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HomeMy WebLinkAbout2013- June File Copy • Jefferson County Board of Health .Agenda Nl inutes • June 20, 2013 • JEFFERSON COUNTY BOARD OF HEALTH June 20, 2013 Jefferson County Public Health 615 Sheridan St. Port Townsend,WA 2:30—4:30 PM DRAFT AGENDA I. Approval of Agenda II. Approval of Minutes of May 16,2013 Board of Health Meeting III. Public Comment IV. Old Business and Informational Items 1. Washington Healthplanfinder Lead Organizations Chosen • 2. Growth Management Hearing Board Rules Against Homeowner Septic System Inspection 3. Heroin Trends Across Washington State 4. Breastfeeding Coalition of Washington V. New Business 1. Food Safety Award Presentation 2. Public Hearing -- Environmental Health Fee Schedule Revisions 3. Multi-state Outbreak of Hepatitis A 4. Agenda for Change: Foundational Public Health Services 5. Small Business Assistance for Hazardous Waste Control 6. Legislative Update VI. Activity Update VII. Public Comment VIII. Agenda Planning Calendar July Board of Health Meeting: Visit from John Wiesman, DrPH, MPH Washington State Secretary of Health IX. Next Scheduled Meeting: July 18, 2013 S 2:30—4:30 PM Jefferson County Public Health 615 Sheridan St. Port Townsend, WA 98368 4. . JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, May 16 2013 Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA 98368 Board Members Staff Members Phil Johnson, County Commissioner District#1 Thomas Locke,MD,MPH Health Officer David Sullivan, Vice Chair, County Commissioner,District#2 Jean Baldwin,Public Health Services Dir John Austin, County Commissioner,District#3 Julia Danskin,Nursing Services Director Roberta Frissell, Citizen at large(County) Jared Keefer,Env.Health Services Dir Catharine Robinson,Port Townsend City Council Veronica Shaw,Deputy Director Sheila Westerman, Citizen at large(City) Jill Buhler, Chair,Hospital Commissioner,District#2 Chair Buhler called the meeting of the Jefferson County Board of Health to order at 2:30 PM. A quorum was present. Members Present: Jill Buhler, David Sullivan, John Austin, Sheila Westerman, Catharine Robinson, Phil Johnson, Roberta Frissell, Staff Present: Dr. Thomas Locke, Jared Keefer, Veronica Shaw, Julia Danskin APPROVAL OF AGENDA Chair Buhler called for moving New Business Agenda Item 5 (Reappointment to the Substance Abuse Advisory Board)to number 1 on the agenda. Member Austin moved to approve the agenda as amended; the motion was seconded by Member Sullivan. No discussion. The motion passed unanimously. APPROVAL OF MINUTES OF APRIL 18,2013 BOARD OF HEALTH MEETING Chair Buhler called for approval, Member Austin moved to approve the Jefferson County Board of Health Meeting Minutes of April 18,2013. The motion was seconded by Member Sullivan. No discussion. The motion passed unanimously. PUBLIC COMMENT Chair Buhler called for public comment. No public comment. S 1 BOH Minutes-May 16,2013 Y.. • OLD BUSINESS • Irondale Beach Closure Michael Dawson, with Jefferson County Public Health Water Quality,reports there were high bacteria counts in Irondale in a small creek which comes down to Irondale Beach Park. The tributary is not the Chimacum Creek, and is about a '/4 mile long. Testing indicated very high levels of E. coli bacteria. Average count was over 1500—higher than any other monitored in recent years. Tests found that the contamination runs from the.ea ek's starting point at a forested ravine. Mr. Dawson reports that it's unusual for contaminationto be that high, coming out of the ground. Sanitary surveys have been conducted of the septic systems in the area, with various permitted and grandfathered systems. Dye tests have been administered in septic systems to see if it shows up in the creek. Dye takes time to traverse to the creek, depending on dilution and distance of each system from the creek. So far there's been good homeowner cooperation. Mr. Dawson estimates that it may take several months for all of the results of testing. Warmer temperatures and less flow may affect the time involved in identifying the source of the contamination. Mr. Dawson reports that as soon as the bacteria levels iefe identified, Jefferson County Public Health issued a press release, and notified Washington State L)epartment of Health, and Washington State Department of Ecology. The Department of Health advised closing the shellfish bed. The shellfish closure area is south of Chimacum Creek to the end of county property at Irondale Beach Park. North of the creek is still open for shellfish harvesting. The • stream is popular for kids, and the stream has a posted warning. 2012 Outstanding Achievement Award—Food establishments in Jefferson County Next month awards will be presented to food establishments. The nominated food establishments are listed in this month's Board of Health agenda packet for member review. NEW BUSINESS Reappointment to Substance Abuse Advisory Board Julia Danskin reports that Ann Dean has submitted a request for reappointment to the Jefferson County Substance Abuse Advisory Board. Several members noted Ann's involvement and contributions to the SAAB. Member Austin moved to approve the reappointment and to direct the chair to send a letter of approval. The motion was seconded by Member Robinson. No discussion. The motion passed unanimously. • 2 BOH Minutes-May 16,2013 • Environmental Health Policy Updates Jared Keefer presented Board of Health policies that have been identified during a recent periodic review of policies. Mr. Keefer notes that a new Washington State food code came into effect on May 1st. There are two Jefferson County Board of Health policies, which are recommended for revision, and two that are recommended for repeal. Polic "Waiver for a Tern sorar Establishment Food Permit": Staff recommends repealing this policy. Mr. Keefer notes that the newly revised State code exempts certain foods from regulation. Since these foods are already exempt from a permit requirement, a local waiver policy is no longer necessary. Policy"Mobile Food Service Establishment": Staff recommends repealing this policy. The majority of the content of this policy is contained in the State Code. Mr. Keefer recommends outlining portions of this procedure/policy—keeping"retain wheels" & "be readily movable"— in an administrative policy. *NW Member Austin moved to repeal policies, "Waiver of Temporary Food Permit" and "Mobile Food Service Establishment." Member Johnson seconded. No further discussion. The motion passed unanimously Policy"Destruction of Potentially Hazafdous Foods": Staff recommends updating this policy to be consistent with new state Food Code. Dr, Locke notes that this policy is important as a BOH policy, as the issue involves destruction of property which may be valuable. Mr. Keefer stated that the update contains some differences from the previous version of policy—due to the food code revisions. The Food Code is unclear about how to handle food that is in violation; this policy offers best practice guidance for the inspector in the field. Policy "Food Establishment Inspection Frequency": Staff recommends updating this policy. The new code contains updates which need to be incorporated into this policy and previous scoring criteria needed to be updated. The ratios of points and percentages which represent violation criteria are maintained with the policy update. Member Frissell moved to adopt new policies: "Destruction of Potentially Hazardous Foods" and "Food Establishment Inspection Frequency"with effective dates to be changed to today's date. Member Robinson seconded the motion. There was no discussion. The motion passed unanimously. Environmental Health Fee Updates Staff recommends changes to the Environmental Health Fee schedule, as outlined on the second page of the Board's agenda materials. Jared Keefer said JCPH is currently required to inspect exempt facilities, and the costs for those inspections aren't recuperated through the fee schedule. An inspection fee for exempt facilities has been added for consideration. JCPH facility re- inspection costs are not currently recuperated through a fee. A re-inspection fee has been added • for consideration. Additional changes have been made to clarify language, and to accommodate 3 BOH Minutes-May 16,2013 time-intensive plan reviews. These changes are consistent with the methodology of other fee • groupings. The intent of the fee additions/changes is to recover the costs. The rates aren't being increased, but the current fee schedule is being clarified. September is an anticipated omnibus fee schedule update. Member Westerman suggested that the language "4 hour minimum" is the only one of its type on the fee schedule, which may lead to public confusion. She said that the intent is reasonable, as it would capture the need to recover fees for time involved, however basing the fee schedule on time requirements may open the County up to procedural discrepancy. Mr. Keefer will look at the issue and attempt to re-work the fee/language and decide on the language for public review. "$268 +additional $67 per hour>4 hrs" is the consensus recommendation. Procedurally, staff recommends that the Board call for a public hearing at their next meeting and make the proposed fee changes available for public review prior to that hearing. Member Austin moved to call a public hearing regarding the proposed Environmental Health fee schedule changes. Member Johnson seconded the motion. No discussion. The motion passed unanimously. County Health Rankings and Roadmap Report 2013 Dr. Locke presented a series of reports compiled by the University of Wisconsin`Population Health Institute, included in BOH agenda packet. In these reports, Jefferson County is measured by a number of parameters, and can be compared to any other county in the United States for those same measures. Dr. Locke notes that there may be a risk for over-interpretation of the reports, with many caveats regarding how accurately the available measures reflect the health . status of a community. However, he feels that the year-to-year data contains valid information especially with respect to trends in particular measures. Jefferson County has fared very well in these measurements and is in the top 1/4 in both of the summary measures. For Jefferson County, looking at the numbers which are statistically significant compared to WA state: (1) Low birth weight number is significantly lower than state and national levels, which is a feather in the cap for those working on those issues in Jeff Co. (2)Motor vehicle death rate is higher than the state average as in the case in many rural counties (3) Our rate for sexually transmitted infections is lower than neighboring counties and Washington State. Jefferson County has very good access to diagnosis and treatment of sexually transmitted infections, much of it provided by Jefferson County Public Health. (4)Preventable hospital stays is significantly lower than the state rate, which means that hospitalizations that shouldn't have occurred or lasted as long, happened less often than the state average. (5) Daily fine particulate matter is elevated relative to the state and elevated compared to other counties—likely due to wood smoke. Also, significant given health reform ea sion of Medicaid, are the numbers regarding primary care providers: the measure is a population per provider in Jefferson County and is 1 per every 1068 residents, better than the state average. i 4 BON Minutes-May 16,2013 Legislative Update: Special Session Schedule, Budget Negotiations, and Local Health • Jurisdiction Flexible Funding Alternatives Letter to Senator Hargrove: "Preserve public health funding including critical DOH activities." This letter supports continuing to preserve foundational local public health funding and restoring critical Department of Health activities that are cut in the Senate budget. Member Johnson moved to approve signing and sending the letter. Member Sullivan seconded the motion. No discussion. The motion passed unanimously. Late breaking issue: Ultra-fine particles and bio-mass. Representatives Tharinger and Van de Wege were able to get a study for Clallam and Jefferson County to measure ultra-fine particles to answer some of the science questions into the budget. This study is in the House budget, but not in the Senate budget. Dr. Locke recommends sending a letter of support for this budget item. Member Johnson moved to send the letter. Member Westerman seconded the motion. Discussion: Member Sullivan notes that this is one priority of many for the budget process and a lot of the questions may be unanswerable. Dr. Locke said that he has looked at the study design, and found that it's basically measuring the baseline for particle emissions. In Port Angeles there will be a before and after study. Dr. Locke also notes that the most relevant study question for Port Townsend is to attempt to determine where the Mill smell is coming from. There are 7 study objectives—in 2nd or 3rd page of the handout. Member Westerman stated that this is one of the most important issues in the community,and she gets many questions from the community. Chair Buhler agrees that this needs to be studied—this isn't taking a stand, but getting the facts. • Member Sullivan's concerned that this may not be addressed, given the budget shortfalls. If not all can be funded, can at least the portion regarding smell be addressed? Dr. Locke feels that it's helpful for Boards of Health to issue letters of support. Member Westerman suggests that the letter and abstract be posted on the Jefferson County website. Member Robinson calls the question. The motion passed unanimously. ACTIVITY UPDATE Mr. Keefer announced that Anderson Lake tested with high biotoxin levels yesterday. A possible July visit from John Wiesman, the new Secretary of the Department of Health has been proposed. Dr. Locke feels that it would be desirable for him to come to a BOH meeting. More information at the next Board of Health meeting. AGENDA PLANNING CALENDAR No additions at this time. • 5 BOH Minutes-May 16,2013 NEXT SCHEDULED MEETING Next Jefferson County Board of Health meeting will be held on July 18, 2013 from 2:30—4:30 p.m. at Jefferson County Public Health, 615 Sheridan St., Port Townsend, WA 98368 ADJOURNMENT Chair Jill Buhler adjourned the meeting at 4:25 pm .h^ tir, JEFFERSON COUNTY BOARD OF HEALTH 44 Jill Buhler, Chair Phil Johnson, Member David Sullivan, Vice Chair John Austin, Member • Catharine Robinson, Member Roberta Frissell, Member Sheila Westeinian, Member Respectfully Submitted: Cara Leckenby • 6 BOH Minutes-May 16,2013 JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, May 16 2013 Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA 98368 Board Members Staff Members Phil Johnson, County Commissioner District#1 Thomas Locke,MD,MPH Health Officer David Sullivan, Vice Chair, County Commissioner,District#2 Jean Baldwin,Public Health Services Dir John Austin, County Commissioner,District#3 Julia Danskin,Nursing Services Director Roberta Frissell, Citizen at large(County) Jared Keefer,Env.Health Services Dir Catharine Robinson,Port Townsend City Council Veronica Shaw,Deputy Director Sheila Westerman, Citizen at large(City) Jill Buhler, Chair,Hospital Commissioner,District#2 Chair Buhler called the meeting of the Jefferson County Board of Health to order at 2:30 PM. A quorum was present. Members Present: Jill Buhler, David Sullivan, John Austin, Sheila Westerman, Catharine Robinson, Phil Johnson, Roberta Frissell, Staff Present: Dr. Thomas Locke, Jared Keefer, Veronica Shaw, Julia Danskin APPROVAL OF AGENDA Chair Buhler called for moving New Business Agenda Item 5 (Reappointment to the Substance Abuse Advisory Board) to number 1 on the agenda. Member Austin moved to approve the agenda as amended; the motion was seconded by Member Sullivan. No discussion. The motion passed unanimously. APPROVAL OF MINUTES OF APRIL 18,2013 BOARD OF HEALTH MEETING Chair Buhler called for approval, Member Austin moved to approve the Jefferson County Board of Health Meeting Minutes of April 18,2013. The motion was seconded by Member Sullivan. No discussion. The motion passed unanimously. PUBLIC COMMENT Chair Buhler called for public comment. No public comment. • 1 BOH Minutes-May 16,2013 • OLD BUSINESS Irondale Beach Closure Michael Dawson, with Jefferson County Public Health Water Quality, reports there were high bacteria counts in Irondale in a small creek which comes down to Irondale Beach Park. The tributary is not the Chimacum Creek, and is about a '/4 mile long. Testing indicated very high levels of E. coli bacteria. Average count was over 1500—higher than any other monitored in recent years. Tests found that the contamination runs from the creek's starting point at a forested ravine. Mr. Dawson reports that it's unusual for contamination to be that high, coming out of the ground. Sanitary surveys have been conducted of the septic systems in the area, with various permitted and grandfathered systems. Dye tests have been administered in septic systems to see if it shows up in the creek. Dye takes time to traverse to the creek, depending on dilution and distance of each system from the creek. So far there's been good homeowner cooperation. Mr. Dawson estimates that it may take several months for all of the results of testing. Wanner temperatures and less flow may affect the time involved in identifying the source of the contamination. Mr. Dawson reports that as soon as the bacteria levels were identified, Jefferson County Public Health issued a press release,and notified Washington State Department of Health, and Washington State Department of Ecology. The Department of Health advised closing the shellfish bed. The shellfish closure area is south of Chimacum Creek to the end of county • property at Irondale Beach Park. North of the creek is still open for shellfish harvesting. The stream is popular for kids, and the stream has a posted warning. 2012 Outstanding Achievement Award—Food establishments in Jefferson County Next month awards will be presented to food establishments. The nominated food establishments are listed in this month's Board of Health agenda packet for member review. NEW BUSINESS Reappointment to Substance Abuse Advisory Board -Anne Julia Danskin reports that Ann Dean has submitted a request for reappointment to the Jefferson County Substance Abuse Advisory Board. Several members noted Ann's involvement and contributions to the SAAB. Member Austin moved to approve the reappointment and to direct the chair to send a letter of approval. The motion was seconded by Member Robinson. No discussion. The motion passed unanimously. • 2 BOH Minutes-May 16,2013 • Environmental Health Policy Updates Jared Keefer presented Board of Health policies that have been identified during a recent periodic review of policies. Mr. Keefer notes that a new Washington State food code came into effect on May 1st. There are two Jefferson County Board of Health policies, which are recommended for revision, and two that are recommended for repeal. Policy"Waiver for a Temporary Establishment Food Permit": Staff recommends repealing this policy. Mr. Keefer notes that the newly revised State code exempts certain foods from regulation. Since these foods are already exempt from a permit requirement, a local waiver policy is no longer necessary. Policy"Mobile Food Service Establishment": Staff recommends repealing this policy. The majority of the content of this policy is contained in the State Code. Mr. Keefer recommends outlining portions of this procedure/policy—keeping"retain wheels" & "be readily movable"— in an administrative policy. Member Austin moved to repeal policies, "Waiver of Temporary Food Permit" and "Mobile Food Service Establishment." Member Johnson seconded. No further discussion. The motion passed unanimously. Policy "Destruction of Potentially Hazardous Foods": Staff recommends updating this policy to be consistent with new state Food Code. Dr. Locke notes that this policy is important as a BOH • policy, as the issue involves destruction of property which may be valuable. Mr. Keefer stated that the update contains some differences from the previous version of policy—due to the food code revisions. The Food Code is unclear about how to handle food that is in violation; this policy offers best practice guidance for the inspector in the field. Policy"Food Establishment Inspection Frequency": Staff recommends updating this policy. The new code contains updates which need to be incorporated into this policy and previous scoring criteria needed to be updated. The ratios of points and percentages which represent violation criteria are maintained with the policy update. Member Frissell moved to adopt new policies: "Destruction of Potentially Hazardous Foods" and "Food Establishment Inspection Frequency"with effective dates to be changed to today's date. Member Robinson seconded the motion. There was no discussion. The motion passed unanimously. Environmental Health Fee Updates Staff recommends changes to the Environmental Health Fee schedule, as outlined on the second page of the Board's agenda materials. Jared Keefer said JCPH is currently required to inspect exempt facilities, and the costs for those inspections aren't recuperated through the fee schedule. An inspection fee for exempt facilities has been added for consideration. JCPH facility re- inspection costs are not currently recuperated through a fee. A re-inspection fee has been added for consideration. Additional changes have been made to clarify language, and to accommodate 3 BOH Minutes-May 16,2013 11111time-intensiveplan reviews. These changes are consistent with the methodology of other fee groupings. The intent of the fee additions/changes is to recover the costs. The rates aren't being increased, but the current fee schedule is being clarified. September is an anticipated omnibus fee schedule update. Member Westerman suggested that the language "4 hour minimum"is the only one of its type on the fee schedule, which may lead to public confusion. She said that the intent is reasonable,as it would capture the need to recover fees for time involved,however basing the fee schedule on time requirements may open the County up to procedural discrepancy. Mr. Keefer will look at the issue and attempt to re-work the fee/language and decide on the language for public review. "$268 +additional $67 per hour>4 hrs"is the consensus recommendation. Procedurally, staff recommends that the Board call for a public hearing at their next meeting and make the proposed fee changes available for public review prior to that hearing. Member Austin moved to call a public hearing regarding the proposed Environmental Health fee schedule changes. Member Johnson seconded the motion. No discussion. The motion passed unanimously. County Health Rankings and Roadmap Report 2013 Dr. Locke presented a series of reports compiled by the University of Wisconsin Population Health Institute, included in BOH agenda packet. In these reports, Jefferson County is measured by a number of parameters, and can be compared to any other county in the United States for those same measures. Dr. Locke notes that there may be a risk for over-interpretation of the • reports, with many caveats regarding how accurately the available measures reflect the health status of a community. However, he feels that the year-to-year data contains valid information especially with respect to trends in particular measures. Jefferson County has fared very well in these measurements and is in the top 1/4 in both of the summary measures. For Jefferson County, looking at the numbers which are statistically significant compared to WA state: (1) Low birth weight number is significantly lower than state and national levels, which is a feather in the cap for those working on those issues in Jeff Co. (2) Motor vehicle death rate is higher than the state average as in the case in many rural counties (3) Our rate for sexually transmitted infections is lower than neighboring counties and Washington State. Jefferson County has very good access to diagnosis and treatment of sexually transmitted infections,much of it provided by Jefferson County Public Health. (4) Preventable hospital stays is significantly lower than the state rate, which means that hospitalizations that shouldn't have occurred or lasted as long, happened less often than the state average. (5)Daily fine particulate matter is elevated relative to the state and elevated compared to other counties—likely due to wood smoke. Also, significant given health reform expansion of Medicaid, are the numbers regarding primary care providers: the measure is a pin '-provider in Jefferson County and is 1 per every 1068 residents, better than the state average. F rov,42 r p 2r }apt,kt\o- • 4 BOH Minutes-May 16,2013 Legislative Update: Special Session Schedule, Budget Negotiations, and Local Health • Jurisdiction Flexible Funding Alternatives Letter to Senator Hargrove: "Preserve public health funding including critical DOH activities." This letter supports continuing to preserve foundational local public health funding and restoring critical Department of Health activities that are cut in the Senate budget. Member Johnson moved to approve signing and sending the letter. Member Sullivan seconded the motion. No discussion. The motion passed unanimously. Late breaking issue: Ultra-fine particles and bio-mass. Representatives Tharinger and Van de Wege were able to get a study for Clallam and Jefferson County to measure ultra-fine particles to answer some of the science questions into the budget. This study is in the House budget, but not in the Senate budget. Dr. Locke recommends sending a letter of support for this budget item. Member Johnson moved to send the letter. Member Westerman seconded the motion. Discussion: Member Sullivan notes that this is one priority of many for the budget process and a lot of the questions may be unanswerable. Dr. Locke said that he has looked at the study design, and found that it's basically measuring the baseline for particle emissions. In Port Angeles there will be a before and after study. Dr. Locke also notes that the most relevant study question for Port Townsend is to attempt to determine where the Mill smell is coming from. There are 7 study objectives—in 2nd or 3rd page of the handout. Member Westerman stated that this is one of the most important issues in the community, and she gets many questions from the community. Chair Buhler agrees that this needs to be studied—this isn't taking a stand, but getting the facts. • Member Sullivan's concerned that this may not be addressed, given the budget shortfalls. If not all can be funded, can at least the portion regarding smell be addressed? Dr. Locke feels that it's helpful for Boards of Health to issue letters of support. Member Westerman suggests that the letter and abstract be posted on the Jefferson County website. Member Robinson calls the question. The motion passed unanimously. ACTIVITY UPDATE Mr. Keefer announced that Anderson Lake tested with high biotoxin levels yesterday. A possible July visit from John Wiesman,the new Secretary of the Department of Health has been proposed. Dr. Locke feels that it would be desirable for him to come to a BOH meeting. More information at the next Board of Health meeting. AGENDA PLANNING CALENDAR No additions at this time. • 5 BOH Minutes-May 16,2013 0 NEXT SCHEDULED MEETING Next Jefferson County Board of Health meeting will be held on June 20, 2013 from 2:30–4:30 p.m. at Jefferson County Public Health, 615 Sheridan St., Port Townsend, WA 98368 ADJOURNMENT Chair Jill Buhler adjourned the meeting at 4:25 pm JEFFERSON COUNTY BOARD OF HEALTH ae'C'-1/61-41--- ill Buhl- Chair 4 Phil Johnson, e fiber ) li 1 Davi. u li,an, i„Z,,_ e ai” `"- John ' stin, Member • (-2 ,14Lei—,:k–L-2, k ., igehf Ai,- \!,,,f,t1-42-6C Catharine Robinson, Member Roberta Frissell, Member C)111:i' 14– W€14e)(tAA-&---1.----- Sheila Westerman, Member Respectfully Submitted: Cara Leckenby • 6 BOH Minutes-May 16,2013 • Board of 3Cealth Old Business & Informational Items .Agenda Item #IV., 1 • 1/V.A. .7Cealthplanfinder Lead Organizations Chosen • June 20, 2 01 washington health finder click.compare.covered. CONTACT: FOR IMMEDIATE RELEASE: Bethany Frey, Washington Healthplanfinder June 5, 2013, 10:30 a.m. PST 360-688-7752 Bethany.Frev@wahbexchange.org Washington Health Benefit Exchange Selects Organizations for In-Person Customer Support Program $6 Million in Grant Funds Awarded to Help Consumers Enroll in a Health Plan that Fits Their Needs and Budget OLYMPIA,Wash.—The Washington Health Benefit Exchange today announced the selection of lead organizations to provide in-person assistance as part of the Washington Healthplanfinder Customer Support Program. Washington Healthplanfinder is a new way for people to find,compare and enroll in health insurance in Washington starting Oct., 1, 2013. Ten organizations, including public health agencies, coalitions, regional health networks, and other community organizations,were chosen statewide to help residents enroll in a qualified health plan starting Oct. 1, 2013 for coverage that takes effect on Jan. 1,2014. Lead organizations will share in the close to$6 million in grants funds being provided by the Exchange. These organizations and their service areas include: • Benton Franklin Community Action Connections:Serving Benton, Franklin and Walla Walla Counties • • CHOICE Regional Health Network:Serving Clallam, Grays Harbor,Jefferson, Lewis, Mason, Pacific and Thurston Counties • Clark County Public Health:Serving Clark, Klickitat and Skamania Counties • Cowlitz Family Health Center: Serving Cowlitz and Wahkiakum Counties • Empire Health Foundation:Serving Adams,Asotin, Chelan, Columbia, Douglas, Ferry, Garfield, Grant, Lincoln, Okanogan, Pend Oreille, Stevens,Spokane and Whitman Counties • Kitsap Public Health District:Serving Kitsap County • Public Health—Seattle&King County:Serving King County • Tacoma-Pierce County Health Department:Serving Pierce County • Whatcom Alliance for Health Advancement:Serving Island, San Juan,Skagit,Snohomish and Whatcom Counties • Yakima Neighborhood Health Services:Serving Kittitas and Yakima Counties "This is another example of Washington State being ahead of the curve—making sure our residents have a marketplace where they can get the health insurance they need and want.This consumer support is essential to getting every Washington resident covered so they can get the health care they need,"said Gov.Jay Inslee. Lead organizations will provide residents with impartial information to help them determine which health insurance option best fits their needs. These efforts may take place through in-person meetings, online communications and over the phone. Lead organizations will also be responsible for building and overseeing a network of partners in their region to serve Washington's diverse populations. • "We are excited to partner with such knowledgeable and trusted organizations that are experts at reaching people in their communities,"said Richard Onizuka, Ph.D., CEO of the Washington Health Benefit Exchange. washington S health - _ finder dick.compare.covered. "Their work will help connect hundreds of thousands of people with quality health coverage—many for the first time." The Washington Health Benefit Exchange will be requiring certification for those providing assistance and will lead curriculum development and training efforts to effectively educate each lead organization and ensure statewide consistency.These organizations will then be responsible for training their partner networks.All in- person assisters will need to pass a certification exam before working with consumers. "Our goal is nothing less than the full enrollment of those uninsured who will become eligible for health insurance next year," said King County Executive Dow Constantine. "With this grant,we can create a 'culture of coverage' in King County." Washington has received a total of$6 million from the U.S. Department of Health and Human Services to develop a robust in-person assistance program to serve residents in all areas of the state.The Exchange also expects to receive$1.6 million in in-kind contributions from lead organizations in the form of additional staff and other agency resources. "The Exchange is fortunate to partner with community organizations who are eager to help make health care coverage a reality for the individuals and families they serve.These organizations are the best way to reach people who are not likely to use a website or call center, but who need one-on-one assistance to help them learn about their options and enroll in coverage,"said Kelly Boston, Navigator Manager for the Washington • Health Benefit Exchange. Washington Healthplanfinder will allow individuals,families and small businesses to make apples-to-apples comparisons of health insurance plans,determine if they are eligible for low-cost or free options, and choose the plan that fits their needs and their budget. In addition to the lead organizations and their networks, residents will also be able to access customer support through the Washington Healthplanfinder Call Center or their insurance broker. More information about Washington Healthplanfinder and the Washington Health Benefit Exchange is available at www.wahbexchange.org or www.wahealthplanfinder.org. About the Washington Health Benefit Exchange The Washington Health Benefit Exchange is a public-private partnership established in accordance with the Patient Protection and Affordable Care Act of 2010(ACA)with the goal to redefine people's experience with health care through the creation of a new health insurance marketplace for individuals and small businesses.The Exchange is separate from the state and governed by an independent 11-member board appointed by former Gov.Chris Gregoire in Dec.2011. About Washington Healthplanfinder Washington Healthplanfinder will be a new online marketplace for individuals,families and small businesses in Washington to compare and enroll in health insurance coverage and gain access to tax credits,reduced cost sharing and public programs such as Medicaid. Washington Healthplanfinder will begin enrolling consumers on Oct. 1,2013,for health insurance coverage beginning on Jan. 1,2014. • Board of Health Old Business & Informationalltems .agenda Item # 117., 2 • crow th .Management rearing Board Rules .Against Homeowner Septic System Inspection June 20, 2013 • The News Tribune - State board tells Whatcom County to impose restrictions on water us... Page 1 of 2 The News Tribune State board tells Whatcom County to impose restrictions on water use JOHN STARK LAST UPDATED:JUNE 11TH.2013 09:09 AM(PDT) In a ruling that could have significant impacts on land development in rural Whatcom County,a state board has ordered county officials to develop more restrictive regulations to protect water supplies in streams and under the ground. The Growth Management Hearings Board found that the county's existing regulations are leaving wide areas of rural Whatcom County without adequate measures to protect the quality and quantity of water supplies.That threatens the rural character of these areas, and that character is supposed to be protected under the terms of the Washington Growth Management Act. 'The board is left with a firm and definite conviction that a mistake has been made,"the board's ruling said in summarizing its review of county regulations. The board also sent the county back to the drawing board on private septic system regulation,finding that the county's existing practice of allowing most homeowners to inspect their own systems"does not protect water quality in Whatcom County's rural areas." That means the county could be pushed back toward regulations that require regular professional inspections of all septic systems.A majority of County Council members approved a self-inspection system for most areas after many homeowners objected to the . cost of professional inspections. The board considered the evidence and made its ruling in response to a legal challenge by four local citizens:Eric Hirst,Laura Lee Brakke,Wendy Harris and David Stalheim, represented by attorney Jean Melious.Futurewise,a land-use policy watchdog group, joined in that challenge. The most dramatic impact of the board's Friday,June 7,ruling could be on the granting of building and subdivision permits for new homes in areas where the state already refuses to grant new permits for withdrawals from creeks. Drilling new wells in those areas can further reduce the flow of water in problem creeks,but smaller wells for residences are exempt from state regulation.That allows people to go on building homes in those areas,because Whatcom County has no rules in place to ensure that nearby streams are protected when new wells are drilled. The hearings board ruled that the county should be requiring developers and builders to show evidence that the new well water supply for a home or subdivision won't reduce the volume of water in already-threatened streams,before permits for buildings or subdivisions are granted. There will be no immediate impact on county permit policies.In an email,attorney Melious said the county has six months to adopt policies that will satisfy the board that county land- use policies are adequate to protect water resources in rural areas. Melious also complained that up to this point,the County Council has chosen to spend its money on legal battles over the Growth Management Act and the board that enforces it, • instead of on developing regulations that comply with the state law. http://www.thenewstribune.com/2013/06/11/v-printerfriendly/2633 160/state-board-tells-w... 6/11/2013 The News Tribune - State board tells Whatcom County to impose restrictions on water us... Page 2 of 2 "The County Council can commit taxpayers to paying some more tens and hundreds of thousands of dollars to keep its crusade against the Growth Management Hearings Board • going,or it can use the same money to protect water resources,"Melious said. Will the county eventually be forced to adopt land-use policies that impose significant new development restrictions? "I don't think there's anybody who knows the answer to that question,"Whatcom County senior planner Gary Davis said. Mark Personius,manager of the long-range planning division of Whatcom County Planning and Development Services,agreed that it's too soon to know for sure what impact the board's ruling will have.He acknowledged that taking the legally required steps to protect water resources will mean new restrictions on land use. "At this point it's unknown yet how we respond to this in order to manage that growth better,"Personius said."Definitely it will change the landscape in rural areas." The board's ruling listed a number of steps that the county could take to steer population growth away from rural areas where water is in short supply or would be threatened by increased runoff from development. "It(the county)may reduce densities or intensities of uses,limit impervious services to maximize stream recharge,impose low-impact development standards throughout the rural area,require water conservation and reuse,or develop mitigation options,"the board's ruling said."It may direct growth to urban rather than rural areas." 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O 'O O '/1 O 01 t\ O .ti 7, 8 N .1 r-: 1.1 'f1 M O O 01 l0 4 .-� 10 .'1 .4 O N .1 Ol 'A O ''fl 01 N O1 M V1 OO Ill M O M 01 O MI r p 1 CO CU N 2 n a M .-i .i N a ti N .--1 .i NI N r1 a •"i .1 1 C a) N TO C0 CA 2 T) i_ C NI 8 N ,- 41) Q CD C a) - 'p m Z 7 U l N7. a a ^ >, N f6 x -1 C N RI L n3 cu p m Q C VI • 1 d > U a E c .'f1 c H c m c c v O m RI 1 U 0 3 J G V1 f1 V U U ]L m 0 N N > - T N O Y Ss Y LL p a N 7 V1 Y N fl a V1 Page 1 of 2 neScattlealttits Winner of Nine Pulitzer Prizes Local News Originally published June 11, 2013 at 8:22 PM I Page modified June 11, 2013 at 11:4o PM Heroin use spikes in young adults, UW report says Heroin use is up across the state—particularly among 18-to 3o-year-olds—as prescription-opioid use declines,according to a report from the University of Washington. By Carol M. Ostrom Seattle Times health reporter Prescription-drug abuse has fallen in Washington,but heroin use— Opiates tested by the state crime labs particularly among those under age 30— The cumber of sanies int by police to the(rimy"lab that tested has increased dramatically,according to a positive tot prescription type opiates began declining stet*in UniversityOf Washington report released 2009.but positive tests for hetom have increased dramaticallyaSn g Tuesday. Number of p e(ec of police evidence%tatewvidr ?500 HEROIN In King County,overdose deaths involving 4751 r„ ' the drug increased from 49 in 2009 to 84 RX TYPE OP tat last year,with all of the increase coming in • i the under-3o age group,according to researcher Caleb Banta-Green,author of the Ictik 1,043 report from the UW Alcohol &Drug Abuse Institute. ',tet 274Because direct measurement of heroin use i .0 °01 "04 'os ' '07 X08 '09 '10 `1.2 '12 is difficult,Banta-Green compiled results ,IgzaKriA:.,4)4from treatment programs,evidence tested Ft"`'g°° "`THE SEAT TU. TIMES by the state crime lab,overdose-death investigation records and information from law-enforcement sources. "We are hearing about heroin as a major and increasing problem from law enforcement across Washington,"Dave Rodriguez, director of the Northwest High Intensity Drug Trafficking Area group,a coordinating center for federal and local law enforcement,said in a statement. Banta-Green said he saw no evidence that legitimate pain patients were turning to heroin as tightened state regulations in recent years have reduced the supply of prescription pain medications. "I think when we reined in opiate prescribing,it dried up the market for diverted prescription pharmaceuticals,and the people who were abusing prescription pharmaceuticals switched over to heroin,"he said. Overall,police have seen a decline in the number of pieces of evidence of drugs sent to the Washington State Patrol's Crime Laboratory for testing over the past decade,the report said. • Prescription opiate evidence has dropped dramatically since 2009. But heroin evidence has soared.According to the report,from 2007 to last year the number of samples collected by police testing positive for heroin nearly tripled,to 2,251. http://seattletimes.com/html/localnews/2021167682_heroinfloodxml.html 6/13/2013 Page 2 of 2 "The numbers are really dramatic,"Banta-Green said. In general,regions with the highest rates of heroin evidence collected per ioo,000 population • now are not urban areas,but those in less populated parts of the state,including the westernmost counties from Clallam to Clark and the northern region from Whatcom to Snohomish counties,which includes San Juan and Island counties. Across the state,first-time admissions to publicly funded addiction-treatment programs where heroin was the primary drug leapt from 590 in 2003 to 1,397 in 2012. Last year,heroin users from age 18 to 29,the majority from outside the Seattle metro area, made up two-thirds of those entering publicly funded treatment programs for the first time. "The increase among young adults is very concerning,"Banta-Green said. Rodriguez said many young people began their drug use through pharmaceutical-type opioids, such as oxycodone and hydrocodone,often raided from a medicine cabinet. "But once that free supply dries up,and they've developed an addiction,they have to go out on the black market,"he said,where Mexican black-tar heroin costs considerably less than prescription opiates."I'm sure it was the last thing on their minds that they would end up getting addicted and using heroin." There isn't enough treatment capacity now,Rodriguez said. "We are severely underfunded for public beds for treatment,"with capacity for only about 20 percent of the need.The federal health-care law may change that,he said,with coverage for drug treatment. Deaths in King County from any type of drug have been dropping from a high of 286 in 2006, but last year saw a swing back upward,to 274.The largest increases were for deaths involving • heroin or methamphetamines. And the increase overall was driven primarily by deaths of those under 30. "Usually people die in their 4os,not in their 20S," Banta-Green said. "We don't know if(the increase in young people's deaths)is something about the drug,about how they use,combining it with other drugs,or that they haven't developed tolerance yet.We just don't know why. But it is unusual." Dr. Daniel Lessler,chief medical officer for Washington state's Health Care Authority,said many opioid overdoses can be prevented.In a statement,he urged those who might overdose or who could witness an overdose to obtain a prescription for naloxone,an antidote. Under state law,users,family members and concerned friends can all carry naloxone. In addition,said Banta-Green,the 911 Overdose Good Samaritan law provides legal immunity from prosecution to an overdose victim or anyone helping a victim seek medical care.More information on naloxone and the law is available at www.stopoverdose.org. Banta-Green noted a bright spot in the report: Surveys of loth-graders in 2012 showed the first statistically significant decline in use of prescription-type opiates to get high. "Now we just have to figure out what to do with those who are already addicted." Carol M. Ostrom:206-464-2249 or costrom@seattletimes.com.On Twitter @costrom • http://seattletimes.com/html/localnews/2021167682_heroinfloodxml.html 6/13/2013 Board of Health 0 C Business & InformationaCltems ,agenda Item # /V., 4 • Breastfeeding Coalition Of"INA June 20, 2013 Washington State Laws Protect a Woman's Right , - to Breastfeed in Places of Public Accommodation } 2001:Breastfeeding in public is not considered indecent exposure. (RCW 43.70,9A.88.010). 2009:Breastfeeding mothers are protected under state anti-discrimination law,and can breastfeed their children in places of public accommodation such as restaurants,pools,theaters,government buildings,museums, libraries,busses, or parks. (RCW 49.60.030 and 49.60.215). x n ,, What Businesses and Employees Ili Need to Know: The owner, manager or employee of a place of public accommodation cannot 100 request that a mother stop breastfeeding,cover her child,move to a different room or area,or leave. " t If someone complains to you,as an employee or owner of a business,about a mother breastfeeding her child,politely explain that the law protects the Nearly 90% of all right of the mother to stay where she is to breastfeed.If they are offended, the only suggestion that you can make is that they avert their eyes or move away. mothers initiate If you choose to provide a space for breastfeeding,place signs prominently in breastfeeding in your business but know it is the breastfeeding woman's right to stay where she is. She does not have to use a designated area. Washington State. The law does not apply to employees. However,Washington Law encourages employers to support breastfeeding employees.To learn more visit the The American Academy Breastfeeding Coalition of Washington website:www.breastfeedingwa.org. ofPediatrics recommends To contact the Washington Human Rights Commission with questions exclusive breastfeeding about the law protecting a mother's right to breastfeed in places of public for 6 months. accommodation call 800-233-3247 or visit www.hum.wa.gov. '` 40g�4 Washington State Ok a Human Rights Breastfeeding a program of y(In , N°��a Commission Coalition of Washington WithinReach ,mss BREASTFEEDING SUPPORT: Ty CLOSE TO MOTHERS : SEEDING s OBJECTIVES OF WBW 2013 S�' A To draw attention to the importance I O of Peer Support in helping mothers to establish and sustain breastfeeding. 2 To inform people of the highly effective benefits of Peer Counselling, and unite efforts to expand peer counselling programmes. To encourage breastfeeding supporters, feregardless of their educational 4 background, to step forward and be Otrained to support mothers and babies. se to ?,tO �� To identify local community support contacts for breastfeeding mothers,that women can go to for help and support after giving birth. WABA \/\/Q r I d To call on governments and maternity • facilities globally to actively implement Breastfeeding Week the Ten Steps, in particular Step 10, to improve duration and rates of exclusive 1 - 7 August 2013 breastfeeding. www.worldbreastfeedingweek.org WABA 2013 ref The World Alliance for Breastfeeding Action(WABA)is a global network of individuals and WABA,PO Box 1200 /✓ ( organisations concerned with the protection,promotion and support of breastfeeding worldwide based on the Innocenti Declarations,the Ten Links for Nurturing the Future and the WHO/ 10850 Penan g,Malaysia UNICEF Global Strategy for Infant and Young Child Pestling.Its core partners are International Tel:60-4-658 4816 I Fax:60-4-657 2655 '� Baby Food Action Network(IBFAN),La Leche League International(LLLI),International Lactation Email:waba@waba.org.my I Web: http://www.waba.org.my/ Consultant Association(ILCA),Wellstart International and Academy of Breastfeeding Medicine (ABM).WABA is in consultative status with UNICEF and an NGO in Special Consultative Status Past WBWs site: http://www.worldbreastfeedingweek.net/ WA BA with the Economic and Social Council of the United Nations(ECOSOC). January February March April May June SMTWTFS SMTWTFS SMTWT FS SMTWTFS SMTWT F S SMTWIFS CO 8 2 3 4 5 1 2 1 2 7 2 3 4 5 6 8 2 3 4 1 e 7 8 9 10 11 12 3 4 5 6 7 8 9 3 4 5 6 7 8 9 7 8 9 10 ti 12 13 5 6 7 8 9 10 it 2 3 4 5 6 7 8 13 14 15 16 17 18 19 10 71 12 13 14 15 16 10 11 12 13 14 15 16 14 15 16 17 18 19 20 12 13 14 15 16 17 18 9 10 11 12 13 14 15 20 21 22 23 24 25 26 17 18 19 20 21 22 23 17 18 19 20 21 22 23 21 22 23 24 25 26 27 19 20 21 22 23 24 25 16 17 18 19 20 21 22 TIM 27 28 29 30 31 24 25 26 27 28 24 25 26 27 28 29 30 28 29 30 26 27 28 29 30 31 23 24 25 26 27 28 29 31 30 O July August September October November December • SM T W T F S S M 1W T F S SM T W T F S SMTWTFS SMTWTFS SMTWTF S N 1 2 3 4 5 6 1 2 3 1 2 3 4 5 6 7 1 2 3 4 5 1 2 1 2 3 4 5 6 7 7 8 9 10 11 12 13 4 5 6 7 8 9 10 8 9 70 11 12 13 14 6 7 8 9 10 11 12 3 4 5 6 7 8 9 8 9 10 11 12 13 14 14 15 16 17 18 19 20 11 12 13 14 15 16 17 15 16 17 18 19 20 21 13 14 15 16 17 18 19 10 11 12 13 14 15 16 15 16 17 18 19 20 21 21 22 23 24 25 26 27 18 19 20 21 22 23 24 22 23 24 25 26 27 28 20 21 22 23 24 25 26 17 18 19 20 21 22 23 22 23 24 25 26 27 28 28 29 30 31 25 26 27 28 29 30 31 29 30 27 28 29 30 31 24 25 26 27 28 29 30 29 30 31 World Breastfeeding Week 2013 BREASTFEEDING SUPPORT: Close to Mothers his year's World Breastfeeding Circles of Support for Mothers And Children Week (WBW) theme, BREASTFEEDING SUPPORT: THE FIVE CIRCLES OF SUPPORT HEALTH CARE SYSTEMS: CLOSE TO MOTHERS', for breastfeeding illustrate theFamily and This includes a multitude of • highlights Breastfeeding Peer potential influences on a Social Network opportunities to support Counselling.Even when mothers are able mother's decision to breastfeeding. These to get off to a good start,all too often in breastfeed and to have a / opportunities range from Workplace the weeks or months after delivery there positive breastfeeding Health mother friendly prenatal and Em— care and supportiveme experience.Previously Care is a sharp decline in breastfeeding rates, ployment • and practices, particularly exclusive featured during World WOMEN p y labor and delivery Breastfeeding Week services to postpartum breastfeeding.The period when mothers 2008, the Circles of ..... and postnatal care that do not visit a healthcare facility is the time Support continue to be a -. facilitates bonding and when a community support system for vital foundation for mothers Response optimal infant feeding.Health Government/ to Crisis or counseling mothers is essential.Continued support to breastfeed their babies, Legislation workers trained in to sustain breastfeeding can be provided and more.The CIRCLES OF Emergency skills support mothers before in a variety of ways.Traditionally,support SUPPORT are: Family and and after birth. is provided by the family. As societies Social Network, Healthcare, change, however, in particular with Workplace and Employment, WORKPLACEANDEMPLOYMENT: • Government/ Legislation and Response to Employed women face challenges and urbanization, support for mothers from Crisis or Emergency,all surrounding women need support to succeed at working and a wider circle is needed, whether it is in the center circle. breastfeeding. The opportunities for mother provided by trained health workers, support are as varied as the work women do, lactation consultants, community WOMEN IN THE CENTER CIRCLE: but usually involve facilitating mother-baby leaders, or from friends who are also Women are in the center because the presence contact or expression and storage of breast mothers,and/or from fathers/partners. or absence of support impacts them directly. milk. Women also have an important role in securing support and in providing it to others.Within GOVERNMENT/LEGISLATION: The Peer Counselling Program is a cost0 the Global Initiative for Mother Support(GIMS) Women who plan to breastfeed or who are effective and highly productive way for Breastfeeding Statement(2007)we noted, already breastfeeding benefit from the support to reach a larger number of mothers 'Mothers are considered active participants in of international documents, protections for more frequently. Peer Counsellors can the support dynamic,being both providers and optimal infant feeding, plus active and well- be anyone from the community who recipients of information and support'.See: funded national commissions. Legislation that is trained to learn to support mothers. http://www.waba.org.my/whatwedo/gims/ combats aggressive marketing of breastmilk Trained Peer Counsellors, readily gims+5.htm substitutes and enacts paid maternity leave also benefits breastfeeding women. available in the community become the FAMILY AND SOCIAL NETWORK: lifeline for mothers with breastfeeding Husbands/partners/fathers-to-be,family and RESPONSE TO CRISIS OR EMERGENCY: questions and issues. "The key to best friends compose the mother's immediate This CIRCLE OF SUPPORT represents the breastfeeding practices is continued and continuous support network. Social need for support IF a woman finds herself in day-to-day support for the breastfeeding support includes community support—at the an unexpected and/or serious situation,with mother within her home and community." market place, within a religious context, at little control. Situations that require special a neighbourhood park, etc. Support during planning and support are: natural disasters, Reference:Saadeh RJ,editor with Miriam H.Lombok,Kristin pregnancy reduces stress. Support during refugee camps, divorce proceedings, critical A.Cooney,Peggy Koniz-Booker(1993),Breast-feeding:the labour and birth empowers the mother. illness of mother or baby,or living in an area of Technics Bass and Recommendations for Action:Role of Mother Societal support increases the mother's high HIV/AIDS prevalence with no support for Support Groups,Geneva,World Health Organization,62-74. http://apps.who.intnris/bitstreamn0665/5672en/WHo_Nur_ confidence in her ability to breastfeed beyond breastfeeding. MCH_93.1_%26part2%29.pdf the early weeks and months. SPONSORSHIP:WABA does not accept sponsorship of any kind from companies producing breastmilk substitutes.related equipment and complementary foods. WABA encourages all participants of World Breastfeeding Week to respect and follow this ethical stance. WBW COORDINATING&DISTRIBUTING CENTRES OVERALL COORDINATION ®ASIA COFAM/SMAM M LATIN AMERICA E NORTH AMERICA ®PACIFIC WABA Secretariat WABA Secretariat chez Nicole LARTIGUE CEFEMINA LLL International Australian Breastfeeding P 0 Box 1200,10850 Penang,Malaysia (See address under OVERALL COORDINATION) 33 rue des Alizfs 17140 LAGORD Apartado 5355,1000 San lose,Costa Rica 957 N.Plum Grave Road Association(ABA) Fax:60-4-657 2655,waba@waba.org.my France Fax:506-1143986,cefemina@racsa.co.o Schaumburg,IL 60173-4808,USA P0Box 4000,Glen Iris,IC 3146,Australia www.waba.org.my ®SOUTH ASIA www.Info-allaitementorg Fax:847-9690460 Fax:61-3-98850866 www.worldbreastfeedingweek.org Breastfeeding Promotion CEPREN Illhq@Illi.org•www.illi.org Info@breastfeeding.asn.au • IBFAN-GIFA www.breastfeeding.asn.au Network W India(BPNq Av.Pardo,1335 06.301-302,Lima-18 Peru ®AFRICA BP-33,Pitampura,Delki 110034,India Avenue de la Pah tt,1202 Geneva, Fax:51-1 241 6205 INFACT CANADA IBFAN Africa Fax 91-11-27343606,bpnl.lndb@gmatcom Switzerland cepren@amauta.rcp.net.pe 520 Colborne Street,Landon,Ontario, Development Officer PINDA PO Box 781,Mbabane,Swaziland Fax:41-22-7984443,info@gifa.org Canada,NAB 2T5 c/o Christine Quested Far 268-4040546,ibfanswd@realnetcasz ®EUROPE IBFAN BRASIL Fax 1416-5919355 Nutrition Centre Health Department AktlonsgruppeDa Baby Milk Action Rua Carlos Gomes,1513, Info@lnhdtanada.ca Private Mail Bag,A IBFAN Afrigue Babynahrung Ev(AGB) Ala,Western Samoa C8210Y, of x:44-,x3 Sala ndia-SP-Brs Gomes www.irdadcanada.o Fax:685-218 70 Cite adougouuaga 0101BPna Faso C82 10Y,UK Fax:44-1223-464417 Untere3 Gottingen, lundlal-SP-Brasil Ouagadougou 01,Burkina Faso Info@babymilkactlon.org D-37073 Gottingen,Germany CEP:13215-021 rhdstlneQ@heahh.gw.ws Fax:226-50-374163,ibfanfan@fasonetbf Fax 49-551-531035,Mfo@babynahrung.org Email:coordena(6fan@terra.com.br Tel/Fax:(111 4522 5658 • Board of 3-feafth Netiv Business .Agenda Item #`V., 2 1 Public 3-fearing - Environme ntaC 3-fe alt( Fee Schedule Revisions June 20, 2 01 • STATE OF WASHINGTON • JEFFERSON COUNTY BOARD OF HEALTH AN ORDINANCE TO AMEND THE FEE SCHEDULE FOR Ordinance No. JEFFERSON COUNTY PUBLIC HEALTH Section 1—Effective Date Section 2—Fees Section 3—Severability Section 4—Prior fee schedule repealed. WHERAS, the purpose of this Ordinance is to amend the fee schedule for Jefferson County Public Health, WHEREAS,ADOPTION OF THIS Ordinance will further the public policy memorialized in Chapter 246- 215 WAC as well as other chapters of the WAC and RCW, WHEREAS,this Ordinance promotes the health, safety and welfare of the citizens of Jefferson County, and WHEREAS, this Ordinance is proposed and may be enacted pursuant to the general police power granted by the State Constitution to Jefferson County and its Board of Health, • NOW, THEREFORE,BE IT ORDAINED by the Jefferson County Board of Health as follows: Section 1 —Effective Date That this Ordinance(and its Attachment) shall be effective as of June 20,2013. Section 2—Fees The schedule for Jefferson County Public Health fees for the year 2013 (Attachment A to this Ordinance) is hereby amended to reflect language and fee updates. Any text listed on Attachment"A", specifically text within the column entitled"Additional Fees and Other Information" is deemed regulatory rather than advisory and as such has the full force and effect of local law. Section 3—Severability A determination that any text,fee or fees adopted as part of this Ordinance is unlawful or illegal shall not cause any other text,fee or fees adopted as part of this Ordinance not affected by that determination to be repealed, revised, or reduced. • Section 4—Prior Fee Schedules Repealed • Any prior fee schedule previously adopted by this Board that contains or reflects fee amounts that are less than those adopted herein or does not include and list any fee first enacted through this Ordinance is hereby repealed and replaced by this Ordinance. AN ORDINANCE AMENDING THE 2012 FEE SCHEDULE FOR JEFFERSON COUNTY PUBLIC HEALTH ADOPTED DAY OF , 2013 JEFFERSON COUNTY BOARD OF HEALTH Jill Buhler, Chair David Sullivan,Vice-Chair • John Austin, Member Phil Johnson, Member Roberta Frissell, Member Sheila Westerman, Member Catharine Robinson, Member • JEFFERSON COUNTY PUBLIC HEALTH ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH 2013 Additional Fees and Other Information GENERAL Health Officer Administrative Hearing 306.00 Administrative Hearing Appeal 306.00 Technical Assistance/Plan Review-Minimum 67.00 Technical Assistance/Plan Review-Per Hour 67.00 Filing Fee 52.00 ONSITE SEWAGE DISPOSAL , Sewage Disposal Permits New Conventional 555.00 Valid for 3 years New Alternative 662.00 Valid for 3 years New septic tank and/or pump chamber only 264.00 Issued in conjunction with an existing sewage disposal New Community or>1000 G.P.D.(base fee) 555.00 Plus$87 per connection-valid for 3 yrs New Commercial>1000 G.P.D. Conventional 662.00 Valid for 3 years Alternative 707.00 Valid for 3 years Repair/Upgrade/Modification/Designate Reserve Area 123.00 _Applies to existing installed sewage disposal system Expansion 413.00 Redesign 123.00 Applies to pending or active but not installed Reinspection 153.00 Evaluation of Existing System/Monitoring Inspection Septic system only 306.00 - Septic system plus water sample 319.00 Retest/Reinspection 107.00 On Site Sewage OnSite-Site Plan Advanced Approval Determination(SPAAD) 306.00 Septic Permit with SPAAD(conventional) 299.00 Septic Permit with SPAAD(alternative) 414.00 Subdivision Review Base Fee 396.00 Plus$78.00 Per Lot Boundary line adjustment review fee 156.00 Plus$78.00 Per Lot Pre application meeting fee 156.00 Planned rural residential development review fee 156.00 Density exemption review fee 78.00 Density exemption review fee requiring field work 156.00 Other WaiverNariance Application 184.00 WaiverNariance Hearing 306.00 Wet season evaluation 413.00 • Revised building_application review fee 156.00 New building application review fee: Residential 78.00 Commercial 156.00 General environmental health review fee 78.00 Licenses Installer,Pumper,Operator(maintenance person) 413.00 Retest 168.00 Annual Renewal 291.00 Delinquent Renewal after January 31 413.00 FOOD SERVICE ESTABLISHMENT FEES PERMIT FEES(Annual Permit) - Restaurants/Take-Out(Based on menu complexity_&seating-menu changes may change category) 0-25 seats(Limited Menu) 186.00 No cooling or reheating 0-25 seats(Complex Menu) 331.00 Cooling and reheating allowed 26-50 seats 331.00 51-100 seats 397.00 101-150 seats 450.00 With Lounge,add 146.00 Separate lounge area Bakery Business 145.00 B&B 186.00 Caterer w/commissary or catering-only kitchen 331.00 w/restaurant,additional fee for catering 186.00 Concession/Commercial Kitchen/Church 145.00 Espresso Stand 145.00 Grocery 1-3 checkouts 186.00 May serve pre-packaged baked goods >3 checkouts 450.00- Meat/Fish Market 331 00 Mobile Unit Limited Menu 186.00 No cooling or reheating Complex Menu 331.00 Cooling&reheating allowed School Cafeteria Central Kitchen 331.00 Warming Kitchen 186.00 • Tavern w/food(see Restaurants) Annual Permit Issued after September 1 50%of fee 50%of Annual Permit Fee 1 of 2 6/13/2013 3:31 PM -a. ENVIRONMENTAL HEALTH 2013 Additional Fees and Other Information Temporary Permits Single Events Limited Menu Initial Application(First Event) 105.00 Not to exceed 21 days at your location • Additional Events(Same Menu) 16.00 Not to exceed 21 days at your location Additional Events(Different Menu) 105.00 Not to exceed 21 days at your location Complex Menu Initial Application(First Event) 139.00 Not to exceed 21 days at your location Additional Events(Same Menu) 16.00 Not to exceed 21 days at your location Additional Events(Different Menu) 139.00 Not to exceed 21 days at your location Organized Recurring Events(e.g.Farmers Markets) Limited Menu Initial Application(First Event) 105.00 Not to exceed 3 days a week Additional Events(Same Menu) 16.00 Not to exceed 3 days a week Additional Events(Different Menu) 105.00 Not to exceed 3 days a week Complex Menu Initial Application(First Event) 139.00 Not to exceed 3 days a week Additional Events(Same Menu) 16.00 Not to exceed 3 days a week Additional Events(Different Menu) 139.00 Not to exceed 3 days a week +50%of fee Additional(Paid when application is submitted less than 7 Late Fee for Temporary Permits days prior to the event) Other Food Fees Permit Exemption 40.00 WaiverNariance 67.00 Per Hour Reopening Fee 67.00 Per Hour Manager's Course 225.00 Plan Review Pre-opening inspection 67.00 Per Hour Minimum 67.00 Per Hour 67.00 Reinspection First Inspection 93.00 Each inspection after first 159.00 Food Handler Card 10.00 Reissue Unexpired Food Handler Card 10.00 SOLID WASTE Annual Permit Fees Landfills requiring environmental monitoring 543.00 Biosolid/Composting Facilities 476.00 • Inert Waste Landfills 344.00 Other Solid Waste Facilities 344.00 Drop Boxes 159.00 Miscellaneous Fees New Facility Application 437.00 Exempt Facility Inspection 344.00 Facility Reinspection 50%of fee Plan,Document and WaiverNariance Review 268.00 +$67.00/hour for>4 hours WATER 159.00 Inspection of well construction,decommission& Application Fee reconstruction Determination of Adequate Water Sypply 66.00 Building Permit Process Well Inspection&Water Sample for Loan 134.00 Well Site Inspection-Proposed public water supply 318.00 LIVING ENVIRONMENTS(Annual Permit) Pool 291.00 Spa 291.00 Pool/Spa Combined 397.00 Plan Review 67.00 Per Hour Indoor Air(Tobacco) Compliance Enforcement 67.00 Per Hour Reinspection 78.00 _Rebuttal Application 156.00 Note: 2013 Fees have been adjusted per Ordinance 12-1209-96,Section 4-Annual Fee Indexing:Fixed amount fees established by this ordinance shall be adjusted annually on the first business day of January(Adjusted Date)by the amount of the increase in the Consumer Price Index(CPIW), The CPIW is the Consumer Price Index-US City Average for All Urban Wage Earners and Clerical Workers,published by the Bureau of Labor Statistics for the United States Department of Labor. The annual fee adjustment shalt be calculated as follows: each fee in effect immediately prior to the Adjustment Date will be increased by the percentage increase in the CPIW as reported for the month of September preceding the Adjustment Date. Increases will be rounded to the nearest dollar. A fee shall not be reduced by reason of such calculation. However,fee increases in accordance with this calculation shall not exceed 5 percent per year. • 2 of 2 6/13/2013 3:31 PM • Board of Health Netiv Business .agenda Item #17., 3 • Nlulti-State Outbreak Outbreak of 3fepatitis .� June 20, 2013 • f5O °� JEFFERSON COUNTY PUBLIC HEALTH qSy °? 615 Sheridan Street o Port Townsend o Washington o 98368 • www.jeffersoncountypublichealth.org Health Alert: Multistate Outbreak of Hepatitis A June 4, 2013 Dear Colleagues: This week a multistate outbreak of hepatitis A that may be linked to "Townsend Farms Organic Anti- Oxidant Blend", was announced. This product is a frozen berry and pomegranate seed mix. Costco has been contacting customers who purchased the product at their stores and according to Costco 23,000 units have been sold in the Northwest. You may also receive calls or see patients who are concerned about their possible exposure and requesting hepatitis A vaccine, or who have symptoms of acute hepatitis and may have consumed the product. The CDC has issued advice to consumers and retailers at: http://www.cdc.gov/hepatitis/Outbreaks/2013/Alb-03-31/advice-consumers.html which include recommendations to discard any product they may still have, and if product has been consumed within the past two weeks, hepatitis A vaccine is recommended, unless the person has previously been vaccinated for hepatitis A or had proven Hepatitis A disease. Patients are advised to seek medical attention for symptoms of hepatitis: jaundice,yellow eyes, abdominal pain, pale stools, or dark . urine. So far 34 cases, including 11 hospitalizations, have been identified in 5 states (Colorado,New Mexico, Nevada, Arizona, and California, but the number of cases and affected states is expected to rise. Please report confirmed cases to us, and suspected cases with a history of exposure to "Townsend Farms Organic Anti-Oxidant Blend" within 2 weeks of onset of symptoms. Please call to report cases any time at 360 337-5235 Jefferson County Public Health (JCPH) has Hepatitis A vaccine available and a limited supply of immune globulin(IG). Please ask patients who have eaten this product and who are susceptible to Hepatitis A to call JCPH at 360-385-9400. Safeway Pharmacy may also be able to provide Hepatitis A vaccine, they do not administer IG. What are the current CDC guidelines for post exposure protection against Hepatitis A? Until recently, an injection of immune globulin(IG)was the only recommended way to protect people after they have been exposed to Hepatitis A virus. In June 2007, U.S. guidelines were revised to allow for Hepatitis A vaccine to be used after exposure to prevent infection in healthy persons aged 1-40 years. Persons who have recently been exposed to HAV and who have not been vaccinated previously should be administered a single dose of single-antigen Hepatitis A vaccine or IG (0.02 mL/kg) as soon as • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES 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 possible, within 2 weeks after exposure. The guidelines vary by age and health status: • • For healthy persons aged 12 months-40 years, single-antigen Hepatitis A vaccine at the age- appropriate dose is preferred to IG because of vaccine's advantages, including long-term protection and ease of administration, as well as the equivalent efficacy of vaccine to IG. • For persons aged >40 years, IG is preferred because of the absence of information regarding vaccine performance for post exposure prophylaxis in this age group and because of the more severe manifestations of Hepatitis A in older adults. Vaccine can be used if IG cannot be obtained. The magnitude of the risk of HAV transmission from the exposure should be considered in decisions to use vaccine or IG in this age group. For children aged <12 months, immunocompromised persons, persons with chronic liver disease, and persons who are allergic to the vaccine or a vaccine component, IG should be used. Please call 360-385-9400 to report cases and if you have additional questions. This message will be posted on our website www.jeffersoncountypublichealth.org. Sincerely, Scott Lindquist MD MPH Deputy Health Officer for Jefferson County 360-337-5237 (office) • COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH • DEVELOPMENTAL DISABILITIES 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 • Board of Health Netiv Business ,agenda Item #17., 4 • .agenda for Change: ToundationaCPu6lic gfealth Services June 20, 2013 • Public Health Improvement Partnership Agenda for Change Foundational Public Health Services 06-05-13 • Introduction Public health in Washington State is at a crossroads. We face the dual challenges of a severe funding crisis and a change in the nature of preventable disease and illness in our state. The Agenda for Change broadly addresses new directions for a reformed public health system. But a reformed public health system must have a strong foundation of core capabilities and programs: the minimum level of public health capabilities and programs that must actually be present everywhere throughout the state for the system to work anywhere. That foundation is the focus of this work. No matter where they live, all residents of our state should be able to rely on the governmental public health system to possess specific skills to detect and remedy public health hazards, deliver an essential set of services that protect their health, and demonstrate their ability to do so by meeting specific standards. Without this underlying foundation the public health system cannot operate equitably and optimally for every resident throughout the state of Washington. As a basic example, the ability to detect an outbreak of infectious disease or foodborne bacteria needs to be present statewide to minimize harm. Foundational capabilities and services are not everything public health departments do, since the full set of public health services must reflect the environment and needs of the local public. However, only when we define the minimum foundational capacities and essential level of services will we have a basis for determining the level of investment needed in public health in Washington State. Two kinds of functions form foundational public health services in Washington: Foundational Capabilities such as assessment, communications, policy development, community partnerships, • emergency preparedness, and modern business practices cut across all program areas. As such, these core capacities should not be supported through categorical funding tied to specific diseases or health risks because these vary over time, by location, and by funding reliability. Rather these basic capabilities should be supported by dedicated, flexible funding, assuring that all local health departments in the state have the basis to carry out high quality public health work on behalf of their residents, regardless of geographic location, population size, local tax base, or other attribute of the locality. Foundational Programs represent a basic level of service in areas such as communicable disease control and environmental public health. The emphasis is on population-based services that are unlikely to get done unless governmental public health does them. A minimum level of funding, outside of categorical funding sources, is needed to ensure that every resident in Washington lives in a community where the governmental public health system can deliver an essential, minimal level of communicable disease control, chronic disease and injury prevention, environmental public health, maternal/child/family health, access or linkage to clinical health care, and vital records. Together, the foundational capabilities and a basic level of services in each of the essential program areas are being called Foundational Public Health Services—those services that no community should be without, regardless of how the they are provided (by a local, regional, or state agency). To define those basics is not to say they are all public health should do. Public health often can and must go beyond the basics to protect residents' health in response to local conditions and emerging problems. These foundational capabilities and programs are designed to serve as a floor to support additional public health services customized to the specific situations and priorities of each jurisdiction. For example, additional, key services including those with dedicated categorical or fee-supported mechanisms for financing will be needed ioto protect the public's health in many locations. In Appendix A, we have included a list of examples of additional important public health services that are tied to other funding sources, local environments, and community needs and priorities. Foundational Public Health Services Definitions With Intro—06-05-13 Page 2 of 7 Even though these additional services in Appendix A are vitally important in many jurisdictions, the focus is on the foundational capabilities and programs. That is partly because even this basic level of public health service • is endangered in many Washington communities today. More fundamentally, even an expansive public health system that fully addresses our current problems will not work well unless it is built on a solid foundation of capabilities and programs. This is meant to form the basis for a long-term effort to achieve a sustainable foundation for a reformed public health system in Washington State. It will be important to develop cost estimates for foundational capabilities and programs statewide. Beyond this costing task may lie several years of additional work with partners in and out of government. One thing is clear enough— no sustainable system will spring up spontaneously. It is up to the public health community to clearly define the absolute minimum foundational public health package. If we do not tackle this, no one else can be expected to do so. Other states have done this, and so can we. In describing these capabilities and programs we have not divided them into state or local responsibilities because most of them are addressed through the combined efforts of local health jurisdictions and the state department of health. State and local costs will be identified in the process of developing a cost estimate, but we are not yet at the point where it makes sense to propose specific state or local funding sources and responsibilities. That discussion must involve several other partners. But that discussion cannot be rationally conducted without a clear idea of what minimum public health funding will pay for and what it will cost. That is why this initial part of the work, in which we clearly define the basics, is so critical. I Foundational Capabilities Capabilities that cut across all program areas. A. Assessment (surveillance and epidemiology) • 1. Ability to collect sufficient statewide data (i.e. BRFSS, HYS, vital statistics) to develop and maintain electronic information systems (i.e. PHIMS, PHRED, CHARS„ CHAT) to guide public health planning and decision making at the state and local level. 2. Ability to , access, analyze, and use data from 8 specific information sources, including: 1) census data, 2) vital statistics, 3) notifiable condition data, 4) certain clinical administrative data sets including hospital discharge, 5) Behavioral Risk Factor Surveillance Survey, 6) Healthy Youth Survey, 7) basic community and environmental health indicators, 8) local and state chart of accounts 3. Ability to prioritize and respond to data requests and to translate data into information and reports that are valid, statistically accurate, and readable to the intended audiences. 4. Ability to conduct a basic community and statewide health assessment and identify health priorities arising from that assessment, including analysis of health disparities B. Emergency Preparedness (All Hazards) 1. Ability to develop and rehearse response strategies and plans, in accordance with national and state guidelines, to address natural or manmade disasters and emergencies, including special protection of vulnerable populations 2. Ability to lead the `Emergency Support Function 8 -Public Health & Medical' for the county, region, jurisdiction, and state 3. Ability to activate emergency response personnel in the event of a public health crisis, coordinate with federal, state and county emergency managers and other first responders, and operate within, and as necessary lead, the incident management system. 4. Promote community preparedness by communicating with the public in advance of an emergency, steps that can be taken before, during, or after a disaster • r Foundational Public Health Services Definitions With Intro—06-05-13 Page 3 of 7 C. Communication • 1. Ability to maintain ongoing relations with local and statewide media including ability to write a press release, conduct a press conference, and use electronic communication tools to interact with the media. 2. Ability to develop and implement a communication strategy, in accordance with Public Health Accreditation Board Standards, to increase visibility of a specific public health issue and communicate risk. This includes the ability to provide information on health risks, healthy behaviors, and disease prevention in culturally and linguistically appropriate formats for the various communities served, including use of electronic communication tools D. Policy Development and Support 1. Ability to develop basic public health policy recommendations that are evidence-based and legally feasible 2. Ability to work with partners and policy makers to enact policies that are evidence-based Ability to utilize cost benefit information to develop an efficient and cost-effective action plan to respond to the priorities identified in a community and statewide health assessment, including identification of best and emerging practices, and those that respond to health inequities E. Community Partnership Development 1. Ability to create and maintain relations with important partners, including health-related national, statewide, and community-based organizations; community groups or organizations representing populations experiencing health disparities; key private businesses and health care organizations; and key federal, tribal, state and local government agencies and leaders 2. Ability to strategically select and articulate governmental public health roles in programmatic and policy activities and coordinate with these partners •F. Business Competencies 1. Leadership - ability to lead internal and external stakeholders to consensus and action planning (adaptive leadership) and to serve as the `public face' of governmental public health in the community 2. Accountability and Quality Assurance services—ability to uphold business standards and accountability in accordance with federal, state, and local laws and policies and to assure compliance with national and Public Health Accreditation Board Standards. 3. Quality Improvement—ability to continuously improve processes, including plan-do-study-act cycles 4. Information Technology services—ability to maintain and access electronic health information to support the public health agency operations and analyze health data. Ability to support, maintain and use communication technology. 5. Human Resources services—ability to develop and maintain a competent workforce, including recruitment, retention, and succession planning functions; training; and performance review and accountability. 6. Fiscal management, contract, and procurement services - ability to comply with federal, state, and local standards and policies 7. Facilities and operations—ability to procure, maintain, and manage safe facilities and efficient operations 8. Legal services and analysis—ability to access and appropriately use legal services in planning and implementing public health initiatives • t Foundational Public Health Services Definitions With Intro—06-05-13 Page 4 of 7 II. Foundational Programs Specific public health programs/functions necessary for basic public health protections to work. • A. Communicable Disease Control 1. Provide timely, statewide and locally relevant and accurate information to the state and community on communicable diseases and their control, including strategies to increase local immunization rates 2. Identify statewide and local communicable disease control community assets, develop and implement a prioritized communicable disease control plan, and advocate and seek funding for high priority policy initiatives 3. Ability to receive laboratory reports and other identifiable data, conduct disease investigations, including contact notification, and recognize, identify and respond to communicable disease outbreaks for notifiable conditions in accordance with national and state mandates and guidelines 4. Assure the availability of partner notification services for newly diagnosed cases of syphilis, gonorrhea, and HIV according to CDC guidelines. 5. Assure the appropriate treatment of individuals who have active tuberculosis, including the provision of directly-observed therapy according to Centers for Disease Control and Prevention (CDC) guidelines 6. Assure availability of public health laboratory services for disease investigations and response, and reference and confirmatory testing related to communicable diseases. 7. Coordinate and integrate other categorically-funded communicable disease program and services B. Chronic Disease and Injury Prevention 1. Provide timely, statewide and locally relevant and accurate information to the state and community on chronic disease prevention and injury control 2. Identify statewide and local chronic disease and injury prevention community assets, develop and • implement a prioritized prevention plan, and advocate and seek funding for high priority policy initiatives 3. Reduce statewide and community rates of tobacco use through a program that conform to standards set by Washington laws and CDC's Office on Smoking and Health, including activities to reduce youth initiation, increase cessation, and reduce secondhand smoke exposure 4. Work actively with statewide and community partners to increase statewide and community rates of healthy eating and active living through a prioritized program of best and emerging practices aligned with national and state guidelines for healthy eating and active living 5. Coordinate and integrate other categorically-funded chronic disease and injury prevention programs and services C. Environmental Public Health 1. Provide timely, statewide and locally relevant and accurate information to the state and community on environmental public health issues and health impacts from common environmental or toxic exposures 2. Identify statewide and local community environmental public health assets and partners, and develop and implement a prioritized prevention plan to protect the public's health by preventing and reducing exposures to health hazards in the environment 3. Conduct mandated environmental public health laboratory testing, inspections and oversight to protect food, water recreation, drinking water, and liquid and solid waste streams in accordance with federal, state, and local laws and regulations 4. Identify and address priority notifiable zoonotic (e.g., birds, insects, rodents) conditions, air-borne, , and other public health threats related to environmental hazards 5. Protect workers and the public from unnecessary radiation exposure in accordance with federal, • state, local laws and regulations [state function] 6. Participate in broad land use planning and sustainable development to encourage decisions that promote positive public health outcomes (e.g. consideration of housing, urban development, recreational facilities and transport) Foundational Public Health Services Definitions With Intro—06-05-13 Page 5 of 7 7. Coordinate and integrate other categorically-funded environmental public health programs and services D. Maternal/Child/Family Health 1. Provide timely, statewide and locally relevant and accurate information to the state and community on emerging and on-going maternal child health trends taking into account the importance of Adverse Childhood Experiences (ACEs) and health disparities 2. Assure mandated newborn screening done by the state public health lab to test every infant born in Washington, to detect and prevent the developmental impairments and life-threatening illnesses associated with congenital disorders that are specified by the State Board of Health. [State Only] 3. Identify, disseminate, and promote emerging and evidence-based information about early interventions in the prenatal and early childhood period that optimize lifelong health and social- emotional development 4. Identify local maternal and child health community assets; using life course expertise and an understanding of health disparities, develop a prioritized prevention plan; and advocate and seek funding for high priority policy initiatives 5. Coordinate and integrate other categorically funded maternal, child, and family health programs and services E. Access/Linkage with Clinical Health Care 1. Provide timely, statewide and locally relevant and accurate information to the state and community on the clinical healthcare system 2. Improve patient safety through inspection and licensing of healthcare facilities and licensing, monitoring, and discipline of healthcare providers [state function] 3. In concert with national and statewide groups and local providers of health care, identify healthcare • assets, develop, prioritized plans for increasing access to health homes and quality health care, and advocate and seek funding for high priority policy initiatives 4. Provide state-level health system planning (place-holder—will work on clearer language). 5. Coordinate and integrate other categorically-funded clinical health care programs and services F. Vital Records 1. In compliance with state law and in concert with national, state, and local groups, assure a system of vital records [state function] 2. Provide certified birth and death certificates in compliance with state law and rule Examples of Additional Important Public Health Services Because Foundational Public Health Services are not all public health can provide The following are examples of additional important public health services that may be provided by public health agencies in some communities, because the Foundational Public Health Services shouldn't be all that public health provides. In some cases the additional important public health services are needed to address important local health risks or community priorities; in other cases they are supported by fees or other funding sources outside of core state and local public health funding. The list is intended to add description and detail to another level of important public health services that many, if not all, jurisdictions will be able to offer. The list is not intended to be all-inclusive. The list of `augmented foundational capabilities'that follows next illustrates capacities that some health departments may develop in response to staff interests and partnerships with educational institutions, organizations in other sectors, and external funders. .A. Communicable Disease Control 1. Management of vaccine distribution for childhood vaccine providers in accordance with national Guidelines for Quality Standards for Immunization (including current federal categorical funding) Foundational Public Health Services Definitions With Intro—06-05-13 Page 6 of 7 2. HIV services, including Ryan White HIV clinical services and federal and state HIV prevention services in accordance with state and federal regulations for these programs (including current federal and state • categorical funding) 3. Assurance of access to HIV/STD testing and treatment 4. Assurance of treatment of latent tuberculosis infection 5. Assurance of provision of partner notification services for chlamydia infections 6. Development of appropriate response strategies for new and emerging diseases through surveillance, program evaluation, and applied research B. Chronic Disease and Injury Prevention 1. Provision of specific clinical preventive services and screening (breast and cervical cancer, colon cancer) in accordance with the USPHTF for Clinical Preventive Services (including current federal and state funding) 2. Other categorically-funded chronic disease prevention programs (including current federal funding for chronic disease and community transformation) 3. Development of appropriate strategies for prevention and control of chronic diseases and injury through surveillance, program evaluation, and applied research C. Environmental Public Health 1. Development of appropriate response strategies for newly-recognized toxic hazards and other adverse environmental health conditions through surveillance, program evaluation, and applied research 2. Assessment, policy development, and implementation of evidence-based health promotion elements in land use, built environment, and transportation D. Maternal/Child/Family Health 1. Assure access and/or coordination of Women, Infants and Children Supplemental Nutrition Services (WIC) that adhere to the USDA Nutrition Services Standards (including current categorical federal funding) 2. Assure access and/or coordination of maternity support and nurse family partnership services (including services currently funded by third party payers including Medicaid) 3. Family planning services (including current state and federal categorical funding) • 4. Child Death Review 5. Outreach, linkage and system development for children with special needs E. Access/Linkage with Clinical Health Care Facilitate the availability of... 1. Clinical services to vulnerable populations that follow established clinical practice guidelines and are delivered in a timely manner, including integrated medical and behavioral care, sexual health, oral health, adolescent health services, immunizations, and travel health services (including services funded by third party payers, including Medicaid) 2. Quality, accessible, and timely jail health services in accordance with standards set by the National Commission on Correctional Health Care that include medical, mental health, chemical dependency, dental, nursing, pharmacy, and release planning services 3. Emergency medical services including basic life support (BLS) and advanced life support (ALS) response by certified EMTs and paramedics to residents in need of emergency medical services (including current locally funded levy services) 4. Public health laboratory testing that meet certification standards of Washington Department of Health's Office of Laboratory Quality Assurance and the federal Clinical Laboratory Improvement Amendments to assure accurate, reliable, and prompt reporting of test results (including services funded by third party payers including Medicaid) 5. Refugee health screening that follows CDC's Refugee Health Guidelines and is delivered within 90 days of arrival in the US, in accordance with the Office for Refugee Resettlement (including current categorical federal funding) 6. Monitoring and reporting of indices of measures of quality and cost of healthcare 7. Death investigations and authorization to dispose of human remains that meet National Association of Medical Examination accreditation standards 410 Augmented Foundational Capabilities 1. Ability to conduct public health practice applied research and evaluation, including data collection, data analysis, policy research, and evaluation services that meet standards for peer-reviewed publications ,# Foundational Public Health Services Definitions With Intro—06-05-13 Page 7 of 7 2. Ability to identify and promote policy change opportunities in non-health sectors including the use of analytic tools Sto assess the health impact of these policies Ability to develop and implement social marketing campaigns, including social media communication platforms 4. Ability to collaborate in training and service with community education programs and schools of public health 5. Ability to develop effective interventions, in partnership with community members, to reduce and eliminate health disparities 6. Ability to compete for grant funding from government organizations, philanthropic organizations, health system partners, and corporate foundations c •c, , -- -= a) 73 ai to L) VI o c C3. a) - E E v co V (1 c (1) w cc N J Z .. _ — _ N ro t ON v5 CO76 N "E > N U v as oW f6 Q U V (0 " LL 03 L C) 0 p u) < across programs > o i) � � — Assessment (surveillance and epidemiology) _ co 73 73' _ Ti , v Emergency preparedness and response (all hazards) 0 I .RS - Communications 0 I Um v aPolicy development and support •v v LL Community partnership development M aBusiness competencies a am Foundational Public Health Services • ! . 6/10/2013 • . .,r ., ,:2,,,,,..,:s.,,,,,2,..., w : ... _ . , . ,,:.,.„,„,„_:, „ti,---- , ���� ask SUSTAINABLE FUNDING FOR FOUNDATIONAL PUBLIC HEALTH SERVICES: A PROGRESS REPORT �,E �'N ""{� a ;r : y,x 10 '�n<.IL 1 s r" ti�`#g9� {",': c �-, 1...u-44,,,,,, ,,'',,,-. t 'b F e Yk^yio r» 1 hII ��'. ;�. i ts t °'z.v �`� Ca" ..''' i .a sz ,):... ', ..cux>rs: ...`aw.sr�s" �i,....,�, `.;x.,a" ...�S:a,,., r � < t..,�.m: • OUR PUBLIC HEALTH FUNDING SYSTEM IS BROKEN r , ,.;a ._AF„ r," , . sa ,#r,' 5.mi56 'r,�' zµ` 'iotD a .' We consider it a legislative success when we don't get cut very much Meanwhile, inflation and population growth have steadily undermined our budgets for 15 years or more It's not just the Great Recession, it's a long term structural defect Now, in many local health agencies and at the Department of Health, the most basic public health services are threatened • 1 t 6/10/2013 • WHAT DO WE NEED? Stable support for basic public health functions Funding that tracks with population growth and inflation - Enough to assure every community has the basics needed for the public health system to work statewide What we need everywhere for the system to work anywhere Recognizing that the basics aren't all we should do but knowing that the system cannot work if the basics are not in place We've called this Foundational Public Health • THE QUESTION If you ask decision makers for such funding, they soon ask, What would we get for the money? If your answer is Trust Us, the conversation soon ends To have any hope for sustainable funding, we have to answer this question clearly This requires a list of boundaries... Not a list of everything we could ever do, but an honest list of the things we consider basic, taking into account our responsibility for population based health • 2 6/10/2013 • WHY FOUNDATIONAL PUBLIC HEALTH? To secure sustainable funding for basic public health services statewide INSTITUTE OF MEDICINE AGREES t r..F4 a� b `ya�r 1 ,, ""`b- `,r " ....^C _. _ _.. ,. ,. ._ ,,. �,,a�... .;i`fi` ;�, �,,.r:� .:6'J,r".',.,.f,.;ln x3k�.' {�' ,� k,a,.�;�_,,..�, sv.. In late 2012, the institute of Medicine issued a report on public health funding called For the Public's Health: Investing in a Healthier Future They showed that basic public health funding is a national problem And they made the very same connection we did You can't be effective pursuing basic funding if you can't clearly state what the basics are CDC is also getting involved Public Health Basics — becoming a national discussion • 3 t 6/10/2013 • WHAT'S OUR PLAN? ErA Define Foundational Public Health Services Cost them out statewide Develop practical policy options for sustainable foundational funding -; Develop a broad based coalition of supporters and advocate for the necessary legislation Don't quit • FOUNDATIONAL PUBLIC HEALTH ❑ Chose this term instead of minimum, basic, or core ❑ The idea of a foundation seems right — it's not the whole house, but the rest of the house doesn't work unless the foundation is solid • A PHIP workgroup began in 201 2 Last spring and summer, the proposed list was widely shared, discussed and modified • 4 6/10/2013 • DEFINING FOUNDATIONAL SERVICES .1 .. "",'' What we need to do everywhere for the system to work anywhere • It's not everything we need to do. There are important categorical services that go beyond the basics and which vary according to local needs and priorities. n The list had to be specific enough to cost it out ❑ It had to take into account our unique responsibility for population based issues and services • THE LIST M ''x P^}"""a ',!,i u , 6 z,='fr .„J ^6%KE,. v :3 ,'.?`•n a+t+ &Wa.'.1rT B ❑ The Foundational Public Health Services include: Capabilities and Programs :2 Foundational capabilities cut across all program areas Foundational programs include specific activities such as basic environmental health regulatory programs and communicable disease surveillance and response As an appendix we also showed examples of additional important services to demonstrate that there are necessary categorical services that go beyond the basics in response to local needs and priorities • 5 6/10/2013 • THE CHART < LL 3 u a ` v p '‘;'.1 v V ra c N a .3 C _ 7-2 = <O u N S a w Q m j a o<n < across all programs > o y =_ Assessment(surveillance and epidemiology) _ 55 gEmergency preparedness and response(all hazards) g ti,v _ Communications ti Policy development and support n▪ y Community partnership development Business competencies Foundational Public Health Services Washington State Pubic Health Improvement Partnership-Agenda to,Change-01110/13 • THE COSTS Through PHIP (with Department of Health dollars), retained Berk & Associates as consultants to help develop a cost model for Foundational Public Health Worked with 9 local health agencies and the Department of Health to develop a detailed cost model From Lincoln County to Public Health—Seattle& King County Each participant filled out a long questionnaire and participated in in-depth follow up interviews Cost data then extrapolated for statewide estimates • 6 6/10/2013 • LOCAL HEALTH JURISDICTIONS IN WASHINGTON '' m vena 5159 Sn �• .r., r t Okahagan rr Ferry Oreille ��}, � Sk it f y25 7'650 650 Stevens i3iz Island 1/77:5° =.* 43e600 79.35' (NortheastTn County) Clatlam s, 7z,000 •1.( Snohomish* 7zz,goo Jefferson j (Chelan-Douglas) 30,175 Chelan D uglas attle&King 73,zoo t� 39,90° L c In Spokane* L Grays �/�yfp*County* ✓`! 10,375 475.600 1h Harbor Eason,{ i,9S7,000 4 73,150 450 ., _ 1 KrtLtas Grant Tacoma Pierce Adams Thurston * 4a,5oo � 29'°5' Whitman ��� z56,8o0 8o8,zoo 45,950 Pacific Lewis frail "r,>, Garfiel. Ilr 2 o,970 763 00 Yakima 8z,5[W� z,z5o z46,000 (Benton-Franklin) Columb Wahkiaku Co Irtz 4100 a3,oso Skamania Walla Wall. Asotin 4,0.5 ss,z75 Benton `*59,100 u,7oo Klickitat x8°,°00 1 Clark zo,600 4�\z50 Departments-Public Health&Human Services Departments-Public Health District-Single County Washington State Total Population,6/zona—c",&.o,rn,+ DisiriR—Multi County Source-Office of Financial Manag=ement * Agency is lead by full-time physician health officer LHJs Contributing Estimates to the FPHS Cost Model • CONCLUSIONS ABOUT THE COST MODEL The model is flexible and able to provide information for different assumptions The cost data that is being used to extrapolate for statewide costs is solid and reasonable The revenue data allows us to identify costs not covered by grant/contract or fee, that should be funded by state and local tax dollars The model is a good tool for better understanding our current funding system and determining options and recommendations for a model of predictable funding Final report on the cost model early July • 7 6/10/2013 • POLICY QUESTIONS Funding for what? (Foundational Public Health Services are defined) How much funding? (Can make estimate based on various assumptions) What is the right mix of revenue a Who should pay how much for what? a Should there be a local match for state dollars? Or vice versa? ❑ Should there be an expected/minimum%of cost recovery for fee-based services? How should funds be distributed across the state? Across services? What is fair/equitable? How should payers/funders monitor the impact of the funds (e.g. accountability, Return on Investment)? • REVIEW: Where we've been and what we need to do... Defined Foundational Public Health Services Costed them out statewide Develop practical policy options for sustainable foundational funding Develop a broad based coalition of supporters and advocate for the necessary legislation Don't quit • 8 6/10/2013 • NEXT STEPS: Policy options 'kt < ( .; z. r asp s4 PHIP Foundational Public Health Services Workgroup Phase II Recruiting members, including beyond public health officials Will continue meeting over the next year Developing specific policy options and proposals for sustainable funding of the foundational capacities and services icy;c:et: June 2014 • NEXT STEPS: Advocacy Z. .` ` egLtMMMMT ZaW t. < .,Fty:*Z WSALPHO will coordinate development of broad support for sustainable funding proposals, in parallel with policy work Doctors, nurses, hospitals, clinics, employers, professional organizations, special interest groups, unions... Aiming to have proposals ready for the next biennial legislative session in 2015 And beyond as needed... • 9 6/10/2013 NEXT STEPS: Don't quit Odds are it won't pass the first time It took 8 years of struggle to get a separate state department of health If this takes that long, it will be worth it We need to have the staying power to see this through • QUESTIONS AND DISCUSSION • 10 • Board of HeaCth New Business .agenda Item #17., 5 • SmaCl Business .assistance Tor 3-fazardous Waste Control- June ontroCJune 20, 2013 ziP 614r OLYMPIC PENINSULA 1•4, WASTE / RECYCLING PROVIDERS SJefferson County Moderate Risk Waste Boat Haven 379-6911 ;�, E. Port of Port Townsend small quantity generators & household hazardous waste m 282 10th Street No Biomedical Waste or Latex Paint s 1,51 Open Fridays only 10-12:00 and 12:30 4:30 PM except for public holidays. _ �u r� 8 Used Oil, Antifreeze, Bilge Water, Hazardous Waste, and Small Quantity Generator Waste Jefferson Co. Moderate Risk Waste 379-6911 ThermoFluids Boat Haven at the Port of Port Townsend (253) 863-3310 1(800) 350-7565 282 10th Street Friday 10-12:00 and 12:30-4:30 1517 Pease (small quantity generators & household hazardous waste) Sumner, WA 98390 Clean Harbors (206)429-9100 Emerald Services (206) 832-3000 19320 Des Moines Memorial Dr#300 1825 Alexander Avenue SeaTac, WA 98148-2330 Tacoma, WA 98421 Philip Services Corporation (253) 627-7568 Safety Kleen (253) 939-2022 1701 E. Alexander Ave Tacoma, WA 98421 3210 C St NE#G Auburn, WA 98002-1719 Marine Vacuum Service Inc (206) 762-0240 (800) 540-7491 Phoenix Environmental (253) 779-8474 • 1516 South Graham Street 2121 Port of Tacoma Rd. P.O. BOX 24263 Tacoma, WA 98421 Seattle, Washington 98124 1 888 475-0116 Electronic Waste Recycling The Recycling Center 385-7678 E-Cycle Northwest (360) 681-8645 301 County Landfill Rd off Jacob-Miller Rd. 272693 Hwy 101 M-S 9 to 4:30 Sequim, WA 98382 Goodwill 385-6600 E-CYCLE WASHINGTON 602 Howard St., Port Townsend www.ecy.wa.gov/programs/swfa/eproductrecycle M-Sat. 8:00 a.m. to 9:00 p.m. 1-800-RECYCLE (1-800-732-9253) ,r 4 . s e �: ', i„,,,,,,,,,,,,„ 4,, ;`�"..=` XI ^r.� `c t ,L.Y''s�. ,�,,% €ter ms's�-: .�sr, : ;,a .S . ' 't''''' "' 21, c" '" r`4.s'r r ",: ,,,,,?-4,:-,-,-,,,,,,,,,,k "-��i{k „ to-e`,,�+..�#., ,„x:7^..,.,.. -Y :.-t -f W ,,... 0,,,4,-. Jefferson Co. Moderate Risk Waste Facility 379-6911 The Recycle Center 385-7678 Boat Haven at the Port of Port Townsend 301 County Landfill Rd off Jacob-Miller Rd. 282 10th Street Fri: 10-12 and 12:30-4:30 Port Townsend, WA 98368 *Port Townsend, WA 98368 M-S 9 to 4:30 OPUBLIC HEALTH ' ALWAYS nnERMI(1NKMOf�lA51{FERAND May 2013 Publication Number EHSW 13-0005 This list is not comprehensive nor an endorsement of any of the facilities on it.You can find a more comprehensive ven- dor list at http://www.lhwmp.org/home/ MEDICAL AND DENTAL HAZARDOUS WASTE & RECYCLING PROVIDERS SERVING THE OLYMPIC PENINSULA • Amalgam Waste AB Dental Trends, inc R&D Services, inc 211 Grover Street 8120 Greenlake Dr. N Lynden, WA 98264 Seattle, WA 98103 (360) 354-4722 (800) 816-4995 (206) 525-2063 Rebec Environmental 3511 132nd St. S.W., #1 j Dental Recycling of North America Lynnwood, WA 98087145 W 58th Street (800)-569-1088 New York, New York 10019 (800) 360-1001 Silver Waste and Silver Recovery Hallmark Refining Corp. Agco Metalex , 1016 Dale Lane 3701 South Rd Mount Vernon, WA 98273 Mukilteo, WA 98275 s (800) 255-1895 (888) 743-7887 (425) 743-7886 '1 Safety-Kleen 3102 B Street NW CMX/NHD Corporation i 4 ,' • Auurn, WA 98001 P.O. Box 58088 (800) 669-5948 f Seattle, WA 98138 //-- _ , 93 2v mnm 869-7191 r')c3� a_ 022 tszn RA , Analytical Testing Services Twiss Analytical (360) 779-5141 Severn Trent Laboratories Inc. (425) 576-5040 26276 12 Trees Lane Northwest 5755 8t" Street E Poulsbo, WA 98370 Tacoma, WA 98033 Orion Environmental Services (253) 952-6717 34004 9th Ave S Federal Way, WA 98003 Medical Waste/Sharps Waste Management (800)664-1434 Stericycle (888) 783-7422 Tracker Mailback Programs Sharps Compliance, Inc (800) 772-5657 Safety-Kleen (800) 669-5948 9220 Kirby Drive#500 3102 B Street NW f Houston, TX 75071 Auurn, WA 98001 i— (253)939-2022 III May 2013 Publication Number EHSW 13-0005 This list is not comprehensive nor an endorsement of any of the facilities on it.You can find a more comprehensive ven- dor list at http://www.lhwmp.org/home/ PUBLIC HEALTH I' �tEAL1WE IEFF $OWN „,,0” C'°2 PUBLIC HEALTH Pollution Prevention Program g $ ALWAYS WORKING FOR A SAFER AND . RSHiSsot° HEALTHIER COMMUNITY Medical Clinics Business Name Contact Person -Business Address Phone UBI Inspector PLEASE CIRCLE YES OR NO CYTOLOGY/ HISTOLOGY/ PHARMECEUTICALS X-RAY WITH SILVER RECOVERY Chemo therapy drugs managed as hazardous N Do you use digital imaging? Y N waste? Cytology stains managed as hazardous waste? Y N If not, do you use a two cartridge silver Y N recovery system? Do you neutralize formalin from tissue samples Y N Do you maintain a log? Y N prior to discharge down the drain? Are anesthetic filters such as carbolyme & Y N Are cartridges recycled? Y N charcoal canisters, managed as hazardous waste? Are pharmaceuticals sent for hazardous waste Y N Are service records kept? Y N disposal or a reverse distributor? Is the X-Ray cleaner managed as hazardous? Y N MANAGING STERILANTS & DISINFECTANTS If not, has it been designated? Y N Chemiclave If spent fixer collected, is it labeled? Y N autoclave Are disposal records kept? Y N Are the following neutralized & discharged? Are containers in good condition? Y N • Glutaraldehyde N Are X-Rays recycled? Y N • OPA? Y N Are lead foils recycled or managed as Y N hazardous waste? • Cidex? Y N • Formalin? Y N COMMENTS/CONCERNS • Other? Y N If not, how are they managed? OTHER Are sharps/biomedical/red bag wastes disposed Y N of with permitted biomedical waste facility? Are fluorescent tubes recycled? Y N Are lead foils recycled or managed as Y N fitazardous waste? n-site sewage system? Y N Sanitary Sewer System? Y N 05/29/13 dm Board of 3feaCth Agenda Panning Calendar .Agenda Item #`VIII . To tiViesman, DrP3-{, .9V1P3C • 147,A State Secretary of aCeaCth June 20, 2013 • Secretary of Health :: Washington State Dept. of Health Page 1 of 2 IHea t Biography of Secretary of Health, John Wiesman, DrPH, MPH John Wiesman, DrPH, MPH was appointed Secretary of Health by Governor Jay Inslee and joined the Department of Health in April 2013. He's an accomplished transformational leader with more than 22 years of local public health experience. � John has been passionate about public health since reading a 1983 Time magazine article about disease detectives tracking Legionnaires' Disease, toxic shock syndrome, and HIV. It was the impetus for him to enter the profession. He has worked in four local public health departments in Washington and Connecticut. He started his public health • career in Connecticut in 1986 and was in its first group trained to rovide HIV counseling and testing. During his career John has: • Transformed health departments from providing individual clinical services to implementing policies, systems and environmental changes that make healthy choices easier and less expensive. • Partnered with a community clinic to provide integrated primary care and behavioral health. • Transformed Clark County Public Health into a first responder organization. John also worked at the University of Washington, School of Public Health as a project director on a back pain outcome assessment team grant. He earned his doctor of public health (DrPH) in public health executive leadership from the University of North Carolina-Chapel Hill in 2012. He received his master of public health (MPH) in chronic disease epidemiology from Yale University in 1987 and his bachelor of arts (BA) in biology from Lawrence University in Wisconsin in 1983. John was born and raised in Wisconsin. He and his husband have lived in Washington State since 1989. • http://www.doh.wa.gov/AboutUs/ProgramsandServices/OfficeoftheSecretary/Secretaryof... 6/13/2013 Board of 3-feaCth _Melia Report • June 20, 2013 • Jefferson County Public Health May/June 2013 NEWS ARTICLES 1. "'Shock mode' over heroin-linked death in Port Angeles," Peninsula Daily News, May 17th, 2013. 2. "Anderson Lake closed due to toxin," Port Townsend Leader, May 17th, 2013. 3. "Anderson Lake closes due to high toxin level," Peninsula Daily News, May 19th, 2013. 4. "Be aware of mental health issues," Port Townsend Leader, May 29th, 2013. 5. "Biomass project heard by state Supreme Court," PT Leader, May 29th, 2013 6. "'We are environmental stewards"," Port Townsend Leader, May 29th, 2013. 7. "Algae toxins keep Anderson Lake off-limits," Peninsula Daily News, June 2nd, 2013. 8. "Peninsula baby boomer suicide rates among state's highest: Clallam No. 1," Peninsula Daily News, June 3rd, 2013. 9. "Ecology to take comments tonight on Port Townsend Paper's permit," Peninsula Daily News, June 4th, 2013. 10. "Hearing on PT Paper discharge permit is June 4," Port Townsend Leader, June 4th 2013. 11. "Odor tops comments concerns about PT Paper mill pond," Port Townsend Leader, June 5th, 2013. 12. "Odor tops comments about mill pond," Port Townsend Leader, June 12th, 2013. • 13. "Jefferson Mental Health furloughs 10," Port Townsend Leader, June 12th, 2013. 14. "Hospital moves to paperless records system," Port Townsend Leader, June 12th, 2013 15. "YMCA to serve food," Port Townsend Leader, June 12th, 2013. `Shock mode' over heroin-linked death in Port Angeles By Jeremy Schwartz, Peninsula Daily News, May 179, 2013 • The last time 19-year-old Ricky Soiseth saw his longtime friend Maceo Niehaus alive, the two were hanging out at the carnival during last weekend's Sequim Irrigation Festival. "The last thing I said to him was, 'I love you, bro,' and he said it back to me," Soiseth said in a Thursday interview. Three days later, the 17-year-old Niehaus, whom Soiseth described as outgoing and active, was dead of a suspected heroin overdose in a home on the 700 block of Ennis Street in Port Angeles. David Zavodny, 18, of Port Angeles, in whose home police and paramedics found Niehaus dead Tuesday afternoon, is being held in the Clallam County jail for investigation of one count of controlled-substance homicide after allegedly providing the teen with the heroin that may have contributed to his death. Zavodny, held in lieu of$250,000 bail Thursday, is expected to be charged in Clallam County Superior Court at 1 p.m. today. According to court documents filed in the case, Zavodny called 9-1-1 Tuesday at 1:48 p.m. after Niehaus had not been breathing for between 40 and 45 minutes. "I still haven't cried because I'm still in shock mode," said Soiseth, adding that he expects many friends to attend a candlelight vigil for Niehaus tonight at 8:30 on Ediz Hook in Port Angeles. "When they have his funeral, it's going to be like a president died," Soiseth said. Niehaus' suspected heroin overdose is part of a recent uptick in such emergencies that first-responders in Port Angeles and the North Olympic Peninsula areas have experienced over the past two weeks. "It's definitely not typical," Port Angeles Fire Chief Ken Dubuc said. "It clearly was enough that it came to our attention." Brian Smith, deputy police chief, said Port Angeles police and paramedics have responded to five likely heroin overdoses in the past 10 days, including Niehaus'. Paramedics were able to revive four of the five individuals, Smith said. Sam Phillips, chief of Clallam County Fire District No. 2, which covers unincorporated Clallam County from roughly Lake Sutherland east to Deer Park Road, said his paramedics have responded to two heroin overdose calls in the past month—both May 11 and in the same apartment complex in the 1800 block of Lauridsen Boulevard. . "We don't normally go out on heroin overdoses, so it's a little bit of an uptick for us," Phillips said. Phillips said Thursday he did not know if those patients survived, though at least one was transported to Olympic Medical Center. Law enforcement and health officials across the North Olympic Peninsula see the smaller heroin overdose uptick as a symptom of the drug becoming more available in recent years. • Police Detective Sgt. Jason Viada, supervisor of the Olympic Peninsula Narcotics Enforcement Team, which investigates illegal drug delivery in both Clallam and Jefferson counties, said heroin has become the top priority for OPNET's investigators over the past two years. "I've been very surprised and disappointed at how easy it is to buy heroin in our communities," Viada said. "It seems that it's becoming increasingly available." Forks Police Chief Rick Bart said his officers have not seen any heroin overdoses in recent months, though the drug itself has become more available in the city. "It's sure really easy to get for some reason," Bart said Thursday. Officer Luke Bogues, Port Townsend Police Department spokesman, said his department has not responded to any heroin overdoses recently, though Port Townsend police are "definitely seeing more - heroin on the streets than the same time last year." Dr. Tom Locke, chief medical officer for Clallam and Jefferson counties, said he does not yet have hard numbers on recent heroin overdoses in the area, though Clallam County has historically had problems with the opiate-based illicit drug. • "In Clallam County especially, we for several years running have had some of the highest rates of opiate- related unintentional deaths in Washington," Locke said. The doctor said he suspects the increase in heroin use is due to area doctors and hospitals pulling back from prescribing opiate-based painkillers, such as Vicodin, due to their ability to make people addicted to the drug after overuse. "As the street supply of the prescription drugs goes down, one unfortunately unintended circumstance is the increase of heroin moving in," Locke said. Reporter Jeremy Schwartz can be reached at 360-452-2345, ext. 5074,or at jschwartzApeninsuladailynews.com. • 5/17/2013 11:55:00 AM,Port Townsend Leader • Anderson Lake closed due to toxin High levels of the potent nerve toxin anatoxin-a were detected in water samples taken from Anderson Lake on May 13. As a result, Washington State Parks has closed the lake to fishing, boating and swimming. Visitors are also urged to keep pets out of the water. Anderson Lake State Park remains open for hiking, biking and horseback riding. Anatoxin-a is produced by bluegreen algae (cyanobacteria) and can result in illness and death in people and animals. The toxin level is more than four times greater than the Washington State recreational criteria. Toxic algae has been an annual problem at Anderson Lake since May of 2006 when two dogs died after drinking from the lake. "The algae bloom at Anderson Lake is not very visible right now," said Michael Dawson, Jefferson County water quality lead. "But don't be fooled by the lack of a bright green scum; the toxin level is high." Gibbs Lake and Lake Leland —two of the best freshwater swimming holes in East Jefferson County— have had light blooms but only low levels of toxins so far in 2013. To check the status of Jefferson County lakes, visit • tinyurl.com/6z64ofy or call 385-9444. • Anderson Lake closes due to high toxin level By Leah Leach,Peninsula Daily News,May 19th,2013 CHIMACUM —Anderson Lake, which has been plagued with high levels of algae-produced toxins for the past seven rears, has been closed to fishing and other recreation after only three weeks. The popular trout-fishing lake between Port Townsend and Chimacum was opened April 27 for the start of the statewide lowland lake fishing season but was closed to all recreation last week because of high levels of the potent nerve toxin anatoxin-a. Anatoxin-a The toxin, which is produced by blue-green algae, was detected in water samples taken Monday from Anderson Lake, said Mike Dawson, water quality lead with the Jefferson County Public Health Department, after results were received from King County Environmental Lab on Friday. Upon the county's recommendation, State Parks Ranger Mike Zimmerman closed the lake to fishing, boating and swimming. People also are urged to keep pets out of the water. The 410-acre Anderson Lake State Park around the lake remains open for hiking, biking and horseback riding. "Visitors should be aware that the algae bloom at Anderson Lake is not very visible right now," Dawson said. "But don't be fooled by the lack of a bright green scum; the toxin level is high." Toxin level climbs The toxin level in Anderson Lake was found to have climbed to 4.26 micrograms per liter, which is more than four times greater than the safety threshold of 1 microgram per liter, Dawson said. Anatoxin-a is produced by blue-green algae, also known as cyanobacteria, which occurs naturally but which can begin, ifor unknown reasons, to produce toxins. It is a quick-acting poison that can lead to death in people and animals within four minutes if ingested in high doses. The county public health department has seasonally monitored area lakes for blue-green algae since two dogs died after lapping water from the lake on Memorial Day weekend in 2006. Monthly monitoring Monthly monitoring of Anderson, Gibbs and Leland lakes in East Jefferson County began in April of this year, with weekly toxin samples taken when blooms are present, Dawson said. No microcystin was detected in Anderson Lake. Microcystin can cause skin irritation, nausea and muscle weakness if touched and liver damage if swallowed over a long period of time. Gibbs Lake, south of Port Townsend, and Lake Leland , north of Quilcene, have had light blooms but only low levels of toxins so far in 2013, he added, saying that caution signs are up at Gibbs and Leland. Researchers don't know why some types of algae will suddenly begin producing toxins. They know only that warmer weather and longer days tend to fuel the growth of blue-green algae when the lake contains enough nutrients, such as phosphorus. Visitors need a Discover Pass—either$10 for a day or$30 for a year—to park within Anderson Lake State Park. • Discover Pass Passes can be bought at any state park, where hunting or fishing licenses are sold, by phoning 866-320-9933 or by visiting www.discoverpass.wa.gov. Toxin-producing blue-green algae has not been spotted in Clallam County. Report algae blooms in Clallam County by phoning 360-417-2258, while Jefferson County blooms can be reported at 360-385-9444. • For more information about Jefferson County lakes, visit http://tinyurl.com/jeffersonlakequality or phone the office. For fishing seasons and regulations, visit the state Department of Fish and Wildlife website at www.wdfw.wa.gov/fishing. Managing Editor/News Leah Leach can be reached at 360-417-3531 or at leah.leachapeninsuladailynews.com. • . Be aware of mental health issues • Wellness is essential to living a full and productive life. Wellness is tied to the balance that exists between our physical,and emotion- al health. Positive mental health from the earliest stages of life allows people to realize their full potential, cope with the stresses of life, work productively and make meaningful contributions to soci- ety. We are all at risk of stress given the demands and the challenges - we face every day at home, at work or school, and in life. Steps that help us all achieve wellness include a balanced diet, regular exercise, enough sleep, a sense of self-worth, emotional awareness, positive con- nections to family,friends and com- munity, and development of coping skills that promote resilience. May is Mental Health Awareness Month, and this year's focus is"Pathways to Wellness.' A community that supports mental wellness enjoys individual health,decreased substance abuse. greater academic achievement by Sour children, stronger families and a more productive economy.In May and year-round, we support local pathways to wellness that encour- age positive mental health, foster- ing overall health. KAREN 0BERi'VIEYER, Jefferson County Public Health MEGIIAN BARKER, Jefferson Mental Health KRIS BECKER, Jumping Mouse KATE BURKE, Jefferson Healthcare ELAINE NELSON, Jefferson Co. National Alliance for Mental Illness • ,P7-(2/zade.,,c, q79,y j Biomass project heard by state Supreme Cour t. By Allison Arthur of the Leader cials at PT Paper now say that the by burning biomass. carbon neutral since burning bio- economics of selling biomass-created "Instead,Ecology and PTPC ergo- mass produces the same amount of The state Supreme Court is energy have changed,and the project neously assumed that carbon dioxide carbon dioxide as allowing biomass expected to decide this summer is not a priority. emissions were exempt from environ- to decay over time. The difference whether a $55 million cogeneration "It is on the back burner, large- mental review by statute and there- is just in the timing of the emission, biomass project proposed by the ly because there were legislative fore need not be discussed,much less said DOE. Port Townsend Paper Corp. needs changes in California concerning the evaluated,"Mann wrote in his brief. Svend Brandt-Erichsen, repre- an environmental impact statement power transmission process," said One judge asked what the court senting PT Paper, said the biomass (EIS)or not. Roger Hagan, new president at PT could do if the state law was wrong. project would not add greenhouse The state's highest court heard Paper, in an interview last week. Mann argued that at some gases. He also said the DOE appro- arguments May 23 on whether the "Those changes took away much of point the notion that biomass proj- priately relied on a state Department state Department of Ecology (DOE) the economic advantage of doing the ects are carbon neutral needs to of Natural Resources study on the had considered carbon dioxide emis- project. We're still looking at it but be "run through the SEPA (State question of whether there was sions and biomass demand when pre- right now it's not a priority for us." Environmental Policy Act)process." enough woody debris in the forests to viously deciding the mill's proposal Attorney David Mann represent- fuel the project. did not need an FIS for the permit ed PT AirWatchers and four other CARBON NEUTRAL? The judges questioned the attor- for the project. environmental groups. He argued PT Paper has argued, and the neys about the state laws and about The case advanced to the Supreme that the DOE avoided consideration DOE permit confirmed, that a bio- whether the laws applied equally Court in spite of the fact that offi- of carbon dioxide emissions caused mass project should be considered See BIOMASS,Page 9.• to decide EISquestion innass. Court _ __ __ ♦Continued from page 1 — The DOE originally to new biomass plants and Dischargepermit hearingJune 4 approved the mill's NOC on plants like the one at the Port Oct. 20, 2010, saying that an Townsend mill that were A formal public hearing on the Port Townsend Paper Corp.'s pro- EIS was not needed. III being expanded to burn more posed new discharge permit is set for June 4.The permit details woody debris and less oil to how the mill should treat the more than 12 million gallons of water APPROVALS produce steam. it uses daily. Five environmental orga- Peter Gonick, an attorney The state Department of Ecology (DOE) has been receiving coin- for om nizations PT AirWatchers, for the DOE, said the agencyments since it released a draft proposal April 24.Most of the corn- had om No Biomass Burn, Olympic had determined there wouldmenu to date deal with the smell of the mill's pond,technically Environmental Council, be a net decrease of green- called an aerated stabilization basin,according to DOE officials. Olympic Forest Coalition, house gases and that it cor- and the World Temperate rectly concluded the mill's A formal public hearing on the draft permit is set for 6:30 p.m. Rainforest Network–appealed proposal would not have a Tuesday,June 4 at the Port Townsend Elks Lodge,555 Otto St. DOE's decision to the state probable adverse impact on Copies of a proposed National Pollutant Discharge Elimination Pollution Control Hearings the environment. He also said System(NPDES)permit are available at the Port Townsend Public Board. That body upheld the there was no evidence to sug- Library.The draft permit includes new requirements for monitoring permit. The next appeal went gest the mill would ever cut groundwater and sediment under the outfall,as well studying the to a Thurston County Superior down live trees to burn forefficiency of the pond.The comment period runs through June 21. Court judge, who also sided fuel because the market valuewith the DOE. of trees for timber is more Another appeal to a state than three times that of woody of Construction(NOC). natural gas. appellate court wasinstead debris for fuel. The cogen project envi- Opponents have contended sent directly to the Washington sioned by the mill would pro- the project would pump more State Supreme Court in 2012. PERMIT EXTENSION vide 25 megawatts of green air pollution into the skies and PT AirWatchers President Because of the legal appeals energy, mill officials say, contribute to global warm- Gretchen Brewer said after the and the drop in demand for that could be sold to regional ing. PT Paper has contend- hearing that she was pleased biomass energy, in December power customers who need ed, backed by DOE, that the with the questions the judges 2012 the DOE granted PT renewable energy as part project would actually reduce were asking. Paper an 18-month extension of their mix. But California air pollution because new air- "Look at the SEPA check- for progress to he made on its markets have changed due to scrubbing equipment would be list. There are holes all over biomass permit,called a Notice legislative changes and cheap installed as part of the project. it,"Brewer said. • -r 29/,3 e are envir . nawntaI . stewards ' Pfpresident er Pap 's lays out his leadership goals By Scott Wilson of the Leader -�. u A _ the opportunities. ;, Q: Tell me about your life before Port Roger Hagan,the new president of ��� y:-`�,- a Port Townsend Paper Corp.,recently �� � "-; - ,' Townsend. sat down with the Leader in his office A: I've spent over 30 years in at the mill to answer questions about s ° - • ;:' the paper industry. I went to the himself and his plans for the cornUniversity of Washington in the pulp pany. �zy; "�' !`� and paper program, then to gradu- ate school at Georgia Tech.I spent a 0:From where did you move? , number of years doing research and A: I moved here from Houston, A , *_ i1,. development, then decided I wanted to get into the production side of the Texas,where we had lived for a year -1:,.:.,:',. , A�,, �� �,. s and a half-Pd been with the paper .,-,41r:&•..._ z r: w industry. I went to a series of mills, • xu ,', r ' starting out in Florida. industry my whole career up to that � �.2,,,,K51,-, ,,,it,.-,-.. � , point but had been recruited to workf.,.-no,;-,,,w,,` . When I moved into the position of ° mill management,I went to progres- with a startup — a biomass energy 1 Pr x r company.I enjoyed that very much. " ``„ js / °' i / sively larger mills, primarily in the 1 ,s South, but also in Illinois and Ohio. 0:How did you come to PT Paper? This is my eighth mill as manager I ,�, .. and my 10th overall.It's been a great A:The opportunity lust kind of ;..,°� 'b`_..' journey;the paper industry has-been came to me. As I checked into it, Roger Hagan,the new president of Port Townsend Paper Corp.,sees open communica- very good to me. I was with one it became more and more exciting, tion with the community,employee safety and environmental stewardship as the primary company for the vast majority of that once I found out the location and themes of his leadership at the mill.Photo by Scott Wilson See HAGAN Page 9V iagan: Trial study under way on pond • ♦Continued from page 1 that takes a number of meet- Q:What do you do in your spare Q: What appealed to you about time,now called RockTenn. ings because there area lot of time? Port Townsend? them.We're still in the`getting Q:Have you run a smaller mill like A:I don't have much of that A: A number of things. to know each other"phase,but PT Paper? right now, but I'm hopeful. I One is the location: it feels we're giving people an idea of A:I've worked at mills this grew up fishing. My dad was like home.I grew up in Seattle my priorities and expectations size; was manager of mill at a commercial fisherman and and Westport: my family has for the mill and the people who Coshocton, Ohio, about this charter boat captain. I love to had a cabin near Brinnon on live here.I'm really focusing on size and this production capac- fish. I also play finger style Hood Canal for 50 years. 1've two areas in these meetings. ity. guitar and have since I was spent a lot of time in this area very young. I play everything and spent a lot of time in Port One is safety — there is 0from the Beatles to old-time 'Townsend.When I left,gradu- nothing more important than in I the paper your wife is also that.And the other is in a er music, whatever tickles my ating from the UW, I've not p p industry. protect- fancy. I know there's a lot of been back to the Northwest.so ing the environment. I believe A: She's in the technical people who are into music here. it was an opportunity to come that everybody in the mill is an side.She works in the technol- I'm looking forward to Fiddle home. Beyond that., the oppor- environmental steward. The ogy group for a paper company, Tunes and Blues at Centrum. f unity that I see here,the chal- mill has an obvious impact on and travels around to paper And I play a little bad golf. lenges here, encompass many the environment. We, as the mills and helps them with We are looking forward to of the things I've worked on in people who live here and work technical problems. Betweengetting involved in the corn- mills through the years.I real- us, eal here, are in the best posi- us, we have five daughters, munity.I love the Wooden Boat ly feel I can contribute,because tion to minimize that impact pretty well scattered around Festival; we went last year. I have some direct experience by making sure everything the country. The youngest — and it just blew us away. I'm thatcan be applied here. is functioning properly and twins—are 24, and mywife's doing everything we can to a boat owner - or I was; I youngest is also 24. had to sell it before moving Q:What have been the first things minimize it. here.The Northwest Maritime you've done at PT Paper? 4111):Where do you live? Center looks great,and we'll be A: I'rn getting acquainted. A: I live in the Uptown involved in that. We, are doing what we call • District right now. Well be town hall meetings. meeting Q �� �B looking for a home to buy after with all the employees, and / / l.0 C.v a while. ,.09//..3 0:Will we see major changes? Q:What's the status of the landfill Q:When will this happen? A: I've learned, going to issue? A: It's a two-month trial so many mills,that you don't A: I just went up this that we hope to get started in come in and start changing morning and toured it for about a month Or so.We should everything, unless you're in the first time. We're still know the result within three • a crisis, and that's not the in discussions with the months or so. case here.I usually do a lot of Department of Ecology and listening,and that's what I'm Jefferson County on the solid Q: How do you see PT Paper's doing. And I'm hearing a lot waste landfill. Our opera- role in the local community? of good things.There are a lot tion and what we are doing A: The mill is very impor- tant great people here. up there has not changed. to the community from We are doing what we have 0:Are new investments planned? done for a mtnrber, . many standpoints—to be good years. environmental stewards at all A: We have a capital plan It's a good operation. I think times, our economic impact we are implementing this the differences of opinion are and from a cultural stand- . year.A big part will be in our more of a regulatory issue point, the mill needs to be a annual maintenance outage in terms of how you clas- part of the community. My in September. A major com- sify it.than what we do there intent is to do that.We'll be as ponent of that will be what or its potential impact. The open as we can be about what we call refiners to improve landfill has plenty of capacity we are doing at the mill. We the quality of•our product. remaining,and it looks to me are part of the community,and We're doing some infrastruc- like it's a good operation and the community should know ture work,significant invest- very stable. what's going on here. We'll ment in transformer replace- talk about our plans, our suc- • 0:What's the status of improve-ment in the mill.We're doing cesses and what progress has a significant amount of work ments in the aeration ponds? been made. Obviously, it's a on Power Boiler 10, takingbusiness, and there is certain A: With the aeration sta it down in June, when we bilizatiobusiness information you can't rr basin (ASB), there share in detail, but beyond will do a significant amount are some issues of odor. It's of tube replacement, where that,we are going to be as open kind of a snowball effect.Most as we can be. water is converted to steam. of those issues arise from 0:What's the budget that? earlier efforts done to reduce q: How does the paper market the odor from air emissions. look today? A:Altogether,that portion Those odors are condensed 11110 of our capital projects are in out of the steam you see corn- A:The market is strong.A the vicinity of$6 million. On ing out of the mill, which is recent price increase has gone top of that, we have another great,but the material has to well. But we can't let it lull us $5 million—$6 million we go somewhere. So it ends up into too great a sense of com- are spending on major main- going into the effluent sys- fort, because we still need to tenance work on existing tem. and into the ASB. The work on reliability and wally equipment. Altogether, that's nature of ASB is you pump The market is good,esp a $10 million—$12 million air through the fluid.The air on the West Coast. Our most ,I investment. then strips out the material profitable mainstay products— and it goes back into the air. containerboard,the linerboard 0:What is the mill's current plan It's a circular deal. and the corrugating medium regarding the biomass-burningare in very short supply on proposal? Q:What will the mill do? the West Coast. That's very A: It is on the back burn- We are finalizing a trial,a good for us. er, largely because there study.We are very optimistic were legislative changes in because similar plants have California concerning the had very ,y,od success. They power transmission process. inject oxy:an to the stream Those changes took away that has reduced sulfur corn- much of the economic advan- pounds. 'fiat oxidizes them tage of doing the project. to the point where they lose We're still looking at it, but the odor. We'll do the trial right now it's not a priority to see if ii works for us. It's for us. not cheap. hitt it's within the Still, we've reduced the realm of possibility for us. petroleum we burn. We've If the t.r'I ,I is effective and • gone down from averaging it does w::o-it we hope it will well over 500 barrels of oil a do, we'll :ontinoe right on day to below 400 barrels. If with it. you go back further, it's even a larger reduction. Algae toxins keep Anderson Lake off-limits Peninsula Daily News,June 2nd,2013 40,ORT TOWNSEND—Anderson Lake remains closed this week while the level of a potent toxin created by blue- green algae continues to climb. Anderson Lake's anatoxin-a level and is now at 39 times the safe level, according to preliminary data from King County Environmental Labs in Seattle, said Greg Thomason, Jefferson County environmental health specialist. Results of samples taken last week found 38.7 micrograms per liter of anatoxin-a in Anderson Lake. State recreational guidelines allow 1 microgram per liter of anatoxin-a. The 410-acre Anderson Lake State Park around the lake remains open for hiking, biking and horseback riding. Anatoxin-a is produced by blue-green algae, also known as cyanobacteria, which occurs naturally but which can begin, for unknown reasons, to produce toxins. It is a quick-acting poison that can lead to death in people and animals within four minutes if ingested in high doses. Anderson Lake—which was closed May 17, only three weeks after it was opened for the fishing season April 27, because of high levels of anatoxin-a— has a heavy bloom with no scum, Thomason said. Only a trace of microcystin, another toxin created by blue-green algae, was found in the lake near Chimacum. The safety threshold for microcystin—which can cause skin irritation, nausea and muscle weakness if touched and Oliver damage if swallowed over a long period of time—is 6 micrograms per liter. Other lakes Caution signs remain posted at Gibbs Lake, south of Port Townsend, and Lake Leland, north of Quilcene. Both lakes have light blooms with no scum. No toxins were detected in Gibbs, while a trace of anatoxin-a, and no microcystin, was found in Leland. Visitors need a Discover Pass—either$10 for a day or$30 for a year—to park within Anderson Lake State Park. Passes can be bought at any state park, where hunting or fishing licenses are sold, by phoning 866-320-9933 or by visiting www.discoverpass.wa.gov. Toxin-producing blue-green algae has not been spotted in Clallam County. Report algae blooms in Clallam County by phoning 360-417-2258, while Jefferson County blooms can be reported at 360-385-9444. For more information about Jefferson County lakes, visit http://tinyurl.com/jeffersonlakequality or phone the office. i Peninsula baby boomer suicide rates among state's highest; Clallam No. 1 By Paul Gottlieb,Peninsula Daily News,Ji3rd,2013 iglallam County leads the state in suicides among baby boomers, while Jefferson County is ninth in the age group. Those statistics are included in a new nationwide Centers for Disease Control and Prevention report on self-inflicted deaths. The CDC listed 53 self-inflicted deaths in Clallam County for the 1999-2010 study period. The per capita rate in Clallam was 32 deaths per 100,000 in the time period for the 55-and-older age group among the 26 counties that reported. That compares with the study period's 48 suicides in Yakima County, another rural county. In Yakima County, the rate is half of Clallam's, while the population of 247,141 is more than three times greater. A quarter of Clallam's population of 71,838 is 65 and older, more than double Yakima County's percentage of the same age group. There were 13 self-inflicted deaths alone in Clallam County among the 55-and-older population in 2010, the same number as Yakima County-size Thurston County and more than one-quarter of Clallam County's total for the 11-year period. Suicide rates tend to be higher in isolated rural areas than in high-population centers, said Kelly Schwab, program manager for Crisis Clinic of the Peninsulas. The agency answers crisis calls from Clallam, Jefferson and Kitsap counties. "A connection to human beings is the biggest buffer"to conditions that lead to suicide, Schwab said. "'Jefferson County's suicide rate for the 55-and-older population of 21.6 per 100,000 from 1999-2010 compares with 16.7 per 100,000 for Kitsap, he noted. The per-100,000 per capita rate was not calculated for Clallam for 2010 because it was fewer than 20 and considered "unreliable," according to the report, and a similar figure for 2010 for Jefferson County was not listed in the study. "We have seen a slight rise in the number of suicides by people over age 50," said Clallam County Prosecuting Attorney Deb Kelly, who also serves as the county coroner. Clallam County was ranked third in all suicides among all age groups among 30 Washington counties in that part of the study over the 11-year period, while Jefferson County was 13th. "Statistically speaking, I don't think it's anything to be worried about," Bob Anderson, head of the CDC's mortality statistics branch, said last week, adding that suicide rates may be higher among the general population. "It's difficult to know without doing a comprehensive analysis of the county's population," he said. "One of the things you have to be worried about when you use aggregate years is you eliminate the ability of looking at trends,"Anderson added. "Suicide is just one of those things that is sort of difficult to predict." Self-inflicted deaths—men tend to commit suicide more than women—"very often" result from poisoning, prescription-drug overdoses and firearms usage, Anderson said. Julie Calabria, clinical director at Peninsula Behavioral Health in Port Angeles and former supervisor of the center's crisis team, said demographically, most suicides in Clallam County occur among adolescents and older adults. "The crisis team does deal with suicide attempts from people of all ages, but I'm not hearing anecdotally that we're seeing more baby boomers" in crisis situations, Calabria said. Baby boomers are those born between 1946 and 1964. "With older adults, you are looking at chronic illness and pain and widowhood," she said. • "All those factors start multiplying with older adults. "It doesn't matter whether you're rich or poor or all that kind of stuff," Calabria said. "What we've seen a lot with older people is often grief and loss issues. "It can be anything from losing a partner to maybe someone has had major health problems and they can no longer live in their own home and need a higher level of care. "Those are huge." Crisis Clinic of the Peninsulas, founded in 1965, is the third-oldest crisis clinic in the U.S., after ones founded in San Francisco and then Seattle, and the first rurally based clinic of its kind anywhere in the country, Schwab said. Schwab said he has not seen an increase in suicide-related calls from Clallam or Jefferson counties but noted that nationally, suicide rates for men ages 50-54 increased by 50 percent from 1999-2010. The suicide rate for women ages 60-64 increased almost 60 percent, Schwab said. "There is a lot of focus on youth suicide prevention and not nearly as much on seniors," Schwab said. "In suicide awareness in Clallam, we do find that there is something of a reluctance to talk about it," he said. "That has to do with it just being a more rural area in general." The national recession probably also played a factor in suicide rates for Clallam and Jefferson counties around 2008, Schwab said. "Jefferson County was probably hit equally as hard" as Clallam, Schwab added. "They are seen as in somewhat of a recovery in both counties, but not as quickly as it has been in other areas." Firearms are "way, way above everything else as the primary means of men dying from suicide," Schwab added. Women tend to overdose using prescription drugs, he said. Erik Nygard, clinical director of Jefferson Mental Health Services, speculated that the economic downturn combined with improvements in medical science leads to people being able to stay alive longer—and could make them feel, as time progresses, that they are a burden on their families. "They may say to themselves, 'Wow, how long is this going to last? I'm in pain, but I'm not dying,- Nygard said. "There's all the guilt of that, too." Senior Staff Writer Paul Gottlieb can be reached at 360-452-2345,ext.5060,or at paul.gottliebApeninsuladailynews.com. • • Ecology to take comments tonight on Port Townsend Paper's permit By Charlie Bermant , Peninsula Daily News, June 4th, 2013 ort Townsend Paper Corp.at a meeting tonight. The meeting begins at 6:30 p.m. at the Elks Lodge, 555 Otto St., and is part of the comment process that ends June 21. "This hearing is to discuss the regular reissuance of a permit,"said Ecology section manager Garin Schrieve. "We normally would not schedule a public hearing for this kind of permit renewal, but everything that the mill does is a matter of public interest." The permit is designed to protect water quality by controlling how much pollution can be discharged into an open waterway, in this case, Port Townsend Bay. National Pollutant Discharge Elimination System permits are required for industrial facilities that discharge wastewater to a bay or a river, according to an Ecology fact sheet. Schrieve said the permits are issued for five years, but the Port Townsend mill's last permit was issued in 2004 and expired in 2009. A labor backlog in Ecology caused the delay, Schrieve said. Permits that are not addressed in a timely manner by Ecology stay in place until a new permit is granted or denied. According to an Ecology fact sheet, there are several"significant"changes since the last permit was issued, including a new pH limit for the sanitary treatment plant, a compliance schedule for removal of sludge buildup from the treatment pond and development of a stormwater pollution prevention plan. Ike new permit also requires a treatment-efficiency study of the treatment pond with a specific requirement to address minimization of odors from the pond. Schrieve said the regulations are to prevent an excess of organic matter from tree waste from going into the waterway. Such an excess can decrease the water's oxygen content and harm the fish population, he said. The permit covers all the wastewater discharges from the mill, and its proposed cogeneration project would have minimal impacts to the wastewater treatment system, according to Ecology,which would require a dry scrubber system to reduce the solids entering the treatment pond. The Port Townsend mill's$55 million, 24-megawatt biomass cogeneration expansion originally was expected to be put into operation last month, but work on the facility has been delayed until 2014 or 2015, the company said after a Dec. 10 state Court of Appeals ruling that sends a suit filed by five environmental groups to the state Supreme Court. The suit—filed by PT Airwatchers, No Biomass Burn,the Olympic Environmental Council,the Olympic Forest Coalition and the World Temperate Rainforest Network—urges the requirement of an environmental impact statement prior to construction of the expanded facility that burns wood waste to create electricity. The National Pollutant Discharge Elimination System permit discussed tonight is not related to the inert-landfill permit that is under dispute between the mill and the Jefferson County Health Department. That will be addressed Aug.20-21 in Ecology's Tumwater office. Comments about the National Pollutant Discharge Elimination System permit can be submitted by email to IltTPC.comments(a)ecy.wa.gov or by mail to Stephanie Ogle,Washington Department of Ecology, P.O. Box 47600, Olympia,WA 8504-7600. Jefferson County Editor Charlie Bermant can be reached at 360-385-2335 or at cbermant(c�peninsuladailynews.com. b //' 4:07:00 PM,Port Townsend Leader Hearing on PT Paper discharge permit is June 4 A formal public hearing on hePort TownsendPheapermC should treat the more orp.'s proposed new (than 12e The permit is set for June 4. permit details how million gallons of water it uses daily. The state Department of Ecology (DOE) has been receiving comments since it released a draft proposal April 24. Most of the comments basdae int adeal with the smell of the Ccording to DOE officials.mill's pond, technically called an aerated stabilization A formal public hearing on the draft permit is set for 6:30 p.m. Tuesday, June 4 at the Port Townsend Elks Lodge, 555 Otto St. Copies of a proposed National Pollutant Discharge Elimination System (NPDES) permit are available at then icor ngroundwaterandedimentunder the outfall Townsend Public Library. draft 't �as welles requirements form g studying the efficiency of the pond. The comment period runs through June 21. Comments from the public and the mill will be used by the DOE to craft a final permit document. • • 6/5/2013 5:04:00 PM,Port Townsend Leader Odor tops comments concerns about PT Paper mill pond *Mill president responds to innuendos of mill falsifying data d . ti �S„tai�'h^� ,�� `�`d. # 5�,. �,"".t rr ie k ` Roger Hagan,president of Port Townsend Paper Corp.,stood up Tuesday,June 4, and responded to comments at a public hearing on a new discharge permit for the mill. Before an audience of more than 150 people, Hagan said that allegations the mill falsifies data are untrue. Photo by Allison Arthur 411 Do something sooner rather than later to require the Port Townsend Paper Corp. to take action on odor coming from a 33-acre treatment pond. That was a running theme at a public hearing Tuesday, June 4 when the state Department of Ecology (DOE) came to Port Townsend to take comments on the mill's proposed new discharge permit. Roger Hagan, who recently was hired as PT Paper president, also made a public debut after listening to more than an hour of questions and comments. A number of people had questioned why the mill is allowed to self-monitor and take samples of water on its own. Although state DOE officials have repeatedly said the federal Clean Water Act was enacted to put the financial burden of testing on the company not the public, a number of people questioned that and wondered aloud if the mill could falsify data. They also chided the DOE for not doing more than annual tests of some things. DOE officials say they do some impromptu visits to the mill and they also say falsification is unlikely, and that mill employees are professionals. But the comments apparently stuck in Hagan's mind. "I heard some implications and some accusations that PT Paper Corp. is engaged in falsifying our • reporting requirements and I'm going to tell you it's untrue," Hagan said. "In fact, two of the people that do that testing and sampling and reporting are sitting in this room and if you didn't know who they were and I didn't point them out to you, you wouldn't know who they are. You know why? Because they are us. They're just like you. So ask yourself. Would you?" Hagan paused and then said, "Would anybody here do it? No." He received some applause. No sooner than Hagan had sat down than Rick Faraci stood up and said what a number of people had noted. "My comment is about the gut-wrenching stench that comes from the pond. Five years is just a crazy idea to wait for this. We all know it stinks. It's like sweeping it under the carpet," Faraci said of the DOE's plan in the draft permit to allow the mill until 2015 to study what efficiencies to make at the mill that would help it reduce the pond odor. Although only Hagan took to the podium, other mill officials, including environmental manager Kevin Scott have said recently that odor studies are currently under way. At the hearing, Johanna Perkins seemed to take both sides of the issue, explaining that her family had immigrated to the United States in the 1850s and that they had started paper mills and that they had responded to public outrage over the stench "without state regulations and without federal regulations." "They cleaned up their act. My great uncle, as a result, became a billionaire. They found uses for what they cleaned out of the area," she said. "It shows what good karma results when you are a good citizen." "There are so many lovely people who work at the mill and their families and the support they give us all. We want them to survive," she said, and then added, "We want the air to be good and breathable and the air to be clean." COMMENT BY JUNE 21 The question-and-answer session ran more than an hour while the public hearing took about 42 minutes. People may also email or mail comments to the DOE by June 21. Comments from the public and the mill are to be used by the DOE to craft a final permit document. People who object to that final document—and that could be either an individual or the mill — could file an appeal with the state Pollution Control Hearings Board once the permit is issued. Copies of a proposed National Pollutant Discharge Elimination System (NPDES) permit are available at the Port Townsend Public Library. The draft permit includes new requirements for monitoring groundwater and sediment under the outfall, as well studying the efficiency of the pond, which is one possible source of odor from the mill. • Odor topscomments about m ' llpond ayAllisonArthuroftheLeader 'N s ^ } is a measure of organic cial comments. final permit document. s �7 ' , material in the wastewater People mayalso email or People who object to that ort Townsend Paper �� � a'� tfizzm • i1 r` that can negatively P President Roger Hagan � �.�- t+ + ,� +.�� s t� g lively impact mail comments to the DOE final document - and that o microphone Juneo `p oxygen in the bay. TSS is.a by 5 p.m., June 21. Send could be either an individ- 4 to dispelo the microphone made ;7 "' '':,..;17'4,':`-1;:',1'F , x ,,�' 9'-^'ru measure of the amount of written comments to:email: ual or the;mill- could file rr a..% -� %i t � ' ': solids in the wastewater. PT PC.comments®ecy. an during a public hearing on I + = e'': 4 , �'> r u' " appeal Control the state the mills wastewater treat F• " a . Anew pH limit for the Ogle, ov; mail to:' Stephanie Pollution Control Hearings • �; z sanitary treatment la g ment permit,that the mill is �x , .f K plant. Ogle, P.E-, WA Dept. of Board once the permit is falsifying data. � -Y �, '-.�� '+ F ,a • A compliance schedule Ecology, P.O. Box 47600, issued. • rpt r. g for removal of sludge build- During a question-and v'P r +, # °• ` u from the treatment pond. Olympia, ntWA 9rom the p Copies o i a proposed answer time before the offs T + f Mj f'Y`c-'�y , P P Comments from the pub- NPDES permit are available cial public hearing, arum -• r s e ,,,.e.„,,..„,0,:,:� x4r r�r lie and the mill are to be at the Port Townsend Public `1i ;f COMMENT BY JUNE 21 ber of people had questioned ' +K +x ,-' F'h. j 9 V used by the DOE to craft a Library. why the mill is allowed- to •e: Cr ! f .;,..,;,,pi, l 1 P i - . self-monitor and take sam f '1!.:1.:!,,f' ' „ }j, ,F7; Then question-and-answer ore pies of water on its own,then session June 4 theon more ' L r ' I' than g hour; public submit them to the state. y -i�� ` Although state -i 1 c # hearing took about 42 min- Department of Ecology � K -•; - ,, utes. officials have said the fed i ' ,,lyv ; A number of people at the eral Clean Water Act was ('� I � . 1 hearing beseeched the DOE enacted to put the financial �. : � ;' to take idtthe.The t e the burden of testing on the corn- `' 41/1: 1 mals said they don't run the pany and not the public, a ,zk ' L3 °� l,' inll. number officials,of people,said number of people questioned Roger Hagan,president of Port Townsend Paper Co includingywould ml said writ- that and suggested the mill day,June 4,and responded to comments at a public hearing on a new they comment in offi- could falsify data.They also discharge permit for the mill.Before an audience of more than 150 people, ing by the deadline for chided the DOE for not doing Hagan said that unsubstantiated allegations the mill falsifies data are Un- more than annual tests to true.Photo by Allison Arthur ensure public safety. The comments spear- FOC odor complaints that her family had immi ently bothered Hagan, who grated to the United States has been with the mill for To record a complaint about in the 1850s and that they less than a month and has Port Townsend paper mill odor, had started papermills and coli: responded to public outrage to be more open about how the mill operates. •WashingtonStateDepartment over the stench "without "I heard some implica- of Ecology at 360-407-7393 state regulations and with- tions and some accusa- or email Angela Fritz at out federal regulations." tions that PT Paper Corp. angela.fritz@ecy.wa.gov. "They cleaned up their aged in falsifying our act. My great-uncle, as a ting requirements and •'Port Townsend Paper Corp. result, became a billionaire. They found uses for what m going to tell you it's at 379-4224.This number cur-untrue,'Hagan said. rently does not indicate it is they cleaned out of the area," "In fact, two of the pee- the correct number to leave she said."It shows what good pie that do that testing and information about odor coot- karma results when you are sampling and reporting are plaints, although it was the a good citizen." sitting in this room and if number the state DOE gave "There are so many lovely. you didn't know who theyout during a public hearing as e local number to call the were and I didn't point them and their people eir work at the mill thfamilies and the out to you, you wouldn't mill to complain. know who they• are. You support they give us all.We want them to survive," she know why?Because they are ( e r- it, said, and then added, "We, us.They're just like you.So System (Nle how permit, want details how the mill the air to be good and ask yourself.Would you?" treats more than 12 million breathable and the air to be Hagan paused and then gallons of water it uses daily. clean." said, "Would anybody here No sooner had Hagan sat do it?No." down than Rick Faraci stood DISCHARGE PERMIT He received someup and reiterated what a .A number of people were applause. number of people had said :onfused about the differ- This was Hagan's first during the hearing. Ince,between the mill's air: public hearing in Jefferson "My comment is about the 1et'rnrt .p.c the discharge County since taking the helm as the president Ofe gut-wrenching stench that permit. The discharge per- helmrson County's largest comes from the pond. Five mit addresses how the mill years is just a crazy idea to operates the pond. DOE private enterprise. wait for this. We all know officials want to include DOE officials say they it stinks. It's like sweeping requirements in the dis- dn same impromptu visits- it under the carpet," Faraci charge permit that addi•ess- to I.Ire mill and they :also said of the DOE's plan in es the efficiency of the pond, say falsification is unlikely. the draft permit to allow which may help reduce odor. and that mill employees are the mill until 2015 to study Specifically, they are professionals who know the what could be done by the looking at how often sludge rules and follow them. mill to help it reduce the is removed from the pond. ODOR TOPS LIST pond odor. According to the DOE,there Requiring the mill to do Although only Hagan are a number of changes took the podium, other mill from the last permit. The ething sooner rather officials,including mill envi- significant changes 4, later about odor com- ronmental manager Kevin include: from the mill's 33-acre Scott, have said recently • A small decrease in treatment pond was a that odor studies are cur- the amount of biochemical running theme through- rently under way. oxygen demand (BOD) and out the public hearing on At the hearing, Johanna total suspended solids(TSS) the National Pollutant /- Discharge Elimination Perkins seemed to take both allowed to be discharged /�J o,>G,u„e�c, sides of the issue,explaining from the main outfall. BOD / -G Hearth fu rlou . hs Jefferson ental g _ Kitsap agency in legal di JMHS g dispute over funding issues • t 1 Health Services a banked reserve fund By Allison Arthur of the Leader a year in funding and may have to return Numbers served on the rise Health r cosh has a figure reserve eed by another $250,000 that the PRSN says it Jefferson Mental Health Services was serving JMHS's board president,Jefferson County Jefferson Mental Health Services(JMHS) wants. about 650 people annually three years ago;today, Sheriff Tony Hernandez.That is just short has put 10 employees on furlough for one day JMHS has hired a Seattle law firm to it serves 1,300. of half of its annual operating budget. "And we need capacity[for]3,000-6,000people,"said JMHS is the primary community men- a al weekt and is members talking about laying iaoff contrac-sev- represent In turn, dealing with questionsue PRSN. Sam Markow,JMHS executive director. tal health agency in Jefferson County. It eral staff members in the fall if aRegional In the PRSN how the In any given population,about 10 percent of people provides individual and group psychother- tual dispute with the Peninsula not-for-profit JMHS uses state funds and have a mental heaah issue,and another 10 percent apy for on Medicaid and Medicare Support Network(PRSN)isn't resolved. why of as a it has more money inof l a revenue reserve than any of the population needs some kind of mental health as well peoples the privately insured and ther Sam Markow,ate, executiveodirectoryith other percentage health organizationn the assistance in their leads e,he ki d. uninsured. • JMHS,a private,not-for-profit agency a In Jefferson County,with a population of 30,000, It provides crisis and emergency services e$2.2 million annual budget and 40 employ- region, including its larger sister agency, „fora lot of services,we're the only show in at its headquarters on West Park Avenue es des, said the agency has been growing for Kitsap Mental Health Services, based in town,"Markow said. See MENTAL,Page in the its cerfewvi years,but may need to cut back Bremerton: V on services.JMHS risks losing$200,000 The PRSN alleges that Jefferson Mental _-- That said, Hernandez gram, but very worthwhile. of cash center of dispute acknowledged that the board These kids are thriving at Mental: Buildup has worked "tirelessly to this point." about the funding stream diversify" its finances, and Hernandez said school both as a law enforcement has now built up reserves. officials have supported the •Continued from page 1 "We have worked hard to Both he and Markow say program. officer who deals daily As for cutting the program the Port Townsend Business the reserve fund is needed in Park. build up our cash reserves with people in need.of men case someone without incur- that helps people with both tal health services, and as mental ps and with both FUNDING ISSUE so we do have furies in a member of the board that ance is hospitalized. mental illnessHernandez saiduthat is ce oversees the mental health It's call "risk mitigation," The PRSN is an umbrella e- ` event of a crisis." the county's top law enforce- a possibility,but not one he'd organization that oversees agency' meet officer said. like to see happen. Tony Hernandez Hernandez said he joined "We have worked hard to. Edgerton questioned why state and federal matching the board because there had ® is Jefferson County Sheriff either program would be in funds that go to mental health - providers in cup Kitsap,Jeffersonbeen a disconnection between build up our cash reserves jeopardy when the agency has and boardna tel t the agency and law enforce• so we do have the• funds in and Clallam counties. Jefferson Mental Health Services so much money in the bank Anders Edgerton,regional meet that he wanted to the event there is a crisis," and also gets more funds resolve. Hernandez said. than it appears to use for administratorgefor the PRSN, - "About 70 percent of the Hernandez character• said his agency isin the pro- months of reserve in the "Some of the match money services. cess of conducting a review bank,and I think that's too is not in dispute,but because people in here[jail]have some izeHern contractual racier- ___vice the high." they delayed doing an audit, kind,of_coexrsting•condition, as one of coding and provid• NO DISPUTE of the amount of money g saying Y either mental Health or sub-Jefferson program should Markow said the six they're the cant oring services that JMHS was There are several fu receive as Medicaid matching months of operating eta the won't go back and restore stance abuse orboth,"vinge said. first told would be eligible ing streams not in disput , funds. es are needed "due to the funding that we would have •When someone is having an for matchingofunds and then, Edgerton said. Edgerton'su agency bundles constant threats of funding been entitled to," Markow episode, law enforcement is usually the first contact." Services receives$36 a month Jefferson County's money with cuts over the last few years." said.-He admitted that ear- Sheriff after the services were pro- Jefferson Mental Health money from other counties, Edgerton acknowledged Tier this year, he thought On June 6, vided,was told they were not Hernandez had been to the eligible after all. for every one of an estimat- then submits it all for fed- that Markow had asked the that the funding issue would home of a woman who had "What seems to be hap- ed 3,400 people in Jefferson era]and staportiote'matches before PRSN's board for an inde- be"rit wasd in,JMHS's surprisesening is that it seems to be County on Medicaid. That's returning t a portion etos JMHS. pendent review of a PRSN q Shortly tried toafterward, hercwas a moving target," he said. approximately $122,400. The two agencies are in staff decision to withhold to us,because,basically,weIt also receives $25,000- asked to discuss the mental dispute about the portion funds. But the board that wreretunder hingstweresfine," health funding issue. PROGRAM CONCERNS $35,000 a month to care for returned to Jefferson County's oversees PRSN, made up g "The last alternative Jefferson Mental Health people who aren't eligible for program. of commissioners from the he Because the dispute has "Since we are in the midst three counties, decided it is should be incarceration. The Services expected to main- Medicaid services w ut men ho of reviewing this program at a contractual issue and`'did escalated into potential lit- first alternative should be fain or expand two servic- come to the agency arkow and getting them the help they es funded through a voter- tal health issues, Edgerton JMHS,and JMHS has hired not merit an independent read ton were oth Mhesitant to need,"Hernandersaid."We're , approved one-tenth of 1 per- said. J Seattle Be firmeBigelowgeSue review."ff County get into details. a nonprofit organization like cent sales tax,Markow.said.f 1peIn dispute is about Janes of Bennett & Jefferson Leedom Bigelow]to represent Commissioner John Austin, p Y Em In des of the agen- everyone else and with the One program treats pro- $23,000 a month that comes them in this matter,I cannot D-Port Ludlow, who sits cy are approved for a state economy the way it is,we're pie with mental illness and from matching funds to the se. w th of 1 comment on the specifics of on that board, declined to will g=Work program and struggling like everyone else. substance abuwould likeoto ycounty's u t 's one-ten g, Edger on our review,"Edgerton said in comment.The PRSN execu- will get partial unemploy- We're very concerned because said the agency five board, of which he is ment for up to a year. we want to help as many expand that, but took a cut said. Janes had asked the PRSN a member, next meets an email. If we have not restored clients as we can, and this in that funding because of "We had concerns about in funding by then,the layoff or definitely taxes the staff we reduced tax revenues in the how they were operating the for more time to respond to its September. reduced hours.become per- have:' county. ro ram, Edgerton said, concerns. Edgerton said that _RETURN OF MONEY A second program funds declining to go into details request was granted.Jefferson "We're absorbing these mental health profession- because of possible legal Mental Health Services had "The agency's.decisions [to furlough els being available in school action. until June 7 to respond. losses across the board," Markow said of the Jefferson staff) have not been made due to clinics throughout Jefferson Hernandez, in turn, Edgerton said in an email County agency. "We're a county, JMHS's decision to that"the agency's decisions[toactions • of the PRSN,in my opinion:' Coun ams are eligible hire defended attorney. small agency and we'll all be • Both programa madeaugd staff]have notbeenpitching•in.'We.have people Anders Edgerton for theh rogramd matching "We an have to. taken the due to actions of the we serve who have nowhere regional administrator funds,funds that Hernandez appropriate action to defend PRSN,in my opinion."ilonelse to go." ort Network says are at the heart of the our services" The $1 million reserve Peninsula Regional Supp dispute. Markow expects actual "The schools had pulled is of special concern to services could be cut if fund- F.d"It's a. out two years ago and they "It's far higher reserve ing isn't restored. manent;'Markow said. had come back,sso we'veathey Since the dispute began III compared to their budget last fall, two employees left RESERVES UP restoring those services and than any other of our agen- voluntarily,and one is retir• Jefferson County Sheriff we expected to be at full cies have," he said. "Kitsapheingand won't be replaced, Tony Hernandez, president capacity next year,"Markow Mental Health has three he said. of the board that oversees said. "It's an expensive pro- JMHS, said he is concerned • 1-*: 40444,10 i > L i Sit yam,� k •#6r 'agts, 4„, o Rhe1 TIEN ..a � A � ••Y et''' a • Hospital .. t „.,..:,...„...-..„..,..„...._..:..„...„.•:„.,.„.::..e...„..,,,4 . . ..„...., moves to John Roster,director of community engagement with Providence Health &Services,introduces Jefferson Heaithcare employees to a paperless medical system called Epic,which he said was designed around patients Pap e rl e s s to get medical professionals to"know me,care forme and ease my way." Leader file photo by Allison Arthur Epic: Big for hospital .. re c or d s .Continued fipsga 1* They"ether efi Y k;r ge� tt John Nowak, project used a program called system manager fornthe move to T- And Epic,could not be reached on And the home-health Monday for'comment on how agency used Allscripts,but` things are going,but Glenn that version doesn't'com said that the system switch municate with the clinics' Eventually patients will is on target for the June 15 system, hospital officials debut. Earlier, Nowak told said. access records online, the hospital board that the Because the systems connect with providers project also has been on weren't connected,patients budget. The hospital's medi- "They recognize cal clinics are set to "go By Allison Arthur of the Leader live" with the change on It will improve Monday,June 17. safety." Jefferson Healthcare expects PATIENT SAFETY • to"go live"at 2 a.m, on Saturday,. Patient safet Mike Glenn y is at the chief executive officer June 15 with a new electronic project's heart, speakers Jefferson Healthcare records system that is merging told health care workers earlier this year during an four patient-records systems into introduction that launched who would go from the din- one paperless system. the system switchover. is to the ER, for example, Port Townsend moue- would have to re-register to 110 Over the last four months, theta hospital has purchased 300 new who climbed r Leif Whittaker, get a lab test. who clMount Everest Under Epic, once a computers and trained more than twice and is a friend of patient is registered at any Nowak's, gave an inspira- Jefferson Healthcare clinic, 500 employees to use the new $4.7 million system, called Epic, tional talk comparing the there won't be a need to re- challenges of the hospital register when moving from which connects patients, doctors moving to Epic with that of one part of the system to and other providers. climbing the world's tallest another. All medical his- "We have prepared for `go peak. tory,such as adverse retie- John Roster, director tions to medications, will live' since December, and I of community engagement be in one place, accessible am confident it will be a suc- with Providence Health to all providers who need it, & Services, talked about hospital officials say. cess," said chief executive officer Mike Glenn. "This has been an why hospitals throughout the region are converting EARLIER THAN MOST extraordinary experience for our to Epic. Jefferson Healthcare is organization. "It's about the getting the system earlier "Every employee is touched PATIENT"were the words than many rural hospi- by this project, and I could not in red shown on' a screen tals because it is affiliated be more. pleased with the effort Juning Jasler'snuary. presenta- with Swedish Hospatad tion in January: which in turn is affiliated and positive approach demon- Roster said Epic was with Providence Health & designed around:patients, Services. strated by the entire Jefferson • to get medical professionals Of the overall $4.7 mil- Healthcare team," Glenn said on Tuesday. to "know me,,care for;me lion that Epic will cost, and ease my way." the hospital expects to be "This will lead to bet- reimbursed to the tune of It's not just hospital employees who will see a change. ter, safer care for patients $2.8 million from Medicare seeking care at Jefferson and Medicaid. By accessing MyEpic online Healthcare,"Glenn said on State and federal;gov. — once Epic is up and running June 10. ernments are encouraging —patients will be able to commu- hospitals to move yst:m nicate directly with "their care FOUR INTO ONE electronic medical system Before Epic, there in the next few years as the team," Glenn said. were four different medi- Affordable Care Act—icom- See EPIC,Page 12♦ cal systems at Jefferson monly known as Obamacare 0 f Healthcare. --is implemented. The hospital was on one "They recognize it,will system, called Meditech, improve safety,"Glend said which is considered out- of why those two govern- dated and involved paper ment programs are Cover- charts. Clinics were on a ing 50 to 60 percent of the system called Allscripts. expense. YMCA to serve food The Jefferson County YMCA is offering three sum- mer food programs starting next week.The goal is to pro- vide healthy food for free, as well as fun activities to pro- mote summer learning. v According to Erica Delma, YMCA program executive,the Summer Meal Program starts at Mountain View Commons and at the Chimacum Creek Primary School on Monday, June 17. The program is offered five days a week, Monday-Friday, and includes a free meal for children ages 1-18,as well as physical activi- ties and literacy activities. A one-day-a-week version of the program starts on July 9 in Quilcene,she added. The program is supported by the U.S. Department of Agriculture,as well as School's Out Washington's Feed Your • Brain project. For more infor-• mation, call 385-5811 or visit jeffersoncountyymca.org. •