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HomeMy WebLinkAbout2014- May • Jefferson County Board Of Health Agenda & Minutes 0 May 15, 2014 0 JEFFERSON COUNTY BOARD OF HEALTH May 15, 2014 • 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 April 17, 2014 Board of Health Meeting III. Public Comment IV. Old Business and Informational Items 1. Fatal Heroin Overdoses on the Increase 2. Letter from Gov. Inslee re: JCPH role in the ACA Enrollment Process 3. Letter to WA State Secretary of Health, John Wiesman 4. Smilemobile in Port Townsend, June 23-27, 2014 5. Healthy Kids Healthy Families Event • Letters from Jefferson County Residents V. New Business 1. Presentation of 2013 Outstanding Achievement Awards for Food Establishments in Jefferson County 2. Jefferson County Clean Water District Briefing 3. Ordinance #04-0505-01 Amending the Duties and Responsibilities of the Jefferson County Board of Health 4. Jefferson County Board of Health Bylaws 5. Community of Health Planning Grants—Letter of Intent 6. Jefferson County Board of Health Action Item List for 2013-2014 VI. Activity Update VII. Public Comment VIII. Agenda Planning Calendar IX. Next Scheduled Meeting: June 19, 2014 • 2:30—4:30 PM Jefferson County Public Health 615 Sheridan St. Port Townsend, WA / r • JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, April 17, 2014 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 DRAFT Board Members Staff Members Phil Johnson, County Commissioner District#1 Thomas Locke,MD,MPH Health Officer David Sullivan, Chair, County Commissioner,District#2 Jean Baldwin,Public Health Services Dir John Austin, County Commissioner,District#3 Julia Danskin,Nursing Services Dir Roberta Frissell,citizen at large(County) Jared Keefer,Env.Health Services Dir Kris Nelson,Port Townsend City Council Veronica Shaw,Public Health Deputy Dir Sheila Westerman, Vice Chair,Citizen at large(City) Jill Buhler,Hospital Commissioner,District#2 Chair Sullivan called the April 17, 2014 meeting of the Jefferson County Board of Health to order at 2:34 PM. A quorum was present. Members Present: Jill Buhler, Roberta Frissell, David Sullivan, John Austin, Kris Nelson Staff Present: Philip Morley, Thomas Locke, Jean Baldwin, Julia Danskin • Members Absent: Sheila Westerman, Phil Johnson APPROVAL OF AGENDA Chair Sullivan called for review and approval of agenda for 3/20/2014 meeting. Chair Sullivan suggested adding the following two items: (1)add"Drug Take-back" as a new item 4. Old Business; and (2) add a new item to New Business: 4. Updating the Board of Health Ordinance. Member Austin moved to approve the agenda as amended; the motion was seconded by Member Buhler. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Sullivan called for review and approval of the minutes of the 3/20/2014 meeting of the Board of Health. Member Austin moved to approve the minutes; the motion was seconded by Chair Sullivan. No further discussion. The motion passed unanimously. PUBLIC COMMENT • Chair Sullivan called for public comment. -. 1 David Weathy requested a progress report on the landfill permit. • Dr. Thomas Locke, Health Officer, Jefferson County Public Health answered saying all mediation, while occurring, is confidential. He noted there will be a public meeting in July where all documents will be made public and people will have an opportunity to ask questions. Peter Lawrenson also requested an update on the landfill permit, and expressed his hope that the negotiations are moving forward without stalling and with integrity. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Washington State Methamphetamine Clandestine Lab Clean-up Standards Dr. Locke followed up on a public comment during last month's meeting where there was an allegation that Jefferson County Public Health was either not correctly interpreting or enforcing the law concerning meth lab remediation. Dr. Locke believes they are correctly interpreting and enforcing the law. He noted it is important for the Board to understand what the law is intended to do, and what some of the unintended consequences of the law are. The law, adopted in 2002, currently triggers a clean-up at 0.1 micrograms per 100 square centimeters of methamphetamine residue,the strictest standard in the nation. This level does not based on a documented health risk, and instead was chosen to denote a contamination level that is detectable. The unintended consequence of this application is triggering costly and destructive clean-up efforts for sites that are not meth labs but have trace amounts of • methamphetamine on environmental surfaces caused by smoking the drug indoors. Current clean-up protocols call for all drywall, carpeting, appliances, and personal possessions to be removed. This is expensive and has limited the availability of public housing because units are closed and/or demolished rather than cleaned. Dr. Locke proposes the state raise its clean-up standards to 1.5 micrograms per 100 square centimeters, which is the level the state of California recommends based on a 2007 scientific study. Member Austin commented that a member of the Peninsula Housing Authority asked if our Board of Health would send a letter, similar to the letter Dr. Locke wrote on behalf of Clallam County, showing support to change this law. This letter will be sent to John Weisman, Secretary of Health, and cc'd to the Peninsula Housing Authority. Jean Baldwin, Director, Jefferson County Public Health, suggested adding a sentence that states we are very aware of the danger and impact of methamphetamine use and manufacture, and are concerned the contamination level approach is missing the point. Member Austin moved to approve the letter; the motion was seconded by Member Buhler. No further discussion. The motion passed unanimously. • I f 2. Governor's 2013 Smart Communities Award to Environmental Health and • Department of Community Development Jean Baldwin suggested sending a copy of this award to Neil Harrington. Chair Sullivan commented that he is very proud of this award; it is the efforts of multiple state and federal agencies, tribal, local citizens, and businesses working together and coming up with a consensus approach that has allowed for safe shellfish harvesting. 3. Regional Nurse-Family Partnership Follow-up Jean Baldwin announced three representatives to the newly formed advisory board: Dr. Molly Parker, Catherine Robinson, and John Austin. 4. Drug Take-back Event Member Joswick commented that Jefferson County will not be participating in the April 26th event because Chief Daily reports he does not have the personnel to manage the event. She is hopeful that Chief Daily will work with Sheriff Hernandez in order to participate because almost 6001bs of unused drugs were turned in to the county last year, and a third of those came from take-back events. The Substance Abuse Advisory Board will follow up with this issue. NEW BUSINESS 1. 2013 Environmental Health Performance Measures • Each department submitted a 2013 Year End Report (attached), and commented on the following: a. Solid and Hazardous Waste—Kristy Fielder (for Pinky Feria Mingo): Expansion of the Solid Waste Education Program, including the One-Less-Bag campaign and 30 presentations to schools; utilization of the TideMark permitting database, developing several small business technical assistance checklists; completing an environmental clean-up resource list and creating a flyer for the general public. Jean Baldwin pointed out the significant work that went into accomplishing Goal 6: Ensuring compliance with permits. b. Food Safety—Susan Porto (for Mina Kwansa): Educating food workers, specifically reduction of in-house training due to online offering ; animals in food establishments; transferring all data from the KIPHS database to TideMark; inspection of food service establishments and investigation of food borne illness. c. Drinking Water— Susan Porto: Decommissioning of new wells is less frequent because new well starts are down; tracking In-Stream Flow Rule information is ongoing, data entry has been simplified; coordination with DCD for compliance of the Seawater Intrusion Ordinance; minimizing the delay of building permits by improving the application review process; coordination with the Department of Ecology for education of water rights. Commented that Group As have testing, but Group Bs do not unless they require a food permit. • 0. d. Water Quality—Mike Dawson: More restricted funding and large workload; • strategic cut back on monitoring for toxic blue green algae; stream monitoring, including Chimacum basin and Leland creek; water resources ended in 2012 in terms of watershed planting, no longer funded by the state; the state cut back stream gauge network, hoping to replace with modeling that can provide information without gauges; completed surveys for pollution identification and control; applied for phase 2, which would pull standards from the highest of the three counties; Clean water fees, if adopted, will allow a restoration of services by 2015. e. On-Site Sewage and Septic—Linda Atkins: Educating homeowners with classes and information on the website; improving on-site sewage system monitoring by following up with a letter and tracking system; documenting how quickly building permits are reviewed, 87% done in less than 14 days; working with IT to get tablets or laptops to use when investigating complaints to help with response rates; monitoring inspections will increase to approximately 200 when active bill reminders are available online; requested and received an extension on the EPA Grant. 2. Measles Outbreak Dr. Locke gave an update on recent Measles outbreak activity in Washington State and British Columbia. A secondary case occurred in Kitsap County, but as of right now there aren't any cases in Clallam or Jefferson Counties. He shared the importance of getting information to the general public in order to persuade people to get the vaccination. Jean II Baldwin is currently reviewing the health records of public health employees to make sure all healthcare workers are vaccinated or have documented immunity. Dr. Locke cautioned that when measles starts to spread in the community, it is a public health emergency and has very significant workload and economic consequences. 3. Cascade Pacific Action Alliance Proposal Jean Baldwin and Dr. Locke will attend the meeting on May 21, 2014 and report back to the Board. It is an exploratory meeting to talk about the Washington State Healthcare Plan submitted to CMS last year. Grays Harbor, Lewis, Mason, Pacific, and Thurston Counties will also be in attendance. Member Austin suggested Jean urge her colleagues in the Mason county health department to attend. 4. Jefferson Healthcare-Jefferson County Public Health Community Health Improvement Partnership Update No Discussion. 5. Review of Ordinance Chair Sullivan commented on inconsistencies in BOH Ordinance of 1997, and suggested • clarification. Jean Baldwin informed the Board that it has to be changed and adopted at the BOCC. The language needs to indicate that the Substance Abuse Board Members are appointed by this group and that the Clean Water District will eventually report to this group; where you live or don't live as opposed to expertise in public health; how people are appointed. A public hearing on the language is set for May 5, 2014. Jean will report back to the Board at the next meeting. ACTIVITY UPDATE Jean Baldwin will bring the 2009 bylaws to an upcoming meeting for the Board to review. Member Nelson sits on a committee that reviews the Port Townsend Paper Corporation's pond clean up data. The data presented to the committee was inaccurate. PTPC responded by saying they performed a different test after the committee was dismissed. The test showed better results, but the information Member Nelson saw did not point favorably toward the PTPC's pond output. PUBLIC COMMENT • No public comment. AGENDA PLANNING CALENDAR No agenda planning. NEXT SCHEDULED MEETING Next Board of Health meeting will be held on Thursday, May 15, 2014 from 2:30 - 4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA. ADJOURNMENT Chair Sullivan adjourned the April 17, 2014 Jefferson County Board of Health meeting at 4:37 PM. JEFFERSON COUNTY BOARD OF HEALTH 110 Phil Johnson, Member Jill Buhler, Member • Roberta Frissell, Member David Sullivan, Chair Kris Nelson, Member John Austin, Member Sheila Westerman, Vice Chair Respectfully Submitted: Natalie Crump • • JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, April 17, 2014 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, Chair, County Commissioner,District#2 Jean Baldwin,Public Health Services Dir John Austin, County Commissioner,District#3 Julia Danskin,Nursing Services Dir Roberta Frissell, citizen at large(County) Jared Keefer,Env. Health Services Dir Kris Nelson,Port Townsend City Council Veronica Shaw, Public Health Deputy Dir Sheila Westerman, Vice Chair, Citizen at large(City) Jill Buhler,Hospital Commissioner,District#2 Chair Sullivan called the April 17, 2014 meeting of the Jefferson County Board of Health to order at 2:34 PM. A quorum was present. Members Present: Jill Buhler, Roberta Frissell, David Sullivan, John Austin, Kris Nelson Staff Present: Philip Morley, Thomas Locke, Jean Baldwin, Julia Danskin Members Absent: Sheila Westerman, Phil Johnson • APPROVAL OF AGENDA Chair Sullivan called for review and approval of agenda for 3/20/2014 meeting. Chair Sullivan suggested adding the following two items: (1) add "Drug Take-back" as a new item 4. Old Business; and (2) add a new item to New Business: 4. Updating the Board of Health Ordinance. Member Austin moved to approve the agenda as amended; the motion was seconded by Member Buhler. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Sullivan called for review and approval of the minutes of the 3/20/2014 meeting of the Board of Health. Member Austin moved to approve the minutes; the motion was seconded by Chair Sullivan. No further discussion. The motion passed unanimously. PUBLIC COMMENT Chair Sullivan called for public comment. • David Weathy requested a progress report on the landfill permit. Dr. Thomas Locke, Health Officer, Jefferson County Public Health answered saying all mediation, while occurring, is confidential. He noted there will be a public meeting in July where all documents will be made public and people will have an opportunity to ask questions. Peter Lawrenson also requested an update on the landfill permit, and expressed his hope that the negotiations are moving forward without stalling and with integrity. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Washington State Methamphetamine Clandestine Lab Clean-up Standards Dr. Locke followed up on a public comment during last month's meeting where there was an allegation that Jefferson County Public Health was either not correctly interpreting or enforcing the law concerning meth lab remediation. Dr. Locke believes they are correctly interpreting and enforcing the law. He noted it is important for the Board to understand what the law is intended to do, and what some of the unintended consequences of the law are. The law, adopted in 2002, currently triggers a clean-up at 0.1 micrograms per 100 square centimeters of methamphetamine residue, the strictest standard in the nation. This level does not based on a documented health risk, and instead was chosen to denote a contamination level that is detectable. The unintended consequence of this application is triggering costly and • destructive clean-up efforts for sites that are not meth labs but have trace amounts of methamphetamine on environmental surfaces caused by smoking the drug indoors. Current clean-up protocols call for all drywall, carpeting, appliances, and personal possessions to be removed. This is expensive and has limited the availability of public housing because units are closed and/or demolished rather than cleaned. Dr. Locke proposes the state raise its clean-up standards to 1.5 micrograms per 100 square centimeters, which is the level the state of California recommends based on a 2007 scientific study. Member Austin commented that a member of the Peninsula Housing Authority asked if our Board of Health would send a letter, similar to the letter Dr. Locke wrote on behalf of Clallam County, showing support to change this law. This letter will be sent to John Weisman, Secretary of Health, and cc'd to the Peninsula Housing Authority. Jean Baldwin, Director, Jefferson County Public Health, suggested adding a sentence that states we are very aware of the danger and impact of methamphetamine use and manufacture, and are concerned the contamination level approach is missing the point. Member Austin moved to approve the letter; the motion was seconded by Member Buhler. No further discussion. The motion passed unanimously. • • 2. Governor's 2013 Smart Communities Award to Environmental Health and Department of Community Development Jean Baldwin suggested sending a copy of this award to Neil Harrington. Chair Sullivan commented that he is very proud of this award; it is the efforts of multiple state and federal agencies, tribal, local citizens, and businesses working together and coming up with a consensus approach that has allowed for safe shellfish harvesting. 3. Regional Nurse-Family Partnership Follow-up Jean Baldwin announced three representatives to the newly formed advisory board: Dr. Molly Parker, Catherine Robinson, and John Austin. 4. Drug Take-back Event Member Joswick commented that Jefferson County will not be participating in the April 26th event because Chief Daily reports he does not have the personnel to manage the event. She is hopeful that Chief Daily will work with Sheriff Hernandez in order to participate because almost 6001bs of unused drugs were turned in to the county last year, and a third of those came from take-back events. The Substance Abuse Advisory Board will follow up with this issue. NEW BUSINESS 1. 2013 Environmental Health Performance Measures • Each department submitted a 2013 Year End Report (attached), and commented on the following: a. Solid and Hazardous Waste—Kristy Fielder (for Pinky Feria Mingo): Expansion of the Solid Waste Education Program, including the One-Less-Bag campaign and 30 presentations to schools; utilization of the TideMark permitting database, developing several small business technical assistance checklists; completing an environmental clean-up resource list and creating a flyer for the general public. Jean Baldwin pointed out the significant work that went into accomplishing Goal 6: Ensuring compliance with permits. b. Food Safety— Susan Porto (for Mina Kwansa): Educating food workers, specifically reduction of in-house training due to online offering ; animals in food establishments; transferring all data from the KIPHS database to TideMark; inspection of food service establishments and investigation of food borne illness. c. Drinking Water— Susan Porto: Decommissioning of new wells is less frequent because new well starts are down; tracking In-Stream Flow Rule information is ongoing, data entry has been simplified; coordination with DCD for compliance of the Seawater Intrusion Ordinance; minimizing the delay of building permits by improving the application review process; coordination with the Department of Ecology for education of water rights. Commented that Group As have testing, but Group Bs do not unless they require a food permit. 410 • d. Water Quality—Mike Dawson: More restricted funding and large workload; strategic cut back on monitoring for toxic blue green algae; stream monitoring, including Chimacum basin and Leland creek; water resources ended in 2012 in terms of watershed planting, no longer funded by the state; the state cut back stream gauge network, hoping to replace with modeling that can provide information without gauges; completed surveys for pollution identification and control; applied for phase 2, which would pull standards from the highest of the three counties; Clean water fees, if adopted, will allow a restoration of services by 2015. e. On-Site Sewage and Septic—Linda Atkins: Educating homeowners with classes and information on the website; improving on-site sewage system monitoring by following up with a letter and tracking system; documenting how quickly building permits are reviewed, 87% done in less than 14 days; working with IT to get tablets or laptops to use when investigating complaints to help with response rates; monitoring inspections will increase to approximately 200 when active bill reminders are available online; requested and received an extension on the EPA Grant. 2. Measles Outbreak Dr. Locke gave an update on recent Measles outbreak activity in Washington State and British Columbia. A secondary case occurred in Kitsap County, but as of right now there aren't any cases in Clallam or Jefferson Counties. He shared the importance of getting • information to the general public in order to persuade people to get the vaccination. Jean Baldwin is currently reviewing the health records of public health employees to make sure all healthcare workers are vaccinated or have documented immunity. Dr. Locke cautioned that when measles starts to spread in the community, it is a public health emergency and has very significant workload and economic consequences. 3. Cascade Pacific Action Alliance Proposal Jean Baldwin and Dr. Locke will attend the meeting on May 21, 2014 and report back to the Board. It is an exploratory meeting to talk about the Washington State Healthcare Plan submitted to CMS last year. Grays Harbor, Lewis, Mason, Pacific, and Thurston Counties will also be in attendance. Member Austin suggested Jean urge her colleagues in the Mason county health department to attend. 4. Jefferson Healthcare-Jefferson County Public Health Community Health Improvement Partnership Update No Discussion. 5. Review of Ordinance Chair Sullivan commented on inconsistencies in BOH Ordinance of 1997, and suggested • clarification. Jean Baldwin informed the Board that it has to be changed and adopted at the BOCC. The language needs to indicate that the Substance Abuse Board Members are appointed by this group and that the Clean Water District will eventually report to this group;where you live or don't live as opposed to expertise in public health; how people are appointed. A public hearing on the language is set for May 5, 2014. Jean will report back to the Board at the next meeting. ACTIVITY UPDATE Jean Baldwin will bring the 2009 bylaws to an upcoming meeting for the Board to review. Member Nelson sits on a committee that reviews the Port Townsend Paper Corporation's pond clean up data. The data presented to the committee was inaccurate. PTPC responded by saying they performed a different test after the committee was dismissed. The test showed better results, but the information Member Nelson saw did not point favorably toward the PTPC's pond output. PUBLIC COMMENT 41 No public comment. AGENDA PLANNING CALENDAR No agenda planning. NEXT SCHEDULED MEETING Next Board of Health meeting will be held on Thursday, May 15, 2014 from 2:30 - 4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA. ADJOURNMENT Chair Sullivan adjourned the April 17, 2014 Jefferson County Board of Health meeting at 4:37 PM. JEFFERSON COUNTY BOARD OF HEALTH 1111 Phil Johnson, Member Jill Buhler, Member • Roberta Frissell, Member David Sullivan, Chair Kris Nelson, Member John Austin, Member Sheila Westerman, Vice Chair Respectfully Submitted: Natalie Crump • • f • Phil Johnson, Member 11 Buhler, Member /// Roberta Frissell, Member David Sulliv. • Chair Alb• Kris Nela , Member Jo n Austin, Member ,' Sheila Westerman, Vice Chair Respectfully Submitted: Natalie Crump • • • Board of Health Old Business and Informational Items S Agenda Item #IV, 1 Fatal Heroin Overdoses on the Increases May 15, 2014 S f 8 • Fatal heroin overdoses on the increase as use skyrockets: Health officials battling opiate epidemic 1. Kim Krisberg At the height of the prescription drug abuse epidemic in rural Scioto County in south-central Ohio, so-called pill mills were pumping out enough pain pills to provide every single county resident — nearly 80,000 people — with 123 pills every year. The problem was so bad that in 2010, county officials declared a public health emergency and went into incident command mode. "It was awful," said Lisa Roberts, RN, public health nurse at the Portsmouth City Health Department in Scioto County. "The place was just crop-dusted with opium...(Pain pills) became a form of commerce here. Pretty much everyone I knew had an addicted kid. It became completely mainstream." 41, c3 410 Registered nurse Babette Richter, of the South jersey AIDS Alliance, holds up a container of naloxone, an antidote for heroin overdose. Heroin overdose deaths have risen in the U.S., increasing by 45 percent between 2006 and 2010. Photo by Mel Evans, courtesy AP Images Today, thanks to statewide efforts to restrict easy access to painkillers, prescription opioids such as oxytocin are hard to find on the street, Roberts said. However, that gap has been quickly filled by another opioid: heroin. "We've had a nearly 100 percent transition to heroin (among people) in our needle exchange program," Roberts told The Nation's Health. Unfortunately, Scioto County is not alone. According to the National Institute on Drug Abuse, heroin use has been on the rise since 2007. In 2012, about 669,000 Americans reported using heroin in the past year, up from about 373,000 in 2007. The greatest increase in heroin use was among young people ages 18 to 25. Heroin overdose deaths have risen as well, increasing by 45 percent between 2006 and 201 0. Closely tied to the rise in heroin use is the rise in prescription opioid abuse, which in 2008 was involved in more overdose deaths than heroin and cocaine combined. • In 2010, national drug surveys found that more than 12 million people reported using prescription painkillers for nonmedical reasons. Not surprisingly, surveys have found a strong link between the , > use of prescription opioids and heroin initiation: Nearly 80 percent of people who reported initiating 4110 heroin use in the past year had previously abused prescription pain medication; whereas, only 3.6 percent of people who began abusing painkillers reported heroin use in the previous five years. In March, U.S. Attorney General Eric Holder called the rise in both heroin- and prescription drug- related overdose an "urgent public health crisis." "It's impossible to understand the heroin problem without first understanding the prescription pill problem," Rafael Lemaitre, MA, communications director in the White House Office of National Drug Control Policy, told The Nation's Health. Wilson Compton, MD, deputy director of NIDA, said that while there are indicators that the prescription drug abuse epidemic is connected to the rise in heroin use, the availability and purity of heroin has increased. He said that even though state and local efforts to restrict the flow of prescription opioids may have steered some people toward heroin, the natural progression of addiction also plays a role. "As someone uses prescription drugs more and more regularly, the propensity to try other forms of opioids goes up," Compton said. "In many ways they're not two separate epidemics — it's just one opiate epidemic" There is no data to suggest that gains made in restricting easy access to prescription painkillers are being voided by a switch to heroin, said Len Paulozzi, MD, MPH, medical epidemiologist in the Division of Unintentional Injury Prevention at the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control. "We can't say that the prescription problem is being replaced by heroin," Paulozzi said. "The safest assumption is that we have a new problem on top of the old problem." In tackling the opioid abuse problem, both Paulozzi and Compton said health officials have to look upstream. In particular, Compton said prevention strategies need to take a long-term approach, such as reducing the kinds of early childhood trauma that often lead to risky behaviors in adulthood. But often the most immediate need -- beyond prevention and treatment — is helping those addicted to opioids prevent a fatal overdose. Naloxone access gaining momentum Across the country, lawmakers and officials are widening access to na|oxone, a prescription drug that can be injected or given nasally to reverse an opioid overdose. Medical first responders have traditionally administered naloxone, which is nonaddictive and only has an effect if a person has opioids in her or his system. Howeve/, people with little or no training can easily administer the life- saving drug as well. APHA adopted a policy statement in 2013 in support of widening access to naloxone. As of this year, policymakers in 17 states and Washington, D.C., had amended laws to make it easier to prescribe and dispense na|oxone, according to the Network for Public Health Law. The legal ���� changes are in line with emerging science on the topic as well. For example, a study published in f January in the British Medical Journal examined naloxone distribution and bystander training 1111) programs in Massachusetts found that such programs are associated with a decrease in opioid overdose deaths. "If a person dies of an overdose, they never get the chance to go to recovery," said Mike Leyden, MPH, NREK4T-P' who oversees the Vermont Department of Health's Naloxone Opioid Overdose Prevention Pilot Program and serves as deputy director of Emergency Medical Services. Last year, in response to a rise in heroin-related overdose deaths, Vermont leaders amended the law to allow health care professionals to dispense and prescribe naloxone to people at risk of overdose as well as to family and friends of those at risk. Today, the pilot program is partnering with needle exchange programs in Burlington and White River Junction to distribute naloxone rescue kits, which include two doses of naloxone as well as instructions on how to administer the drug nasally. As of late March, Leyden said, the two pilot sites had distributed more than 200 rescue kits. In addition to educating community members, health officials are also providing naloxone training to Vermont State Pn|ice, who have agreed to carry the drug and are often the first to respond to an emergency overdose call. 110 , , , , Used syringes are readied for collection at a needle exchange clinic in St. Johnsbury, Vt. The clinic provides new syringes and other clean materials for people dependent on heroin. The state is experiencing "a full-blown heroin crisis," according to Gov. Peter Shumlin, with a more than 250 percent increase in people receiving heroin treatment in Vermont since 2000. Photo by Spencer Platt, courtesy Getty Images To the south in Baltimore, which has a long history of heroin abuse problems, the Staying Alive Drug Overdose Prevention and Response Program has been training people at risk of an opioid overdose to use naloxone since 2004. According to Chris Serio-Chapman, program director for community risk reduction services at the Baltimore City Health Department, the Staying Alive program has trained more than 3,000 people and documented more than 225 overdose reversals. When the program first began, naloxone was only distributed to people in "drug-using pairs." But last year, state legislation passed allowing physicians to prescribe naloxone to friends and family of those at risk of overdose. In turn, Serio-Chapman said, the Staying Alive program will soon begin training programs throughout east and west Baltimore. In 2013, the Maryland Department of Health and Mental Hygiene reported a 54 percent rise in • heroin-related overdose deaths between 2011 and 2012. ^ "I've met so many people (addicted to heroin) who you'd never dream would get hooked on this stuff," Serio-Chapman said. �� Back in Ohio, where two-thirds of fatal drug overdoses involve an opioid. Project Deaths Avoided With Naloxone, better known as Project DAVVN, began in 2012 to distribute naloxone rescue kits. With training and distribution sites in Portsmouth and Cleveland, the project was initially restricted to people at risk of overdose. But as of March, state legislation expanded naloxone access to friends and family members as well as first responders such as fire and police. So far, Roberts reported, the project has documented 23 overdose reversals. "This truly is a public health problem and we are the solution," Roberts said. "You've got the treatment side, law enforcement, the drug courts...and public health has the ability to bring all those people together to work as a unified force." For more information on naloxone and the rise in heroin use, visit www.drugabuse.gov/drugs- abuse/heroin. Copyright The Nation's Hea|th, American Public Health Association 1110 • • Board of Health Old Business and Informational Items • Agenda Item #IV, 2 Letter from Governor Inslee: TCPH role in ACA Enrollment Process May 15, 2014 S "RLVED JAY INSLEE Governor APR 2 8 2814 • STATE OF WASHINGTON Jefferson County OFFICE OF THE GOVERNOR Public Heel-, April 23, 2014 Jefferson County Public Health Department 615 Sheridan Street Port Townsend, WA 98368 Dear Enrollment Partner: I would like to take this opportunity to thank you for your outstanding contributions to the success of Washington State's first open enrollment period under the Affordable Care Act (ACA). Our state did an outstanding job of enrolling Washingtonians during open enrollment, which is a testament to the tireless efforts of the many partners involved in this endeavor, including the organizations and individuals who guided people through the enrollment process, helped resolve • glitches and bumps in the road and ultimately got enrollees signed up. The numbers are in and the results are impressive—more than half a million people are now covered by new, affordable plans. More than 146,000 people enrolled in private plans through the Washington Healthplanfinder, and more than 403,000 people are newly covered by Washington Apple Health. In fact, our Medicaid enrollment efforts have been so outstanding that Washington has already met its Apple Health enrollment goals for 2018. Your work has made an enormous difference in people's lives, and I applaud your energy and diligence during this critical enrollment period. Having worked directly with enrollees, you know firsthand what a relief it was for many to finally get health coverage or to afford a plan that is actually there when needed and not just in the event of a catastrophe. Again, thank you for your dedicated efforts. You have been part of a defining moment in history, and together we are building a brighter and healthier future for all Washingtonians. Very truly yours, Jay Inslee Governor • <_t- P.O. Box 40002•Olympia, Washington 98504-0002•(360)902-4111 •www.governor.wa.gov L«1 +Vv. .„ __,„----) , cc•.-T?-tou. trr 1 1 i `"/'D' , fr.2tikt- f t- ,ac,- , • An Ordinance amending the } ORDINANCE NO. 03-0428-14 Jefferson County Clean Water District, 1 Jefferson County Code Ch. 8.65 1 WHEREAS,the Findings of Fact listed below leads to the conclusion that the amending of Chapter 8.65 of the Jefferson County Code, entitled "Clean Water District," in order to establish a stable funding source for said District is not only authorized by state law but would promote the general health, safety and welfare of the citizens of Jefferson County, and WHEREAS,Jefferson County Public Healthconsulted with staff from the City of Port Townsend to discuss the proposal to extend the applicability of Chapter 8.65 JCC to those parcels and premises located within the City not served by a sanitary sewer(as that term is defined and regulated in Ch. 36.89 RCW and Ch. 36.94 RCW) and City and County staff agreed such an extension was both lawful and in furtherance of the public policy behind Ch. 90.72 RCW, NOW,THEREFORE, BE IT ORDAINED BY THE BOARD OF JEFFERSON COUNTY COMMISSIONERS as follows: • Section 01: Findings of Fact amended Section 8.65.020(28) of the Jefferson County Code (JCC) is hereby revised to read as follows: (28) Certain regions of Jefferson County, specifically the city of Port Townsend and the master planned resort at Port Ludlow,have in place stoimwater management facilities and/or sanitary sewers that serve to control,properly dispose of and mitigate nonpoint sources of water pollution. Clean Water District programs shall not be duplicative of the programs and services provided in areas where fees, rates or charges are imposed under Chapters 36.89 and 36.94 RCW. Section 02: Findings of Fact supplemented Section 8.65.020 is amended to reflect the addition of the following text: (29) The Jefferson County Board of Commissioners also serve on and appoint the Jefferson County Board of Health.The Jefferson County Board of Health is responsible for all matters pertaining to the life and health of the people of Jefferson County (as required by JCC 8.00.010). The Board of Health is well qualified to coordinate the activities of the Clean Water District under this Chapter with other programs and activities which fall under the duties and responsibilities of the Board of Health. Ill X •N This fee adjustment shall be calculated as follows: it shall be increased by the • percentage increase in the CPIW as reported for the month of September preceding the Adjustment Date. 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. Section 08: Text is added to the Public Health Fee Schedule: The following text is added to the Fee Schedule for Public Health found in the Appendix to the Jefferson County Code: Beginning with the year 2015,there is hereby established for the Clean Water District a fee of Twenty Dollars ($20.00)per year per tax parcel, except for parcels or lands described in JCC 8.65.100. The Clean Water District fee shall be adjusted annually accordingly 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 of the United States Department of Labor. This fee adjustment shall be calculated as follows: it shall be increased by the percentage increase in the CPIW as reported for the month of September preceding the Adjustment Date. 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. Section 09: Certain •arcels exem.t from fee section rewritten: Section 8.65.100 of the Jefferson County Code (or"JCC") is hereby repealed and replaced so that it shall read in its entirety as follows: Parcels within the boundaries of the City of Port Townsend and the Port Ludlow Master Planned Resort connected to a sanitary sewer service will not be subject to this fee. Lands classified as forest land under Chapter 84.33 RCW and timber land under Chapter 84.34 RCW shall not be subject to said fee (as required by Chapter 90.72 RCW). Additionally, any parcel that is owned by, and is the personal residence of, a person or persons approved by the county assessor for a senior citizen or disabled persons property tax exemption under RCW 84.36.381 (as currently enacted or hereafter amended) is hereby exempted from this fee. Section 10: Severability If any provision of this ordinance, or its application to any person or circumstances, is held invalid,the remainder of this ordinance, or the application of the provisions to other persons or circumstances, shall not be affected. 4110 . Regular Agenda JEFFERSON COUNTY • BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners Philip Morley, County Administrator FROM: Jared Keefer, Environmental Health & Water Quality Director DATE: April 28,2014 SUBJECT:hJCT. Clean Water Districtrdinance Amendment Ordinance STATEMENT OF ISSUE: Jefferson County Public Health is requesting an amendment to the Clean Water District Ordinance. ANALYSIS: Jefferson County Public Health (JCPH) has found a number of water quality impairments that have the ability to adversely affect public health and shellfish. Jefferson County Clean Water District Advisory Council •(CWDAC) has found that JCPH has used Clean Water District funds to pursue a number of cost-effective projects that have restored and protected shellfish growing areas and clean water throughout Jefferson County. In December 2012, the Jefferson County Clean Water District Advisory Council (CWDAC) developed its recommendations for Clean Water District Activities and stable funding. These recommendations were presented to the BOCC in January of 2013. CleanWater Chimacum Di5trid Chimacum Creek Activities +� project microbial sources 2011-12 f:xx axo3x0.i llIf1ItQIIfIQIH A� Indicators of human fecal sources were found in 18 out of 19 Chimacum sampling sites. • -.. Regular Agenda • Public hearing was held on this ordinance revision on April 7th 2014, at 10:00am. The public comment period was extended to Monday, April 14th 2014 until 4:30pm. Further discussion took place on Monday, April 21st, 2014. During the discussion on the 21st, it was asked whether or not tax exempt parcels were receiving the assessment. It was decided that question needed to be answered before taking action. Staff has followed up on the question about tax exempt parcels and the Clean Water District assessment. Currently, tax exempt parcels are not receiving Jefferson County's existing Clean Water District assessment. Staff surveyed other Shellfish Protection Districts in Washington State, and all the districts we successfully contacted also exclude tax-exempt parcels from a district assessment. Legal staff advises that this common practice is well within the legislative discretion provided under RCW 90.72.070, which reads in part, "The county legislative authority establishing a shellfish protection district may finance the protection program through ...(3) reasonable charges or rates specified in its protection program,...." The proposed Jefferson County ordinance revision is to maintain the current assessment structure and expand that structure into the remaining areas of the Clean Water District not served by sanitary sewer. Jefferson County Public Health is now requesting approval to the amendment to the Clean Water District Ordinance to address the CWDAC recommendations, establish a stable funding source with which to address the adverse water quality conditions and restore cut funding. RECOMMENDATION: JCPH management's recommends approval of an amendment to the Clean Water District Ordinance. REVWED BY: / 4-(4 Philip Morey, ounty Administ for Date • Board of Health New Business Agenda Item #V, 3 Ordinance #01-4-0505-01 Amending the Duties and Responsibilities of the Jefferson County Board of Health May 15, 2014 • STATE OF WASHINGTON JEFFERSON COUNTY An Ordinance Amending the Duties and Responsibilities } ORDINANCE NO. 04-0505-14 of the Jefferson County Board of Health, and the } Appointment of Its Members } WHEREAS, on May 5, 1997, the Jefferson County Board of County Commissioners adopted Ordinance No.03-0505-97, establishing a new Chapter 8.00. Board of Health, defining the responsibilities and the membership of the Jefferson County Board of Health; and WHEREAS, on May 16, 2005 the Board of County Commissioners adopted Resolution No. 31-05 regarding the Substance Abuse Advisory Board, including delegating to the Board of Health the appointment of the Substance Abuse Advisory Board members; and WHEREAS, on April 7, 2014,the Board of County Commissioners held a public hearing to consider an ordinance amending the Jefferson County Clean Water District,Jefferson County Code Chapter 8.65; and WHEREAS,the Board of County Commissioners wish to further amend the responsibilities of the Jefferson County Board of Health and refine how its members are appointed; • NOW,THEREFORE, be it ordained by the Jefferson County Board of County Commissioners as follows: Section 1. JCC 8.00.010 as adopted by Jefferson County Ordinance No. 03-0505-97 is hereby amended to read, 8.00.010 Duties and responsibilities. The board of health shall have responsibilities over all matters pertaining to the preservation of the life and health of the people of Jefferson County and shall: (1) Collect, analyze and disseminate to the community, through the Jefferson County health department, information about community health conditions, risks and resources, and the availability of resources to address identified problems; (2) Enact such rules, regulations and policies as are necessary to preserve, promote and improve the health status of Jefferson County residents, and guide the allocation of appropriate and necessary public health resources; (3)Assure that necessary, high quality, effective public health services are available for the protection of the people of Jefferson County, including the control and prevention of any • dangerous, contagious or infectious disease within the county; (4) Provide for the prevention, control and abatement of nuisances detrimental to public health; (5) Enforce, through the health officer, the public health statutes of the state and county; (6) Establish fee schedules for issuing and renewing licenses and permits, or for such other services as are authorized by the law and rules of the State Board of Health; (7) Appoint the members of the Jefferson County Substance Abuse Advisory Board; and (8) Coordinate the activities of the Clean Water District under Chapter 8.65 JCC with other programs and activities which fall under the duties and responsibilities of the Board of Health. Section 2. JCC 8.00.020 as adopted by Jefferson County Ordinance No. 03-0505-97 is hereby amended to read, 8.00.020 Members. The board of health shall be composed of seven members. The three elected members of the board of county commissioners shall be members of the board of health. Four members of the board of health shall be appointed by the county commissioners. Appointed members of the board of health shall include one elected official from the city of Port Townsend city council, one Jefferson County Public Hospital District#2 commissioner; and two at-large community representatives. • Section 3. JCC 8.00.030 as adopted by Jefferson County Ordinance No. 03-0505-97 is hereby amended to read, 8.00.030 Terms. Appointed members shall serve for three-year terms. The term of office for all appointees shall commence on the first day of June in the year in which the term is to commence. Section 4. JCC 8.00.040 as adopted by Jefferson County Ordinance No. 03-0505-97 is hereby amended to read, 8.00.040 Appointment. The board of county commissioners shall appoint the members of the board of health. The board of county commissioners shall request that the city of Port Townsend and Jefferson County Public Hospital District#2 each nominate one candidate for appointment to the board of health. The county commissioners shall seek applications from citizens of Jefferson County to fill the at- large membership positions on the Board of Health. • • Section 5. JCC 8.00.050 as adopted by Jefferson County Ordinance No.03-0505-97 is hereby amended to read, 8.00.050 Vacancies. Vacancies on the board of health shall be filled by appointment by the board of county commissioners. Appointments shall be for the unexpired portion of the term of the position filled. Section 6. Severability. If any provision of this ordinance, or its application to any person or circumstances, is held invalid,the remainder of this ordinance, or the application of the provisions to other persons or circumstances, shall not be affected. Section 7. Effective Date. This amendment to JCC 8.00 as adopted by Jefferson County Ordinance No. 03-0505-97 shall take effect seven (7) days after adoption. ---,_-th //AA ADOPTED this, day of lL'i� , 2014. J JEFFERSON COUNTY BOARD OF 0 TY COMMISSIONERS SEAL: ' / �14 it John Au n, Chir • / i'/ ' —�._, 0 :' y ��� PhilJohns,/ V -m•:r/ 4*.-, .. ' David Sullivan, Member rr ' " . rf?9qa ' , ATTEST: APP OVED A TO FO M: /if / 1 ) 177 614 4.-1,6/71-- VO\itr\ck tr11,1,/,,,, — Carolyn Aver' , Deputy Clerk ofi e Board David Alvarez, Chief Civil DPA • Consent Agenda JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS • AGENDA REQUEST TO: Board of County Commissioners Philip Morley,County Administrator FROM: Leslie Locke,Deputy Clerk of the Board DATE: May 5,2014 SUBJECT: HEARING re: Proposed Ordinance Amending the Duties and Responsibilities of the Jefferson County Board of Health and the Appointments of its Members STATEMENT OF ISSUE: The proposed ordinance would amend Chapter 8.00 of the Jefferson County Code regarding the Jefferson County Board of Health. ANALYSIS: If adopted,the ordinance would amend the Board of Health's duties and responsibilities to include its existing role in appointing members of the Substance Abuse Advisory Board, and add a responsibility to coordinate the activities of the Clean Water District with the programs and activities within the purview of the Board of Health. The proposed ordinance would also revise the members,terms, appointment and vacancy provisions regarding the Board of Health with technical corrections, and provide greater flexibility in appointing at-large positions. These proposed revisions are timely, as the County Commissioners will be considering appointments for several positions on the Board of Health in the near future. The revisions would become effective seven days after adoption. FISCAL IMPACT: None. RECOMMENDATION: The Board approve the proposed ordinance amending the Duties and Responsibilities of the Jefferson County Board of Health and the Appointments of its Members. REVIEWED BY: '''R`ip Mor ey�untY Administrator Date • JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS CONSENT AGENDA REQUEST TO: Board of County Commissioners FROM: Philip Morley, County Administrator AV DATE: May 12,2014 RE: Appointments to the Board of Health STATEMENT OF ISSUE: The Board of County Commissioners is requested to make appointments to the Board of Health,pursuant to Chapter 8.00 of the Jefferson County Code. These appointments would be for the remainder of current teims, and for two members,new 3- year terms beginning June 1,2014. ANALYSIS: Commissioners recently adopted Ordinance No. 04-0505-14, amending the duties and responsibilities of the Jefferson County Board of Health and the appointment of its members. . The Board of Health has two vacancies for at-large citizens to be filled by appointment. Sheila Westerman has served on the Board of Health since 1997 and has requested reappointment to her current seat. The other at-large citizen position was left vacant upon the retirement of Roberta Frissell,who also was first appointed in 1997. Applications for appointment were received from Nancy O'Neill,Ph.D. and Sally Aerts PT, OCS. Public Health Officer Dr. Tom Locke and County Commissioner John Austin interviewed Dr. O'Neill and Ms. Aerts, and have unanimously recommended that the County Commissioners appoint Ms. Aerts and reappoint Ms. Westelman. Ms. Aerts,a physical therapist,was co-owner of Uptown Physical Therapy for eleven years, and will receive a Master of Public Health degree this June from the University of Washington. Most recently, she served as a Navigator assisting citizens in signing up for health insurance under the Affordable Care Act. Ms. Westellnian has ably served on the Board of Health since its membership first expanded in 1997. She brings long experience and knowledge of public health issues in Jefferson County, and contributes invaluable institutional memory as context for the Board's policy deliberations. On May 5,2014, Commissioner Austin briefed the County Commissioners on the appointment recommendations. The Commissioners asked that the appointments be placed on the Consent IP Agenda. FISCAL IMPACT: None. RECOMMENDATION: It is recommended that the Board of County Commissioners pass a • motion to: • Affirm Sheila Westerman as at-large citizen member of the Board of Health and Kris Nelson as the Port Townsend City Council member of the Board of Health,both to continue serving through the end of the present term, ending May 31,2014; • Affirm Jill Buhler as the Jefferson County Public Hospital District#2 Commission member of the Board of Health to continue serving through the end of the present term, ending May 31,2015;and • Affirin and appoint the appointed members of the Jefferson County Board of Health for the following team pursuant to Chapter 8.00 JCC, as follows: Position Individual BoH Term Boll Term End Start Port Townsend City Council Kris Nelson June 1, 2014 May 31, 2017 Jefferson County Public Jill Buhler June 1, 2012 May 31, 2015 Hospital District#2 Commission At-large Citizen Position 1 Sheila June 1, 2014 May 31, 2017 Westerman At-large Citizen Position 2 Sally Aerts May 12, 2014 May 31, 2015 (mid-temu • appointment) RENEWED BY: f/ if 7z. 7�1Y Philip Morley County Ai .tor Date i W N Sn N Sn A Z N H W a M M M M Q H N N M ^p W S i kr) 3 Q V] N N V'3 • a _ O , pr O 0\ N O ~ ca ' N er �, .U. Fy .N-� .-r N o7 O N N ,N. ., O\ 01 O CN .S" ... AO \ 3!'3 v• '� Oma-, V'3 yi--1 0. � \O 00 ,D H a M c N•` y ra nr N N N �. N N M Q 00 00 00 y, v> Q Z0 0 0 O M Mrn 3 ++ 3. Cr, O, O\ v1 •-• N w 00 d- 00 d• 4-+ x 00 00 00 00 00 . Z 0 M ,4::> M M "" �' a M M M M M M S 0 1 I I' O d N . hN 00 00 00 00 00 y 0 a M M M M M 00 0 •ZA. ,0 U O M M 00 00 00 cC E Z Q Q 00 M 00 0 00 00 00 3 3 '.0 00 1��..11 4 U UL" \O '.0 •0 M 00 01 K1 = N •.. 01 01 O,00 00 00 N y 0100 00 Q 01 Q o `O �✓ Q 00 -0 °' a) 3 3 g c 3 Q 00 = 3 ee w °' �; a a 0 �, �, 0 0 0 0 0 0 H z d a Q <,. E- H E 6a 0 E d ani CO• •a) on o a a a Y 0 o 0 • a o 0 0 2 a 5 a 2 H • a\00 N N N a. � � W o 0 0 °' c o x ca aa Pa ¢ x � a U � �tr) A 0 0 0 0 0 Cr S ?, x Z a a: a; a N O, o v, w ^0 ° OA o A 3 0 0 (11 �4 x Q - a w 0 0a 0 N U c0 a) > o CO N 3-4 r0 VI V] 1--, 1-4 •-•r.+ 4.+ •V iy a) 3. •UQ Q a) 3-4 VI ti ti z Q �I 7 -fl Q Q Q O (4 g4 O 1 O 1 ali C0 rn ) oo ' .' C. O 0 crl o _� ', 1 a) a o a - o 0 0 U �. U a 0 . H cn rn � y o 0 Z C H o w 0 E E 0 U U w CA U U ' Qz U a U U U H . a H y Y A. v a p Q ) a ti - - a° x ¢ d a 0 0 0 v g Ci • zccsr43 I o . �, .° .� w A V) 0 w 0 gcl ' Z 0 ¢, H '" v) = 0 ani 4 atiti U CV) Z H -a te* g$0N C,o © 1820 Jefferson Street • ck L. 6 ,P® Box 1220 a w 4\ ,a Port Townsend, WA 98368 Phil Johnson, District 1 David W. Sullivan, District 2 John Austin, District 3 -Ts ° May 12, 2014 Sally Aerts 637 H. Street Port Townsend, WA 98368 Dear Ms. Aerts, On May 12, 2014 the Board of County Commissioners was pleased to appoint you to detesfdd serve a three (3) year term, on the Jefferson County Health Board as a At-Large Community Representative. Your term expires on May 31, 2015. lae41 You will be contacted by Jefferson County Public Health staff with meeting dates and y times. If you have any questions, please contact 360-385-9400. We feel certain you will make a worthwhile contribution in this service to the community and we appreciate your willingness to devote time to this Board. 0,51i Sincerely, (Excused Absence) /'° John Austin, Chairman Phil ,ohnso , mb avid S' Ivan, Member cc: Public Health • Phone (360) 385-9100 Fax (360) 385-9382 jeffboccC:co.jefferson.zva.us oN 1820 Jefferson. Street 0011111101, �� �o 4 � � PO Box 1220 w 1 14 Port Townsend, WA 98368 44 Phil Johnson, District 1 David W. Sullivan, District 2 John Austin, District 3 1/ING May 12, 2014 Jill Buhler 440 Adelma Beach Road Port Townsend, WA 98368 Dear Ms. Buhler, On May 12, 2014 the Board of County Commissioners was pleased to reappoint you to • serve a three (3)year term, on the Jefferson County Health Board as the Jefferson County Public Hospital District#2 Commissioner Representative. Your term expires on May 31, 2015. dezizdtil ertain y y ou will continue to make a worthwhile contribution in this service to the 16( Wefeelc ¢404e community and we appreciate your willingness to devote time to this Board. Sincerely, ' /Ile - j r f' (Excused Absence) ,1 ' ' John Austin, Chairman Phil Johnson, Member vid Sullivan, Member cc: Public Health • Phone (360) 385-9100 Fax (360) 385-9382 jeffbocc@co.jefferson.wa.us g- $ON 1820 Jefferson Street �► ���4` °6 POfeO Box 1220 ® w 441,‘ Port Townsend, WA 98368 •4 Phil Johnson, District 1 David W. Sullivan, District 2 John Austin, District 3 IN May 12, 2014 Sheila Westerman 914 Washington Street Port Townsend, WA 98368 Dear Ms. Westerman, • On May 12, 2014 the Board of County Commissioners was pleased to reappoint you to serve a three (3)year term, on the Jefferson County Board of Health as the At-Large Community Representative. Your term expires on May 31, 2017. We feel certain you will continue to make a worthwhile contribution in this service to the community and we appreciate your willingness to devote time to this Board. Sincerely, (Excused Absence) {1C- John Austin, Chairman Phil Jo son, Member D va ,/7+ ember cc: Public Health Phone (360) 385-9100 Fax (360) 385-9382 jeffhoccco.jefferson.wa.us 1820 Jefferson Street S ' ` ��ON �, � �� PO Box 1220 •® r.r.4 Port Townsend, WA 98368 Phil Johnson, District 1 David W. Sullivan, District 2 John Austin, District 3 MING May 12, 2014 Kris Nelson 250 Madison Street, Ste. 2 Port Townsend, WA 98368 Dear Ms. Nelson, On May 12, 2014 the Board of County Commissioners was pleased to reappoint you to serve a three (3)year term, on the Jefferson County Health Board as the City of Port Townsend Representative. Your term expires on May 31, 2017. We feel certain you will continue to make a worthwhile contribution in this service to the community and we appreciate your willingness to devote time to this Board. Sincerely, (Excused Absence) 11/7 John Austin, Chairman Phil ohnson, Member O't u van, ` ember cc: Public Health • Phone (360) 385-9100 Pax (360) 385-9382 jeffbocc(co.jefferson.wa.us • Board of Health New Business Agenda Item #V, 4 Jefferson County Board of Health Bylaws May 15, 2014 r • BYLAWS OF THE JEFFERSON COUNTY BOARD OF HEALTH ARTICLE 1. NAME The name of this organization shall be the Jefferson County Board of Health. ARTICLE II. PURPOSE The purpose of the Jefferson County Board of Health is to supervise all matters pertaining to the preservation of the life and health of the people of Jefferson County and to comply fully with the requirements of all applicable chapters of Title 70, Revised Code of Washington. The Board of Health shall: • Collect, analyze and disseminate to the community, through Jefferson County Public Health, information about community health conditions, risks and resources, and the availability of resources to address identified problems. • Enact such rules, regulations and policies as are necessary to preserve, promote and improve the health status of Jefferson County residents, and guide the allocation of appropriate and necessary public health resources. • Assure that necessary, high quality, effective public health services are available for the protection of the people of Jefferson County, including the control and prevention of any dangerous, contagious or infectious disease within the county. • Provide for the prevention, control and abatement of nuisances detrimental to public health. • Enforce, through the Health Officer, the public health statutes of the state and county. • Establish fee schedules for issuing and renewing licenses and permits or for such other services as are authorized by the law and rules of the State Board of Health. • Jefferson County Board of Health Bylaws Page 1 % ARTICLE III. REPRESENTATION • Membership: The Board of Health shall consist of 7 members, selected as follows: • Each member of the Jefferson County Board of County Commissioners shall serve as a member of the Board of Health for the duration of their elected term of office. • Four members of the Board of Health shall be appointed by the County Commissioners. Appointed members shall include one Port Townsend City Council Member and one Jefferson Healthcare District#2 Commissioner nominated by their respective organizations, one at-large community representative from the city and one at-large representative from the county. Terms: Appointed members shall serve for three year terms. Board of Health members may serve more than one term, including consecutive terms. Vacancies: In the event that a vacancy occurs for an appointed representative, the Board of County Commissioners shall appoint another representative within thirty (30) days, or as soon as practical, from the date of vacancy. In the event that a vacancy occurs from the Port Townsend City Council or Jefferson Healthcare District #2 member, the City or District shall nominate another representative from their membership within thirty (30) days. • Absences: Board members shall notify the Chairperson in advance if unable to attend any regular meeting of the Board of Health. Appointed Board members may be removed from Board membership by action of the County Commissioners for lack of attendance. Three or more unexcused absences from regular Board of Health meetings in one calendar year will be considered cause for removal. Non-Voting Members: The Board, by majority vote, may appoint non-voting members to the Board for a defined term of office. ARTICLE IV. OFFICERS Chairperson: The presiding officer of the Board of Health shall be the Chairperson, who shall serve for a term of one (1) year. The Chairperson shall be selected by a majority vote of the Board members present at the first regular meeting of each year. Vice-Chairperson: At the same meeting, a Vice-Chairperson shall also be selected for a term of one (1) year, who shall preside over all proceedings of the Board in the absence of the Chairperson. Vacancies: In the event of a vacancy in the office of Chairperson, the Vice- Chairperson shall immediately assume the duties of the Chairperson for the remainder of the year. Another representative shall be selected to serve as Vice-Chairperson at the next regular or special meeting of the Board. • Jefferson County Board of Health Bylaws Page 2 • Consecutive Terms: Board members shall not serve consecutive terms as Chairperson or Vice Chairperson. ARTICLE V. RULES OF BUSINESS Business shall be conducted in accordance with the most current edition of Robert's Rules of Order, so long as they are consistent with these Bylaws or amendments thereto. ARTICLE VI. COMMITTEES The Chairperson shall appoint subcommittees from the Board of Health or members of the community from time to time as the Chairperson shall deem necessary. The Chairperson shall be an ex-officio member of all committees. ARTICLE VII. ADMINISTRATIVE OFFICER The Board of Health may appoint an Administrative Officer who shall fulfill the responsibilities specified by RCW 70.05.045, including administering the operations of the Health Department. The Administrative Officer shall serve at the will and approval of the Board. • ARTICLE VIII. HEALTH OFFICER The Board of Health shall appoint a County Health Officer, who shall be a qualified physician trained and experienced in public health, who shall exercise the powers, and perform the duties prescribed in RCW 70.05.070. The Health Officer shall serve at the will and approval of the Board. ARTICLE IX. OPERATING RULES Section 1. Meetings Regular Meeting: Regular meetings of the Board of Health shall be held on the third Thursday of each month. If the third Thursday is a legal holiday, an alternate day may be selected by the Chair. Any regular meeting of the Board of Health may be cancelled with the concurrence of a majority of the Board. The location of the meetings shall be within Jefferson County. Special Meeting: The Chair or two-thirds of the voting members of the Board may call a special meeting of the Board consistent with RCW 42.30.080. Executive Session: The Board may hold executive sessions from which the public may be excluded for the purposes set forth in RCW 42.30.110. • Quorum: A majority of all voting Board members, including at least two Jefferson County Commissioners, shall constitute a quorum for Board meetings. Jefferson County Board of Health Bylaws Page 3 Tape Recordings: The proceedings of all Board meetings shall be recorded . electronically. Any person may request a copy of electronic recording media of any meeting of the Board by payment of reasonable cost per policy. Minutes: Written minutes of each Board meeting shall be prepared and approved by the Board at the subsequent regular meeting. Minutes shall be signed by the attending Members at the time of their approval by the Board. Meetings Open to Public: All regular and special meetings of the Board and Board committees shall be open to the public, in accordance with RCW 42.30. Materials to Board Members: Except in cases of emergency, the agenda and materials related to action items shall be sent to Board members in advance of the meeting at which the items will be considered. Section 2. Voting Actions Requiring a Vote: Each regular member of the Board shall be entitled to one vote on all actions of the Board that require a vote. An affirmative vote of a majority of voting Board members shall be required to pass an action of the Board, provided that a quorum of the Board is present. Tie Vote: In the event of a tie vote, the action does not pass. Voting By Proxy: There will be no voting by proxy on any question before the Board. Section 3. Ethics • Conflict of Interest: Members of the Board of Health having personal or professional interest on an action item that may be deemed conflicting or infringe upon the appearance of fairness shall declare the conflict. If the member or the Board, by majority vote, determines the conflict of interest to be significant,the member shall refrain from discussing or voting on the matter. Section 4. Public Testimony General Public Comments: At each meeting, according to the usual order of business, the Chair shall call for general comments. Persons wishing to comment shall give their name and address. The Chair may establish time limits for individuals who wish to speak. Comments on Action Items: Prior to voting on any item requiring action by the Board, the Chair may call for comments by persons interested in or affected by the matter under consideration before the Board. Persons wishing to comment on action items shall give their name and address. The Chair may establish time limits for individuals who wish to speak. Section 5. Public Hearing The Board shall conduct public hearings prior to adoption of fees, ordinances, rules, or other exercises of its quasi-legislative powers. All members of the public in attendance at a public hearing will be allowed to speak if they so desire. Persons • wishing to provide testimony shall give their name. Time limits may be placed on individual comments at the discretion of the Board Chair and the public should be Jefferson County Board of Health Bylaws Page 4 advised that comments must relate to the matter at hand. Order and decorum should be maintained at all times. Rules for the conduct of the hearing should be stated by the Board Chair at the beginning of the hearing. Following public testimony, the Board Chair shall close the public hearing and the Board may deliberate and take action on the matter at hand. Call for Public Hearing: A public hearing may be called for by an affirmative vote by a majority of the Board. Public notice will be given at least 10 days prior to a public hearing of the Jefferson County Board of Health. Section 6. Appeals Hearing Board of Health appeal hearings shall be open to the public and presided over by the chair of the Board of Health. Such hearings shall be recorded. Board of Health hearings shall be opened with a recording of the time, date, and place of the hearing; and a statement of the cause for the hearing. The hearing shall be limited to argument of the parties submitted in writing prior to the meeting and no additional evidence shall be taken unless, in the judgment of the chair, such evidence could not have reasonably been obtained and submitted prior to the hearing. Additional appeal hearing procedures may be required by the specific public health code (e.g. On-site Sewage, Solid Waste, or Food Safety) that governs the matter under appeal. ARTICLE X. MISCELLANEOUS • Reimbursement of Expenses: Board of Health members may receive reimbursement for approved expenses related to completion of their responsibilities. ARTICLE X. AMENDMENTS TO BYLAWS These Bylaws can be amended at any regular meeting of the Board by two-thirds (2/3) vote of total members, provided the amendment has been submitted in writing to the Board of Health at least ten (10) days prior to said meeting. ADOPTED the day of , 2009 Chairperson,Jefferson County Board of Health • Jefferson County Board of Health Bylaws Page 5 • Board of Health New Business Agenda Item #V, 5 Community of Health Planning Grants, Letter of Intent May 15, 2014 • r yti7 JEFFERSON COUNTYPUBLIC HEALTH S .7 615 Sheridan Street o Port Townsend o Washington o 98368 www.jeffersoncountypublichealth.org May 8, 2014 Ms. Andria Howerton GOA Coordinator Washington State Health Care Authority Olympia, WA Re: GOA #14-015 Community of Health Planning Grant Dear a Ms. Howerton: I am submitting the following information in support of our Letter of Intent. Applicant's Organization Name: Jefferson County Public Health (JCPH) Applicant's authorized representative for this GOA: Thomas Locke, MD, MPH Title of authorized representative: Jefferson County Health Officer IIIIAddress: 615 Sheridan Street, Port Townsend, WA 98368 Telephone number: (360) 385-9448 Email address: tlocke@co.clallam.wa.us Applicant's eligibility addressing all criteria listed in section c. 1: a)JCPH is a local public health jurisdiction with the proven ability to enable public-private partnership and cross-organizational priority setting. JCPH has a long experience working with neighboring counties, public hospital districts, Tribal Nations, and mental health, chemical dependency, oral health, and medical care providers. b) JCPH has a state-of-the-art financial management system and manages a wide range of grants. Learning assistance is a continuous activity for local health jurisdictions. c) The Community of Health Plan will serve two contiguous counties, Jefferson and Clallam, including the 5 sovereign Tribal Nations that share boundaries with these two counties— the Jamestown S'Klallam, Lower Elwha Klallam, Quileute, Makah, and Hoh Tribes. Total population served (2012 estimate) is 101,709. COMMUNITY HEALTH DEVELOPMENTAL DISABILITIES PUBLICHEALTH ENVIRONMENTAL HEALTH IIIMAIN: (360) ALWAYS WORKING FORSAFER T} HEALTHIER CO UNITY WATER QUALITY FAX: (360)385 9401 MAIN: 385-9444 FAX: (360)379-4487 RI d) JCPH has a long history of innovative engagement with community health partners. Currently, community health assessments and community health improvement plans are underway in both Clallam and Jefferson counties in collaboration with Olympic Medical Center (Clallam County) and Jefferson Healthcare (Jefferson County). Jefferson and Clallam County are signatories to an innovation Mutual Assistance and Collaboration Agreement with the 5 Tribes named above. This agreement authorizes a wide range of partnership activities. e) The concept of an Accountable Community of Health as laid out in the State's Health Care Innovation Plan and supporting legislation defines a voluntary association that reaches decisions through consensus. This structure prevents any single entity or sector from dominating the community agenda or having majority control. JCPH agrees with this conceptual approach and is committed to a Plan that adheres to these goals. The intended geographic population served by the applicant: Jefferson County(2012 estimate population 29, 846) and Clallam County(2012 estimated population 71,863. It is the intent of Jefferson County Health to submit a Community of Health Planning Application to include the two local health jurisdictions, 3 public hospital districts, 5 federally recognized Tribes, and other appropriate community partners. Sincerely, f.-7,--2)„, Thomas Locke, MD, MPH Jefferson County Health Officer COMMUNITY HEALTHPUBLIC HEALTH ENVIRONMENTAL HEALTH DEVELOPMENTAL DISABILITIES WATER QUALITY • MAIN: (360)385-9400 ALWAYS+AYS W 9 FOR A €E ANS MAIN: (360)385 9444 FAX:(360)385 9401 HEALTHIER COMMUNITY FAX: (360)379-4487 • Board of Health New Business Agenda Item #V, 6 Jefferson County Board of Health Action Itme List for 2014-2014 May 15, 2014 • t : IR cn 01 CA 01 01w w w w Ni 0 R3 R3 CD rn rn 0) rn rn co Ni Ni Ni N Ni Ni Ni Ni Ni Ni N N --i. OO O O O O O O O O O O E •W W W W OD W W (h) W W W W CD _T �00 m CD G m m N m 3 Q- 3 1 CD a fD 0 (D , m o c m ° m m O CSD) 0- O 0- m m T 0' Q Q a ( 0' . 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Cl) () C1 N N Com) 3 (D O -. p a CS < ca m c ccn CD m C v m y o Cl,o v Q v O N N v c- v ° < . 3 m a o `� o < 5 m N n- v, co O w co 5 N CD 0 v 3 (0 ° 00 oCD v 0. ° m '5 a Q- 0) Q CO' CD 11 CD (0 a CD 0 0 0 0 0 0 0 0 0 0 0 0 0 5 5• O 5 5 5• o 0 o O o' O C) C) C) C) C) C) C) C) C) C) C) C) o v v v v v v v v v a) v ' -, CD CD CDCD CD CD' 'CDCD' CD 5 CD 0 n Q n n O n 0. Q n. n n a III co N N N O O N N OO • K > E CD CT m w 3 0 CD O m D -, 0- co O . c m 0 3 O ,, 3 co 3 0 0 v o < Q a CD a o 0 ET v v o -- a CDD 3 g o c) < o 0 CD z W (D CD• CD Et) Q) -0 6 .0 O N -n �' N 7,-'.• O to N 3 (f) o m c0) o co av, > a o c 0 CD 5. C (i) c co CT C) O v a 0 a m O 0 o' o' n o 0 ✓ v co R. ' 0 a a 0 • Board of Health Media Report s May 15, 2014 S • Board of Health Media Report S May 15, 2014 0 Board of Health Media Report 0 May 15, 2014 0 • Jefferson County Public Health April/May 2014 NEWS ARTICLES 1. "Peninsula health officials on lookout for measles after recent outbreaks elsewhere in state," Peninsula Daily News, April 17th, 2014. 2. "Measles in San Juan, Whatcom, and Kitsap counties," Port Townsend Leader, April 23rd, 2014. 3. "Anderson Lake still closed by biotoxin, fish elsewhere this opening day," Port Townsend Leader, April 23rd, 2014. 4. "UPDATE: Anderson Lake is open for fishing starting Saturday," Port Townsend Leader, April 24th, 2014. 5. "Anderson Lake between Port Townsend and Chimacum to open Saturday for trout fishing season," Peninsula Daily News, April 25th, 2014. 6. "Anderson Lake reopening to fishing may be short-lived," Peninsula Daily News, April 27th, 2014. 7. "Anderson Lake tests show fishing is safe," Port Townsend Leader, April 30th, 2014. 8. "SmileMobile comes to Quilcene," Port Townsend Leader, April 231d, 2014. 9. "EnviroStars —Certified Dentists," Port Townsend Leader, April 23`d, 2014 "Anderson 10. "EnviroStars —Certified Dentists," Port Townsend Leader, May 7th, 2014. i • , Peninsula health officials on lookout for measles after recent outbreaks elsewhere in state •By Rob 011ikainen, Peninsula Daily News,April 17`h,2014 PORT ANGELES — Since a total of 13 measles cases were detected last month in San Juan, Whatcom and Kitsap counties, North Olympic Peninsula health officials are on the lookout for more cases closer to home. Dr. Tom Locke, public health officer for Clallam and Jefferson counties, said it is possible that another wave of the highly contagious viral illness will spill onto the Peninsula. "It's sort of a serious situation going on in the state, likely to get worse before it gets better," Locke told the Clallam County Board of Health on Tuesday. The good news is most people have already been vaccinated for measles or were exposed to it before 1957 and are now immune. Measles is associated with a cough, sore throat, conjunctivitis and fever within 12 days of exposure, progressing to a generalized rash that usually begins on the face. Up to 30 percent of measles cases lead to significant complications, including pneumonia and swelling of the brain. •"The other reason this is serious is that measles is the most contagious disease we know of," Locke said. Six Whatcom County measles cases are linked to a larger outbreak, going on now, of more than 375 in southern British Columbia. A separate six-case outbreak occurred in San Juan County late last month after a young man who had not been immunized returned from the Philippines and visited several restaurants and public events before he developed the measles rash. A Kitsap County man came down with measles after eating at a Friday Harbor restaurant where the contagious San Juan County individual had been. The Kitsap County man traveled on Washington state ferries. Measles is so contagious, Locke said, that you can catch it through airborne transmission two hours after an exposed person leaves a room. In a Wednesday interview, Locke said it is a "definite possibility" that the recent outbreaks will spread to the Peninsula. "I don't know if it's a probability, though," he added. "If we stat seeing [new] measles cases this week, that means a lot of people got exposed. Clallam and "'Jefferson counties could be a risk for what you would call a third wave." Case rates have been rising nationally because of lower vaccination rates and importation since measles Ink was declared to be eliminated from the U.S. in 2000. aThere were large measles outbreaks last year in unvaccinated communities in New York and Southern California. "Washington state has one of the worst measles vaccination rates," Locke told the health board. "As a general rule, if the immunity to measles in the population drops to below 95 percent, you're at risk for outbreaks. And we're well below that number. "So this has been a problem we've been concerned about for many years, and now it's starting to happen." Parents are urged to get their children vaccinated if they haven't had a shot. The highly effective vaccine is available at health care clinics, the Clallam and Jefferson County health departments, and certain pharmacies. Students and health care workers who have been exposed to measles and can't provide proof of immunity can be quarantined for three weeks. "From a workload standpoint, even a single measles case in a community is a huge workload issue for the public health department, for the health care system," Locke said. •"You end up having to do all these case investigations to try to determine whether people are immune or not, find vaccination records, do blood tests to see if you can detect immunity that way and vaccinate a lot of people. "So it takes what amounts to a kind of an emergency response of the health department, even with a single case." A British Columbia-style outbreak would be "way beyond" what the state lab capacity could handle, Locke added. "Our goal is to not let this get as bad as British Columbia," Locke said. Fears about the measles vaccine being linked to autism have been discredited as "fraudulent research" by someone who was trying to sell a different kind of vaccine, Locke said. Information about measles is available on the state Department of Health website at www.doh.wa.gov. Reporter Rob 011ikainen can be reached at 360-452-2345, ext. 5072, or at rob.ollikainen@peninsuladailynews.com. S • Measles in San Juan, Whatcom, and Kitsap counties Port Townsend Leader, April 23, 2014 Cases of measles are occurring in three Washington state counties — San Juan, Whatcom and Kitsap — along with a large outbreak (more than 375 cases) in southern British Columbia. To date, there have been 12 confirmed cases in Washington state, the most recent being that of a Kitsap County man who was exposed in a restaurant while visiting Friday Harbor. Several of those people known to have measles have traveled around the state during their contagious period, including time spent on Washington state ferries, and in restaurants and public gatherings, according to Jefferson County Public Health. Measles is a viral respiratory disease that starts with flu-like symptoms and progresses to fever and rash. It is one of the most contagious diseases known and is easily spread when an infected person breathes, coughs or sneezes. If a person is susceptible to the infection — has not been vaccinated or has had a III previous measles infection — they can get measles just by walking into a room occupied, or that has been occupied in the previous couple of hours, by someone with the disease. Symptoms of a measles infection include fever, runny nose, cough, reddened eyes and a rash that begins on the head and spreads downward covering the body. Symptoms begin seven to 21 days after exposure, and a person is highly contagious for four to five days before the rash appears and for four days afterward. People at highest risk of becoming infected with measles are those who are unvaccinated, pregnant women, infants younger than 6 months of age and those with weakened immune systems. Anderson Lake still closed by biotoxin, fish elsewhere this opening day Port Townsend Leader, Wednesday, April 23, 2014 Cross Anderson Lake off your fishing list again this year. The lake just west of Chimacum is closed to fishing and other public use due to a persistent toxic algae bloom. Jefferson County Public Health tested Anderson Lake on April 14, 2014, and it remains closed. Lake Leland and Gibbs Lake (sites of county parks) were also tested April 14 and carry a "caution" label. Human contact with lake water is not advised, but fish can be eaten if cleaned well. Sandy Shore, Crocker and Silent lakes are clear of toxic algae so far this year. Statewide, the Washington State Department of Fish and Wildlife has stocked 16 million hatchery fish to prepare for the lake fishing opener this Saturday, April 26. The state has stocked hatchery fish into seven East Jefferson lakes. • Two weeks ago Gibbs Lake was stocked with 70 rainbow trout with an average weight of 1 .5 pounds each, plus 740 rainbow averaging three-quarters of a pound each. Horseshoe Lake received 260 rainbows, averaging three-quarters of a pound each. Lake Leland gained 260 larger rainbow and 6,000 fry. Sandy Shore Lake received about 2,275 rainbow. Silent Lake drew 800 rainbow, Teal Lake gained 300 fish weighing three-quarters of a pound each and Tarboo Lake had 1 ,650 rainbow. For most people, a valid 2014-15 fishing or hunting license is required to participate in state fisheries, freshwater or saltwater. The exception is young people under age 15, who can fish for free. Licenses and permits are available online at fishhunt.dfw.wa.gov, by phone at 1- 866-246-9453 and from sporting goods stores and other retail license dealers around the state. S UPDATE: Anderson Lake is open for fishing starting Saturday port Townsend Leader, Wednesday, April 23, 2014 - UPDATED April 24, 2014 Anderson Lake State Park in Jefferson County is going to be open for the start of statewide lake fishing season this Saturday, April 26. As of April 21, Anderson Lake itself was closed to public use after a July 14 water quality test by Jefferson County Public Health found the presence of toxic bluegreen algae. More water tests were conducted earlier this week, and now Anderson Lake has been upgraded from "closed" to "caution" meaning humans and animals should still not come in contact with lake water, but well-cleaned fish are edible. "We know that a lot of people are interested in the opening day of trout fishing," said Michael Dawson, Water Quality lead for Jefferson County, in a press release April 23. "At the same time we want to be sure people are well aware of what's in the water. In speaking with Anderson Lake State Park Manager Mike Zimmerman, I was told that Anderson Lake will be open at daylight on Saturday, April 26." A state Discover Pass vehicle parking fee applies at Anderson Lake. The season's initial lake sampling was done April 14, with additional samples were taken April 21 at Anderson, Gibbs and Leland lakes, and sent to the King County Environmental Lab to be analyzed. Anatoxin-a was detected in Anderson Lake at 0.3 micrograms per liter, which is below the state recreational guideline of 1 microgram per liter, Dawson reported. This is up slightly from the April 14 results of 0.09 per liter. A bloom of the bluegreen algae species Aphanizomenon and Anabaena is visible in Anderson Lake; these are often toxin producers and typically form a thick bloom as the water warms in spring and summer. Anatoxin is dangerous, fast-acting nerve toxin that can result in paralysis and death in animals and humans, Dawson Ilforted. s week in Gibbs Lake and Lake Leland, light blooms of bluegreen algae are visible, but no toxins were detected, according to Jefferson County Public Health. In late May 2006, two dogs quickly died after drinking from Anderson Lake —the first sign of toxic algae. The problem has also occurred in other lakes here, but usually in later May or June when the weather is warmer. Sandy Shore, Crocker and Silent lakes are clear of toxic algae so far this year. RAINBOW TROUT Statewide, the Washington State Department of Fish and Wildlife has stocked 16 million hatchery fish to prepare for the lake fishing opener this Saturday, April 26. The state has stocked hatchery fish into seven East Jefferson lakes. Two weeks ago Gibbs Lake was stocked with 70 rainbow trout with an average weight of 1.5 pounds each, plus 740 rainbow averaging three-quarters of a pound each. Horseshoe Lake received 260 rainbows, averaging three-quarters of a pound each. Lake Leland gained 260 larger rainbow and 6,000 fry. Sandy Shore Lake received about 2,275 rainbow. Silent Lake drew 800 rainbow, Teal Lake gained 300 fish weighing three-quarters of a pound each and Tarboo Lake had 1,650 rainbow. For most people, a valid 2014-15 fishing or hunting license is required to participate in state fisheries, freshwater or saltwater. The exception is young people under age 15, who can fish for free. enses and permits are available online at fishhunt.dfw.wa.gov, by phone at 1-866-246-9453 and from orting goods stores and other retail license dealers around the state. Anderson Lake between Port Townsend and Chimacum to open Saturday for trout fishing season •By Charlie Bermant , Peninsula Daily News, April 25, 2014 p While signs against fishing or boating were up all winter at Anderson Lake,the county expects safe lake access will be granted Saturday.—Charlie Bermant/Peninsula Daily News CHIMACUM —Anderson Lake is scheduled to open for fishing and boating Saturday on the first day of the state lowland lake trout fishing season. But access to the popular trout fishing lake in Anderson Lake State Park could change as the weather warms since it has a history of high summertime levels of toxins created by blue-green algae. "Right now, it's safe," said Michael Dawson, water quality lead for Jefferson County. •"We are a little below state guidelines for toxins. "But it's been predictable in past years. As soon as the temperature goes up, we get higher toxin levels that can go up as much as 1,000 percent." In 2013, State Parks closed Anderson Lake, located between Port Townsend and Chimacum, on May 17 after just a few weeks of fishing, and it was not reopened for the rest of the season because of high levels of anatoxin-a, a nerve poison that can kill within four minutes of ingestion. Anderson Lake has been tested for toxins since two dogs that lapped water from the lake died Memorial Day weekend in 2006. In June 2008, the 60-acre lake set a world record: 172,640 micrograms of anatoxin-a per liter. The safety threshold for the toxin is 1 microgram per liter. The latest tests, from samples taken April 21, found 0.3 micrograms of anatoxin-a per liter in Anderson Lake water. That's well below the danger level. But it also is higher than the 0.09 micrograms per liter found in the samples taken a week earlier April 14. "We know that a lot of people are interested in the opening day of trout fishing." Dawson said, "At the same time, we want to be sure people are well aware of what's in the water." •The park will open at daybreak, said Mike Zimmerman, the state ranger who supervises the 410-acre Anderson Lake State Park. Zimmerman expects a "good harvest" of fish since the lake was closed for most of last year and the fish have multiplied. *But he doesn't anticipate large crowds. "A lot of people have made other plans for the opening of the season because we wait until the last minute to announce whether we will be open," he said. Dawson said both Lake Leland north of Quilcene and Gibbs Lake south of Port Townsend have visible algae blooms but are free of toxins. The two county lakes were tested both for anatoxin-a and microcystin, another blue-green algae poison often seen in East Jefferson County lakes. Microcystin can cause skin irritation if touched and liver damage if ingested over a long period of time. Caution signs will be posted at all three lakes throughout the season. Dawson said state budget cutbacks have decreased the frequency of testing, but he expected the testing of Anderson Lake would be conducted on a weekly basis for the first part of the season. Samples are tested by King County Environmental Labs. Blue-green algae occurs naturally and usually is benign. Researchers don't know what causes certain species of algae to suddenly begin producing toxins. They do know that toxin levels can rise in the summer. Warm weather fuels algae growth when sufficient *nutrients such as phosphates are present. A Discover Pass or day pass is required for any vehicle that enters Anderson Lake State Park. A Discover Pass costs $30 for the year, while a day pass costs $10 and a boat pass $7. A 12-month launch pass costs $80 and includes a Discover Pass along with covering all of the boat launch fees in state parks. Up until 11 a.m., the passes will be sold at the lake using a portable credit card machine. After that time, only cash and check will be accepted. All passes also will be available at the Fort Flagler State Park visitor center at the northern tip of Marrowstone Island through a machine that takes credit cards 24 hours a day, Zimmerman said. Toxin-producing blue-green algae has not been spotted in Clallam County, where routine tests are not done. 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. • Jefferson County Editor Charlie Bermant can be reached at 360-385-2335 or cbermait(a�peninsuladailynews corn Anderson Lake reopening to fishing may be short-lived By Joe Smillie, Peninsula Daily News,April 27th, 2014 • :;:er� e miEk Vii' to .. . . . Robbie Kessler, left and Matt Laballe, both of Kingston,are among early-birds on Anderson Lake on Saturday. —Photo by Charlie Bermant/Peninsula Daily News CHIMACUM — The fish were biting at Anderson Lake, and plenty of anglers turned out as the lake, often closed because of high toxin levels, opened to rainbow trout fishing Saturday. "The weather's been cooperative; the fish have been cooperative. It's been a great day to go fishing," said Mike Zimmerman, the ranger who supervises Anderson Lake State Park. Lines were dropped at daybreak, with 26 people fishing in boats and 15 on shore at 7 a.m., according to state Fish and Wildlife's Cheri Scalf. Charles Cox of Port Townsend said he got quite a few bites. "The fish were healthier, they were meatier, than last year, although they weren't quite as big," he said. Zimmerman reported that 49 people were still fishing with 16 boats at 10:30 a.m. He said a company testing a new trout lure caught and released 40 fish in an hour and a half on the lake. Zimmerman advised anglers, or even boaters, to hit the lake quickly, as the toxins created by blue-green algae that plague the lake when temperatures warm are likely to prompt the Jefferson County Health Department to close it as soon as next month. "If we get three weeks in, we feel like we've done real well," Zimmerman said. Last year, the lake between Port Townsend and Chimacum closed May 17 because of toxins. The primary concern, said Michael Dawson, water quality lead for Jefferson County, is anatoxin-a, a nerve poison that can kill within four minutes of ingestion. "The amount of algae scum we have out there right now is indicating there will be another early closure," Zimmerman said. Scum can show thick algae growth, but it is impossible to know whether the algae is producing toxins without laboratory tests of water samples. "'For instance, two county lakes — Lake Leland north of Quilcene and Gibbs Lake south of Port Townsend — have visible algae blooms now but are free of toxins, according to tests. .. „ Conversely, a lake clear of scum may be poisoned. Tests are done for anatoxin-a and microcystin, another blue-green algae poison often seen in East Jefferson County lakes that can cause skin irritation if touched and liver damage if ingested over a long period of time. When lab tests determine the amount of toxin is found to be above the state recreational guideline of 1 microgram per liter of water, then rangers will not allow anyone on the lake. "The first thing you do when you fall into cold water is to take a big gulp," Zimmerman said. "We don't want people doing that." Anderson Lake has been tested for toxins since two dogs that lapped water from the lake died Memorial Day weekend in 2006. In June 2008, the 60-acre lake set a world record: 172,640 micrograms of anatoxin-a per liter. The latest tests, from samples taken April 21, found 0.3 micrograms of anatoxin-a per liter in Anderson Lake water. That's well below the danger level. But it also is higher than the 0.09 micrograms per liter found in the samples taken a week earlier April 14. Researchers don't know what causes certain species of blue-green algae—which occurs naturally and •usually is benign —to suddenly begin producing toxins. They do know toxin levels can rise in the summer because the warmth fuels algae growth when sufficient nutrients such as phosphates are present. Anglers who pull trout from the lake are advised to handle them carefully. Once the fish are eviscerated, carefully dispose of their entrails in a manner that ensures no pets or wildlife can eat them. Zimmerman also advised those with cuts on their hands to wear latex gloves while gutting fish and to rinse them thoroughly and remove the skin before eating. Signs are posted on the lake to warn anglers to be careful with the fish. For more information about Jefferson County lakes, visit http://tinyurl.com/jeffersonlakequality or phone the office at 360-385-9444. Toxin-producing blue-green algae has not been spotted in Clallam County. Report algae blooms in Clallam County by phoning 360-417-2258. Sequim-Dungeness Valley Editor Joe Smillie can be reached at 360-681-2390,ext. 5052, or at jsmillie(a�peninsuladailynews.com. • Anderson Lakè.1ëjs:: show fishing is : ,safè Anderson Lake State contact with lake water, but and Lake Leland,light blooms Park in Jefferson County well-cleaned fish are edible. ofblue green algae'are visible, opened for the start of state- "We know that a lot of butno toxins were;detected, wide lake fishing season this people are interested in the according to Jefferson County Saturday,April 26. opening day of trout fishing," Public'Health.' As of April 21, Anderson said Michael Dawson, Water .How long Anderson Lake Lake itself was closed to pub- Quality lead for Jefferson remains open for fishing this lic use after a July 14 water County, in a press release season depends on when quality test by Jefferson April 23. `At the same time warm weather potentially County Public Health found we want to be sure people elevates water temperature. the presence of toxic blue- are well aware of what's In In late May 2006; two green algae.More water tests the water. In speaking with dogs quickly died after drink were conducted earlier this Anderson Lake State Park ing from Anderson Lake—the week, and now Anderson Manager Mike Zimmerman, first sign of toxic algae. The. Lake has been upgraded I was told that Anderson problem has also occurred in from "closed" to "caution," Lake will be open at daylight other lakes here, but usually meaning humans and ani- on Saturday,April 26." in later May or June when mals should:still not come in This week in Gibbs Lake the weather is warmer. SmileMobile comes touil Q Gene Port Townsend Leader, April 23, 2014 The Washington Dental Service Foundation SmileMobile is scheduled to serve Quilcene April 28-31. The SmileMobile is staffed by a clinic manager, dentist, dental assistant and a local volunteer as it visits communities around the state offering examinations to children who might not otherwise have access to dental care. Examinations take place 1-4 p.m., Monday, April 28 and 9 a.m.-4 p.m., Tuesday, April 29. Follow-up treatments are to be provided through Thursday, May 1. Call 888-286-9105 to schedule an appointment. The SmileMobile is hard to miss — it's a brightly painted 38-foot dental clinic on wheels. Sponsored by Delta Dental of Washington and in partnership with Seattle Children's Hospital, the SmileMobile will be parked at the Quilcene Schools, 294715 U.S. Hwy. 101. • S n +n • d - s ENVIROSTARS=~ CERTIFIED DENTISTS Uptown Dental Clinic 3854700 Tyler Fordham,DDS s �` 385-7000 Dentistry Northwest �. 385-1000 ENVIRO TARS' Envirostars Certification is free and can help you attract new customers: CERTIFIED PUBLIC HEALTH • ALWAYS*Ammo FOR A SAFER AND DENTISTS HEALTHIER COMMUNITY Uptown Dental Clinic To get certified call 3794489 3854700 Tyler Fordham,DDS 385-7000 Dentistry Northwest 385-1000 Envirostars Certification is free and can help you attract new customers. PUBUCHEatif ALWAYS WORKING FOR 4 SAFER ARD. HEALTHIER COMMUNITY To get certified call 379-4489 • Y/02?/y