Ballard Market, and others around King County last year. That's according to a new report by the County Health Department. It found hundreds of violations, nearly 200 of which were considered 'red critical.' That means improper food handling which could make you sick. Rosemary Byrne is an inspector with the Health Department. She carries a clipboard and a thermometer. She's checking the temperature of the hot and cold food being sold. Byrne: "Hand wash set up here. Soap and your paper towels. Ok, great! What I need to look at is your cold holding. Yes, and your cheese. Also, the tamales and the hot holding temperatures and the temperature of the cooked vegetables, so." The vendors welcome Byrne into their stalls. She inspects the wash station to make sure the vendors' hands are kept clean. • Byrne: "Well, we are constantly working with the vendors. I mean, there are some really great vendors that just pass with flying colors. Do everything right the first time. And there are others that take more work. And we need to work with them, along with that they have their hand wash set up the food is kept cold or hot." Here, Byrne notices a problem. The insulated water container is not up to code. Byrne: "So, you have the hand wash here with a push button. It really needs to be like free flowing so you can have both hands free." Vendor: "Ok." Byrne: "Rather than one hand at a time to wash your hands." Vendor: "Ok." Byrne: "Do you change your knife out every two hours? Do you have extra knives for cutting?" Vendor: "Yes, I have the other one." Byrne: "Ok. Alright, thank you!" The market coordinator is hovering nearby. She immediately phones for someone to bring the vendor a replacement water container for the day. Across the way, there's a stand from Tiny's Organic Produce. Like many vendors, they offer free samples to attract more customers. James Wood stands behind crates of plums. He explains how they follow strict food regulations. • Wood: "Well, what we do is we have a bleach bucket in the back here, and we keep a cutting board and a knife in the back. And so every time we want to cut some samples, we take a couple of food handler's gloves, and we put those on. And then we reach in to our bleach bucket and then we cut our samples on that so it keeps everything sanitary. All the samples are washed in a food certified kitchen. We want to keep it as obviously sanitary health code as we can." Byrne says if she finds violations they are fixed right away, or the vendor must stop selling their goods. Byrne: "Right now, when we go to visit the various vendors we have them correct what they need to do on the spot. So, if they're not washing their hands, they don't have a hand wash set up, we make sure they stop what they're doing, they go and get their hot water. Sometimes they can get those from the coordinator who has extra ones. If they are sampling, we make sure that the samples are washed in the produce sink that the farmer's market provides." Rose Byrne says things are improving. Since last year, with the high number of violations, farmers markets are watching the vendors much more closely to insure they're following food safety rules. Byrne says so far this year the number of violations at markets around the county is down. The county is also considering increasing vendor registration fees to allow for more inspections. For KUOW News, I'm Sprince Arbogast. © Copyright 2011, KUOW S Pertussis returns; vaccinate your children Pertussis, a serious but ease can be prevented through nearly forgotten childhood dis- vaccination. Jefferson County ease, is back and on the rise Public Health (JCPH) and throughout the U.S.,including local health care providers Washington state, according are now offering Tdap (teta- to health officials. nus,diphtheria and pertussis) Infants and young chil- vaccine to adults Who have dren are especially at risk for contact with infants. JCPH severe illness from pertussis. also offers free vaccine to low- Since 2010, four infants have income,uninsured adults who died of the disease in this are in contact with infants. state. Contact JCPH, 385-9400, for In children, early symp- more information. toms of pertussis are simi- Children and teens should lar to those of a cold, with a also be immunized against runny nose, sneezing and a pertussis. Children receive it mild cough.It can worsen over as part of their early child- the following two weeks with hood DTaP (diphtheria, teta- coughing becoming severe, nus, pertussis) series. Tdap sometimes causing cough-. is required for all students ing spasms to the point of entering sixth grade, and a vomiting. The cough in chil- dose is recommended for all dren is often followed by a adolescents through their teen • characteristic high-pitched years. This vaccine is includ- whooping sound; hence the ed in the federal Vaccine for disease's more common name Children program. of"whooping cough." JCPH has walk-in immuni- Adults may contract a mild nation clinics from 1 to 4 p.m. case of pertussis, be unaware on Tuesdays and Thursdays. that they have it and unknow- The health department is ingly pass it on to an infant. located at 615 Sheridan St., The good news is the dis- Port Townsend. • SmileMobile heads to Chimacum • The SmileMobile, a fully equipped mobile dental clinic, will be in Chimacum Oct. 31 through Nov4, and appoint- ments are now being accepted. Dental care is provided to children through 18 years of age whose far•iliPs are on lim- ited incomes.The SmileMobile accepts DSHS Services Cards (ProviderOne) and also has a sliding-scale system based on family income. Make an appointment by calling Karen Obermeyer at Jefferson County Public Health, 385-9400, before Oct. 31. The SmileMobile is oper- ated,by Washington Dental Service Foundation in partner- ship with Seattle Children's. /moi' gg/li 411/ • A-8 4-2-8-II Port Townsend&Jefferson County Leader •Boiler Room garners interest • from Issaquahofficials . teens anymore." By Nicholas Johnson of the Leader v- ,,, .# Marts said he is par "It felt like serendipity." � ticularly attracted to the Ir �` Boiler Room's practice of That's how Issaquah Y 1 �pti 4 , �;: fit � giving teens the respon- City Council member Tola- A._ ."" giving ofe operating and Marts described stumbling _ - � upon the Port Townsend � t C` ,- M policing the coffeehouse, Boiler Room in May 201E —"'="11t _ ` '' ' `* which provides those teens A meeting called Action •r with a sense of agency. He Forum for Youth, held also said Issaquah could `"- � use recreational options a couplea weeks prior by �� u 171 beyond traditional school the Issaquah Community sports and clubs, as many Network, found estab- `' � teens don't gravitate fishing a place for teens .,„,, ;;,,", toward activities. and youth to gather for Issaquah City Council member Tola Marts(far left)speaks with(from left) FILLING suchA VOID entertainment, social net Allison Slater,Jason Bishop,Thomas Overman and Collin Cabe on Sept. "I think a teen hang- working and music" to be 16 at the Boiler Room in downtown Port Townsend. out should be alternative a top priority in address- Photo by Nicholas Johnson and counter culture," said ing challenges facing that city's youth. fee shop greeted Marts and noticed a lack of alterna- Marts, who has a 13-year- On a day trip with his Winterstein. The group, tive recreational options old daughter. "What I family, Marts said he saw including Mayor Michelle for teens and youth in would think was cool in • the alternative coffee shop Sandoval, longtime board that city, located just east a coffee shop surely isn't and thought, "Wow. I won- members Bruce and Julie of Seattle. Although his what my daughter would der what the story is here." Marston, Kelly Matlock visit to the Boiler Room find cool." Marts returned Sept. of Jefferson County was not made in an offi- Upon returning to 16, along with the chair Public Health, Anne cial capacity, Marts said Issaquah, Marts said he of Issaquah's Human Dear) of Jefferson County he would like to see some- and Winterstein would Services Commission,Paul Community Network and thing similar established present their findings to Winterstein, to answer several others, sat around in Issaquah. various community groups that question. a large table to share a "In my day, it seemed as a model to spur further Boiler Room staff and meal as well as the Boiler there were places for kids discussion about how that a handful of community Room's 18-year history. to hang out," he said. "I city can fill a void in teen members who've helped Marts said he and don't see as many clean, and youth recreational create and preserve the cof- others in Issaquah have safe venues for kids and options. III Does Your Child Need ental Care? / t r} The Washington Dental Service Foundation SmileMobile is coming to Chimacum October 31 - • November 4. The SmileMobile is a fully equipped mobile dental clinic that: • provides dental care to CHILDREN (birth through high school) with limited family income • accepts State of Washington Services Card (Provider One) & sliding fee scale based on family income Call Karen Obermeyer at Jefferson County Public Health 385-9400 before October 31 to schedule an appointment or for more information. 8th Annual Port Townsend Main Street's Girl's Night Out •,1 -? M About Girls' Night Out! Thursday, October 6 from 11 a.m. - 8 p.m. lit, Sponsored by Jefferson Healthcare, Main Street, OZONE Socks & 27 Businesses ;• A day and night of girlfriend fun and shopping - Uptown, Downtown and on Kearney St. Get your coupon books and goody bags at participating businesses. Proceeds go to support breast/cervicalcancer testing for local women in need. Door prizes at the wrap-up t party at 8 p.m. at Alchemy Bistro and Wine Bar. Visit www.ptmainstreet.org for more details. Fq, • • Jefferson County Public Health would like to invite all breastfeeding and pregnant women to Breastfeeding Tea Come join this education and support group that meets every Wednesday at 1:30 p.m. at the Jefferson County Public Health Department, 615 Sheridan St. Call 385-9400 for more information. • 1 Flu vaccines now available • Flu season is coming, Jefferson Healthcare Townsend. No appoint- arid health care providers Family Medicine: 9 a.m.- ment necessary for vac- in Jefferson County have noon, Oct. 1.8, 1010 cinations. Medicare and flu vaccine. Sheridan St., Suite 101, most insurances. billed; Because vaccines only Port Townsend. bring card. Medicaid protect people for the cur- Jefferson Healthcare accepted for clients ages rent season, it's important Primary Care: 9 a.m.- 19 and older. Flu shots to get vaccinated every noon, Oct. 8 and Oct. 29. $30. High-dose flu shots, year, health officials say. 915 Sheridan St. $57. Pneumonia. vaccine Certain people are at Jefferson Medical & also available. Clients greater risk for flu and Pediatric Group: 9 a.m.- must be at least 8 years are urged to be vaccinat- noon, Oct. 15 and Nov. 5. old. ed. 915 Sheridan St. Children 5 and young- Jefferson Healthcare STATE-SUPPLIED er, adults 50 and older, clinics accept Medicare, VACCINES pregnant women, and private insurance and State-supplied chil- people with chronic con- cash. Vaccines are $25. dren's flu vaccines are ditions such as asthma, Other medical facili- now recommended for all heart disease, neurologic ties: children ages 6 months conditions and diabetes Madrona Hill Urgent through 18 years old. are at higher risk, as are Care: 9 a.m.-7 p.m., Children's vaccines are health care workers and Monday-Friday, and 9 available at the following caregivers. a.m.-4 p.m., Saturday. clinics. Because babies under 6 2500 Sims Way, Port Call your provider for months old are too young Townsend. Vaccine avail- an appointment. to get a flu vaccine, it's able for clients ages 3 Jefferson Medical & important to protect them years and older. Flu Pediatric Group: 382- by ensuring parents, sib- shots, $30. Medicare will 4848 lings and caregivers are be billed; bring Medicare Jefferson Healthcare • vaccinated, officials say. card. All others must pay Primary Care: 379-8031 Young children up to age cash. Jefferson Healthcare 8 may need two doses of QFC Hadlock Family Medicine: 385- flu vaccine, about a month Pharmacy: 1890 Irondale 3500 apart, for best protection. Road,Port Hadlock.Walk- South County Medical Practicing good hygiene ins welcome. Medicare, Clinic: 294843 Highway habits, such as washing Medicaid and insurance 101, Quilcene, 765-3111 hands, covering coughsbilled; bring cards. Flu Jefferson County and staying home when shots, $25. 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