Loading...
HomeMy WebLinkAbout2015- September tr4/ N" c1j°n Public Hea It • File Copy Board of Health Meeting September 17, 2015 • Jefferson County Public Health Agenda Minutes Public Healt September 17, 2015 JEFFERSON COUNTY BOARD OF HEALTH September 17, 2015 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 August 20,2015 Board of Health Meeting III. Public Comment IV. Old Business and Informational Items 1. Olympic Community of Health Web Page 2. Mill Update—Odor Complaints 3. Strengthening Families and Youth Mental Health Training: Chimacum Prevention Coalition 4. School Based Clinics Reopen • V. New Business 1. Food Safety Program Fees—Possible Action Item: Call for Public Hearing 2. Proposed Comp Plan Amendment: Active Lifestyle and Chronic Disease Prevention 3. Back to School Initiatives: Immunizations and Heads Up Concussion Awareness Program VI. Activity Update VII. Public Comment VIII. Agenda Planning Calendar IX. Next Scheduled Meeting: October 15,2015 2:30—4:30 PM Jefferson County Public Health 615 Sheridan St. Port Townsend, WA • • JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, August 20, 2015 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 Board Members Staff Members Phil Johnson,County Commissioner District#1 Thomas Locke,MD,Health Officer David Sullivan,County Commissioner,District#2 Jean Baldwin,Public Health Dir Kathleen Kler,Vice-Chair,County Commissioner,District#3 Julia Danskin,Public Health Manager Kris Nelson,Port Townsend City Council Jared Keefer,Env.Health Dir Sheila Westerman,Chair,Citizen at large Veronica Shaw,Public Health Deputy Dir Jill Buhler,Hospital Commissioner,District#2 Michael Dawson,Water Quality Dir John Austin,Citizen at large Chair, Sheila Westerman called the August 20, 2015 meeting of the Jefferson County Board of Health to order at 2:35 p.m. A quorum was present. Members Present: Sheila Westerman, David Sullivan, Kathleen Kler, Kris Nelson, Jill Buhler, Phil Johnson Members Excused: John Austin • Staff Present: Jean Baldwin, Jared Keefer, Julia Danskin, Veronica Shaw, Philip Morley APPROVAL OF AGENDA Chair Westerman asked for approval of the August 20, 2015 Agenda. Member Buhler moved to approve the agenda; the motion was seconded by Member Sullivan. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Westerman asked for approval of the July 18, 2015 minutes. Member Buhler noted a mistake in the Activity Update section of the minutes—rather than "to adopt recommendations to form..."the sentence should read: "moved to approve recommendations from the task force." Chair Westerman called for approval of the minutes, as amended, of the July 18, 2015 meeting of the Board of Health. Member Nelson moved to approve the minutes as amended; the motion was seconded by • Member Kler. No further discussion. The motion passed unanimously. • PUBLIC COMMENT No public comment. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Port Townsend Paper Corporation (PTPC) Settlement Agreement Jared Keefer, EH Director, JCPH, reported on the completion of the PTPC Settlement Agreement. Operations, Closure, and Post Closure Plans were completed and accepted. Approval occurred on August 3, 2015, and began a 90-day period in which the PTPC submits its financial assurance report guaranteeing its ability to pay should the need to close the plant arise. Once JC Environmental Health approves the specific financial figures contained in PTPC's financial assurances, this document will be sent to the County Auditor for final approval. Mr. Keefer will write a press release once the entire process in complete. 2. Youth Mental Health Training Julia Danskin, Community Health Manager, JCPH, reported funding to host Youth Mental Health Training. The class was limited to 20 attendees. And because the class filled quickly, Ms. Danskin is considering a second class, the decision depends on the availability of trainers from Project Aware. • 3. New Naloxone Law Takes Effect Jean Baldwin, Director, JCPH, updated the Board on HB1671, a law that increases access to naloxone. Ms. Baldwin explained JCPH's plan for making naloxone available in the syringe exchange program to prevent opiate overdose fatalities. JCPH is working on securing funding for naloxone and to improve access to it in the community. 4. West Nile Virus Death Reported in Benton County Ms. Baldwin reported to the Board on increased awareness and attention being paid to bats, and increases in mosquito populations. It was suggested that people who sleep with their windows open due to the unusually high temperatures use screens to prevent mosquitos from getting into the house. NEW BUSINESS 1. Olympic Accountable Community of Health (ACH) Briefing—Peter Browning Peter Browning, Browning Solutions, introduced his credentials and discussed his role in the formation of the Olympic Accountable Community of Health(ACH), the three- county ACH to which Jefferson County played a key role in establishing. Mr. Browning reviewed unique demographics throughout the region, and emphasized the importance and difficulties of working with Health Care Authority(HCA) at the state level and Centers for Medicaid and Medicare Services (CMS) at the federal level. Browning also discussed the timeline for formation of the Behavioral Health Organization(BHO). The • ACH is focused on specific tasks in order to secure designation as a state designated • ACH in late 2015. Establishing a governance structure and administrative capacity; developing a governing body and structure for funding; and refining communication that promotes transparency and regional awareness are the priorities. Managing data region- wide will improve rural health care with the "triple aim"to provide health care "better, faster, and cheaper." Understanding data is key to comprehensive, coordinated healthcare delivery. Electronic Medical Records will be core to making all of this work. All of this combined will enable the ACH's future achievement of Medicaid Waiver status with CMS, which will give the organization control of its federal Medicaid dollars. Mr. Browning stressed the importance of this in securing specific improvements in healthcare delivery appropriate to the community's unique demographics. Browning acknowledged that we have a long,bumpy road ahead but he is enthusiastic, and believes in the high-level collaborative functioning of the group members. 2. Solid Waste Enforcement Mr. Keefer further discussed the reduction in funding at the state level for the JCPH, Solid Waste program. In order to maintain some vigilance and response to complaints, Mr. Keefer suggested county-backed bridge funding to take up the slack while the county waits for the State to provide backfill money. There was concern among Board members about where the county would get the additional funds to bridge the gap. Keefer emphasized the need for a methodical, planned decline in enforcement and reiterated the importance of bridge funding. • 3. Food Safety Program Mr. Keefer provided to the Board the second installment of a review of the Food Safety program in Jefferson County. He reviewed and explained inspection detail by establishment type and uncompensated activity in detail. The problem is uncompensated costs, and how the program might recoup those costs. Mr. Keefer is not suggesting fees support the program at 100%, but that fees and performance improvements support the program. 4. Community Health Improvement Plan—Activity Update Ms. Baldwin reported to the Board the immediate problem facing the Community Health Improvement Plan: how to pull all of the piece together. The group needs someone to coordinate, track, record, and schedule all of the many aspects of Plan elements; as well, she noted finding new funding sources for continued work is needed. She is hopeful hospital stakeholders will contribute to these needs. JCPH is emphasizing the importance of integrating healthy behaviors within the County's Building Comprehensive Plan. If communities are designed to be conducive to healthy behaviors at the building and infrastructure levels, then populations will be better able to consistently engage these behaviors. 5. Community Health Director Interview Process Ms. Baldwin stressed the importance of this position in providing stability in the face of the many upcoming retirements and asked for a volunteer from the Board to participate in • the interview process. It was tentatively decided that John Austin, who was absent, might • participate in lieu of Sheila Westerman, should her schedule prevent her participation. ACTIVITY UPDATE Ms. Baldwin reported that Jefferson Healthcare was awarded World Health Organization's Baby Friendly Hospital designation. Jefferson Healthcare is one of five hospitals in the state to receive this designation. Mr. Keefer informed the Board that JCPH has formed a partnership with the Jamestown S'Klallam tribe in establishing a working relationship regarding water quality and Pollution Identification and Correction. Ms. Baldwin noted JCPH has budget shortfalls. Member Buhler will not attend the September 17, 2015 Board of Health meeting. PUBLIC COMMENT There was no public comment. NEXT SCHEDULED MEETING The next Board of Health meeting will be held on Thursday, September 17, 2015 from 2:30- 4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT Chair Westerman adjourned the August 20, 2015 Jefferson County Board of Health meeting at 4:15 p.m. JEFFERSON COUNTY BOARD OF HEALTH ABSENT Phil Jo '.on, Member Jill Buhler, Me ber Davi. ull , em•er Sheila Westerman, Chair Kris Nelson, Member Kathleen Kler, Vice-Chair kele John Austin, Member • Respectfully Submitted: Board of Health S IV Old Business Item 1 Olympic Community of Health Web page 4 -16941- n Public Flea it September 17, 201 i Welcome Yage 1 of 2 • OLYMoPIC COMMF �,�R�THUNITY Sin In Olympic Community of Health g Search Inn site w p' Welcome Accountable Community of Health Building healthier communities through a collaborative regional approach focusing on social determinants of health,clinical-community linkages,and whole person care. The Olympic Community of Health's 2015 ACH design phase In January 2015,the three-county region of Kitsap,Clallam and Jefferson(Olympic Community of Health)was selected by the Washington Health Care Authority as the successful applicant for a$100,000"design community"grant for the Olympic Community's Regional Service Area. Learn more about the regional ACH design grants and statewide ACH initiative. A copy of the Olympic Community's application is available for review:Download the application(PDF). The purpose of the Design Community Grants is to allow regions to build on the ACH planning efforts that occurred in 2014. Meetings Olympic Community of Health Stakeholder Meeting Wednesday,July 29th,2015;1:00-4:00 p.m. • Hood Canal Vista Pavilion 4740 View Drive,Port Gamble OCOH Flow Chart(PDF) Olympic Community of Health-Initial Meeting Friday,November 7th,2014;9:30 a.m.-12:30 p.m. Fort Worden State Park Commons Building(Room A) 200 Battery Way,Port Townsend The Health of Our Counties(PDF) Learn More • Washington State Health Care Innovation Planning-Accountable Communities of Health • Medicaid Transformation and Washington State's exploration of a Global Medicaid Waiver • ACH Regions Map • ACH-Intents and Goals • ACI-1-Setup and Outcomes Contacts For additional information about the Olympic Community of Health,please To be added to the Olympic Community of Health email list,please contact: contact: Peter Browning,OCOH Project Manager Kathy Greco Browning Solutions Kitsap Public Health District (360)770-4321 (360)337-5216 • pbrowning.solutions@gmail.com kathy.greco@kitsappublichealth.org http://www.olympiccommunityothealth.org/Pages/Welcome.aspx 8/31/2015 Board of Health • IV Old Business Item 2 Mill Update: Odor Complaints 4( ,,, '' ' • )4;2/son Public Healfi September 17, 2015 r Jefferson County Commissioners and Jefferson Healthcare Hospital Commissioners: • In response to a significant number of frequent reports by Port Townsend citizens of nuisance odors and adverse health effects due to toxic air pollutant emissions from the PTPC mill, a group of citizens have been conducting their own reporting and odor tracking activities via the facebook page"MillOdorous", which we invite you to view on facebook. The following comments are taken from the MillOdorous facebook page (httos://www.facebook.com/groups/1125341257483459/)to show county and hospital commissioners the serious degree of adverse impacts the frequent detrimental emissions and nuisance odor episodes are having on the health and well being of people living in Port Townsend and surrounding areas. The individuals contributing descriptions of the odor/toxic emissions events are representative of the wider population as they are reporting from different neighborhoods, some of which are a significant distance from the PTPC Mill, and most of which are well outside the range of what used to be referred to as"the plume" near the mill. While we are well aware that this is an issue that is under the jurisdiction of the WA State Dept of Ecology, nearly a decade of efforts to get the Dept of Ecology and the PTPC to take action with regard to protecting the health and well being of people by eliminating, or at least reducing, the toxic air pollutants and the nuisance odors have not had any real results and it continues to be, and at some times seems to be a worsening problem. We present this information to you as an issue that should be recognized by our Jefferson County representatives as a serious problem, and as such should be addressed by the elected representatives of the people of Jefferson County. August Odor Map: https://www.google.com/maps/d/edit?mid=z-mLKHcUXboA.kXOamME_FT3A Thank you for your consideration, Nancy Botta Lynda Woodson N.'s Stinky this morning on 0 Street 8-5-15 house F.'s Stinks downtown too!! 8-5 house N.'s 8-2 and 8-3 2nd night in a row I had to close up the windows from the house stench downtown. Really getting old. N.'s Was woken up at 2:30 am this morning (8/5/2015)to the foul stench of our house friendly neighborhood polluters, i.e. the Mill. 3rd night in a row, and it's been quite cool, so this bs from them that the heat of the summer is the problem is bogus. As has been noted by others, there is a distinct sourness/sulfur/metal that is part of the rotting smell. Wish the EPA were really doing its job. Nancy, if you know of someone higher up in the chain I can send a scathing letter to (or several), let me know, I'm happy to do so. I don't think the people we are reporting this to at the EPA really do anything at all except maybe shove the data into File 13. 410 Crystal Tuesday night(8-4) I smelled the mill strong on the East Beach on . Marrowstone, yesterday afternoon I smelled the mill strong on the East Beach on Marrowstone, Last night I smelled the mill bad at the Hadlock Hotel. There now seems to be no escaping it. And for some reason the city of Port Townsend is not able to be aggressive enough. Who is the hold up as when you watch the meetings it seems that Sandavol, Nelson and others are not really in favor of the Mill having rights over the town so who is the hold up? Is it county commissioners. Is there pay offs? I sure believe there are and it's time for ALL of Port Townsend and ALL of Jefferson County to fight back. S.'s Aug 7 at 0544 I was awakened to stink near Hastings and Howard. house N.'s 8-10-15 8:30 am this morning- I cannot open the windows because of the house mill smell, which started in the middle of the night. I can't count how many nights in a row I have had to leave them closed now. How the shopowners downtown let this continue is unbelievable. J.'s it's stinkin' up here on q and fir as well. 8-10-15 house S.'s Slammed with stink for the second time today. At 2100 hrs had to close house window. Aug 8 near Hastings and Howard. N.'s 8-10-15 Stinks this morning 4 on a scale of 1 to 8 on 0 Street house L.'s Sunday night, the 7th, here at Clay and Madison it was a 3. By morning it house was an 8. I give it that high of a rating because it permeated my apartment even though the windows had been closed all night, and because my air filter was unable to keep the entire apartment clear as it usually does. This morning it could only keep the air clear in my 10x10 bedroom. It was more dense than what I've experienced previously... N.'s 8-10-2015, 11:30pm, mill smell 7/8, Mill/Water Street Downtown PT house N.'s Noxious mill fumes Water Street at 9pm 8/12/2015. Unbelievable. What do house the owners of the Pour House, Sirens, Finns, Jordinis, The Belmont do when this happens? Hustle all of their diners inside off the decks/patios? Do they shut up all the windows? Is it really obnoxious that it even gets into the building when the windows are shut. • S.'s Hit by mega stink Aug 15 at 0003 hrs. 7 out of scale of 8 near Hastings house and Howard. Window was closed and fan was run with a Jean Nate anointed dryer sheet in back of it. O.'s 8-19-15 Strong Mill stench this morning just off San Juan on Cedar St. house near Froggy Bottoms. About a 6 or 7, I guess. Had to close my window. It actually woke me up. Sore throat. Will report to Stephanie Ogle. My Japan family coming back today from trip to CA and two of them have asthma. Of concern. F.'s 8-19-15 I'd say 8 or 9 downtown. Woke me up around 5am. Makes me house feel kind of sick to my stomach. S.'s Aug 19 at 0219 hrs , I had my mill stench wake up call. This was a 7 out of house 8. This is the first time I woke up with a headache. It's now 0826 and the smell hasn't completely cleared yet. This event is going over 6 hours, although the smell is, now, less intense. L.'s Mill odor report 8/19/15: really strong pulp cooking odor at 4:30 AM it woke house me up, and I couldn't get back to sleep because when the odor is that strong I really feel like I can't breathe. I just got a wave of extremely foul sewer/rotten egg smell, about 20 minutes ago 7:50 AM. I am getting ready to leave my house because the odor is so bad. This is the worst that I have 411 experienced in a long time. It also irritates my throat. I will be contacting the mill and DOE to ask"what in the hell are they doing? at the mill that is causing this" L.'s 8-18 Mill stench began about 2:30 am. Had to close all windows and go house upstairs (smell seems to hang low and is not as bad up there. Had to also close upstairs windows. Coughing, sore throat, bad taste in my mouth hours later. At Cook and Hastings. I want to report, but I think there is a new person monitoring -does anyone know latest contact? N.'s Every single evening this month the Mill smell has been downtown. I am house tired of recording and calling. N.'s 8-15 Mill really bad over here. YUCK. At 35th and Haines. And yesterday. house Eyes watering right now. Geez, do the owners live here? N.'s 8-19-15 Was woken by mill smell around 7 a.m. on 0 Street. Scale of 4/8 house N.'s 8-20-15 Another stinky day in Port Townsend 7 a.m. On 0 Street. 3/8 house scale • S.'s Aug 21...Here it comes AGAIN. My guest and I just returned to P.T. 6:30 11111house p.m. Along Jacob Miller to Hastings the stench was incredible 7/8. My guest must have said OMG about 10 times. Its creepy to sit here waiting to be attacked by the plume. I may not have to plan for many repeat visitors. F.'s 8-24-2015 Mill smell hitting downtown PT pretty heavy right now 7:30am house seems about a 5 at this time. N.'s Crap. It's starting to stink here. 8-24-2015 8 a.m. on 0 Street. 4/8 house S.'s 8/24 at 0825 a very intense blast hit 7/8 right now near hastings and house Howard. Only 5 minutes ago I sniffed outside after reading Paul's comments and my air smelled like pine trees. We are off to the airport, so my guest will be greeted with a lovely send off from the mill. My phone calls will be later as I must hurry to leave. I'll be happy to smell the clean air in Seattle. N.'s Yep it stinks. 35th and Haines. Good thing it's not toxic. 8-24-2015 house N.'s 8-24-2015 Ditto for me on Water Street, it's a 10/10. But it IS toxic- I get house headaches and my throat is sore. N.'s 8-26-2015 Smelly morning on 0 Street 4/8 house S.'s I took a"mental health day" yesterday 8/25 even after getting hit at 0520 house with the stink Of 5 on a scale of 8. Last night, I was so desperate for sleep that I closed the window ahead of the smell. I HATE sleeping without the window open. I missed this morning's"smell of economic success", but I feel the richer for it. J's 8-26-15 7:20 am approaching 19 from Jacob Miller- a few have to hold position breath minutes til I was well past Seton heading out of town. Seemed particularly bad -thick, for me nauseus-making. .... I've been thinking things were improving in recent weeks-but from the reports here it doesn't seem that way N's 8-26-2015 Really bad right now folks. Has been for weeks. 35th and house Haines Street. I am getting really tired of the headache, sore throat, itchy eyes and disgusting smell and taste in my mouth. Please tell me how I can invite the owners to stay in my guest room • • so they can experience it for themselves? Or, I am open to other ideas of how to get these"community" members to cooperate with their neighbors and remind them that we share common space. S.'s I'm writing this at 0517 hrs on Aug 27. A wall of stink just hit. It's a 7 out of house 8 here near Hastings and Howard. L's 8/24/2015 moderate to strong odor woke me up at 5:30 AM had to get up house and close windows. The odor was barely noticeable at 7:00AM, but another wave came through about 8:00AM. Paper Mill M's 8-26-15 I was sickened yesterday near the Habitat store. Strong,clinging location smell that stayed in my body long after I left the area. S.'s Aug 28 at 0919 hrs a wall of stink hit near Hastings and Howard . It's a 6 house out of 8. I had just dragged out some gardening equipment to start a small clean up project...will not happen today. N.'s Stinks downtown on Water Street(actually all the way from Safeway to . house downtown) as of 10:42pm, the 28th of the month of August in the year 2015 AD. S.'s Stink just hit here near Hastings and Howard on Friday Aug28 at 2301 hrs. house I was sitting right next to the open window, so I caught it early and got the window closed before it stunk up my house (5 out of 8 but it was early in the assault). I was reading Nate's very complete report when it hit. N.'s August 27, 12:23 am. WOW IT STINKS. Help. house J.'s around 11 pm last night 8/28 the stink was horrendous on q and fir. house S.'s I opened my window after the stink cleared at 1930 hrs, 8/29. At 2130 hrs I house had to run to close the window(in my bedroom) because the stink came into my living room. ANOTHER big blast of stink is a 7 out of 8. Reporting from near Hastings and Howard. 19 hrs • Like S.'s 8/30/15. Wall of stink at 1525 hrs near Hastings and Howard. 7 out of 8. house I'm grieving the loss of my beautiful Sunday. • N.'s 8-30-2015 I'm not mad at the people here who report, call, email and raise • house a ruckus. I'm furious at the inn owners, the restaurant owners (some of whom are on city council) the retail shop owners and anyone who is afraid to hold the Mill accountable because of how they feel it would negatively impact their$$$. Our elected officials have done nothing, are doing nothing, and will do nothing, so it's up to the citizens to fix this problem. Guess what: if people don't return because the air is so obnoxious, they won't be spending any money. And soon the reviews of PT being such a tourist hot spot will become "Port Townsend, the town that stinks." N.'s It's 7:30 PM and downtown STINKS?I IIIiiiiiiiii llw Enough of this crap house already. S.'s Hey... the Stink Train has visited my house twice already on Monday, Aug house 31. My windows are opened and closed so many times, I no longer need to buy any WD40. There's an upside to everything. I'll send an official complaint lonight. Me thinks it's likely to be one of those rotten in Denmark days. N.'s 8-31 really stinks outside on 0 St. I'd say a 6/8 at8pm house N.'s Yep, same downtown, I've had my filter running continuously since house yesterday and left my windows closed since then too. to be specific, the • odor stench on Water Street at 8:52pm on 8/31/15 is a 15/10. Yes, it's that bad. S.'s This is my final report for the day. Aug 31. At 0900, I opened the front door house and quickly closed it. Stink was a 4/8. At 1000 it left. At 1153 a bigger hit came at 5/8. At 1406 it was still going. I left the area and returned at 1845 and the smell was at a 4/8. At 2230, it quickly ramped up to a 7/8. L.'s I got the same thing at the same time as Sherry, but earlier at 6: 8/31/15, house L'.s Odor Report: noticed it around 6:45PM, and it got strong enough that I had house to close my windows around 7:45PM. on 8/31/15. Typical ASB pond odor. (I always suspect that my dog did it, that's what it smells like. • • Board of Health IV Old Business Item 3 Strengthening Families and Youth Mental Health Training: Chimacum Prevention Coalition • 4 I 7 deilffison Public Health September 17, 2015 Community Prevention & 4 Wellness Initiative .1, Division of Behavioral Health and Recovery Chimacum Prevention _ Coalition Chair . . _. 4.. . 11111111111- Je'erson County CHIMACUM, WASHINGTON 1 Chimacum Prevention Coalition Sponsored by Community Prevention and Wellness Initiative In the summer of 2013 Chimacum, Washington was selected to Whitney receive support to focus on keeping youth, young adults and others free � �High Meissnerert of alcohol and other drug misuse, while creating a healthier community. Pmtipal The Community Prevention and Wellness Initiative (CPWI) is a collabo- ration between the Chimacum Prevention Coalition (CPC), Olympic 360-732.4219 Educational Service District 114, Chimacum School District, and Jeffer- WhItney_ tielemid4torg son County Public Health. It is funded by the state Department of Social and Health Services' Division of Behavioral Health and Recovery Chimacum Prevention (DBHR). The Chimacum Prevention Coalition has been developed to Coalition o-Chair assess the unique community strengths and needs, canvas existing resources and then develop a strategic prevention plan. To learn more, go to: www.jeffersoncountypublichealth.orgfindex.php?c-p-c ID , Or contact Kelly Matlock or Julia Danskin, the CWPI Coordinators at: kmatlock@co.jefferson.wa.us jdanskin@co.jefferson.wa.us Mission Statement: Uniting kids, families and agencies I in support of healthy youth in Chimacum. Johnny Colden Chimacum is a rural, unincorpo- Development of the Juvenile Probation Officer rated community in eastern Chimacum Prevention Coalition Diversion Coordinator Jefferson County on the Olympic To effectively represent the 360.385.9190 Peninsula. It was named after the icoldenc, o jefferson.wa.us Chimacum group of Native Ameri- Chimacum community, the cans who lived there until the late Chimacum Prevention Coalition is Chimacum Prevention 19th century. It is an agricultural represented by community members Secretary area with many small farms and a from the following sectors: farmers' market. -youth under the age of 18 -parents The Chimacum School District -law enforcement r� r ' � serves the unincorporated -religious/fraternal organizations communities of East Jefferson -civic/volunteer groups County to the south of Port -healthcare professionals Townsend and north of Quilcene, -state/local/tribal government including Chimacum, Port -substance abuse organizations Sue Hay Hadlock, Irondale, Marrowstone -businesses SiiIJ Jefferson County Extension Island, Oak Bay, Paradise Bay, -media ,Youth and Families Coordinator Port Ludlow, and Shine. -schools, and 360-379-5610 -youth-serving organizations. sue.hay dewsu.edu Updated June 2015 ''...-,,:=:-.!,,,::,.'t,-4 £ Chimacum Jefferson County, WA •yLit Illikiiiii*: ikror II.. ,. . ,, „ . ,.. b6 B „. . A•k 1111L101.111 AilliiiilillaLtilL M. 3 .. .. . miligipil i' Brief Community Prole '� h,$ �� Highlights of Local Problems Current Prevention Programs ' Chimacum High School is a small Evidence-Based Programs: rural school with limited school and Chimacum Elementary School � � �, looT_ : community resources in Jefferson Protecting You/Protecting Me ' County. Some of the cate ories where g Chimacum High School Jefferson County youth reported Project Success higher use rates than the State in the Chimacum Community �-, z, ' r ,,,,,...,..„:",�:* * : 2014 Healthy Youth Survey are: Strengthening Families Progra ' ter *�; 10th grade Jeff. Co. WA €G k04, 30 day marijuana use 31.7% 18.1% ry ' Binge drank in past 2 wks 13.5 % 10.6% 12th grade What is the TRUE COST of 30 day tobacco use 33.3% 13.0% SUBSTANCE ABUSE? 30 day marijuana use 44.2% 26.7% t - � Vit, `f '14 30 day alcohol use 5.3% 32.9% In 2010 the Jefferson County .,, ° ° Substance Abuse Advisory Board Binge drank in past 2 wks 24.5/° 19.2/° r did a comprehensive review and } ; report of public funding spent on the General Statistics direct and indirect costs associated -xf 4 Chimacum School District with substance abuse in Jefferson „` i ? OSPI Data from Fall 2011 Co.for 2007. The report was Zoning: Rural modeled on a study completedo by Population: 1,132 Columbia University's Center of 1 R Alcohol and Substance Abuse �.` , , <'` 4 FreelReduced meals 50.1% (CASA). The cost was estimated at Ethnic Diversity: over$17 million. This means that in White 81.6% Jefferson Co. the cost of substance Hispanic 7.3 ° child was apabuse to proz mately $600 (in man and _ 2 or more races 6.80/0 2007). AsianlPacific Island 1.9% Was A/aplva Sr,ta '' Asian 1.6% To learn more go to: • iiiitDepartment of Social ., &Health Services American Indian IDBHR Division of Behavioral 8r Alaska Native 1.4% ,ieffcocommunitvnetwork.orat Hetet,° Racowerr African American .9% truecost The Chimacum Prevention Coalition Presents: • YOUTH MENTAL HEALTH Topics covered FIRST AID COMMUNITY TRAINING include: Youth Mental Health First Aid is designed to teach parents, • anxiety caregivers, teachers, and other adults who regularly interact with • depression young people how to help an adolescent (age 12-18) who is • substance use experiencing a mental health and/or addiction challenge or is in • disorders in crisis. which This free, 8-hour workshop introduces common mental health challenges for youth, reviews typical adolescent development, and psychosis may teaches a 5-step action plan for how to help young people in both occur crisis and non-crisis situations. • disruptive Registration is required and space is limited. behavior disorders FACILITATORS (including AD/HD), and Stephanie McDonald, OESD 114/ Pathways to Success • eating M. Linton Petersen, LMHC, DMHP of West End Outreach disorders. DATE/T1MEI LOCATION October 19, 2015 / 8:00 a.m. — 5:00 p.m. Participants required to attend full 8-hour training Jefferson County Public Health / Pacific Room 615 Sheridan St., Port Townsend, WA 98368 - SPACE IS LIMITED - LU NCH TO REGISTER, CONTACT: One hour brown bag lunch (QFC is next door) Kelly Matlock OESD114r CNIMACYMrR[VtNTION ,..., .:,... 360-379-4476 COALITION y awnae.cdsocW J AWARE U�p .�J M z ,. kmatlock@ C,,. ,� t IDONRD. �eea.a.a Public Health »ow ono R onwn co.jefferson.wa.us STRENGTHENING FAMILIES For Parents/Caregivers and Youth ages 10-14 Thursdays, October 8- November 19, 2015 Seven sessions, one session per week 5:30* - 8:00 pm Irondale Church 681 Irondale Rd. Port Hadlock 98339 " Free dinner will be served to your family • Free nursery available for children under age 5 =4' • Optional kids' club available for children ages 5-9 Enrollment limited to 12 families! *October 8Th session starts at 5:00 p.m. DINNER 5:30 to 6:00 each night (no cooking, no dishes, no tip, nothing for the family to do but eat and enjoy). 6:00—7:00 Youth work together with other youth. Parents work together with other parents 7:00—8:00 Family Sessions. The youth and parent group come together to play and work on activities, skill building, play games, etc. THIS IS NOT A BORING PROGRAM! It's fast-paced with ice-breaking games, lots of fun activities for parents and youth alike that are designed to be develop communication skills, increase bonding, increase participants ability to appreciate youth and parents roles, stresses, concerns, etc. It's heartfelt, evidence-based and effective. The designers of the program realize how busy and stressed most families are these days and this is meant to be fun and give fast results. Fill out the registration form below and return to: • Kelly Matlock, Jefferson County Public Health 615 Sheridan Street, Port Townsend, Wa 98368 Questions? Call 360-379-4476 or email kmatlock@co.jefferson.wa.us Parent/Caregivers' Names: #1: #2: Telephone: Cell Phone: E-mail: Name(s) of youth (ages 10-14)enrolled in class NOTE: Each youth must be accompanied by an adult to classes 1. Youth Name#1: Age: 2. Youth Name#2: Age: #of youth age 4 and under needing nursery care provided at the church 6:00-8:OOpm: #of youth age 5-9 participating in an optional Bible club provided at the church 6:00-8:OOpm: &Malan programs andemp.ayAlent are as-ati ab:s al;without eitscrietialataolo. Evidence enoncomeplieesce may be reported grog*yeli7 local gxtension office. 11'k••II t AtySI I I;vnI p.mH• . 1511"\M"\ CHIMACUM PREVENTION � �. COALITION I is�atetbWM 'kMce�' f{'f ,� a Uniting kids,families and agences in [' .1 I support of healthy youth in Chimecum loans Devon a mews �p L1 ,. -41 AP- Hsds as Rome.), Public Healp �''-'y^., ■ .,..,. -_-.. Board of Health S IV Old Business Item 4 School Based Clinics Reopen 4l • %con Publ c Elea It September 17, 2015 • Chimacum High School School Based Health Center Located in the CHS commons Medical Health Staff Easy Access to CONFIDENTIAL and AFFORDABLE Sarah Kirkegaard,Nurse Practitioner Healthcare for high school students Megan Eastlick,AmeriCorps These services are available at your doctor's office or at the School Based Health Center Monday&Wednesday 9:00am to 3:00pm Illness and injury • Sports Physicals • Immunizations • Mental health services • Reproductive Health • Nutrition • Stress Management • Family or relationship issues • and so much more For Medical Appointments: Drop a request slip in the locked box at the clinic door or call 360-385-9400, or stop by the clinic • •Mental Health Staff Patricia Flowergrowing For Mental Health Appointments: drop a request slip in the locked box on the Licensed Mental Health Specialist Tuesday&Thursday clinic door, or request at counselor office, or stop by the clinic. 8:00 am to 3:00pm Public =• Payment by sliding scale or insurance. No student is denied services due to inability to pay School Based Health Center, brought to you by: Jefferson County Public Health• Jefferson Healthcare • Chimacum School District • Jefferson �, I lealtheue Public Heaflfi F.. 2015-2016 Port Townsend High School III4,,,,.ik 4° ' School Based Health Center Located in the Gael Stuart building at PTHS Medical Health Staff Easy Access to CONFIDENTIAL and AFFORDABLE Healthcare Susan O'Brien, Nurse Practitioner for high school students Healther Sebastian Clinic Support These services are available at your doctor's office or at the School Based Health Center Tuesday 9:00am to 2:00pm Thursday noon to 3:00 pm Illness and injury • Sports Physicals • Immunizations • Mental health services • Reproductive Health • Nutrition • Stress Management • Family or relationship issues • and so much more For Medical Appointments: Drop a request slip in the locked box at the clinic door • or call 360-385-9400, or stop by the clinic Mental Health Staff For Mental Health Appointments: drop a request slip in the locked box on the Licensed Mental Health Specialist clinic door, or request at counselor office, orstop by the clinic. Monday 8:00 am to 3:00pm Friday 8:00 am to 3:00pm ejt 0 Public Health School Based Health Center, brought to you by: Jefferson County Public Health• Jefferson Healthcare • Port Townsend School District 6tneo„ Jefferson ihn, PORT TOWNSEND Healthcare High School Public Heat Payment by sliding scale or insurance. No student is denied services due to inability to pay IF i _a) CL) S a) c - V LO L O 0 O ^ 0 o '" i v c - 0 0 0 0 _S � ..i�+ 0 'E CZ H Dob 00 u 1-, A'! 0000 v .. n ••��W •• .-, �i� tOOIOO X = •, 00100 , __ . 139O� COO n 0 C90 ..a00 0 ++ O O N u Q` c: C66 co 7:5c d CCGI d V u U) ri Z is C - !� o o CQ L � c� � o UI $` � >, -5 m M as L h et '- W C C "G c C '� r t "0 y .ccoo m o M _ N 7 _° — N In L a I aI L � � E L u _ I al 72 c s o L.L. 1— F _ CL 0 LL F- F- -. cL //1 p E O V♦ Q ' c Ci) O o E ,n Q c O T eL '-' c U Ua. Ci) `� a ° U ed � o wc0 (n ocU Y N a. ft = a. b r.. N 111 S Eau 111 Ea. 0I 0 _.� ••• 0 • 01L L+ W W C ,. 4 C , .4 G) _ . o°. ,_ U o -,0 ° 0 �� 0 - t v,Gu 00 00 CU V► M m .G u CI O M M M .- w M M ` M M C ~ Q) _v O O 0 O O - n T� V O Oc 4-, 4.1 n OO c �C _' 00 0o x Z •� OOIOOc, , __ T� CI C � o d �► 00 _. 00 x V H 0% 4 CO CO -0 '� 0 V C; C Ci CO -n 'O 12 G o CO L �. co " � CO c co L > C crn Oen = al 17 c .a O cd .� 'N c a w ° 'v m 1- iv— _ d L = s , u I O s r`w' 0 u- F— F- v o 0 I+ F- F- C L C// O EE ° a._ o a V o '^ m ° v U �/, o cU N ii uC N� o £ � o H O C' 0 0 L^+ rn ^ m V / W y� 4-0 m T M C r = V a)U U T ' m itim U Oc 00 a '�..+ o0 00 a 9r, ,coo �, as N N o rh if) N N o . inn v a) U 2O a O 0 l7 V04-' 000 7 71 •� � 0 0 = 00 V •� v0 O 00 •a N u0% Z acorn -a N v °•` Z vco60 (I) nt Z Z x IAI. o ij CO O -p - >, c �CV vi ' COW O - - rd o S a� z o v �' v — Z °� -° Q (n o ax 0 o _ a - c -: 0- rt , CL v v rt .......4. ._ 111 E. :I H d • 0 0 00 L cr L' CD Lo .....0 cc 4-0 M = CI) o x01: (,, .:2,41-1 c7,S 0 0o v 2 I1 o0 -a+ o o a — -= ori „coo ,,, a Ca IA N o M M CICS ;44 N o M [h a) o - a r o �' a o o 6 _ • o o o o r.-. _ L. o o a, - 0 0 2 0 0 V 0 0 � � O o = 00 N VOsZ - •• •• .� N °, c� Z acdco (.1) � � x U) � Z x CI in ) L c 3, •v L > c ›. M es13 CO W TO tV� C O L 0 v 0 I— C LL 'w 0 C 0 O _ (�, O aa // J -Y j- Board of Health V New Business Item 1 Food Safety Program Fees — Possible Action ti de Mon f.f id,r Public Healt Call for Public Hearing September 17, 2015 • 2015 Food Safety Activity and Fee Review • During the last meeting we discussed detail by establishment type, uncompensated activity detail for new establishments & new owners of establishments as well as examine proportional time spent by program staff. Today is the last in the series of presented information to the Board. We will discuss current costs by Establishment type, current fee spread and the corresponding proposed fees. For illustration and a demonstration of variability in fees only, also attached is a table of neighboring jurisdiction fees for our region. Facility #of Full Cost Current Fee Proposed Fee Establishments Lounge 13 $275.19 $149.00 $149.00 Church 2 $320.42 $149.00 $199.00 Bakery 5 $348.69 $149.00 $199.00 Commercial Kitchen 7 $351.84 $149.00 $199.00 Espresso Stand 12 $423.04 $149.00 $199.00 Concession 10 $460.74 $149.00 $199.00 Caterer from Restaurant 11 $425.43 $191.00 $249.00 Small Grocery 29 $441.37 $191.00 $249.00 Bed & Breakfast 13 $462.64 $191.00 $249.00 Small Limited 62 $512.97 $191.00 $249.00 Restaurant School Warming Kitchen 7 $1,147.06 $191.00 $249.00 To be renamed • Limited Mobile Unit 7 $603.15 $191.00 $349.00 Meat& Fish Market 4 $508.91 $339.00 $349.00 School Central Kitchen 7 $797.02 $339.00 $469.00 Small Complex 18 $829.33 $339.00 $469.00 Restaurant Caterer from 10 $949.96 $339.00 $469.00 Commissary Complex Mobile Unit 8 $1,017.81 $339.00 $469.00 To be renamed Medium Restaurant 36 $988.49 $340.00 $469.00 To be renamed Large Restaurant 34 $887.63 $407.00 $469.00 To be renamed Large Grocery 4 $593.72 $462.00 $469.00 X-tra Large Restaurant 14 $1,084.50 $462.00 $469.00 To be renamed • 2015 Food Safety Activity and Fee Review Jefferson Jefferson- Clallam Mason Kitsap Island -Cost Current Fee • Restaurant-Limited Small $513.00 $191.00 $230.00 Restaurant-Limited Large $305.00 Restaurant-Complex Small $460.00 Restaurant-Complex Large $690.00 Food Service Establishment-0 seats $618.00 0-25 Seats $829.00 $339.00 $242.00 $472.00 $822.00 26-50 $988.00 $340.00 $322.00 $916.00 25-75 $511.00 51-100 $888.00 $407.00 $403.00 $996.00 76-100 $592.00 More than 100 $1,085.00 $462.00 $483.00 $668.00 $1,090.00 W/Lounge $275.00 $149.00 $115.00 120-198 $418.00 Catering w/Rest $425.00 $191.00 $161.00 $160.00 $205.00 Catering w/Comm $950.00 $339.00 $242.00 $230.00 $230.00 $390.00 School Warming $1,147.00 $191.00 $81.00 $160.00 $185.00 $150.00 School Central $797.00 $339.00 $161.00 $230.00 $282.00 $358.00 Pre-school $109.00 Limited (B&B Tavern, Etc.) $161.00 Espresso $423.00 $149.00 $160.00 $338.00 B & B $462.00 $149.00 $160.00 $205.00 $268.00 Confectionary $160.00 $268.00 Bakery $348.00 $149.00 $230.00 $336.00 $472.00 Vending machine $70.00 Food Demonstrators $230.00 • Retail Commercial Fishing Vessel $126.00 Concession $460.00 $149.00 Church $320.00 $149.00 Tavern -Limited (no food) same as rest $230.00 $170.00 $432.00 seating Tavern-Complex Small same as rest $460.00 same as seating rest seating Tavern -Complex Large same as rest $230.00 same as seating rest seating Mobile Unit- Limited $603.00 $191.00 $230.00 $205.00 Mobile Unit-Complex $1,018.00 $339.00 $455.00 $230.00 $449.00 Grocery-Small $441.00 $191.00 $242.00 $230.00 $152.00 $552.00 Grocery-Medium $607.00 Grocery-Large $594.00 $462.00 $322.00 $270.00 $395.00 $646.00 Grocery Depts 149-339 81 - 161 75- 120 $268.00 Convenience Stores-No Food $338.00 Convenience Stores-With Food $618.00 Commercial Kitchen - Small $352.00 $149.00 $81.00 $160.00 $150.00 Commercial Kitchen-Large $352.00 $149.00 $81.00 $230.00 $449.00 Meat and Fish Market $508.00 $339.00 $253.00 Non-profit $144.00 New Establishment $247.00 New Owner/Change of Owner $160.00 45- 121 S JEFFERSON COUNTY PUBLIC HEALTH ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH 2015 Additional Fees and Other Information Health Officer Administrative Hearing 314.00 Administrative Hearing Appeal 314.00 Technical Assistance/Plan Review-Minimum 86.00 Technical Assistance/Plan Review-Per Hour 86.00 Late Fee for Invoices 50.00 For Invoices past due date Case Scannin. Fee 30.00 Filing Fee 54.00 Recording Fee 65.00 Plus the Auditors Office recording fees Notice to Title Rescission 525.00 .fW DiSpAtialPennft New Conventional 569.00 Valid for 3 years New Alternative 829.00 Valid for 3 years New septic tank and/or pump chamber only Issued in conjunction with an existing sewage disposal 340.00 s stem or communi s stem New Community or Commercial Conventional 719.00 Base Fee-Valid for 3 years Alternative 919.00 Base Fee-Valid for 3 years Each Connection 90.00 Add to base permit fee Development and Review Financial Assurance and System 86.00 Per Hour O•eration A•reements Septic Permit with Approved SPAAD(conventional) 307.00 Septic Permit with Approved SPAAD(alternative) 569.00 •pp ies o exis mg ins a e• sewage •isposa sys em; e Repair 50%of fee Technical Assistance/Plan Review hourly rate will be charged for repairs where the applicants require additional assistance Modification or Reserve Area Designation 258.00 Expansion 538.00 Redesign 172.00 Applies to pending or active but not installed Reinspection 215.00 Septic system only 334.00 Septic system plus water sample 377.00 Retest/Reinspection 172.00 On Site : -Su i • an . OnSite-Site Plan Advanced Approval Determination(SPAAD) 397.00 Subdivision Review Base Fee 516.00 Boundary line adjustment or Lot Certification review fee 202.00 Planned rural residential development review fee 202.00 Per lot fee 90.00 or u••'vision eview,' :ounr•y me •justment an• Planned Rural Residential Development Review fees Pre application meeting fee 202.00 Density exemption review fee 129.00 Field Work for Density Exemption Review 86.00 Per Hour Building application review: Residential-Individual OSS 129.00 Review after Building Permit issued, is same fee Commercial-Individual OSS 258.00 Review after Building Permit issued, is same fee Community OSS 258.00 Review after Building Permit issued, is same fee Revised Site Plan Review 65.00 Review of resubmission before Building Permit is issued WaiverNariance Application 237.00 WaiverNariance Hearing 387.00 Wet season evaluation 538.00 General environmental health review fee 86.00 Per Hour Licenses Installer, Pumper,Operator(maintenance person) 538.00 Retest 215.00 • Homeowner Authorization 10.00 Annual Certificate Renewal 299.00 Delinquent Renewal after January 31 538.00 FOOD SERVICE ESTABLISHMENTS FEES PERMIT FEES(Annual Perfnit)- Annual Permit Fees (Based on menu complexity&seating-menu changes may change category) Restaurant/Take-Out/Tavem-Limited 249.00 No cooling or reheating Restaurant/Take-Out/Tavem-Complex 469.00 Cooling and reheating allowed x&-1,99 3,39-.40 26 50 c ate 340,99 61-100-seats 107.00 101 160 scats 462;00 With Lounge, add 149.00 Separate lounge area Bakery Business 199.00 B&B 249.00 Caterer w/commissary or catering-only kitchen 469.00 w/restaurant,additional fee for catering 249.00 Concession/Commercial Kitchen/Church 199.00 Espresso Stand 199.00 Grocery 1-3 checkouts 249.00 May serve pre-packaged baked goods >3 checkouts 469.00 Meat/Fish Market 349.00 Mobile Unit Limited Menu 349.00 No cooling or reheating Complex Menu 469.00 Cooling&reheating allowed School Cafeteria Central Kitchen 469.00 Warming Kitchen 249.00 Annual Permit Issued after September 1 t 50%of fee 50%of Annual Permit Fee ,Te, Single Event Initial Application(First Event) 107.00 Not to exceed 21 days at your location Additional Event(Same Menu Only) 61.00 Not to exceed 21 days at your location Organized Recurring Event(e.g.Farmers Market) Limited Menu 107.00 Not to exceed 3 days a week at a single location Complex Menu 142.00 Not to exceed 3 days a week at a single location Late Fee for Temporary Permits +50%of fee Additional(Paid when application is submitted less than 7 days prior to the event) Other Food Fees New Establishment 172.00 New Owner/Change of Owner 108.00 Permit Exemption 43.00 Waiver/Variance 86.00 Per Hour;for review and/or approval Reopening Fee 86.00 Per Hour Manager's Course 231.00 Plan-Review Pre-opening inspection 86.00 Per Hour Minimum 86.00 • Food Service Plan Review 86.00 Per Hour;for review and/or approval Reinspection Ar First Inspection 129.00 Each inspection after first 215.00 Food Handler Card Reissue Unexpired Food Handler Card 10.00 Landfills requiring environmental monitoring 557.00 Biosolid/Composting Facilities 489.00 Inert Waste Landfills 353.00 Other Solid Waste Facilities 353.00 Drop Boxes 163.00 Miscellaneous Pees New Facility Application 448.00 Exempt Facility Inspection 353.00 Facility Reinspection 50%of fee Plan,Document and WaiverNariance Review 345.00 +$86.00/hour for>4 hours nspection o we cons ruction,decommission Application Fee 163.00 reconstruction Determination of Adequate Water Supply base fee 129.00 Tech Assist and Document Review,billed at the hourly rate Well Inspection&Water Sample for Loan 137.00 Well Site Inspection-Proposed public water supply 326.00 Water Recreation Facilities Operation Permit Single Swim Pool(in operation for<6 months of the year) 296.00 Single Swim Pool(in operation for 6 months of the year) 299.00 Single Spa Pool(in operation for<6 months of the year) 259.00 Single Spa Pool(in operation for>_months of the year) 299.00 Single Wading Pool(in operation for<6 months of the year) 214.00 t, ,. •.. .. •, ., 377.00 107.00 Spray Pool or Pools(in operation for>6 months of the year) 162.00 Each Additional Swim,Spa,or Wading Pool(in operation for<6 months of the year) 64.00 Each Additional Swim,Spa,or Wading Pool(in operation for>_6 months of the year) 85.00 Reinspection 86.00 Per Hour plus associated lab costs • Plan Review 86.00 Per Hour Compliance Enforcement 86.00 Per Hour Reinspection 80.00 Rebuttal Application 160.00 Note: 2015 Fees have been adjusted per Ordinance 08-0918-14,Section 3-Fees. Fixed amount fees established by this ordinance shall be adjusted annually on the first business day of January(Adjusted Date)by the amount of the increase in the Consumer Price Index(CPIW). The CPIW is the Consumer Price Index-US City Average for All Urban Wage Earners and Clerical Workers,published by the Bureau of Labor Statistics for the United States Department of Labor. The annual fee adjustment shall be calculated as follows: each fee in effect immediately prior to the Adjustment Date will be increased by the percentage increase in the CPIW as reported for the month of September preceding the Adjustment Date. Increases will be rounded to the nearest dollar. A fee shall not be reduced by reason of such calculation. However,fee increases in accordance with this calculation shall not exceed 5 percent per year. • JEFFERSON COUNTY PUBLIC HEALTH ENVIRONMENTAL HEALTH DIVISION ENVIRO7 :71 MENHEALTH 2015 Additional Fees and Other Information by 7 7 ' `�o F �a $ + l Health Officer Administrative Hearing 314.00 Administrative Hearing Appeal 314.00 Technical Assistance/Plan Review-Minimum 86.00 Technical Assistance/Plan Review-Per Hour 86.00 Late Fee for Invoices 50.00 For Invoices past due date Case Scanning Fee 30.00 Filing Fee 54.00 Recording Fee 65.00 Plus the Auditors Office recording fees Notice to Title Rescission 525.00 New Conventional 569.00 Valid for 3 years New Alternative 829.00 Valid for 3 years New septic tank and/or pump chamber only Issued in conjunction with an existing sewage disposal 340.00 s stem or communi s stem New Community or Commercial Conventional 719.00 Base Fee-Valid for 3 years Alternative 919.00 Base Fee-Valid for 3 years Each Connection 90.00 Add to base permit fee Development and Review Financial Assurance and System 86.00 Per Hour O.eration A•reements Septic Permit with Approved SPAAD(conventional) 307.00 Septic Permit with Approved SPAAD(alternative) '569.00 pp ies o exis ing ins a e• sewage •isposa sys em; e Technical Assistance/Plan Review hourly rate will be Repair 50%of fee charged for repairs where the applicants require additional assistance Modification or Reserve Area Designation 258.00 Expansion 538.00 Redesign 172.00 Applies to pending or active but not installed Reinspection 215.00 Septic system only 334.00 Septic system plus water sample 377.00 Retest/Reinspection 172.00 On Sin S arum► i y OnSite-Site Plan Advanced Approval Determination(SPAAD) 397.00 Subdivision Review Base Fee 516.00 Boundary line adjustment or Lot Certification review fee 202.00 Planned rural residential development review fee 202.00 or u••'vision eview,- :ounr.y me •justmentan• 90.00 Per lot feePlanned Rural Residential Development Review fees Pre application meeting fee 202.00 Density exemption review fee 129.00 Field Work for Density Exemption Review 86.00 Per Hour Building application review: Residential-Individual OSS 129.00 Review after Building Permit issued, is same fee Commercial-Individual OSS 258.00 Review after Building Permit issued, is same fee Community OSS 258.00 Review after Building Permit issued,is same fee Revised Site Plan Review 65.00 Review of resubmission before Building Permit is issued WaiverNariance Application 237.00 Waiver/Variance Hearing 387.00 Wet season evaluation 538.00 General environmental health review fee 86.00 Per Hour Licenses Installer, Pumper,Operator(maintenance person) 538.00 Retest 215.00 Homeowner Authorization 10.00 Annual Certificate Renewal 299.00 Delinquent Renewal after January 31 538.00 Annual Pewit Fees ased on mc+aiplexly& menu en :r Restaurant/Take-Out/Tavern-Limited 249.00 No cooling or reheating Restaurant/Take-Out/Tavern-Complex 469.00 Cooling and reheating allowed With Lounge,add 149.00 Separate lounge area Bakery Business 199.00 B&B 249.00 Caterer w/commissary or catering-only kitchen 469.00 w/restaurant,additional fee for catering 249.00 Concession/Commercial Kitchen/Church 199.00 Espresso Stand 199.00 Grocery 1-3 checkouts 249.00 May serve pre-packaged baked goods >3 checkouts 469.00 Meat/Fish Market 349.00 Mobile Unit Limited Menu 349.00 No cooling or reheating Complex Menu 469.00 Cooling&reheating allowed School Cafeteria Central Kitchen 469.00 Warming Kitchen 249.00 Annual Permit Issued after September 1 50%of fee 50%of Annual Permit Fee T envy Single Event Initial Application(First Event) 107.00 Not to exceed 21 days at your location Additional Event(Same Menu Only) 61.00 Not to exceed 21 days at your location Organized Recurring Event(e.g.Farmers Market) Limited Menu 107.00 Not to exceed 3 days a week at a single location Complex Menu 142.00 Not to exceed 3 days a week at a single location Late Fee for Temporary Permits +50%of fee Additional(Paid when application is submitted less than 7 da s •rior to the event Other Food Fees New Establishment 172.00 New Owner/Change of Owner 108.00 Permit Exemption 43.00 Waiver/Variance 86.00 Per Hour;for review and/or approval Reopening Fee 86.00 Per Hour Manager's Course 231.00 Pre-opening inspection 86.00 Per Hour Food Service Plan Review 86.00 Per Hour;for review and/or approval Reinspection First Inspection 129.00 Each inspection after first 215.00 Food Handler Card Reissue Unexpired Food Handler Card 10.00 .< Pen,*Fees Landfills requiring environmental monitoring 557.00 Biosolid/Composting Facilities 489.00 Inert Waste Landfills 353.00 Other Solid Waste Facilities 353.00 Drop Boxes 163.00 s Fees New Facility Application 448.00 Exempt Facility Inspection 353.00 Facility Reinspection 50%of fee Plan, Document and WaiverNariance Review 345.00 +$86.00/hour for>4 hours nspe Ion o we cons ruc hon, •ecommission Application Fee 163.00 reconstruction Determination of Adequate Water Supply base fee 129.00 Tech Assist and Document Review, billed at the hourly rate Well Inspection&Water Sample for Loan 137.00 Well Site Inspection-Proposed public water supply 326.00 Water Recreation Facilities Operation Permit Single Swim Pool(in operation for<6 months of the year) 296.00 Single Swim Pool(in operation for 6 months of the year) 299.00 Single Spa Pool(in operation for<6 months of the year) 259.00 Single Spa Pool(in operation fora_months of the year) 299.00 Single Wading Pool(in operation for<6 months of the year) 214.00 Single Wading Pool(in operation for a_6 months of the year) 377.00 Spray Pool or Pools(in operation for<6 months of the year) 107.00 Spray Pool or Pools(in operation for>_6 months of the year) 162.00 Each Additional Swim,Spa,or Wading Pool(in operation for<6 months of the year) 64.00 Each Additional Swim,Spa,or Wading Pool(in operation for 6 months of the year) 85.00 Reinspection 86.00 Per Hour plus associated lab costs 86.00 Per Hour . . ..,., Compliance Enforcement 86.00 Per Hour Reinspection 80.00 Rebuttal Application 160.00 Note: 2015 Fees have been adjusted per Ordinance 08-0918-14,Section 3-Fees. Fixed amount fees established by this ordinance shall be adjusted annually on the first business day of January(Adjusted Date)by the amount of the increase in the Consumer Price Index(CPIW). The CPIW is the Consumer Price Index-US City Average for All Urban Wage Earners and Clerical Workers,published by the Bureau of Labor Statistics for the United States Department of Labor. The annual fee adjustment shall be calculated as follows: each fee in effect immediately prior to the Adjustment Date will be increased by the percentage increase in the CPIW as reported for the month of September preceding the Adjustment Date. Increases will be rounded to the nearest dollar. A fee shall not be reduced by reason of such calculation. However,fee increases in accordance with this calculation shall not exceed 5 percent per year. • Board of Health V New Business Item 2 Proposed Comp Plan Amendment: Active Lifestyle and Chronic Disease Prevention nit tso 411( iiffe, Public Healt September 17, 2015 • DRAFT: Healthy Jefferson County Module • Access to healthy food Active transportation Safety and Social &land use Connections •ti ff PIC Environmental The built envfro im t ''In Parks&open quality irnpkts health, spaces Climate change and Economic human health opporttmity Affordable,quality housing • Goal: Promote the health of people, of all ages and abilities, by g ado tin policies and P regulations that encourage safe healthy lifestyles in the community that we plan, build, and preserve. Your zip code may be more important to your health than your genetic code. Residents who live in a safe neighborhood with easy access to healthy foods and routine destinations they can walk to are healthier than residents living in places without sidewalks or nearby grocery stores accessible only by car. We can design communities that promote health. Across the state and region, municipalities are adopting health language and elements into their comp plans: Whatcom Co., City of Bellingham, Island County, Mason County, Kitsap County, City of Bremerton, City of Port Orchard, Thurston Co, and Seattle/King. Access to healthy foods and increasing opportunities for exercise can improve health. The comp plan is a document that sets a vision of how we want our county and community to grow. It is the framework that guides us for how we grow and develop. How a community is developed can affect the behaviors of its residents. This built environment can promote health or create barriers to healthy choices. i Build a Healthier Community 8/17/2015 Factors that contribute to health include: • affordable housing . • access to healthy foods • parks and open space • infrastructure that encourages active transportation • connectivity If you look at each of those elements and apply it to the Growth Management Plan the goal is that health is important and can be improved by good planning. Health can be a large umbrella that improves quality of life. If a health element is added to the comp plan, it will ensure that plans for future development will be viewed through the lens of a person trying to live an active life and incorporate healthy elements into the build design: • Active transport, parks, community gardens, and a mix of affordable quality housing with nearby jobs and economic opportunities • Connectivity—walk to school, the store, or work. Play through easements. In different parts of our community and within the state, people don't have access to make a healthy choice. These are all opportunities, not only to plan for our community, but also to plan and • build a healthy community with thoughtful policy going forward. Our built environment impacts our health. Putting health language in the GOALS of the comp plan explicitly connects the broader impact that our built environment has on our community's health. It would also connect what we know about the relationships between how our communities are planned and built with the health of our community. We recommend putting that health statement in the GOALS section of the comp plan. Additional Resources: http://www.clark.wa.gov/public- health/community/growing healthy/documents/ExecutiveSummary 4312.pdf • Build a Healthier Community 8/17/2015 4, In Jefferson county fewer than half of adults and 75% of youth are at a healthy weight. • 4,400 Jefferson County residents experience food insecurity— not having enough g nutritionally adequate foods • 29% of adults and 1 in 3 youth report at least 5 servings of fruits/veg daily • 56% of Jefferson County and WA State 8th graders report at least 60 minutes of daily physical activity Obesity leads to chronic disease • In Jefferson County, the top four causes of death (Death Certificate Database) and top 3 causes of hospitalization (Inpatient Hospitalizations (CHARS)) are chronic disease. Chronic Disease disabilities are preventable with Health activities and access to nutritional foods. Automobiles are not the only option for personal transportation. Each additional hour of driving per day increases the odds of obesity by 6%, while walking just a half mile per day will decrease the chances by the same amount. • People are more likely to rely on cars if neighborhoods lack an active transportation structure. • Sidewalks, bike paths, pedestrian friendly access to nearby transit We know we need to exercise, but if there isn't a place to walk we are less likely to go out and exercise. We know to eat healthy, we must eat fruits and vegetables, but if you live in parts of the county, they will not be available to you. If you have to take the bus to get to the grocery store to get healthy food, you might not be inclined to do so. • Build a Healthier Community 8/17/2015 Board of Health • V New Business Item 3 Back to School Initiatives: • 4f t/fr ffetson Public Healt Immunizations, and Concussion Awarness September 17, 2015 • Back to School Immunizations • September 9, 2015 FOR IMMEDIATE RELEASE Contact: Marjorie Boyd, PHN Immunization Program 360-379-4480 margieb@co.jefferson.wa.us Back to School Immunizations Port Townsend—September 9, 2015, Port Townsend—School is starting. If your children still need to update their vaccines, now's the time to get them in to their doctor's office. All immunizations required for school are available to children up to age 19 at no cost for the vaccine through the state's Childhood Vaccine Program.The Jefferson County clinics offering children's vaccines are:Jefferson Healthcare Primary Care,Jefferson Healthcare Family Medicine,Jefferson Healthcare Madrona Family Medicine,and Jefferson County Public Health.There may be a charge for the office visit • and an administration fee to give the vaccine. People who can't afford the administration fee can ask for it to be waived. Several immunizations are required before kids can start school or child care.Vaccination against whooping cough (pertussis) is especially important given the recent outbreak in our county and state. The following are the minimum required immunizations for the 2015-2016 school-year: Kindergarten:through 5th grades •DTaP:4 doses with the last dose on or after the 4th birthday. •Polio: 3 doses with the last dose on or after the 4th birthday. •Hepatitis B: 3 doses. •MMR (measles, mumps,& rubella): 2 doses. •Varicella (chicken pox): 2 doses of vaccine or medical provider verification of disease. 6th through 8th grade: •Tdap: 6th-12th grade students are required to have 1 dose if 11 years or older. •Varicella (chicken pox): 2 doses of vaccine or medical provider verification of disease. • •Polio, MMR, and Hepatitis B requirements same as for K—5th grades. 9th through 12th grades: •Varicella (chicken pox): recommended, but not required for students who have not had the disease. • Next year two doses of varicella will be required. •Tdap same as 6th grade requirements. •Polio, MMR,and hepatitis B requirements as above for K-5th grades. Other vaccines are available and recommended for children and teens by the Centers for Disease Control (CDC), but are not required for school attendance. Ask your provider or Jefferson County Public Health about HPV, hepatitis A, and meningococcal vaccines as well as an annual flu shot. Meningococcal vaccine is especially important and frequently required for freshmen entering college. To schedule an appointment for school immunizations,call your medical provider. Jefferson County Public Health has walk-in immunization clinics every Tuesday and Thursday between 1 and 4 pm at 615 Sheridan Street, Port Townsend. For more information on immunization schedules contact your medical provider or www.jeffersoncountypublichealth.org or call JCPH,360-385-9400. ### Always working for a safer and healthier community • Jefferson County Jefferson County Public Health 615 Sheridan Street-Port Townsend,WA 98368 Community Health: 360.385.9400 I Environmental Health: 360.385.9444 info@jeffersoncountypublichealth.org • r I 4 a* �� r � �`�` � arm� .? a a r t;'4,,41.5[4„ : /40 1. i � a 1, 1! �t z t "a qtr ' k Ski WHAT IS A CONCUSSION? A concussion is a type of traumatic brain injury that changes HEADS U p the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head or body that causes the CONCUSSION head and brain to move quickly back and forth. Even a "ding,""getting your bell rung,"or what seems to be a mild bump or blow to the head can be serious. WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION? SYMPTOMS REPORTED BY ATHLETE: Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days or • Headache or"pressure" in head weeks after the injury. • Nausea or vomiting • Balance problems or dizziness • If an athlete reports one or more symptoms of concussion • Double or blurry vision after a bump, blow, or jolt to the head or body, s/he should be • Sensitivity to light kept out of play the day of the injury. The athlete should only • Sensitivity to noise return to play with permission from a health care • Feeling sluggish, hazy, foggy, or groggy professional experienced in evaluating for concussion. • Concentration or memory problems • Confusion • Just not"feeling right" or is"feeling down" DID YOU KNOW? • Most concussions occur without loss of SIGNS OBSERVED consciousness. BY COACHING STAFF: • Athletes who have, at any point in their lives, had a concussion have an increased risk for • Appears dazed or stunned another concussion. • Is confused about assignment or position • Young children and teens are more likely to • Forgets an instruction get a concussion and take longer to recover • Is unsure of game, score, or opponent than adults. • Moves clumsily • Answers questions slowly • Loses consciousness (even briefly) • Shows mood, behavior, or personality changes • Can't recall events prior to hit or fall • Can't recall events after hit or fall "IT'S BETTER TO MISS ONE GAME • [INSERT YOUR LOGO] THAN THE WHOLE SEASON" CONCUSSION DANGER SIGNS WHY SHOULD AN ATHLETE REPORT In rare cases, a dangerous blood clot may form on the THEIR SYMPTOMS? brain in a person with a concussion and crowd the brain If an athlete has a concussion, his/her brain needs time to • against the skull.An athlete should receive immediate heal. While an athlete's brain is still healing, s/he is much medical attention if after a bump, blow, or jolt to the more likely to have another concussion. Repeat concussions head or body s/he exhibits any of the following danger can increase the time it takes to recover. In rare cases, signs: repeat concussions in young athletes can result in brain • One pupil larger than the other swelling or permanent damage to their brain.They can even • Is drowsy or cannot be awakened be fatal. • A headache that gets worse • Weakness, numbness, or decreased coordination • Repeated vomiting or nausea • Slurred speech • Convulsions or seizures • Cannot recognize people or places • Becomes increasingly confused, restless, or agitated • Has unusual behavior STUDENT-ATHLETE NAME PRINTED • Loses consciousness(even a brief loss of consciousness should be taken seriously) STUDENT-ATHLETE NAME SIGNED WHAT SHOULD YOU DO IF YOU THINK YOUR ATHLETE HAS A CONCUSSION? 1. If you suspect that an athlete has a concussion, remove DATE the athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says s/he is symptom-free and it's OK to • return to play. PARENT OR GUARDIAN NAME PRINTED 2. Rest is key to helping an athlete recover from a concussion. Exercising or activities that involve a lot of concentration, such as studying, working on the computer, and playing video games, may cause concussion symptoms PARENT OR GUARDIAN NAME SIGNED to reappear or get worse. After a concussion, returning to sports and school is a gradual process that should be carefully managed and monitored by a health care professional. DATE 3. Remember: Concussions affect people differently. While most athletes with a concussion recover quickly and fully, some will have symptoms that last for days, or even weeks. A more serious concussion can last for months or longer. JOIN THE CONVERSATION www.facebook.com/CDCHeadsUp S Content Source:CDC's Heads Up Program.Created through a grant to the CDC Foundation from the National Operating Committee on Standards for Athletic Equipment(NOCSAE). Parent/Athlete Concussion Information Sheet A concussion is a type of traumatic brain injury that changes the way the brain normally works.A concussion is caused by blow or jolt to the head or body that causes the head and brain to move rapidly back and forth. Even a"ding," "gettingimp, g ur bell rung,"or what seems to be a mild bump or blow to the head can be serious. WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION? Signs and symptoms of concussion can show up right after the Did You Know? injury •Most concussions occur without loss of or may not appear or be noticed until days or weeks after the injury. consciousness If an athlete reports one or more symptoms of concussion listed •Athletes who have,at any point in their below after a bump, blow,or jolt to the head or body,s/he should lives,had a should be kept out of play the day of the injury and until a health concussion have an increased risk for care professional,experienced in evaluating for concussion,says another concussion. s/he is symptom-free and it's OK to return to play. •Young children and teens are more likely to get a concussion and take longer to recover than adults. SIGNS OBSERVED BY COACHING: Appears dazed or stunned Is confused about assignment or position Forgets an instruction Is unsure of game,score,or opponent Moves clumsily WHAT SHOULD YOU DO IF YOU THINK Answers questions slowly YOUR ATHLETE HAS A CONCUSSION? Loses consciousness(even briefly) Shows mood,behavior,or personality changes If you suspect that an athlete has a concussion, remove the Can't recall events prior to hit or fall athlete from play and seek medical attention. Do not try to Can't recall events after hit or fall judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a SYMPTOMS REPORTED BY ATHLETES: health.care professional, experienced in evaluating for AgaeadacheMI or"pressure" in head concussion,says s/he is symptom-free and it's OK to return usea or vomiting to play. glance problems or dizziness Rest is key to helping an athlete recover from a concussion. Double or blurry vision Exercising or activities that involve a lot of concentration, Sensitivity to light Sensitivity to noise such as studying,working on the computer,or playing video Feeling sluggish,hazy,foggy,or groggy games, may cause concussion symptoms to reappear or get Concentration or memory problems worse. Confusion After a concussion, returning to sports and school is Just not"feeling right"or"feeling down" a gradual process that should be carefully managed and CONCUSSION DANGER SIGNS monitored by a health care professional. In rare cases,a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull.An athlete should receive immediate medical attention if after a bump,blow or jolt to the head or body s/he exhibits any of the following danger signs: • One pupil larger than the other • Is drowsy or cannot be awakened •A headache that not only does not diminish,but g ets worse Remember •Weakness, numbness,or decreased coordination Concussions affect people differently.While most • Repeated vomiting or nausea athletes with a concussion recover quickly and • Slurred speech fully,some will have symptoms that last for days, • Convulsions or seizures or even weeks.A more serious concussion can •Cannot recognize people or places last for months or longer. • Becomes increasingly confused, restless, or agitated • Has unusual behavior • Loses consciousness(even a brief loss of consciousness should be taken seriously) ØHY SHOULD AN ATHLETE REPORT THEIR SYMPTOMS? an athlete has a concussion, his/her brain needs time to heal.While an athlete's brain is still healing,s/he is much more ely to have another concussion. Repeat concussions can increase the time it takes to recover. In rare cases, repeat concussions in young athletes can result in brain swelling or permanent damage to their brain.They can even be fatal. It's better to miss one game than the whole season. For more information on concussions, visit: www.cdc.gov/Concussion • j 11: , A FACT SHEET FOR PARENT ss a IN HIGH SCHOOL C NCU 11 SPORTS What is a concussion? What should you do if you think your A concussion is a brain injury. Concussions are teenage athlete has a concussion? caused by a bump, blow, or jolt to the head. They can range from mild to severe and can disrupt the 1. Seek medical attention right away. A health way the brain normally works. Even a "ding" or a care professional will be able to decide how bump on the head can be serious. serious the concussion is and when it is safe for your teen to return to sports. What are the signs and symptoms? You can't see a concussion. Signs and symptoms 2. Keep your teen out of play. Concussions take of concussion can show up right after the injury time to heal. Don't let your teen return to play or can take days or weeks to appear. If your teen until a health care professional says it's OK. reports any symptoms of concussion, or if you Athletes who return to play too soon—while notice the symptoms yourself, seek medical the brain is still healing—risk a greater attention right away. chance of having a second concussion. • Signs Observed Symptoms Reported Second or later concussions can be very seri- by Parents or Guardians by Athlete ous. They can cause permanent brain damage, • Appears dazed • Headache affecting your teen for a lifetime. or stunned • Nausea • Is confused about 3. Tell all of your teen's coaches about any • Balance problems recent concussion. Coaches should know if assignment or dizziness • Forgets plays your teen had a recent concussion in ANY • Double or fuzzy vision sport. Your teen's coaches may not know about • Is unsure of game, score, or opponent • Sensitivity to light a concussion your teen received in another or noise sport or activity unless you tell them. Knowing • Moves clumsily about the concussion will allow the coach to • Feeling sluggish • Answers questions slowly keep your teen from activities that could • Feeling foggy or grog- result in another concussion. • Loses consciousness gy • Shows behavior or • Concentration or 4. Remind your teen: It's better to miss one personality changes memoryproblems game than the whole season. • Can't recall events • Confusion prior to hit • Can't recall events after hit It's better to miss one game than the whole season. r DEPARTMENT OF HEALTH AND HUMAN SERVICES ` CDC CENTERS FOR DISEASE CONTROL AND PREVENTION '„ February 2005 Parent/Athlete Concussion 1 ) CDC i.® �.._....�.�. � _ HEJWS UP Information Sheet CONCUSSION ; �./ IN YOUTH SPORTS A concussion is a type of traumatic brain injury that changes the way the brain normally works.A concussion is caused by bump,blow or Did You Know? jolt to the head or body that causes the head and brain to move • Most concussions occur without loss of consciousness rapidly back and forth. Even a "ding," "getting your bell rung," • Athletes who have,at any point in their lives,had a or what seems to be a mild bump or blow to the head can be serious. concussion have an increased risk for another concussion. • Young children and teens are more likely to get a WHAT ARE THE SIGNS AND SYMPTOMS OF CONCUSSION? concussion and take longer to recover than adults. Signs and symptoms of concussion can show up right after the injury below after a bump,blow,or jolt to the head or body,s/he should or may not appear or be noticed until days or weeks after the injury. should be kept out of play the day of the injury and until a health If an athlete reports one or more symptoms of concussion listed care professional,experienced in evaluating for concussion,says s/he is symptom-free and it's OK to return to play. SIGNS OBSERVED BY COACHING STAFF SYMPTOMS REPORTED BY ATHLETES Appears dazed or stunned Headache or"pressure"in head Is confused about assignment or position Nausea or vomiting Forgets an instruction Balance problems or dizziness Is unsure of game,score,or opponent Double or blurry vision Moves clumsily Sensitivity to light Answers questions slowly Sensitivity to noise Loses consciousness(even briefly) Feeling sluggish,hazy,foggy,or groggy Shows mood,behavior,or,personality changes Concentration or memory problems Can't recall events prior to hit or fall Confusion Can't recall events after hit or fail Just not"feeling right"or"feeling down" � CONCUSSION DANGER SIGNS Remember"it In rare cases,a dangerous blood clot may form on the brain in a person Concussions affect people differently.While most athletes with a concussion and crowd the brain against the skull.An athlete should with a concussion recover quickly and fully,some will receive immediate medical attention if after a bump,blow or jolt to the have symptoms that last for days,or even weeks.A more head or body s/he exhibits any of the following danger signs: serious concussion can last for months or longer. • One pupil larger than the other • Is drowsy or cannot be awakened • A headache that not only does not diminish, but gets worse WHAT SHOULD YOU DO IF YOU THINK • Weakness,numbness,or decreased coordination YOUR ATHLETE HAS A CONCUSSION? • Repeated vomiting or nausea If you suspect that an athlete has a concussion, remove the • Slurred speech athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out • Convulsions or seizures of play the day of the injury and until a health care • Cannot recognize people or places professional,experienced in evaluating for concussion,says • Becomes increasingly confused,restless,or agitated s/he is symptom-free and it's OK to return to play. • Has unusual behavior Rest is key to helping an athlete recover from a concussion. • Loses consciousness (even a brief loss of consciousness should Exercising or activities that involve a lot of concentration, be taken seriously) such as studying,working on the computer,or playing video games,may cause concussion symptoms to reappear or get WHY SHOULD AN ATHLETE REPORT worse.After a concussion,returning to sports and school is THEIR SYMPTOMS? a gradual process that should be carefully managed and If an athlete has a concussion,his/her brain needs time to heal. While monitored by a health care professional. an athlete's brain is still healing,s/he is much more likely to have another concussion.Repeat concussions can increase the time it takes to recover. It's better to miss one game than the whole In rare cases,repeat concussions in young athletes can result in brain season. For more information on.concussions, swelling or permanent damage to their brain. They can even be fatal. visit: www.cdc.gov/Concussion Student-Athlete Name Printed Student-Athlete Signature Date Parent or Legal Guardian Printed Parent or Legal Guardian Signature Date Media Review • lefflsotsfrPublic Healt Jefferson County Public Health • August/September 2015 NEWS ARTICLES 1. "Sequim, Port Angeles vaccination clinics next week to cut shots' cost," Peninsula Daily News, August 13th, 2015. 2. "Bad bugs: State's lice now highly resistant to common treatment," Seattle Times, August 18th, 2015. 3. "Is your child fully vaccinated?" Peninsula Daily News, August 23rd, 2015. 4. "Anderson, Gibbs lakes in Jefferson remain closed to recreation because of toxin levels," Peninsula Daily News, August 25th, 2015. 5. "Shellfish biotoxin talk spotlights Jefferson County," Port Townsend Leader, September 2nd, 2015. • • Sequim, Port Angeles vaccination clinics next week to cut shots'cost By James Casey, Peninsula Daily News,August 13th,2015 0 S'7,d1,:. :11/,,•`:*, .,..t ,... 4W'.', k The measles virus Parents can trim $30 from the cost of having their children vaccinated at three special back-to-school clinics Aug. 18-20 in Sequim and Port Angeles. Health officials hope the clinics—and vouchers for later immunization visits—can head off a repeat of last winter's measles outbreak—or an outbreak of any communicable disease. The string of six measles cases caused the death of one young Clallam County woman and cost public agencies at least$227,000. The schedule of the special clinics: • Sequim: 2:30 p.m. to 6:30 p.m. Tuesday and Wednesday next week, Sequim Middle School, 301 W. Hendrickson Road. • Port Angeles: 9 a.m. to 3 p.m. Thursday, Aug. 20, Stevens Middle School, 1139 W. 14th St. Middle schools were chosen for the clinics because their students now are required to receive booster immunizations for chicken pox (varicella), said Iva Burks, Clallam County Health and Human Services director. • Clinicians also will provide vaccinations for tetanus, diphtheria and whooping cough (pertussis); measles, mumps and German measles (rubella); and measles, mumps and rubella plus varicella. The vaccinations are free for children younger than 18, but Clallam County Health and Human Services charges an administration fee of$23 per shot. People visiting the special clinics, however, will not be charged the usual $30 clinic-visit charge. They also can obtain vouchers to waive the$30 clinic fee if they subsequently visit the county's usual vaccination clinic, which is from 11 a.m. to 4 p.m. each Wednesday at 111 E. Third St., Suite 1-A. Call 360-417-2364 for details. "We hope that by encouraging the vaccinations, we can get the countywide rate up," Burks said. At Clallam County's special clinics, Medicaid will be billed directly. For other insurers, parents will receive receipts after paying for vaccinations by cash or check. Jefferson clinics Jefferson County Public Health is adding staff to its normal immunization clinics from 1 p.m. to 4 p.m. Tuesdays and Thursdays at 615 Sheridan St., Port Townsend, in Castle Hill Mall during the runup to the start of school. Fees are on a sliding scale. No appointments are needed. Call 360-385-0400 for details. Students also can receive vaccinations at the school-based clinic at Chimacum High School and Port Townsend • High School. Reporter James Casey can be reached at 360-452-2345, ext. 5074, or at jcaseypeninsuladailynews.com Bad bugs: State's lice now highly resistant to common treatment (:tri =,1nalle pul?1is}ted August 18. 201.5 at.2:01 an Updated August 18. 2015 at 10:061 am Washington is one of at least 25 states where head lice have become highly resistant to the most common pesticides. (Steve Ringman/The Seattle Times) Nancy Gordon, owner of Lice Knowing You on Mercer Island, uses a special comb she calls "my knock-out terminator comb"to check a client's hair after a treatment. (Steve Ringman/The Seattle Times) By JoNel Aleccia • Seattle Times health reporter It's 9 a.m. on a warm Wednesday and at least five families have already crowded into the tiny waiting room of a Mercer Island business aimed at ridding the world of head lice. There are two long-haired teen girls and their dad, all clearly anxious to be bug-free before college starts. There's a young girl in a pink-striped T-shirt, scratching her head. And there's Marcela Salazar, 26, of Seattle, who battled lice last year with her 5-year-old twins and wants to head off any new problems before kindergarten begins. "It cost me $1,300 and I took off a week and a half from work," she said. It's back-to-school season, which might be one reason that business is so brisk, said Nancy Gordon, 49, whose firm, Lice Knowing You, started in Seattle eight years ago and has since expanded to four states. As summer break peaks and wanes, "this gets into our busiest time," she said. But a new study suggests another reason for the uptick: Researchers say Washington is one of at least 25 states where head lice have become highly resistant to the most common pesticides used to treat them. The tiny, wingless critters that crawl quickly from head to head have developed genetic mutations that fend off pyrethroids, the pesticides that are the active ingredients in over-the-counter shampoos and rinses like Rid and Nix. • "If you use a lot, you can still kill the insects, but the problem is, they tend to develop additional resistance mechanisms," said Kyong Yoon, an assistant professor in the biological sciences department at Southern Illinois University in Edwardsville, who is presenting new research Tuesday at a meeting of the American Chemical Society. • That's a real problem for parents and kids in the United States, where an estimated 6 million to 12 million cases of lice occur each year among children ages 3 to 11, according to the Centers for Disease Control • and Prevention. Head lice are now nearly as common as the common cold in elementary schools, experts say, and the arsenal of weapons to treat them is becoming weaker. "I tell people all the time, 'If there was a magical solution, head lice wouldn't be a problem,- said Katie Shepherd, president and CEO of the Lice Solutions Resource Network, a nonprofit lice treatment, training and certification organization in West Palm Beach, Fla. Neither Shepherd nor Gordon is surprised about the tough new lice. It's a trend that's been shaping up for more than 15 years, when Yoon and colleagues first wondered about a growing resurgence of what's formally known as pediculosis in the United States. Back then, Yoon began testing the pests for three genetic mutations known as kdr, or knock-down- resistance, changes originally found in house flies that developed resistance to the insecticides in the late 1970s. His early work found that many of the lice did have the kdr mutations, which make them essentially immune to pyrethroids. Those bugs, dubbed "super lice" in some early news reports, drew dire predictions that it would soon be impossible to kill the insects with existing treatments. That situation, Yoon said, may now be coming true. Steps to take Yoon's latest study cast a wide net, collecting lice from 30 states and then testing them for the mutations. Gordon, of Lice Knowing You, was among the providers contacted by Shepherd, who oversaw the • gathering of the pests. Gordon's samples, taken from the heads of clients in Seattle and beyond, helped confirm that Washington lice have developed the trio of mutations that make them most resistant to the treatments. As it turns out, Michigan is the only state where lice can still routinely be killed by common products, Yoon's current study found. A spokeswoman for Bayer, which produces Rid, said the firm had not seen Yoon's study and couldn't comment on it. Rid is effective at killing lice when package directions are followed, she added. Officials for Prestige Brands Holdings, the firm that sells Nix, did not respond to a request for comment. The reported resistance is just another wrinkle for parents who regard adult lice and their tiny eggs, called nits, with disgust and fear. But experts from school nurses to pediatricians say the most important thing to remember is to not overreact. "Anyone can get head lice, it is not a sign of being dirty, and no child should be excluded from school for head lice and especially nits alone," said Dr. Cynthia Devore, a Fairport, N.Y., pediatrician who authored a clinical report on head-lice treatment published this year by the American Academy of Pediatrics (AAP). Head lice are a nuisance, but not a public-health threat, Devore said, a point emphasized by Terri Helm- Remund, president of the School Nurse Organization of Washington. "Compared to other health issues that we try to plan for kids, this is low on the priorities," Helm-Remund • said. In general, the AAP recommends that parents who suspect head lice contact their pediatricians for advice. In areas where there's no known resistance to the over-the-counter treatments, it's OK to treat with those products, including second or third treatments spaced a week to 10 days apart, Devore said. In areas where there's known resistance to the insecticides, doctors can recommend new prescription products. That includes Sklice, a lotion made by Sanofi Pasteur that uses the pesticide ivermectin, • recently approved by the Food and Drug Administration. Such products appear to be more effective than over-the-counter treatments, but they're also much more expensive. And they'll have to be used judiciously to prevent the bugs from developing resistance to those chemicals, too, she added. Manual removal of the insects and nits is also vital, the AAP noted. "I had tried everything" "Ninety percent of our clientele are people who have been working on it for months," said Gordon of Lice Knowing You. "They try to follow the instructions. And they still have live lice and nits after weeks and weeks." That was the case for Marcela Salazar, whose twin girls, Jasmeen and Jesenia, contracted lice during a day-care outbreak of the bugs. It took eight boxes of Rid and three hours of combing with each girl —and the lice still came back, Salazar said. She finally looked up Lice Knowing You because there was no one at home who could check her thick and curly hair. Gordon charges by 15-minute increments: It might take 45 minutes to go through a boy's hair, with a fee of$75. An average girl will take 60 to 90 minutes, and cost $95 to $145. Salazar said by the time she paid for drugstore treatments, plus combs and gloves and quarters for the laundromat washers to clean all the clothes, toys and linens, it was worth it. • Jessica Rodriguez, 37, of Seattle joined the parade of parents heading into the Lice Knowing You waiting room. She was there for a free head check for herself and her son, Tristan, 13, after enduring a long bout of lice with her 8-year-old daughter, Kaitlin, this spring. "We just wanted to make sure," Rodriguez said. "It was a very long month." JoNel Aleccia: 206-464-2906 or jaloccia@seattletimes.com. On Twitter©JoNel Aloccia • GUEST COLUMN — Is your child fully vaccinated? (with where to get III immunizations for your kids) By Jeanette Stehr-Green, Peninsula Daily News,August 23,2015 EDITOR'S NOTE—Jeanette Stehr-Green of Port Angeles is the interim public health officer for Clallam County. , .-° g �. is n - `: , Jeanette Stehr-Green WHERE TO GET IMMUNIZATIONS FOR YOUR KIDS REQUIRED SCHOOL VACCINATIONS, or immunizations,are available at the offices of most family and pediatric medical providers and some pharmacies in Clallam and Jefferson counties. Because pharmacies vary in the ages of clients served, immunizations provided and types of insurance accepted,you should contact the pharmacy for more information. Both Clallam and Jefferson County offer walk-in immunization clinics(no appointments necessary). III • Clallam County Health and Human Services, Port Angeles, at 111 E. Third St., Suite 1-A(across from Safeway), Wednesdays, 11 a.m.to 4 p.m. There will be an office visit fee and a$23 charge per vaccination. Clallam County will bill Medicaid directly or provide a receipt for submission to other insurance carriers. Call 360-417-2274 for more information. •Jefferson County Public Health,615 Sheridan St., Port Townsend, in the Castle Hill Mall, Tuesdays and Thursdays, 1 p.m.to 4 p.m. Sliding-scale fees are used for uninsured children. Jefferson County will bill private insurance and Medicaid. Call 360-385-9400 for more information. Peninsula Daily News IT'S BACK-TO-SCHOOL time, which means it's time for haircuts, shopping for school supplies and getting new shoes. It also means it is time to make sure children are up to date on their immunizations in Clallam and Jefferson counties, where vaccination rates are falling. • By law, children must be vaccinated against certain diseases to attend public or private schools in Washington. It is recommended that parents begin vaccinating their children soon after birth to protect them from a variety of serious diseases. The earliest vaccination takes place before a newborn is discharged from the hospital; other vaccines follow soon thereafter to protect the child from a host of diseases as quickly as possible. • At school entry, the stakes become higher. As children congregate, risk is significantly increased for the spread of diseases. Being vaccinated can prevent a child from getting infected. When enough children are vaccinated, those who are vaccinated can provide a shield of protection for those who cannot be vaccinated. This shield of protection, called "community immunity," protects children with weakened immune systems and those who cannot get the shots because of certain medical conditions. (It also protects community members with these same issues.) High levels of immunization coverage are needed for community immunity. For measles, 95 percent of children need to be immune for protection of others. Since the introduction of vaccinations, the U.S. has witnessed an enormous decrease in illnesses and deaths due to vaccinating preventable diseases. Endemic transmission of polio, measles and rubella has been eliminated. Mumps, whooping cough and chickenpox have shown striking decreases. • Declining immunization rates, however, have made it possible for these highly infectious diseases to make a comeback. According to the Washington State Department of Health, the proportion of kindergartners in Clallam County with all of the required immunizations fell from 91 percent in 2004-05 to 76 percent in 2014-15. During the same period, immunization coverage rates were even lower in Jefferson County, dropping below 60 percent in five of those years. Last school year, only 87 percent of kindergartners in Clallam County were immunized against measles, while in Jefferson County, only 78 percent were protected. These levels were well below the 95 percent coverage rate necessary for community immunity against measles. Not surprisingly, in February and March of 2015, Clallam County experienced its first measles cases in over 20 years. The outbreak that resulted in six cases, including two school-age children, led to the death of a young woman with an underlying illness and cost over$250,000 in response efforts. We must do better at immunizing ourselves and our children to protect the vulnerable people in our community. • School vaccination requirements play a critical role in increasing childhood immunization rates, preventing outbreaks in schools and protecting the whole community. State regulations establish vaccination requirements for schoolchildren based on national immunization guidelines. Students attending public and private schools in Washington state must be immunized against chickenpox, diphtheria, German measles, hepatitis B, measles, mumps, polio, tetanus and whooping • cough. New this fall, all students in seventh and eighth grade will need to show proof of having received two doses of chickenpox vaccine or a health care provider's previous diagnosis of chickenpox. If parents want to claim an exemption for their children, they must be counseled by a Washington state licensed health care practitioner (medical doctor, naturopathic doctor, osteopathic doctor, advanced registered nurse practitioner, physician's assistant) about the benefits and risks of vaccinations and parental responsibilities, if they choose not to vaccinate. All parents requesting an exemption must be counseled, unless the parent's religious beliefs do not allow treatment by professionals, and they must complete a Certificate of Exemption for their child. If a child is not up to date on the required vaccinations and does not have a Certificate of Exemption, the child may be excluded from school until the required vaccinations are received. Unvaccinated children will be excluded from school if a case of a vaccine-preventable disease (against which the child has not been vaccinated) occurs in the school. It is a lose-lose situation. The child is not protected against the disease and misses school. Make this school year a win-win. • Vaccinations are safe and effective. Get your child vaccinated to protect your child's health and protect the health of your community. This guest column appeared in the print edition of the Sunday,Aug. 23, 2015, Peninsula Daily News. • Anderson, Gibbs lakes in Jefferson remain closed to recreation because of toxin levels • Peninsula Daily News,August 25th,2015 PORT TOWNSEND— Both Anderson and Gibbs lakes remain closed to fishing, boating and swimming, although the latest test of Anderson Lake found it no longer contains a harmful amount of toxin. Anderson Lake, which is near Chimacum, which is south of Port Townsend, was closed to recreation May 7 because of high levels of anatoxin-a, a nerve poison that can kill within 4 minutes of ingestion. The state recreational criteria for the toxin —which is created by blue-green algae, also known as cyanobacteria — is 1 microgram per liter. "The last round of toxin samples from Anderson Lake were below recreational guidelines," said Michael Dawson, lead environmental health specialist for the Jefferson County Water Quality Program, in an email. However, the bloom at Anderson Lake, a popular trout-fishing lake, is still dominated by microcystis and anabaena, cyanobacteria species known to sometimes produce toxins. So Washington State Parks, which oversees Anderson Lake and the state park surrounding it, decided to keep the lake closed for now, Dawson said. "If the bloom dissipates, that may change, but we have often seen a late season resurgence of cyanobacteria toxins in Anderson Lake," he said. • The next test will be in September, he added. The state park remains open for recreation. Gibbs Lake Gibbs Lake, a catch-and-release trout lake near Chimacum, also remains closed to recreation. The county park around it remains open. The lake was closed early this month because of high levels of the toxin microcystin. Microcystin, which is produced by blue-green algae, can cause skin irritation, nausea and muscle weakness if touched and liver damage if swallowed over a long period of time. Gibbs Lake was mentioned in a state Department of Ecology news release last week as one of several lakes with toxic algae blooms in the state. "Lakes, rivers and Puget Sound are experiencing more intense and widespread algae blooms this summer," Ecology said. Warm waters It added that scientists believe warm water due to the state's drought is partly to blame. • Warmth increases the growth of blue-green algae, which is usually benign but which can begin to produce toxins. Researchers do not know what triggers the toxin release. l ` Algae growth also is fed by nutrients such as phosphorus, which is found in large amounts in Anderson Lake. • "If you see green algae in the water, don't go into the water," said Lizbeth Seebacher, an environmental scientist who oversees the state's freshwater algae control program in conjunction with the state Department of Health. A good rule to remember is that if you see scum on the water, don't swim in it, and don't let pets swim in or drink the water." For more information about Jefferson County lakes, visit http://tinyurl.cam/jeffersonlakequality. Those who see a bloom on a lake are urged to report it to 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. For fishing seasons and regulations, see the state Department of Fish and Wildlife website at www.wdfw.wa.qov. Last modified:August 24.2015 6:20PM • • Shellfish biotoxin talk spotlights Jefferson County Port Townsend Leader, September 2, 2015 A talk on shellfish biotoxins, which are the source of paralytic, amnesic and diarrhetic shellfish poisoning, takes place at 1 p.m., Sept. 9 at Jefferson County Public Health, 615 Sheridan St. The event is free and open to the public. The presenter, Adi Hanein, is a Washington Sea Grant Marc Hershman Marine Policy fellow at the Washington State Department of Health. She is working with the shellfish biotoxin monitoring program studying natural toxins that cause paralytic, amnesic and diarrhetic shellfish poisoning. Her talk focuses on recent trends observed in Washington, with a spotlight on Jefferson County. Biotoxins have impacted more than 90 percent of Washington waterbodies, causing shellfish harvest closures from 14 to 200 days in length, according to the health department. Call the Department of Health Biotoxin Hotline at 800-562-5632 before • harvesting shellfish anywhere in Washington state. •