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2015- October
de �1S012 Public Health • File Copy Board of Health Meeting October 17, 2015 • Jefferson County Public Health Agenda Minutes 6-\:4t) eiTesLj Public He-alth � October 15, 2015 JEFFERSON COUNTY BOARD OF HEALTH October 15, 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 September 17,2015 Board of Health Meeting III. Public Comment IV. Old Business and Informational Items 1. SmileMobile coming to Blue Heron School in Port Townsend,Nov. 2-13,2015 2. Jefferson County Public Health Hires a New Community Health Director V. New Business • 1. Food Safety Program Fees—Possible Action Item: Call for Public Hearing 2. End of Year Report Lake Monitoring Program 3. End of Year Report School Based Clinic Program 4. Community Health Improvement Plan Update: Meeting Agendas and Preliminary Goals for Chronic Disease Prevention,Access to Health Care, Mental Health/Substance Abuse Working Groups VI. Activity Update VII. Public Comment VIII. Agenda Planning Calendar IX. Next Scheduled Meeting: December 17,2015 2:30—4:30 PM Jefferson County Public Health 615 Sheridan St. Port Townsend,WA • JEFFERSON COUNTY BOARD OF HEALTH • MINUTES Thursday, September 17, 2015 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 Board Members Staff Members Phil Johnson,County Commissioner District#1 Thomas Locke,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,WQ Manager John Austin,Citizen at large Chair Sheila Westerman called the September, 2015 meeting of the Jefferson County Board of Health to order at 2:30 p.m. A quorum was present. Members Present: David Sullivan, Sheila Westerman, Phil Johnson, John Austin, Kathleen Kler Members Excused: Jill Buhler, Kris Nelson • Staff Present: Tom Locke, Jean Baldwin, Jared Keefer, Veronica Shaw APPROVAL OF AGENDA Chair Westerman asked that item 2,New Business move to item 1 in Old Business. Chair Westerman asked for approval of the September 17, 2015 Agenda. Chair Westerman moved to approve the agenda; the motion was seconded by Member Austin. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Westerman called for approval of the minutes of the August 20, 2015 meeting of the Board of Health. It was noted that John Austin was excused from that meeting. Member Austin moved to approve the minutes as presented; the motion was seconded by Member Sullivan. No further discussion. The motion passed unanimously. • PUBLIC COMMENT • Helen Lauritzen requested an update on the Port Townsend Paper Corporation(PTPC)taking financial responsibility for its landfill. Chair Westerman asked Dr. Tom Locke, Health Officer, JCPH, to respond and he informed Mrs. Lauritzen that the Mill is licensed, and financial assurance agreements are nearing completion. The Department of Ecology is now working on final review and approval. In addition, Locke noted, since 2014, when JCPH approved the permit, the PTPC's financial responsibility for its landfill and any future closure costs has been incontrovertible. A representative from the PTPC said the financial assurances process with the Department of Ecology is near completion;November 2, 2015 is the deadline for this process. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Proposed Comp Plan Amendment: Active Lifestyle and Chronic Disease Prevention Ms. Karen Obermeyer, JCPH, briefed the Board on Chronic Disease Prevention activities funded through a grant by the Dept. of Health. Activities include proposals to integrate health language to encourage healthy lifestyles into the Comprehensive Plan. Research shows the built environments that surround us impact the decisions residents make concerning activities that impact their health by promoting healthy lifestyles or imposing barriers to healthy behaviors. One of the Jefferson County Health Priorities is Healthy Communities and Active Living with Chronic Disease Prevention. With this in mind, Ms. Obermeyer and Jared Keefer, Environmental Health Director, JCPH, are working with the Department of Community Development and local community groups (such as Food System Council and Local 20/20) to integrate into the county- wide planning policy explicit health language that links health to the built environment. Elements include access to healthy food, affordable housing, transportation, and impacts of climate change, all of which is in response to community request. Mr. Keefer told the Board the planning policy proposals now being vetted at the staff level will be presented to the planning commission in October. The next step is to present these proposals to the Board of Health and then to the Jefferson County Commissioners. Finally, the proposals to integrate explicit health language into the Jefferson County Comprehensive Plan will be presented to the Steering Committee. Chair Westerman voiced her concerns about balancing the varied challenges with adoption of expensive infrastructure. 2. Olympic Community of Health Web Page Dr. Locke informed the Board that there is a Web page dedicated to helping the public and Board members stay current on developments in the Olympic Community of Health. Current priorities are focused on efforts to pull together stakeholders in the ongoing development of the Accountable Communities of Health (ACH) design and address governance issues. 3. Mill Update—Odor Complaints Dr. Locke explained to the Board a document presented to JCPH concerning PTPC mill odors. The citizen report chronicles mill odor by date, time, and degree of impact. Citizens post this to their website dedicated to the purpose of tracking mill odors and also submit this data to state regulatory agencies. Locke explained that air quality regulation authority falls within state and federal jurisdiction, rather than county, and stated that if the PTPC is adhering to those • regulatory standards there are few remedies. County commissioners or local boards of health lacks specific legal authority to regulate air pollution. Member Johnson told the Board the 111 Department of Ecology is the agency responsible for mill activities. A representative from the PTPC addressed the Board telling them the Mill has taken action to mitigate the odors. Chair Westerman called for staff to respond to the citizen concern in a logical, sympathetic way.No Board action was taken. 4. Strengthening Families and Youth Mental Health Training: Chimacum Prevention Coalition Jean Baldwin, Director, JCPH, informed the Board there will be second Youth Mental Health Training on October 19th. The initial training was so well attended there was a waiting list, so additional funding was sought and awarded to host a second training. Additional Strengthening Families events, October 8 and November 19th, are also planned in response to the overwhelming community response. 5. School Based Clinics Reopen Ms. Baldwin explained to the Board the importance of marketing flyers, included in the packet, to keep school populations abreast of who is in their building, when School Based Clinics (SBC) are open, who is associated with the SBC, and what service they provide. Baldwin touched on updates to the SBC Final Report, End of the School Year statistics and said she will have more information next month. NEW BUSINESS • 1. Food Safety Program Fees—Possible Action Item: Call for Public Hearing Mr. Keefer reviewed documents included in the Board packet that compare actual costs of Food Safety activities with current and proposed fees. Chair Westerman, stated that she found the documents confusing and questioned their logic. Specific license fees and their associated costs were discussed at length. Additional Board members voiced their concern that the program fees proposed fell substantially short of the actual cost of the program activities. It was decided the proposal isn't ready to move to a Public Hearing and that next month Mr. Keefer will present additional fee proposals and their budget impacts. 2. Back to School Initiatives: Immunizations and Heads Up Concussion Awareness Program Ms. Baldwin shared with the Board JCPH's Back to School Immunization press release that lets the public know which vaccines are required, where they can be obtained, and the various payment options. New school administrators are much more amenable to immunization discussions. Dr. Locke let the Board know that immunizations are universally covered under new insurance regulations. Ms. Baldwin explained a new national focus on clarifying sports-related concussion information and training of medical staff to recognize concussion symptoms and treatment, and the standardization of systems to evaluate sports injuries. The effort is focused on prompt recognition of the signs and symptoms of concussion and appropriate exclusion from sports activity during the recovery period. Included in the Board packet were parent information handouts. • I • • ACTIVITY UPDATE Mr. Keefer mentioned a visit in late August to JCPH from a representative of Senator Patty Murray's office who was very impressed by the breadth of JCPH's reach. Chair Westerman shared her recommendations vis-à-vis a Seattle Times article in the September 17, 2015 paper heralding a state-wide increase in the number of residents insured. Vice-chair Kler enjoyed the excellent marine biotoxins discussion that was held at JCPH on September 9th, and informed the Board there is Regional Support Network meeting Friday, September 18th. Vice-chair Kler and Ms. Baldwin attended a meeting today with Clallam and Kitsap representatives to prepare for the September 18th meeting. PUBLIC COMMENT There was no public comment. NEXT SCHEDULED MEETING The next Board of Health meeting will be held on Thursday, October 15, 2015 from 2:30—4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT • Chair Sheila Westerman adjourned the September 17,2015 Jefferson County Board of Health meeting at/4:30 p.m. App 41 / J �. ' . 'i 1 NTY BOARD OF HEALTH diE P i it .l •- M mbe J 11 Buhler, M ber K/A UL 6) ie/4-4"---4 David ul iv.s , Member Sheila Westerman, Chair Kris Ne n, M mber Kathleen Kler, Member \if . 4*, . Respectfully Submitted: D. Banker • JEFFERSON COUNTY BOARD OF HEALTH • MINUTES Thursday, September 17, 2015 Jefferson County Public Health, 615 Sheridan Street, Port Townsend WA 98368 DRAFT Board Members Staff Members Phil Johnson,County Commissioner District#1 Thomas Locke,Health Officer David Sullivan,County Commissioner,District#2 Jean Baldwin,Public Health Dir Kathleen Kier,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,WQ Manager John Austin,Citizen at large Chair Sheila Westerman called the September, 2015 meeting of the Jefferson County Board of Health to order at 2:30 p.m. A quorum was present. Members Present: David Sullivan, Sheila Westerman, Phil Johnson, John Austin, Kathleen Kler Members Excused: Jill Buhler, Kris Nelson IIIStaff Present: Tom Locke, Jean Baldwin, Jared Keefer, Veronica Shaw, Denise Banker APPROVAL OF AGENDA Chair Westerman asked that item 2,New Business move to item 1 in Old Business. Chair Westerman asked for approval of the September 17, 2015 Agenda. Chair Westerman moved to approve the agenda; the motion was seconded by Member Austin. No further discussion. The motion passed unanimously. APPROVAL OF MINUTES Chair Westerman called for approval of the minutes of the August 20, 2015 meeting of the Board of Health. It was noted that John Austin was excused from that meeting. Member Austin moved to approve the minutes as presented; the motion was seconded by Member Sullivan. No further discussion. The motion passed unanimously. III PUBLIC COMMENT i • Helen Lauritzen requested an update on the Port Townsend Paper Corporation(PTPC) taking financial responsibility for its landfill. Chair Westerman asked Dr. Tom Locke, Health Officer, JCPH, to respond and he informed Mrs. Lauritzen that the Mill is licensed, and financial assurance agreements are nearing completion. The Department of Ecology is now working on final review and approval. In addition, Locke noted, since 2014, when JCPH approved the permit, the PTPC's financial responsibility for its landfill and any future closure costs has been incontrovertible. A representative from the PTPC said the financial assurances process with the Department of Ecology is near completion; November 2, 2015 is the deadline for this process. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Proposed Comp Plan Amendment: Active Lifestyle and Chronic Disease Prevention Ms. Karen Obermeyer, JCPH, briefed the Board on Chronic Disease Prevention activities funded through a grant by the Dept. of Health. Activities include proposals to integrate health language to encourage healthy lifestyles into the Comprehensive Plan. Research shows the built environments that surround us impact the decisions residents make concerning activities that impact their health by promoting healthy lifestyles or imposing barriers to healthy behaviors. One of the Jefferson County Health Priorities is Healthy Communities and Active Living with Chronic Disease Prevention. With this in mind, Ms. Obermeyer and Jared Keefer, Environmental Health Director, JCPH, are working with the Department of Community Development and local community groups (such as Food System Council and Local 20/20) to integrate into the county- wide planning policy explicit health language that links health to the built environment. Elements include access to healthy food, affordable housing, transportation, and impacts of climate change, all of which is in response to community request. Mr. Keefer told the Board the planning policy proposals now being vetted at the staff level will be presented to the planning commission in October. The next step is to present these proposals to the Board of Health and then to the Jefferson County Commissioners. Finally, the proposals to integrate explicit health language into the Jefferson County Comprehensive Plan will be presented to the Steering Committee. Chair Westerman voiced her concerns about balancing the varied challenges with adoption of expensive infrastructure. 2. Olympic Community of Health Web Page Dr. Locke informed the Board that there is a Web page dedicated to helping the public and Board members stay current on developments in the Olympic Community of Health. Current priorities are focused on efforts to pull together stakeholders in the ongoing development of the Accountable Communities of Health (ACH) design and address governance issues. 3. Mill Update--Odor Complaints Dr. Locke explained to the Board a document presented to JCPH concerning PTPC mill odors. The citizen report chronicles mill odor by date, time, and degree of impact. Citizens post this to their website dedicated to the purpose of tracking mill odors and also submit this data to state regulatory agencies. Locke explained that air quality regulation authority falls within state and federal jurisdiction, rather than county, and stated that if the PTPC is adhering to those • regulatory standards there are few remedies. County commissioners or local boards of health , lacks specific legal authority to regulate air pollution. Member Johnson told the Board the • Department of Ecology is the agency responsible for mill activities. A representative from the PTPC addressed the Board telling them the Mill has taken action to mitigate the odors. Chair Westerman called for staff to respond to the citizen concern in a logical, sympathetic way. No Board action was taken. 4. Strengthening Families and Youth Mental Health Training: Chimacum Prevention Coalition Jean Baldwin, Director, JCPH, informed the Board there will be second Youth Mental Health Training on October 19th. The initial training was so well attended there was a waiting list, so additional funding was sought and awarded to host a second training. Additional Strengthening Families events, October 8 and November 19th, are also planned in response to the overwhelming community response. 5. School Based Clinics Reopen Ms. Baldwin explained to the Board the importance of marketing flyers, included in the packet, to keep school populations abreast of who is in their building, when School Based Clinics (SBC) are open, who is associated with the SBC, and what service they provide. Baldwin touched on updates to the SBC Final Report, End of the School Year statistics and said she will have more information next month. NEW BUSINESS • 1. Food Safety Program Fees—Possible Action Item: Call for Public Hearing Mr. Keefer reviewed documents included in the Board packet that compare actual costs of Food Safety activities with current and proposed fees. Chair Westerman, stated that she found the documents confusing and questioned their logic. Specific license fees and their associated costs were discussed at length. Additional Board members voiced their concern that the program fees proposed fell substantially short of the actual cost of the program activities. It was decided the proposal isn't ready to move to a Public Hearing and that next month Mr. Keefer will present additional fee proposals and their budget impacts. 2. Back to School Initiatives: Immunizations and Heads Up Concussion Awareness Program Ms. Baldwin shared with the Board JCPH's Back to School Immunization press release that lets the public know which vaccines are required, where they can be obtained, and the various payment options. New school administrators are much more amenable to immunization discussions. Dr. Locke let the Board know that immunizations are universally covered under new insurance regulations. Ms. Baldwin explained a new national focus on clarifying sports-related concussion information and training of medical staff to recognize concussion symptoms and treatment, and the standardization of systems to evaluate sports injuries. The effort is focused on prompt recognition of the signs and symptoms of concussion and appropriate exclusion from sports activity during the recovery period. Included in the Board packet were parent information handouts. • • ACTIVITY UPDATE Mr. Keefer mentioned a visit in late August to JCPH from a representative of Senator Patty Murray's office who was very impressed by the breadth of JCPH's reach. Chair Westerman shared her recommendations vis-à-vis a Seattle Times article in the September 17, 2015 paper heralding a state-wide increase in the number of residents insured. Vice-chair Kler enjoyed the excellent marine biotoxins discussion that was held at JCPH on September 9th, and informed the Board there is Regional Support Network meeting Friday, September 18th. Vice-chair Kler and Ms. Baldwin attended a meeting today with Clallam and Kitsap representatives to prepare for the September 18th meeting. PUBLIC COMMENT There was no public comment. NEXT SCHEDULED MEETING The next Board of Health meeting will be held on Thursday, October 15, 2015 from 2:30—4:30 p.m. at Jefferson County Public Health, 615 Sheridan Street, Port Townsend, WA. ADJOURNMENT • Chair Sheila Westerman adjourned the September 17, 2015 Jefferson County Board of Health meeting at 4:30 p.m. JEFFE'Al COU t % BOARD OF HEALTH Phil Jo% :if *4 /e 11 B er, ember 7 Davis ` llivan, Member Sheila Westerman, Chair IMIPP Vddif-- -ezvt 1<ee-&. Kris Nelson, ember Kathleen Kler, Member Respectfully Submitted: D. Banker . Board of Health IV Old Business Item 1 Smile Mobile Public Health October 15, 2015 suEMo y * 0 PROTECT YOUR CHILD'S SMILE ® tar r SCHEDULE A DENTAL EXAM NOW Of se nhI% The Washington Dental Service Foundation b • l (a fully equipped mobile dental clinic) Coming to Port Townsend • Blue Heron School 3939 San Juan Ave. November 2, 2015 Appointment or questions, call: 1.888.286.9105 Have Apple Health card/number available. The SmileMobile: • Provides dental care to children (birth - high school) w/ limited family income • Accepts Apple Health /Medicaid • Provides sliding fee scale based on family income • Operated by WDSF in partnership w/ Seattle Children's Hospital • This event/activity is NOT being sponsored by the school district and the district assumes no responsibility for the conduct of or safety of the event/activity. In consideration for the privilege to distribute these materials,the school district shall be held harmless from any cause of action, claim,or petition filed in any court or administrative tribunal arising out of the distribution of these materials,including all costs,attorney's fees,and judgments or awards. Board of Health IV Old Business Item 2 Community Health Director Hired 6\4i7en &son Public Healt October 15, 2015 S • Board of Health V New Business Item 1 Food Safety Program Fees • &/;effassort Public Healt Possible Action: Call for Public Hearing 410 October 15, 2015 2015 Food Safety Activity and Fee Review • During the last meeting we discussed current costs by Establishment type,current fee spread and the corresponding proposed fees. For illustration and a demonstration of variability in fees only, a table of neighboring jurisdiction fees was included for our region. One option for consideration was proposed to the board. More options and information were requested by the board on Permit fees. Today we will revisit and examine 3 potential options for action by the board on permit fees. Option#1 Goals: • Balance an approximate 50%fee/full cost ratio where appropriate with the tiered system of the current fees o The components of full cost are:Administration, Customer Service(education), Customer Service (outreach), Enforcement, Inspections, and Travel • Simplify the tiered system format for food establishment fees o Facilitates a transition to a risk-based system in the future o A risk-based system more closely matches costs incurred than the current system o Reduces the amount of administration and customer service time spent o Reduces the fee confusion for food establishments • Transition the Restaurants to a risk-based fee structure from a#of seat-based fee structure o This would utilize the current risked-based determination in place(heating&cooling) o A risk-based system more closely matches costs incurred than the current system o The final future step would be to transition all establishment types to a risk-based fee • structure o Reduces the amount of administration, customer service and enforcement time spent Facility Full Cost Current Fee Proposed Fee Change Ratio Bakery $348.69 $149 $199 $50 57.07% Church, Commercial $377.67 $149 $199 53.95% Kitchen, Concession $50 Espresso Stand $423.04 $149 $199 $50 47.04% Lounge $275.19 $149 $199 $50 72.31% Outlier Bed & Breakfast $462.64 $191 $249 $58 53.82% Caterer from Restaurant $425.43 $191 $249 $58 58.53% School Warming Kitchen $1,147.06 $191 $249 $58 21.71% Outlier Small Grocery $441.37 $191 $249 $58 56.42% Small Limited Restaurant $512.97 $191 $249 $58 48.54% To be renamed Meat&Fish Market $508.91 $339 $249 ($90) 48.93% Limited Mobile Unit $603.15 $191 $299 $108 49.57% Caterer from $949.96 $33949.37% Commissary $469 $130 School Central Kitchen $797.02 $339 $469 $130 58.84% Small Complex $829.33 $339 $469 $130 56.55% Restaurant Medium Restaurant $988.49 $340 $469 $129 47.45% To be grouped Large Restaurant $887.63 $407 $469 $62 52.84% together X-tra Large Restaurant $1,084.50 $462 $469 $7 43.25% • Large Grocery $593.72 $462 $469 $7 78.99% Outlier Complex Mobile Unit $1,017.81 $339 $499 $130 49.03% *Table is grouped by Proposed Fee OVR RATIO 52.96% **Full costs are estimated at the current hourly rate-$86.00 2015 Food Safety Activity and Fee Review S Option#2 Goals: • Maintain the current fee structure with a 28%increase • Matches the EH hourly rate increase done last year • Continues the current system format for food establishment fees (tiered and seat-based) Con: • Does not move us toward a risk-based permitting system and its benefits Facility Current Fee Proposed Fee Change Bakery $149 $191 $42 Church, Commercial $149 $191 $42 Kitchen, Concession Espresso Stand $149 $191 $42 Lounge $149 $191 $42 Bed & Breakfast $191 $244 $53 • Caterer from Restaurant $191 $244 $53 School Warming Kitchen $191 $244 $53 Small Grocery $191 $244 $53 Small Limited Restaurant $191 $244 $53 Limited Mobile Unit $191 $244 $53 Meat& Fish Market $339 $434 $95 Caterer from $339 $434 Commissary $95 Complex Mobile Unit $339 $434 $95 School Central Kitchen $339 $434 $95 Small Complex $339 $434 Restaurant $95 Medium Restaurant $340 $435 $95 Large Restaurant $407 $521 $114 Large Grocery $462 $591 $129 X-tra Large Restaurant $462 $591 $129 *Table is grouped by Proposed Fee 1111 2015 Food Safety Activity and Fee Review • Option#3 Goals: • A hybrid option between Options#1 • Maintain the tiered fee system format for all establishments other than restaurants and mobile units(Option#2) o 28%increase o Matches the EH hourly rate increase done last year • Transition the Restaurants to a risk-based fee structure from a#of seat-based fee structure (Option#1) o This would utilize the current risked-based determination in place(heating&cooling) o A risk-based system more closely matches costs incurred than the current system o The final future step would be to transition all establishment types to a risk-based fee structure o Reduces the amount of administration,customer service and enforcement time spent • Utilize the mobile unit fee structure from Option#1 for Mobile units to better capture costs. Facility Current Fee Proposed Fee Change FeRatioe/Cost Bakery $149 $191 $42 • Church, Commercial $149 $191 $42 Kitchen, Concession Espresso Stand $149 $191 $42 Lounge $149 $191 $42 Bed & Breakfast $191 $244 $53 Caterer from Restaurant $191 $244 $53 School Warming Kitchen $191 $244 $53 Small Grocery $191 $244 $53 Small Limited Restaurant $191 $259 $68 50.49% To be renamed Limited Mobile Unit $191 $299 $108 49.57% Caterer from $339 $434 Commissary $95 Meat& Fish Market $339 $434 $95 School Central Kitchen $339 $434 $95 Large Restaurant $407 $469 $62 Medium Restaurant $340 $469 $129 Small Complex 50.02% To be grouped Restaurant $339 $469 $130 Ave together X-tra Large Restaurant $462 $469 $7 Complex Mobile Unit $339 $499 $130 49.03% • Large Grocery $462 $591 $129 *Table is grouped by Proposed Fee Board of Health V New Business Item 2 End-of-Year Report Lake Monitoring Program ife)&s; Public Health October 15, 2015 • • Board of Health V New Business Item 2 End-of-Year Report Lake Monitoring Program 0 i 4 • 4, Nrez,on Public Health 0 October 15, 2015 µg/L,log scale µg/L,log scale O p N o O o N o 9'>r b o N o 0 0 9'0' b 0 o - o 0 0 ')O N N N o o o 0 10 N N i- N o o o o O� ipvesoc : ., . „„ : : : 1 ) — O T009 0 ( ��X00 _ , 0C�� Oct` i 9 009 E — X00 Edi i �,pr _ - 010 A• — — _I. 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Medical services are provided by Advanced Registered Nurse Practitioners(ARNP)for medical services. Mental health services are delivered by counselors under a contract with Jefferson Mental Health Services. Medical services are funded by Jefferson County Public Health and Free and Reduced Lunch Rates Jefferson Healthcare. Mental health services are funded by the Jefferson OSPI,October 2014 County Mental Health/Chemical Dependency sales tax. Services are Chimacum School District 48 available re ardless of insurance or abilit a Chimacum Creek Primary 56 g y to p y—nearly 4 in 10 students at CHS and PTHS are low-income (see Free and Reduced Lunch Chimacum Elementary 57 rates table). Medical services focus on preventative services including Chimacum Middle 46 immunizations,tobacco cessation, nutrition,eating and weight Chimacum High School 37 • concerns, reproductive health care, physicals, and mental health Port Townsend School District 47 counseling.Visits for injuries, illness,and infection are also common Grant Street Elementary 54 throughout the year. Blue Heron Middle School 54 Port Townsend High School 36 Evaluation Methods: For every medical visit, data on student concerns,clinician addressed topics, and referrals were recorded by the SBHC nurse practitioner.Additional demographic and health care access data were collected at each client's first visit by clinical support staff in the SBHCs. For every mental health visit, data on student concerns, clinician addressed topics, and referrals were recorded by the MH clinician.Additional demographic data were collected at each client's first visit. Data in this report were collected from August 2014 through June 2015. SBHC Medical Services Report: Pages 2-4 SBHC Mental Health Services Report: Pages 5-8 • Ill 8 hours PTHS, 12 hours CHS (21 10 hours PTHS, 10 hours CHS SBHC Report analysis by Siri Kushner,Kitsap Public Health District(9/15;MH added 10/15) 1 I P a g e SBHC Demographics IIIThe majority of students using the SBHC in Chimacum are 11th and 12th graders; 11th, 10th and 12th graders at Port Townsend. No middle school students are seen in Port Townsend. Most clinic users are female. Grade(unduplicated) Gender(unduplicated) L 50 ■Chimacum ■Port Townsend 100% 83% • 40 71% U -• 30 50% 46 29% a, 20 • 17% 10 ■ II. 0% Z 0 - I • II II II 11 Il Female Male 6 7 8 9 10 11 12 ■Chimacum •Port Townsend Grade Chimacum saw students in grades 6 through 12 while Port Townsend saw students in grades 9 through 12. The elementary, middle,and high school share a campus in Chimacum explaining the clinic use by younger students. SBHC Clinic Usage PTHS CHS Based on enrollment numbers(grades 9-12 only), Total visits:288 Total Visits:353 41%of CHS students and 27%of PTHS students • Total#of clients: 113 Total#of clients:136 utilized SBHC physical health services during the Total#clinic days:68 Total#clinic days:78 2014-2015 school year. Port Townsend:Average number of clinic visits per day OVERALL AVERAGES: co per month PT:26 visits per month; 10 4 visits per clinic day tj 8 6 CH:32 visits per month; 4 02 I I I I 111 . I II II ' S visits per clinic day a, co • Aug Sept Oct Nov Dec Jan Feb Mar Apr May June a, Q 2014 2015 Chimacum:Average number of clinic visits per day per month 10 c u 8 aw 6 a 4 I it 0 a, o a Aug Sept Oct Nov Dec Jan Feb Mar Apr May June • ¢' 2014 2015 SBHC Report analysis by Sid Kushner,Kitsap Public Health District(9/15;MH added 10/15) 2 ! Page • At Port Townsend, 11th graders had the greatest number of clinic users and number of total visits.On average, PT clinic users made 2.5 visits during the year. At Chimacum, 11th graders had the greatest number of clinic users and 12th graders had the greatest number of total visits. On average,9th42th grade clinic users made 2.7 visits during the year(6th-8th grade clinic users made 2.0 visits on average). Port Townsend Clinic Visits by Grade Chimacum Clinic Visits by Grade II Total#individuals(unduplicated) ■Total#visits •Total#individuals(unduplicated) •Total#visits 120 120 109 110 100 89 88 100 8067 80 60 44 60 51 54 37 40 22 27 27 40 27 25 35 31 3 11 9 9 6 8 20 20 9 10 11 12 6 7 8 9 10 11 12 SBHC Visit Reasons • Top five clinic visit issues by category: BEHAVIORAL HEALTH PHYSICAL HEALTH HEALTH EDUCATION Student Clinician concern addressed Student concern Clinician addressed Clinician addressed anxiety school reproductive health reproductive health pregnancy depression relationships sports physical sports physical tobacco eating/weight family injury screen:vision/hearing/blood pressure injury prevention family drugs/alcohol immunization injury substance use mh screen screen:vision/hearing/blood pressure immunization nutrition/exercise Top 10 Student Concerns Top 10 Issues Addressed by Clinician reproductive health reproductive health sports physical school miliummill injury no relationships iiimismow immunization — family anxiety - drugs/alcohol mom screen:...es mh screen iiim flu/cold is stress mom dermatology ■ sports physical mmi depression • depression inn asthma ■ anxiety num 0 100 200 300 400 500 0 100 200 300 400 500 • SBHC Report analysis by Siri Kushner,Kitsap Public Health District(9/15;MH added 10/15) 3 I P a g e The vast majority of visits are for reproductive health which may include STI screening,pregnancy test,birth control,emergency contraception,and education on risky sexual behavior and harm reduction techniques.Likely due in part to the SBHCs, Jefferson County has one of the lowest teen pregnancy rates in Washington State(Source:Table 17,WA State Dept.of Health,2014 Vital Statistics.http://www.doh.wa.gov/DataandstatisticaiReportsivitaistatisticsoata/AbortionPre(tnancVData/AbortionPregnancv-rabiesweear.aspx.) Student athletes are required to get a sports physical every two years.Both SBHCs provide this service which is also available to Quilcene students.Before fall sports begin in August,both clinics open to give students convenient and inexpensive access to sports physicals. According to data from the 2014 Healthy Youth Survey(HYS),Jefferson County 12th graders have higher rates than state average for current alcohol,cigarette,and e-cigarette use as well as marijuana use for 10th and 12th graders. Further,Jefferson County youth perceive that access to cigarettes,alcohol and marijuana is not very difficult and that most adults do not think youth drinking and smoking marijuana is"very wrong"(Source:2012 HYS). A third of 10th graders and 12th graders in Jefferson County reported experiencing depressive feelings in the past year.One in 5 10th graders and 1 in 4 12th graders reported having seriously considered suicide in the past year(Source:2014 HYS). SBHC clinicians regularly address all of these issues with students,working to educate and empower our youth to make healthier choices! SBHC Referrals Referrals for students are made on a consistent and ongoing basis to a variety of providers and organizations in the area.Common referrals from the SBHCs are for mental health services(SBHC MH counselor or out-patient), additional medical or public health services,school counselor,domestic violence resources, insurance plans(Apple • Health and Take Charge),among others. SBHC Clinic Usage Over Time Total SBHC Visits Over Time Chimacum SBHC Visits Port Townsend SBHC Visits Over Time Over Time —6—Unduplicated clients—0.,•Total visits 1000 'Unduplicated clients'Total visits 'Unduplicated clients Total visits 800 600 600 600 500 500 400 400 400 300 300 200 •••••"""rnr 200 200 0 • 100 100 0 0 656 0)" ,yp ,y�y1ti'yl';y�1„iy0.1�;Ly ��0 ,yp O;yy yy'L 3 d Q,yh OOo' ,,p�10 0,17' 1y1� 111", 1�yA yQ,yh 1, 10 1, P. - ,10 yQ` 111 107 1,, 1,, 1,, 1,07 • 1ICY LO ,10 1, 10 10 The total number of clients in 2014-15 is about the same as previous years;total visits were about the same as the past 1-2 years. • SBHC Report analysis by Siri Kushner,Kitsap Public Health District(9/15;MH added 10/15) Mage SBHC Mental Health i Demographics The majority of students using MH services at Chimacum are in 10th grade,at Port Townsend students are from most grades and the majority at Quilcene are in 11th grade.At Chimacum and Port Townsend,the majority are female,at Quilcene an equal proportion of females and males were seen. SBHC MH Clinic Users by Grade SBHC MH Clinic Users by ■Chimacum ■Port Townsend ■Quilcene Gender 40% •Chimacum ■Port Townsend ■Quilcene 30% 100% 20% 100/ 'I■ �� ■II diI'' II L .'1 III 50% 111111 2&3 4 5 6 7 8 9 10 11 12 0% Female Male Unduplicated(#individual clients)and Total MH Visits by Grade: Analysis by grade for total visits(dark bars)compared to the unduplicated number of individuals using MH services (light bars)shows highest clinic use by 4th,8th and 10th graders at Chimacum;4th and 9th graders at Port Townsend, • and 6th graders at Quilcene. Chimacum Port Townsend Quilcene •Total individuals(unduplicated) •Total visits ■Total individuals(unduplicated) ■Total visits ■Total individuals(unduplicated) •Total visits 125 125 125 100 100 100 75 75 75 50 50 50 2500— ■ _I -• _ J ■I I .' �I 25 I ■ ■ ■I . ■I ■ ■I 25 I _. . _I .I3 4 5 7 9 10 11 12 4 5 6 7 8 9 10 11 12 2 3 4 6 7 8 10 11 12 Visits Port Townsend had the highest number of MH visits and clients and the highest average visits per day.Chimacum had the highest range in number of MH visits per client.Quilcene had the highest average number of MH visits per client.The proportion of students in grades 9-12 using SBHC MH services ranged from 9%to 17%. Chimacum Pt Townsend Quilcene Based on enrollment: Total visits:468 Total visits:587 Total visits:225 14%of Chimacum, Total#of clients:72 Total#of clients:77 Total#of clients: 29 9%of Pt Townsend,and Av visits/client:6.5 Av visits/client:7.6 Av visits/client:7.8 17%of Quilcene 9-12th grade Range: 1 to 35 Range:1 to 31 Range: 1 to 28 students utilized SBHC mental Total days:84 Total days:84 Total days:46 health services during the 2014- • Av visits/day:5.6 Av visits/day:7.1 Av visits/day:4.9 2015 school year. SBHC Report analysis by Siri Kushner,Kitsap Public Health District(9/15;MH added 10/15) Wage • The highest average MH visits per clinic day were in December for Port Townsend Average number of MH visits per day per month and Quilcene and in January for Chimacum Port Townsend Quilcene Chimacum. 12.0 Quilcene had the most consistent average 10.0 number of MH visits per month(range: 8.0 3.0 to 7.0). 6.0 4.0 2.0 0.0 Sept Oct Nov Dec Jan Feb Mar Apr May June 2014 2015 SBHC MH Visit Length: The majority of MH visits were 30 minutes long;about one100% •■>60 I quarter of visits were less than 30 minutes at all three 80% ■60 schools.Almost half of Chimacum visits were longer than ■46-59 30 minutes compared to about one quarter of visits in Port 60% ■45 Townsend and Quilcene. 40% ■31-44 20% ■30 ■<30 • 0% Chimacum Port Quilcene Townsend Top Reasons for SBHC MH Visits: Family was the first or second top reason for Chimacum Port Townsend Quilcene SBHC MH visits identified by both students fairti Fat* and clinicians at all schools. Relationships Relationships were a top reason for visits at Chimacum and Relationships Depression Student ,� Quilcene. Family and anxiety were the two Concern Amu- A w top 5 visit reasons identified by both Stress School Anxitty students and clinicians at all three schools. • ,> ... 1,, � Anger of total 79% 85% 81% Farm : Relationships Clinician School Issue School Addressed �, Relationships Amil. � Self Esteem Court Diversion %of total 62% 82% 82% • SBHC Report analysis by Siri Kushner,Kitsap Public Health District(9/15;MH added 10/15) 6 I P a g e Chimacum Visit Reasons Ranked by Port Townsend Visit Reasons Ranked by III Student Concern(bottom of chart=top rank) Student Concern(bottom of chart=top rank) •student concern ■clinician addressed •student concern •clinician addressed suicide IN suicide self esteem ' stress I school self esteem r mental health .... relationships !ow grief Ir grief depression ` future r court diversion ! court diversion anger (L anger II alcohol/drug prevention IV alcohol/drug prevention ' abuse ■ abuse future !• mental health stress 111111r " school M. anxiety anxiety relationships 11111111 depression 11 family issues N11111= family issues 0 100 200 300 0 100 200 300 400 Quilcene Visit Reasons Ranked by Student For the top two visit reasons at each school, more Concern students identified the reason than clinicians reported •student concern •clinician addressed addressing it thereby indicating that additional reasons were identified and addressed by the clinician.The profile suicide of other visit reasons identified by students vs.those stress I self esteem r' addressed by clinicians differs by school (difference school r between the bar pairs for each issue(light vs.dark bars). 111 future depression Other visit reasons not represented in the chart court diversion i p alcohol/drug prevention 1 categories included:sexual identity,behavior,social skills, abuse anger i self-harm,feelings,body image,and sleep. anxiety .-- mental health Eimmmmil family issues - relationships 0 100 200 300 400 Visit Type:Individual Therapy 100% 93% 930 The vast majority of visits were for individual therapy—93% at Chimacum and Quilcene,74%at Port Townsend—the 80% 74% remaining visits were primarily for contact/work with other agencies,family,or school staff. 60% 40% 20% 0% Chimacum Port Townsend Quilcene • SBHC Report analysis by Siri Kushner,Kitsap Public Health District(9/15;MH added 10/15) 7 I P a g e Referrals • The most common referrals from the SBHC MH clinicians were for outpatient mental health services and for medical services. Note:No referrals were logged for Quilcene. SBHC Mental Health Visits Over Time Note that the trend over time for SBHC MH services Number of MH Clinic Days at SBHCs Over is difficult to interpret due to changes in days and Time hours MH clinicians over the years. In 2014-15,the number of MH clinic days at Chimacum. .1:)t Townsend Quilcene Chimacum and Port Townsend was up while it was 120 down in Quilcene compared to previous years 100 (chart to the right).The total number of individuals 80 using SBHC MH services was up in all three schools 60 (chart below on the left);total visits were up in 40 Chimacum and Port Townsend and down slightly in 20 Quilcene(chart below on the right). 0 Jan-June 2010-11 2011-12 2012-13 2013-14 2014-15 Note:The spike in 2010-11 in Chimacum resulted from 2010 increased MH services in May/June 2011 to help students cope Sept-June after the aiirirlp of a rlaccmatp Number of Individuals Served by MH Number of Visits to MH Clincians at • Clincians at SBHCs Over Time SBHCs Over Time Chimacum Pt Townsend Quilcene Chimacum Pt Townsend Quilcene 100 700 90 80 600 70 500 50 400 40 300 30 200 20 .0,"'" 100 0 0 O O0 e-1 N .m-I N .-I 0 O ,-i N m V 1 u1 0 ei e-1 e-1 .-I 'i U O O O ..14 1i Clcm4 -I e-I N N O ea NA 4 9NNNNN O 0 0 0 0 0 Cl) 0 0 O0 0 O a ... CO CO In cn Sept-June Sept-June • SBHC Report analysis by Sid Kushner,Kitsap Public Health District(9/15;MH added 10/15) 8 I P a g e Board of Health V New Business Item 4 Community Health Improvement Plan Update: '-\/\' 11/ Gzep u in Public Health Meeting Agendas and Preliminary Goals for Chronic Disease Prevention; Access to Health Care; Mental Health / Substance Abuse Working Groups October 15, 2015 Chronic Disease Prevention Workgroup Community Health Improvement Plan • Agenda Kickoff Meeting Thursday September 17, 3:00 — 5:00 PM 803 W. Park Ave. Meeting objectives 1. Workgroup kickoff and team building 2. Develop candidate list of a handful of Community Goals for Chronic Disease Prevention Pre meeting preparation Begin to identify candidate community goals. Goals should be specific and achievable. Look at what other communities have done or consider what has been reported in the literature. Examples of goals might be: • Reduce Jefferson County average body mass index by VV% in WW years • XX% of all school children ride bikes to school YY% of the school year • ZZ% of vegetables sold in Jefferson County are locally sourced. If you are unable to attend the kickoff meeting, send your suggestions for community goals to murman@mit.edu by COB Tuesday September 15 • 3:00 Introductions —All 3:10 Team Activity— Earll 3:25 Workgroup Ground Rules and Commitment — Earll 3:35 Workgroup Charter— Joe 3:45 Review of Background Data— Joe 3:55 Questions —All 4:00 Break 4:05 Workgroup Plan — Earll 4:10 Chronic Disease Prevention Goals Brainstorm Session —All 4:45 Summary of Candidate Goals and Follow-up Action(s) — Earll 4:55 Team Check-in —All 5:00 Adjourn • Mental Health/Chemical Dependency Community Health Improvement Planning Kickoff Meeting Wednesday September 30, 2015 3:00-5:00 Location: Jefferson County Public Health -615 Sheridan — Pacific Room Meeting Objective 1. Workgroup and team building 2. Develop list of a handful of community goals for Mental Health /Chemical Dependency Pre Meeting preparation Begin to identify community goals. Goals should be specific and achievable. Look at needs here and what other communities have done or consider what has been reported in the literature. Examples of goals might be: • Reduce the number of Jefferson Co. residents who Use the Emergency room as a MH crises center over the next 2 years • Increase the percentage of teens who do not use Marijuana by 15% to xx% • • Decrease the death rate from drug overdoses in Jefferson County by 2017. If you are unable to attend the kickoff meeting, send your suggestions for community goals to Kobermeyer@co.jefferson.wa.us. Proposed Agenda Facilitators:Catharine Robinson LMHC Jumping Mouse/Thomas Locke,MD-Jefferson Co. 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WS Welcome»News&Events COMMUNITY HEALTH IMPROVEMENT(CHIP) PROJECT INITIATED September 28,2015 FOR IMMEDIATE RELEASE Contact: Jean Baldwin Jefferson County Public Health jbaldwin@co.lefferson.wa.us Community Health Improvement(CHIP)Project Initiated Port Townsend-The Community Health Improvement Plan partnership is an innovative collaboration between Jefferson Healthcare (JCH)and Jefferson County Public Health (JCPH)devoted to identifying the most pressing health priorities for Jefferson County and actions that will lead to improvements. The CHIP partnership focuses on four Jefferson County health priorities, which were identified through a rigorous community data assessment study and ranked at data assessment meetings.The four health priorities that are focused on include immunizations; access to care;access to mental health and substance abuse care; and healthy eating, active living and chronic disease prevention. Mike Glenn, CEO of JHC, believes that the identification of health priorities for Jefferson County was a critical first step in moving towards a healthier community. Glenn states"The work that went into the Community Health Assessment was phenomenal,and is a testament to how much this community values the health of its citizens.This work has really just begun to take off,and JHC is committed to seeing the • process through to the implementation of appropriate changes for Jefferson County." Health Care reform in Washington has a regional component called Accountable Communities of Care.Jefferson, Clallam and Kitsap are completing a regional design plan for the three Counties.This local CHIP process gives Jefferson County the data,direction and first step towards looking at improving Health locally,yet work within the region. Now that the health priorities have been identified,the partnership between JCH and JCPH has been convening work-group meetings specific to each of the four topics.Jean Baldwin,JCPH Director, reports that the work-group meetings will develop actionable targets the community will be able to attain. Baldwin says"We have identified key priorities for moving forward,and are looking to the community to help set goals for each health priority. We have engaged community members who are interested in these topics in the workgroups." The work-group meetings focus on identifying health priority goals and develop a strategy. Meetings take place monthly for each workgroup. If you are interested in participating in one of the workgroups or would like additional information on meeting schedules and how you can be involved, please contact Karen Obermeyer(KObermever(aco.iefferson.wa.us) For more information on Jefferson County Public Health,the Community Health Assessment,and the health priorities that have been identified, please visit www.ieffersoncountypublichealth.oro # # # Always working for a safer and healthier community Jefferson County Public Health - 615 Sheridan Street-PortTownsend,WA 98368 Community Health:360.385.9400 Environmental Health:360 385.9444 info(o�,jeffersoncountypublichealth.org JCPH Employee Resources • http://www.j effersoncountypublichealth.org/index.php?community-health-improvement-c... 10/9/2015 C (ti CL °' a) CU Ct3 CU 6. +� s. qs 0E �, �, 0 > O oE z.0 '47; ..... V. cc .4- O +r CO o 2 w Q Ifl co E imp 6 C7u u. G) i 0 L. i o :c L. E S ■0 =pi, < to al _J ) to u a. cn Oo w u C a }, = p a 4J LA rn o w W E CO H U a >° d > ota = ,Q to E 0. N E Ton3 uV W CD 0 a; o cn ., Q CD .a k..) V W 3 0 0 LD- CU C .0 2 o. © a. to •� O :� 0. (D fa L 0 riao (15 C C� �A 'QA C G O C m N s }, ,c c *'' > .x _4-0 U u w O M �^ v 'r° to *' '- 3 > 0 c °� 0 > o > Dli ra co fi) ' � +-'Ei. c C >. •• 0 tri 8 0-0 •• n i O 'n CO 4- ‘-.1co (X 4.+ . 0 . O w # N e. 6". ca ( o >. vi o Rya ` +a < 8 w E 0 _ a, CI ,.., 2 4, E 0 0 e2 Ln O VJ Ln TQC wc>a ov :c v ,cc cast. L. t C L. 5 L. > tom.. N C i® t U Media Review • • 6,ffsfai Public Heal ‘A• Jefferson County Public Health September/October 2015 NEWS ARTICLES 1. "'Girls' Night Out' to strut its stuff in Port Townsend on Oct. 1", Peninsula Daily News, September 18th, 2015. 2. "Back-to-school immunizations offered in Jefferson County," Port Townsend Leader, September 23rd, 2015. 3. "12th Annual Girls' Night Out in Port Townsend," Port Townsend Leader, September 23rd, 2015. 4. "Girls Night Out to include health, wellness activities at Thursday's annual shopping event in Port Townsend," Peninsula Daily News, September 30th, 2015. 5. "Girls' Night Out Oct. 1 is fun, for a great cause," Port Townsend Leader, September 30th, 2015. 6. "12th Annual Girls' Night Out in Port Townsend," Port Townsend Leader, September 30th, 2015. 7. "Smile Mobile coming to Port Townsend," City of Port Townsend Newsletter, October 2015. 8. "Community Health Improvement Plan promoted," Port Townsend Leader, October 7th, 2015. 9. "Septic system info," Port Townsend Leader, October 7th, 2015. • • • Jefferson County Public Health September/October 2015 NEWS ARTICLES 1. "'Girls' Night Out' to strut its stuff in Port Townsend on Oct. 1", Peninsula Daily News, September 18th, 2015. 2. "Back-to-school immunizations offered in Jefferson County," Port Townsend Leader, September 23rd, 2015. 3. "12th Annual Girls' Night Out in Port Townsend," Port Townsend Leader, September 23rd, 2015. 4. "Girls Night Out to include health, wellness activities at Thursday's annual shopping event in Port Townsend," Peninsula Daily News, September 30th, 2015. 5. "Girls' Night Out Oct. 1 is fun, for a great cause," Port Townsend Leader, September 30th, 2015. 6. "12th Annual Girls' Night Out in Port Townsend," Port Townsend Leader, September 30th, 2015. 7. "Smile Mobile coming to Port Townsend," City of Port Townsend Newsletter, October 2015. 8. "Community Health Improvement Plan promoted," Port Townsend Leader, October 7th 2015. 9. "Septic system info," Port Townsend Leader, October 7th, 2015. • • BUSINESS BRIEFS: 'Girls' Night Out'to strut its stuff in Port Townsend on Oct 1 . Peninsula Daily News, September 18th,2015 • PORT TOWNSEND—Port Townsend Main Street's "Girls' Night Out," sponsored by the Port Townsend Main Street Program, Jefferson Healthcare, OZONE Socks and other businesses, starts at 7 a.m. Thursday, Oct. 1. This year's theme is "Beautiful, Healthy You" and begins with an early morning free Fun Run/Walk called "The Tiara Trot." Meet at 213 Taylor Street(next to Lehani's in the Mount Baker Block Building) to register for this 1.47-mile walk/jog/run. "Girls' Night Out" participating businesses will offer special events, in-store promotions and refreshments from 11 a.m. to 8 p.m. The evening ends with the popular"Wrap Party" at 8 p.m. at The Belmont, 925 Water St., with a no-host bar, appetizers, dessert and door prizes. There is a $5 suggested donation at door. Goodie bags, valued at$10 each, are filled with OZONE socks and small gifts and will be on sale Oct. 1 at About Time, April Fool and Penny Too, Bickie's Cotton Casuals, The Clothes Horse, Glow Natural Skincare, Maricee Fashions, Port Townsend Fudge Co., Posh Hair Salon and Day Spa and Tickled Pink. "Beautiful, Healthy You" raffle tickets will be on sale in advance for$5 at participating merchants, with prizes valued at over$700. Prizes include the following: • An overnight stay at the Bishop Victorian Hotel. • Deja View Photography studio session and print. • The Belmont$100 gift certificate. • Port Townsend Athletic Club one-month membership. • Rose Theatre tickets/treats. • Two haircuts at Seasons Hair Salon—one with Jolene and one with Mary Lou. • Posh Salon gift certificate. • Wine Seller wine club membership. • Pampering gifts,jewelry and more. Proceeds benefit the Jefferson Healthcare Foundation to help provide breast and cervical cancer screenings, care and treatment for low-income Jefferson County residents and the Port Townsend Main Street Program, a nonprofit. To date, the "Girls' Night Out" event has raised nearly$30,000 to assist women in need of cancer screenings. • For program updates, visit www.ptmainstreet.orq and follow the Port Townsend Main Street Program on Facebook and Twitter. Back-to-school immunizations offered in Jefferson County • Port Townsend Leader, September 23, 2015 3:00 am 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. 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. Those who can't afford the administration fee can ask for it to be waived. Several immunizations are required before kids can start school or childcare. Vaccination against whooping cough (pertussis) is especially important given the recent outbreak in our county and state, according to the health department. Although exemptions are allowed for medical, religious or personal reasons, the best disease protection is to make sure children have all recommended immunizations, emphasize health department spokespersons. Children who are not fully immunized may be excluded from attending school, preschool or childcare if a disease outbreak occurs. The following are the minimum required immunizations for the 2015-2016 school-year: Kindergarten through fifth grade: DTaP: four doses with the last dose on or after the 4th birthday; polio: three doses with the last dose on or after the 4th birthday; hepatitis B: three doses; MMR (measles, mumps & rubella): two doses; varicella (chicken pox): two doses of vaccine, or medical provider verification of disease. Sixth through eighth grades: Tdap: Sixth through eighth grade students are required to have one dose if • 11 years or older; Varicella (chicken pox): two doses of vaccine or medical provider verification of disease; polio, MMR, and hepatitis B requirements same as for kindergarten through fifth grade. Ninth 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 sixth-grade requirements; polio, MMR, and hepatitis B requirements as above for kindergarten through fifth grade. 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 p.m. at 615 Sheridan St., Port Townsend. 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''''''''' 0',$.!i*,,,f,1,..`;',i.,:t.-;4.- ',.;:'-.- ; . ,9 7- 0 Girls Night Out to include health,wellness activities at Thursday's annual shopping event in Port Townsend 411) By Charlie Bermant, Peninsula Daily News, September 30th,2015 P �c Downtown merchants Sue Arthur, left, and Bickie Steffan stuff goodie bags that will be sold at Thursday's Girls' Night Out fundraiser. —Charlie Bermant/Peninsula Daily News PORT TOWNSEND—The 12th Girls' Night Out on Thursday will add health and wellness activities to • the annual shopping event. "This is something that we all look forward to," said Mari Mullen, Main Street executive director. "It gives us a chance to connect customers with merchants prior to the holiday season and get them to learn about what our wonderful local retailers have to offer." The event takes place from 11 a.m. to 8 p.m. in 32 stores in downtown and uptown Port Townsend, offering special discounts and in-store promotions for anyone who has paid $10. Sponsor Jefferson Health Care will take over an empty storefront at 213 Taylor St., providing information about breast cancer screening and discussing its new 3-D mammogram technology. "We want to bring awareness about breast cancer and cervical cancer screening," Mullen said. "Cancer is preventable, treatable and survivable, and we have treatment resources right here in our county." Main Street has assembled 500 "goodie bags" that are stuffed with items such as socks and compacts as well as coupons and promotions. The goodie bags cost $10 and are available at all participating merchants. "We want people to come down on Thursday and make a day of it," Mullen said. • The event is usually attended by 400 to 500 women each year, Mullen said, with the goodie bags usually selling out or coming close to doing so. The shopping spree will be preceded by "The Tiara Trot," a 1.46-mile fun run/walk routed eastbound on Water Street around Point Hudson Marina and back via Washington Street. i4 Participants will meet at 7 a.m. at 213 Taylor St., with each receiving a tiara as supplies last. • At the finish line, participants will be treated to refreshments prepared by Jefferson Healthcare chef Arran Stark. "Beautiful, Healthy You" raffle tickets will be on sale in advance for$5 at many participating stores, with a bag of prizes worth $700 that includes a one-month membership to the Port Townsend Athletic Club and two haircuts at Seasons Hair. Proceeds from raffle sales and goodie bag purchases will benefit Jefferson Healthcare Foundation to help provide breast and cervical cancer screenings, care and treatment for low-income Jefferson County residents and the Port Townsend Main Street Program. The evening will end with an 8 p.m. wrap party at the Belmont Restaurant, 925 Water St., with a no-host bar, appetizers, dessert and door prizes. For more information, go to www.ptmainstreet.orq or call 360-379-3911. Jefferson County Editor Charlie Bermant can be reached at 360-385-2335 or cbermantApeninsuladailynews.com. Last modified:September 29.2015 8:45PM • • ry; w HEALTH FOCUS: Girls' Night Out Oct. 1 is fun, for a great cause • Port Townsend Leader, September 30, 2015 w m `•4p.- IL, r0,-- — :.1....dt , L .:; 4 Irr , -*/( ¢w. 4 , Sue rthur, Bickie Steffan Kris Nelson,^ AConnie Segal and Amy Jordan get in the Girls'Night Out spirit.Arthur, Steffan and Segal are PTMS Promotion Committee members,and Nelson and Segal are board members.The 12th annual event takes place in downtown Port Townsend on Thursday, Oct. 1. Photo by Deja View Photography • Thirty-two stores have signed up to participate in Port Townsend Main Street's "Girls' Night Out" event on Thursday, Oct. 1. This year's theme is "Beautiful, Healthy You," and the day starts with afree early- morning "Tiara Trot." Meet at 213 Taylor St. to register for this 1.47 mile walk/jog/run, which starts at 7 a.m. All participants get a tiara, while supplies last. Refreshments are provided by Arran Stark of Jefferson Healthcare after the Tiara Trot. From 11 a.m. to 8 p.m., Girls' Night Out participating businesses are offering special events, in-store promotions and refreshments. The evening ends with the popular Wrap Party at 8 p.m. at the Belmont Restaurant, 925 Water St., with a no-host bar, appetizers, dessert and door prizes. Cost is $5 suggested donation at door. Sporty attire is encouraged. Goodie bags, $10, filled with OZONE socks and small gifts, are on sale on Oct 1. Participating businesses are: About Time Clothing*, Abracadabra, April Fool & Penny, Too*, Bickie's Cotton Casuals*, The Boiler Room, The Clothes Horse*, Conservatory Coastal Home, Elevated Ice Cream, Expressions Apparel, Face of Grace, Getables, Glow Natural Skin Care*, The Green Eyeshade, Jefferson Healthcare Pop-up at 213 Taylor St., Lively Olive Tasting Bar, Maestrale, Magpie Alley, Maricee*, The Perfect Season, Pippa's Real Tea, Port Townsend Fudge Co.*, Posh Hair Salon and Day Spa*, Quimper Mercantile, Sea Salt Cottage, The Spice and Tea Exchange, Summer House • Design, Tickled Pink*, Wandering Angus, Wandering Wardrobe, What's Cookin', The Wine Seller, and World's End. (* Indicates goodie bags sponsors.) $ Raffle tickets, with the prize valued at over $700, are available in advance for $5 at many of the participating merchants. Prize includes an overnight stay at the Bishop Victorian • Hotel; a Deja View Photography studio session and print; a $100 Belmont gift certificate; a Port Townsend Athletic Club one-month membership; Rose Theatre tickets/treats; two haircuts at Seasons Hair Salon, one with Jolene, one with Mary Lou; a Posh Salon gift certificate; membership to the Wine Seller wine club; pampering gifts; jewelry and more. PROCEEDS HELP WOMEN Proceeds from raffle sales and goodie bag purchases benefit Jefferson Healthcare Foundation to help provide breast and cervical cancer screenings, care and treatment for low-income Jefferson County residents and the Port Townsend Main Street Program, both 501(c)(3) nonprofit organizations. The newly established Jefferson Healthcare Foundation's mission is to develop relationships and financial resources to support the healthcare programs, projects and services of Jefferson Healthcare, according to a press release from Main Street. Patients at Jefferson Healthcare can receive the latest in 3D mammography screening at the Diagnostic Imaging department located on the second floor of the hospital. 3D mammography (tomosynthesis) screening and diagnostic tools, designed for early detection of breast cancer, can be done in conjunction with a traditional 2D digital mammogram. The technology provides three-dimensional images of the breast by using • a technology similar to CT scans, or computed tomography. According to the Jefferson Healthcare website, researchers are finding that Hologic 3D mammography combined with 2D mammography provides greater than 25 percent improvement in overall cancer detection rates, finding invasive cancers 40 percent earlier than conventional 2D mammography alone; better visualization of masses, distortions and asymmetric densities; and significant reduction in false-positive recall rates by up to 40 percent. Visit jeffersonhealthcare.org for more information. To date, Port Townsend Main Street's Girls' Night Out event has raised nearly $30,000 to assist local women in need receive cancer screenings. This event is sponsored by the Port Townsend Main Street Program, Jefferson Healthcare, OZONE Socks and participating businesses. For program updates, visit ptmainstreet.org. The Port Townsend Main Street Program fosters economic vitality and preservation of place within the historic business districts, while maintaining our small town quality of life. . .i-;'''7:41,:,':.::; :::,:,'.0..:-J.: CH' as C ''''''..4,',.::•.; i mow._w _... • ,',,•.; . .. 711 Y aF se st. .A. .,aAt,t;,..,:.5,,',..,,,,,...-.,..•:.:,:n..•- TMr a .f r .c,...,-.1,:-..;'...,,--.,1'.:.=:, f x • ll ;. �. 7� �ry�4,'� Mai, . { 6..I'11,.!, p °,a#gy+" wD C {� Y y1149,F F ,1 r.l r a Kti 01 y � . '..x �F' k f ' -- - O °t{ 'r I P© I T I r • wJ b j"x H � Y� z k r .1 ' ] fin" ry .. t • e r y )., `! i iy � �'4 ,-- ..:.•..• • '-. 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'# :: 5 � � �Y t �r�3 ��Y �Ni f�r5��'� t � 2 3 Taylor St t(next to Lehanis) m a5 N `�b�lt . ft dNat� x!.... 11.!1'-'4•,.:Y.'"'.','.'-..,',.,..',.'...,,,,,''', i' 7 i ,, rg,. ,, Yr t I ..„...,,,,;,4i '.0t e� �: b quay d: ," .y' yn r p • �' -1!''..•- aD .� ...4...;—:1,..1.1 C a' �l 'ah r -,,�z t ..1.'{ 7 W TT 8yrfs sfi 3JJ :€ far ;+z11r3 -d r �'l 1 / � "; ,o-,s.y.�s�:..� " � ' r .n�u �`{ ` ya`W � �s �l f f23'//SS+0'"'S ` 4 ' �^ 4 6`#m k� m 1"r` orf j l /��}7/y %/ (+;.. , •4,-,,,m,:-.10.:411.4.',„, �s C sY,dtvr x �' r:3'�.A, �ke r.,w H 1.`r ,R�.0 _b s 4 ! F/V/I J • Smile Mobile coming to Port Townsend Full ServiceMobile Dental Clinic coming to Port Townsend in No- vember. Call now for appointments 1.888.286.9105 For dental exams and treatment for children and teens to 19 years old. Operated by WA Dental Service Foundation in partnership with Seat- tle Children's Hospital and Jefferson County Public Health. Accepts Apple Health, sliding scale. No child turned away due to inability to pay. • 111 ay Pr f_euAlzz&.. 6 u62 /0 0 Community Health Improvement Plan promoted Port Townsend Leader, October 7, 2015 1:30 am The Community Health Improvement Plan (CHIP) partnership is an innovative collaboration between Jefferson Healthcare (JHC) and Jefferson County Public Health (JCPH) devoted to identifying the most pressing health priorities for Jefferson County and actions that lead to improvements. The CHIP partnership focuses on four Jefferson County health priorities: immunizations; access to care; access to mental health and substance abuse care; and healthy eating, active living and chronic disease prevention. These priorities were identified through a rigorous community data assessment study and ranked at data assessment meetings, according to a press release. Mike Glenn, CEO of JHC, considers the identification of health priorities for Jefferson County to have been a critical first step. "The work that went into the Community Health Assessment was phenomenal, and is a testament to how much this community values the health of its citizens. This work has really just begun to take off, and JHC is committed to seeing the process through to the implementation of appropriate changes for Jefferson County," Glenn stated in a press release. • Health care reform in Washington has a regional component called Accountable Communities of Care. Jefferson, Clallam and Kitsap are completing a regional design plan for the three counties. This local CHIP process gives Jefferson County the data, direction and first step toward looking at improving health locally, yet work within the region. Now that the health priorities have been identified, the partnership between JCH and JCPH has been convening work-group meetings specific to each of the four topics, according to a press release. Jean Baldwin, JCPH director, reports that the work-group meetings develop actionable targets the community would be able to attain. "We have identified key priorities for moving forward, and are looking to the community to help set goals for each health priority. We have engaged community members who are interested in these topics in the workgroups." Baldwin said. The work-group meetings focus on identifying health priority goals and develop a strategy. Meetings take place monthly for each workgroup. To participate, or for more information, contact Karen Obermeyer at kobermeyer@co.jefferson.wa.us. For more information on Jefferson County Public Health, the Community Health Assessment, and the health priorities that have been identified, visit ieffersoncountypublichealth.orq. • fe ,' system info i 0 , 7, -, �°� n ,d Port L d1 9 F d 9 e►t4 Yste and upda es on wajteriquality° `j '4o ¢a--s -d3 ;',..-„,„''264,' , k-las s '' f {�la'e�,,ventstakeslaee i b t Lk nL'- �0,t., VaUey.. ! rn.to�i ..7i30tp ea i •IIo 04'L 2V ,;For. mo a 4 atioh, phi 33fi9t--� 2 ��,mh .5n ] i''q't k I��f $,,-,e 5 e:edinit y�Con , se 7.: e n ® trtct •