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HomeMy WebLinkAbout127 Public HealthJEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 1 of 100 2019 DEPARTMENT SUMMARY Revenues were impacted substantially in 2017 in both Environmental Health Division (EH) and Community Health Division (CH) grants and fees. In 2018, Jefferson County Public Health brought the responsibility of medical billing back inhouse instead of outsourcing it. CH fees are projected to exceed budgeted revenues; first time since 2014. The Washington State Legislature approved a Capital Budget in 2018, which returned funding to the Solid Waste programs and allowing Solid Waste programs to resume.. The health department, was without the Coordinated Solid Waste Prevention Grant funding from July of 2017 until the Capital Budget went into effect in 2018. Staff hours were reallocated to other programs within EH and also the Water Quality Department during the interim without funding. Client numbers have decreased over the last few years in nearly every CH program with the exception of Syringe Exchange and TB. Outreach became a focus in 2017, using The Leader to promote our programs. In 2018, the Family Planning program was awarded a grant with an element focused on outreach. A social media campaign was conducted, aimed to outline services, hours of operations, and reach a targeted population. Public Health has learned that both print media and social media have their purpose and specific benefits. In 2019, Public Health will continue to do more with outreach using social media. As the State moves towards full implementation of Medicaid Transformation with funding for medical care flowing through Managed Care Organizations, the change will result in funding for all Medicaid lives being given to primary care providers. This means that as currently planned, the health department clinical services would no longer be able to direct bill Medicaid for the services we provide through our Family Planning and School Based Health Clinics as well as potentially our immunization clinics (except Travel). We have begun discussions with the Olympic Community of Health and Jefferson Healthcare. We will also have discussions with the Managed Care Plans that operate within Jefferson County. This issue should not affect our Title X Family Planning grant, our State Take Charge funding or private insurance and uninsured. However, because we serve a large Medicaid population with our clinical programs, this issue will need to be resolved before full integration becomes final in our region. Key notes and changes in JCPH 2019 Budget:  FTEs increase by 2.20 o Increase hours in Finance Operations Coordinator (Medical Billing returned) o CHIP Executive Director o End temporary increases in ARNP and PHN II and make permanent o Increase in Community Health Educator o HRSA Project Coordinator o Other hours moved from WQ  Step increases for bargaining members reflected JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 2 of 100  1.75% increase for non-union employees reflected  CH client numbers and fee revenue will need to be closely monitored on a program by program basis  EH Division is requesting a one-time only add of $200,000, transfer from the County General Fund, in order to complete existing site abatement projects.  In 2018, Public Health was unsuccessful at recruiting a Finance Manager. Management will revisit this position and consider opening the position again or hiring a Financial Operations Coordinator. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 3 of 100 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 4 of 100 BUDGET/PROGRAM: 127 DEPARTMENT REVENUES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Restricted Fund Balance 244,548 244,548 244,548 244,548 244,548 - Reserve Fund Balance 189,922 406,999 486,691 525,298 541,320 54,628 CHIP Program & HRSA Grant (Also CHIP Related) Beg Fund Balance 120,900 186,579 199,020 274,271 319,512 120,493 Unexpected Vacant positions Taxes 45,123 46,410 46,284 47,459 47,568 1,284 Based on projections Licenses and Permits 265,179 273,687 248,037 272,002 336,646 88,609 Based on projections & expected CPIW increase Federal Grants 744,876 573,625 406,301 424,726 456,637 50,336 Increase in federal funding State Grants 557,291 484,028 469,034 565,822 620,322 151,288 Increase in state funding State Entitlements 135,821 177,821 180,487 177,821 177,821 (2,666) Based on projections Intergovernmental 71,368 48,259 48,259 55,759 48,259 - Charges for Goods & Svcs 1,436,825 1,712,063 1,805,912 1,919,220 1,961,551 155,639 Based on projections Misc. Revenue, Contributions 2,324 3,621 1,025 3,265 1,015 (10) Interfund Chg. For Service - Disposition of Capital Assets 1,710 1,058 150 40 100 (50) Special Purpose Tax 104,043 107,180 110,404 110,407 113,719 3,315 Special Purpose Tax increase approx. 3% Transfer from Solid Waste 18,200 20,971 20,971 20,274 20,274 (697) Based on projections Other Transfers (one-time/payout)17,117 - 417,541 200,000 200,000 $327,000 transferred in 2018 for purchase of Energov. Request $200,000 Add for Site Abatement Projects in 2019. General Fund Revenue 616,289 597,770 619,583 619,583 638,170 18,587 Dept GF increased by approx 3% + GIS Total Revenue 4,554,419 4,901,735 4,886,706 5,678,036 5,727,462 840,756 BUDGET/PROGRAM: 127 DEPARTMENT JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 5 of 100 BUDGET/PROGRAM: 127 DEPARTMENT (cont’d) EXPENDITURES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Wages & Benefits 2,671,325 2,549,440 2,818,778 2,796,225 3,153,432 334,654 Step increases for bargaining members and 1.75% for non-bargaining members Supplies 130,354 117,069 113,986 135,736 109,878 (4,108) Based on projection/grant deliverables moved Tool & Equipment 4,938 - - - - - Professional Services 388,134 423,029 543,032 548,849 940,858 397,826 Projections & Abatement Projects in 2019 Communication 19,798 20,933 18,609 18,557 18,118 (491) Based on projections Advertising 4,372 9,795 2,350 12,696 19,535 17,185 Projections and Adv Campaign for Dept Travel 16,135 22,187 15,048 18,340 19,268 4,220 Based on anticipated conferences and training Machinery & Equipment - Operating Rents & Leases 1,613 855 - 985 1,760 1,760 Grant deliverables Insurance 39,466 44,458 45,760 43,260 45,760 - Miscellaneous 27,101 39,870 28,769 29,224 49,480 20,711 New maintenance fees Intergovernmental Services 1,650 1,650 1,650 5,950 24,606 22,956 Grant deliverables Capital Outlays - - - 327,000 - - Software Replacement in 2018 Interfund Prof Svcs 211,037 326,674 335,575 339,331 333,014 (2,561) Based on projections Interfund Rents & Leases 277,310 300,010 297,799 296,503 285,426 (12,373) New County Cost Allocation Interfund Payment for Svcs - - - - - - Sub-Total Expenditures 3,793,232 3,855,968 4,221,356 4,572,656 5,001,135 779,779 Adjustment - 1,649 - - - - Reserved Fund Balance 422,846 525,298 282,656 541,319 354,260 71,604 Required Fund Balance 244,548 244,548 244,548 244,548 244,548 - Total Expenditures 4,460,626 4,627,463 4,748,560 5,358,524 5,599,942 851,383 Balance Forward 170,732 274,272 138,146 319,512 127,520 (10,627) STAFFING:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Annual Hours 67,989 64,667 70,022 66,725 74,675 FTE’s 32.6 31.1 33.6 32.0 35.8 BUDGET/PROGRAM: 127 DEPARTMENT JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 6 of 100 BUDGET/PROGRAM: 127 DEPARTMENT (cont’d) JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 7 of 100 BUDGET/PROGRAM: DEPT ADMINISTRATION REVENUES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Restricted Fund Balance 216,000 216,000 216,000 216,000 216,000 - Reserve Fund Balance 68,539 19,607 31,373 42,484 118,681 87,308 CHIP Program & HRSA Grant Beg Fund Balance 48,538 56,606 91,781 77,436 91,221 (560) Taxes - Licenses and Permits - Federal Grants - 12,000 3,000 5,589 124,030 121,030 New federal grant State Grants - - - - - State Entitlements - Intergovernmental 48,259 48,259 48,259 55,759 48,259 - Charges for Goods and Svcs 321,985 447,437 494,845 561,528 540,193 45,348 Funding for CHIP Program started in 2018 Misc. Revenue, Contributions 160 138 - 98 - - Interfund Chg. For Service - Disposition of Capital Assets - Special Purpose Tax - Transfer from Solid Waste - Other Transfers (one-time/payout)24,221 - - 9,535 - - General Fund Revenue 210,555 178,622 103,981 103,981 107,100 3,119 GF increased by approx. 3% and distributed to all divisions Total Revenue 938,256 978,669 989,239 1,072,410 1,245,484 23,565 BUDGET/PROGRAM: DEPARTMENT ADMINISTRATION JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 8 of 100 BUDGET/PROGRAM: DEPT ADMINISTRATION (cont’d) EXPENDITURES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Wages & Benefits 538,745 529,924 609,243 592,881 743,751 134,507 Step increases for bargaining members and 1.75% for non-bargaining members. Staff hours moved from CH to Admin Supplies 4,046 4,325 4,356 13,657 7,496 3,140 Based on projections Tool & Equipment - Professional Services 13,601 11,174 14,467 14,467 53,367 38,900 Based on projections Communication 2,474 2,933 3,222 2,697 3,919 697 Based on projections/department allocation Advertising 553 398 650 2,179 11,340 10,690 New Advertising Campaign for Dept Travel 1,779 841 1,095 967 3,205 2,110 Based on anticipated conferences and training Machinery & Equipment - Operating Rents & Leases 500 - - 240 240 240 Based on projections Insurance 39,466 40,243 45,760 43,260 45,760 - Miscellaneous 4,916 4,869 4,740 4,138 4,900 160 Based on projections Intergovernmental Services 10,919 10,919 Capital Outlays Interfund Prof Svcs - - - - - - Interfund Rents & Leases 39,963 46,712 47,045 47,022 45,424 (1,621) Based on projections Interfund Payment for Svcs - Sub-Total Expenditures 646,043 641,420 730,578 721,508 930,321 199,742 Adjustment 1,329 - Reserved Fund Balance 35,454 42,484 43,681 88,756 88,756 Required Fund Balance 216,000 216,000 216,000 216,000 216,000 - Total Expenditures 897,497 901,233 946,578 981,189 1,235,077 288,499 Balance Forward 40,759 77,436 42,661 91,221 10,407 (32,254) STAFFING:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Annual Hours 14,687.13 14,361.74 15,098.85 14,541.06 17,894.40 FTE’s 7.03 6.90 7.26 6.96 8.57 BUDGET/PROGRAM: DEPARTMENT ADMINISTRATION JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 9 of 100 BUDGET/PROGRAM: DEPT ADMINISTRATION (cont’d) PROGRAMS: Administration, Public Records Requests, Local Capacity Development Funds, , Public Health Emergency Preparedness and Response, Foundational Public Health Capabilities including Assessment and Public Health Policy, Community Partnership and Communication. MISSION: The mission of the Administration and Finance Division is to provide excellent internal and external customer service, provide strategic budgeting with vision for sustainable funding, and minimize the risk to the department with effective policies, procedures, and trained staff. The mission of the Administration Division’s Director’s Office and Health Officer’s Office is to provide internal and external leadership in the development of recommended public health policy based on data driven decisions designed to improve the public’s health throughout East Jefferson County and preparation of same for the Board of Health. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Provide complete financial and administrative support to departments Assure funding sources are maximized Renew existing contracts and assist with application process for all grants # total grants (federal & state) 56 40 43 39 40 Leverage Contracts-Professional Service Agreements, MOU’s, for maximum program effectiveness # total contracts 188 167 76 92 91 Bill other sources; Medicaid, Private Insurance, Clients/Customers % of Community Health (clinic) budget funded by fees 22.3% 18.7% 15.0% 16.7% 19.0% % of Environmental Health budget funded by fees 29.5% 42.3% 71.7% 75.5% 78.5% Goal 2: Conduct duties of PH to the benefit of other agencies & the community Provide services to other agencies and community Supply certified birth and death records to requesters in a timely manner # of certified birth certificates issued 443 384 408 # of certified death certificates issued 1,742 1,671 1,942 Provide Assessment/Data Evaluation Collect, evaluate, and present data to boards and committees # of boards and committees supported directly or indirectly 10 8 9 9 9 Assure response to public record requests Maintain admirable response system for public records requests; replying in a timely manner to all requests # of public record request received 281 188 78 50 44 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 10 of 100 Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 3: Improve and streamline grant billing, reporting, and tracking Track revenue and expense transactions with multiple levels of coding Hold monthly finance meetings to review financial status % of monthly meetings held 83% 75% 75% 58.3% 100% Present financial data at staff meeting (# of mtgs.) N/A N/A 4 4 4 % of total Public Health revenue budget received 97.4% 110.1% 102.4% 100% 100% % of total Public Health expense budget expended 99.4% 95.9% 92.5% 100% 100% % of total WQ revenue budget received 68.2% 85.0% 100% 100% % of total WQ expense budget expended 56. 7% 83.9% 100% 100% Reduce/eliminate coding errors # of errors resulting in coding corrections – monthly invoices 19 79 26 26 26 # of errors resulting in coding corrections – monthly payroll 148 293 126 42 42 # of errors resulting in coding corrections – monthly revenue transactions 29 57 36 38 38 Goal 4: Standardize community messages from JCPH Increase awareness and trust in community using standardized logo, letterhead, signs, and website Form new outreach team and identify goals and events # of outreach activities completed 28 11 13 18 20 Goal 5: Assure federal/state guidelines are met Track grant deliverables, contractual agreements Ensure all audits/reviews of federal/state grants are passed with no findings # of findings 0 0 0 1 0 Participate in statewide conference calls and attend training to maintain knowledge of grant requirements # of webinars, conferences, and trainings attended 22 11 17 20 20 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 11 of 100 Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 6: Maximize State funding to ensure stable and adequate funding for local public health services in Jefferson County Provide input on proposed public health statutes amendments and seek stable and ongoing funding Participate in WSALPHO meetings, conference calls, funding workgroups and initiative development including funding methodology/allocations Number of meetings, conference calls, document development N/A N/A 12 100 100 Goal 7: Ensure Jefferson County Board of Health and Jefferson County Public Health (JCPH) Staff understand the Foundational Public Health Services and Capabilities and Additional Important Public Health Services provided by JCPH Transition JCPH budget and reporting to capture Foundational Public Health Services and Capabilities and Additional Important public health services. Develop documents and PowerPoint information that illustrates and crosswalks JCPH programs with the Foundational Services and Capabilities. Align the budget with FPHS and Capabilities and evaluate per the corresponding metrics. Institutionalize continuous quality improvement and program evaluation throughout the department to assure effectiveness and efficiency in all program areas. Number of presentations to internal and external partners regarding FPHS and Capabilities and the changes to the governmental public health systems. Begin to shift, where possible, from output measures to outcome measures to ensure the services we provide are providing the outcomes we expect. Provide staff training on program evaluation and quality improvement N/A N/A 2 4 12 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 12 of 100 Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 8: Support and Enhance the Community Partnerships created through the Community Health Improvement Plan (CHIP) and the Regional Olympic Community of Health (OCH) and align the work between the two as appropriate. Ensure that the Jefferson County communities continue to be served by periodic Community Health Assessments (CHA) to inform countywide public health policy and actions. Ensure that Jefferson County continues to be served by a robust Community Health Improvement Plan that is adequately staffed to work with community partners and residents to improve health. Work with partners at the local and regional levels to encourage participation in the next CHA in 2019 and to modify the CHIP, if needed, based on the information learned from the data gathered for the CHA. Seek funding to stabilize and provide ongoing staff support for CHIP implementation to improve the health of individuals, families and Jefferson County communities. Completion of a Broad Community Health Assessment in Jefferson County in 2019. Work with Kitsap County to leverage funds for a regional Community Health Assessment in 2019 with regional and county-specific data available to each county. Seek on-going funding to enable continued health improvement in Jefferson County through the participation of all sectors and interested residents in both the CHA and the CHIP process. CHA Completed including Jefferson County specific data. Continued active engageme nt with OCH (Kitsap, Clallum and Jefferson) to assure alignment. SUMMARY OF KEY FUNDING/SERVICE ISSUES FOR 2017-2018: Staffing changes in 2016 came with unexpected costs. The 2017 budget is dependent upon a change in the county general fund contribution, which will provide assistance to three divisions in the department. In 2014, a reorganization of the Department Administration occurred when three employees ended their employment. Budget restraints made it necessary to reduce staff. Doing so created more errors in certain areas within the financial and support staff teams. In 2016, three major programs funded by grants required approximately 100 coding corrections. This was not due to administration staff, but in order to provide adequate documentation of appropriate use and accountability. In order to reduce errors, continue to ensure all federal and state audits have no official findings, and provide management and program leads with reports and other documentation necessary to track their budgets and grants, .175 FTE was added in July, 2016.99 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 13 of 100 Local and State public health leaders in Washington have been working to develop Washington’s Foundational Public Health Services (FPHS) framework since 2011. The FPHS framework is based on the role of the governmental public health system. The FPHS framework defines the services residents need to have access to or have provided for them everywhere statewide. Foundational Public Health Services include Communicable Disease Control, Chronic Disease and Injury Prevention, Environmental Public Health, Maternal, Child and Family Health, Access to Clinical Care and Vital Records. Foundational Capabilities are the cross-cutting capacities and expertise that are essential to supporting public health programs. In mid-2018 local health departments and the State Department of Health were directed to record time under new BARS codes reflecting the Foundational Public Health Capabilities which reflect the infrastructure necessary for any agency to effectively provide services to the communities we serve. Foundational Capabilities are: 1. Assessment (Surveillance and Epidemiology) 2. Emergency Preparedness (All Hazards) 3. Communication 4. Policy Development and Support 5. Community Partnership Development 6. Business Competencies Together, the foundational capabilities and foundational programs are the limited statewide set of core public health services that must exist everywhere for services to work anywhere. In other words Because Foundational Capabilities cross all divisions of public health jurisdictions, they are reflected in the Administration Budget. A summary of the Foundational Capabilities definitions follows: Assessment (Surveillance and Epidemiology)– The ability to collect sufficient, statewide and community level data and develop and maintain electronic information systems to guide public health planning and decision making at the state, regional and local level; the ability to access, analyze, use and interpret data; ability to conduct a comprehensive community health assessment, including analysis of health disparities and the social determinants of health. Emergency Preparedness (All Hazards) – The ability to develop emergency response plans for natural and man-made public health hazards; train public health staff for emergency response roles and routinely exercise response plans; the ability to lead the Emergency Support Function B – Public Health and Medical and/or a public health response for the county, region, jurisdiction and state; the ability to activate and mobilize public health personnel and response teams; request and deploy resources; coordinate with public sector, private sector and non-profit incident command system; and the ability to communicate with diverse communities across difference media, with emphasis on population that are disproportionately challenged during disasters, to promote resilience in advance of disasters and protect public health during and following disasters. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 14 of 100 Communication – The ability to engage and maintain ongoing relations with local and statewide media; and the ability to develop and implement a communication strategy, in accordance with Public Health Accreditation Standards, to increase visibility of public health issues. This includes the ability to provide information on health risks, healthy behaviors, and disease prevention and culturally and linguistically appropriate formats for the various communities served. Policy Development and Support - The ability to develop basic public health policy recommendations. These policies must be evidence-based, or, if innovative/promising, must include evaluation plans; the ability to work with partners and policy makers to enact policies that are evidence-based (or are innovative or promising and include evaluation plans) and that address the social determinants of health and health equity; and the ability to utilize cost-benefit information to develop an efficient and cost-effective action plan to respond to the priorities identified in a community and/or statewide health assessment. Business Competencies  Leadership Capabilities. Ability to lead internal and external stakeholders to consensus and action planning (adaptive leadership) and to serve as the public face of governmental public health in the community.  Accountability and Quality Assurance Capabilities. Ability to uphold business standards and accountability in accordance with local, state and federal laws, regulations and policies and to align work with national and Public Health Accreditation Standards.  Quality Improvement Capabilities. Ability to evaluate programs and continuously improve processes.  Information Technology Capability. Ability to develop, maintain and access electronic health information to support operations and analyze health data. Ability to support, maintain and use communication technology.  Human Resources Capabilities. Ability to develop and maintain a competent workforce, including recruitment, retention and succession planning functions; training; and performance review and accountability.  Fiscal Management, Contract and Procurement Capabilities. Ability to comply with federal, state, and local standards and policies.  Facilities and Operations. Ability to procure, maintain, and manage safe facilities and efficient operations.  Legal Capabilities. Ability to access and appropriately use legal services in planning and implementing public health initiatives. Meeting these core capabilities and core services will require additional investments statewide at the local, regional and state levels. It is the intent of the State Department of Health, the Washington State Association of Local Public Health Officials (WSALPHO) and the Washington State Association of Counties (WSAC) to request state funding in 2019 to fund the first of those foundational services and capabilities. The areas of the first ask are Communicable Disease, Environmental Public Health, and Assessment plus an initial investment in foundational capabilities to support public health basic infrastructure and cross-cutting services as identified above. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 15 of 100 BUDGET/PROGRAM: DEPT ADMINISTRATION (cont’d) FORM F BARS #PROGRAM TITLE ESTIMATED 2018 REVENUES BUDGET 2019 REVENUES NET COUNTY EXPENDITURES 2019 (SEE NOTE**)Additional Information 332.93.20.1000 Billing Update Incentive 3,000 3,000 678,099 Multiple funding sources, see below (Grant Admin, State Block Grant, Charges for Goods & Svcs. & County General Fund) 333.93.06.8800 PHEPR - 20,196 - 333.93.06.8801 PHEPR Admin - 6,529 - Multiple funding sources, see first row 331.93.91.1270 Rural Health Network-CHIP - 71,265 - 331.93.91.1271 Rural Health Network-Indirect - 23,040 - 3,000 3,000 678,099 **Note: Net County Expenditures includes the total annual cost for the program, including adminstration, minus grant revenue received. Rural Health Network (RHN) & RHN Indirect are the same grant just coded to two BARS lines. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 16 of 100 BUDGET/PROGRAM: DEPT ADMINISTRATION (cont’d) JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 17 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH PROGRAMS: Drinking Water, Food Safety, Onsite Sewage & Septic Operations & Monitoring, and Solid & Hazardous Waste MISSION: The mission of Jefferson County Public Health services is to protect the health of Jefferson County residents by promoting health communities and environments. REVENUES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Restricted Fund Balance - Reserve Fund Balance (6,636) 267,344 357,553 384,325 363,081 5,527 Program Specific Projects & Grants Carry Forward Beg Fund Balance 99,875 89,072 120,859 134,173 45,101 Based on rev & exp projections Taxes - Licenses and Permits 265,179 273,687 248,037 272,002 336,646 88,609 Based on projections & expected CPIW Federal Grants 315,677 28,971 - - - - State Grants 241,966 181,504 131,045 157,493 208,728 77,683 State Grants returned State Entitlements - Intergovernmental - Charges for Goods and Svcs 256,988 507,793 551,720 542,731 573,921 22,201 Based on projections & expected CPIW Misc. Revenue, Contributions - 5 - - - - Interfund Chg. For Service - Disposition of Capital Assets - Special Purpose Tax - Transfer from Solid Waste 18,200 20,971 20,971 20,274 20,274 (697) Based on projections Other Transfers (one-time/payout)9,500 3,760 - 353,316 200,000 200,000 $327,000 transferred for purchase of Energov (Tidemark replacement). Request $200,000 Add for Site Abatements in 2019 General Fund Revenue 94,914 55,202 60,738 60,738 72,560 11,822 GF increased by approx. 3% and distributed to divisions + GIS Total Revenue 1,195,787 1,439,111 1,459,136 1,911,737 1,909,383 450,247 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 18 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH (cont’d) EXPENDITURES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Wages & Benefits 651,593 702,561 867,096 809,711 982,593 115,497.44 Step increases for bargaining members and 1.75% for non-bargaining members Supplies 8,476 12,347 7,740 11,041 11,807 4,067 Based on projections/project needs Tool & Equipment - Professional Services 9,767 6,832 60,174 51,730 388,740 328,566 Abatement Projects in 2019 Communication 6,103 5,189 2,969 4,030 4,016 1,047 Based on projections/department allocation Advertising 957 2,700 800 1,270 1,775 975 Based on projections Travel 3,413 2,604 1,925 3,342 4,800 2,875 Based on projections/projects Machinery & Equipment - Operating Rents & Leases 175 140 - 70 70 70 Insurance - Miscellaneous 8,715 9,907 13,100 5,233 32,477 19,377 New maintenance fees Intergovernmental Services - - - 4,300 10,000 10,000 Grant deliverables Capital Outlays - - - 327,000 - - Software Replacement Interfund Prof Svcs 65,432 105,000 109,609 113,365 125,374 15,765 Based on projections Interfund Rents & Leases 73,936 86,647 79,896 83,392 87,613 7,717 New County Cost Allocation Interfund Payment for Svcs - Sub-Total Expenditures 828,568 933,927 1,143,309 1,414,483 1,649,265 505,956 Adjustment - Reserved Fund Balance 267,344 384,325 267,467 363,081 208,915 (58,551) Required Fund Balance - - - Total Expenditures 1,095,912 1,318,252 1,410,776 1,777,564 1,858,180 447,404 Balance Forward 99,875 120,859 48,360 134,173 51,203 2,843 STAFFING:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Annual Hours 17,980.84 18,876.40 22,759.20 20,199.57 24,422.40 FTE’s 8.61 9.08 10.90 9.67 11.70 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 19 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Food Safety Program MISSION: The mission of the Food Safety Program is to minimize the risk of the spread of disease from improperly prepared, stored or served foods handled in commercial retail settings and community events. Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Better educate food service workers, owners and the public on proper food handling and food safety topics+ Offer food safety training, educational materials and technical assistance for identified needs Provide food worker education that meets the needs of the community # of food workers trained 1568 1721 1631 1775 1650 1650 Provide business owners facility specific education and information re: Fats, Oils and Grease (FOG) # of FOG inspections completed 10 48 20 20 55 55 Goal 2: Improve operational efficiency Ensure effective program management system is in place to ensure ongoing stability of the program Coordinate with Ener Gov database transition team to ensure that food service permitting is properly accounted for Pass/Fail NA PASS PASS JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 20 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Food Safety Program (cont’d) Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 3: Work to ensure safe food is served to the public Inspect all food service establishments at a frequency adequate to assure compliance with state and local regulatory requirements Timely and accurate inspections % of required inspections completed 98.6% 99.5% 100% 90% 100% 100% # of critical violations 309 303 271 274 274 274 # of repeat critical violations 48 74 50 40 40 40 # of establishment re-inspections 13 8 3 6 6 6 Timely investigation of foodborne illness and establishment complaints Investigate and respond to all foodborne illnesses and complaints # of foodborne illness investigations 10 7 11 11 11 11 # of complaints investigated 40 27 33 44 44 44 Inspect all temporary food establishments at a frequency adequate to assure compliance with state and local regulatory requirements Ensure all temporary food vendors are permitted consistently # of temporary food service inspections 171 179 197 228 228 228 # of temporary food service permits 185 188 204 260 260 260 % of temporary food establishments inspected 92% 95% 96.6% 88% 92% 95% JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 21 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Food Safety Program (cont’d) FOOD WORKER EDUCATION 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Total # of food workers trained 1568 1721 1631 1775 1775 1775 # of Food Workers trained in class 54 91 51 71 71 71 # of Food Workers trained on-line 1514 1630 1580 1704 1704 1704 # of Instructor-led classes 9 11 9 11 11 11 # of food worker classes at Health Department 8 7 7 9 9 9 # of food worker classes at other locations 1 4 2 2 2 2 # of Fats, Oils and Grease (FOG) inspections completed 10 48 20 20 20 20 ANNUAL FOOD SERVICE ESTABLISHMENTS 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned # of food establishment permits 255 254 223 229 229 229 # of complex menu food establishments 109 113 98 137 137 137 # of non-complex menu food establishments 146 141 125 92 92 92 % of required inspections completed 98.6% 99.5% 100% 90% 95% 97% # of required routine inspections completed 364 365 341 328 328 328 # of critical violations 309 303 271 274 274 274 # of repeat critical violations 57** 74 50 40 40 40 # of re-inspections required due to violations 13 8 3 6 6 6 # of Pre-opening Inspections done 28 38 24 30 30 30 # of foodborne illness investigations 10 7 11 11 11 11 # of Complaints received and resolved 40 27 33 44 44 44 * Routine Inspections Only. Pre-opening inspections and complaint inspections were removed from this category and individually categorized. ** Repeat critical within 2014 for Complex menu. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 22 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Food Safety Program (cont’d) TEMPORARY FOOD SERVICE ESTABLISHMENTS 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned # of temporary food service permits 192 188 204 260 260 260 # of temporary food inspections 177 179 197 228 247 247 % of temporary establishments inspected 92% 95% 96.6% 88% 95% 95% FOOD PROGRAM ADMINISTRATIVE TASKS 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned # of establishments receiving Outstanding Achievement Awards 23 21 26 21 23 23 # of newsletters, press releases and meetings done 0 2 5 7 7 7 # of plan reviews done 34 33 30 23 30 30 # of plan reviews that opened 28 30 26 17 26 26 CHANGES IN FOOD TEAM MEMBERSHIP The new Environmental Health Programs Manager and a new Environmental Health Specialist will receive field training and attend inspector training in December 2018. Both will have full capability to conduct inspections in 2019. MEETINGS Food Program staff will continue to participate in Quad County Meetings, the purpose of which is to share updates of important activities in each the various local health jurisdictions (LHJs), WSDA, FDA and WA DOH and any other invited agencies, find solutions to challenging issues faced by LHJs and generally to network. The EH Director or EH Manager will continue to attend Jefferson County Food Council Meetings when feasible. Topics discussed are geared towards solutions of challenges faced by the food industry and regulatory authorities. INTERAGENCY COLLABORATION: The Food Team will continue to work with agencies such as WA DOH and WSDA to protect the health of the public. We are specifically interested in better cooperation and understanding with WSDA as they have changed some of their practices, and those changes are impacting our operations. INTER DEPARTMENTAL COLLABORATION: Food Program staff and Communicable Disease staff will continue our important collaboration in relation to complaints of food borne illness lodged with JCPH. The CD Program Lead takes time to discuss symptoms of food borne illness with the Food Inspectors. This not only facilitates the food borne illness investigation but provides educational information to the Food Inspector(s). JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 23 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Onsite Sewage (OSS) Permitting & Onsite Operations and Monitoring (O&M) MISSION: The mission of the Onsite Sewage Program is to minimize the threat of surface and ground water contamination from failing or improperly designed, installed or maintained onsite sewage systems. The mission of the Operation and Monitoring Program is to protect public health by ensuring onsite sewage systems are monitored, identify failures, and items that may lead to costly premature failures of OSS that contaminate ground and surface waters. Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Educate homeowners, builders, real estate personnel, banks, installers, designers and onsite system maintenance personnel in the proper operation and maintenance of onsite sewage systems (OSS) Conduct workshops for the public addressing OSS operation and maintenance, program incentives for initial inspection, installation of monitoring access risers and homeowner inspection program Provide training to community groups to increase awareness of OSS regulatory requirements Maintain written and web accessible educational materials Conduct OSS operations and maintenance needs and requirements workshops for homeowners & professionals # of workshops and presentations 4 10 7 6 6 6 Goal 2: Ensure a high quality- onsite sewage system monitoring program Send Monitoring Inspection Reminders to property owners Create and send inspection reminders # of reminders sent 0 4,980 2,375 see summary 1,842 see summary 2.000 2,000 Review monitoring and inspection reports, provide timely follow- up and coordinate with online submittal program data Increase percentage of OSS receiving required monitoring inspection. % of OSS receiving monitoring inspection 5.1% 7.8% 14.4% 14.4% 18% 15% see summary re capacity Review reports, triage, send follow-up letters/notices # reports reviewed 685 1060 980 2,731 1,500 2,400 # follow-up letters sent 156 168 157 247 220 240 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 24 of 100 Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 3: Investigate complaints and action requests in a timely manner to reduce the threat of human contact with untreated wastewater Utilize existing data systems to track action requests and complaints1 Report complaint investigation response % OSS complaints investigated within 30 days 94% 98% 96% 98% 98% 98% Goal 4: Document all onsite sewage systems in Jefferson County Identify previously unknown onsite sewage systems Complete sanitary surveys to move sites served by OSS from unknown to known status # of systems identified 69 107 76 See summary 64 See summary 70 75 % of estimated existing 13,500 systems identified 78.5% 79.2% 81.5% 81.9% 82.7% 83.3% Goal 5: Implement the Homeowner Inspection Program adopted in code revisions May 2012 to comply with monitoring requirements under WAC 246-272A Establish access to training programs (Septics 101 and 201) for homeowners to obtain authorization to complete monitoring inspections Provide trainings and link to online trainings # of homeowners who take in person and online trainings 81 251 591 533 500 500 Respond to requests for authorization to inspect by homeowners # of homeowners authorized 75 147 354 553** 500 500 Provide trainings and link to online trainings # of homeowners that submit inspection reports 3 66 216 190 250 250 Goal 6: Implement conversion to new data base - Energov Create clean data/ information in database and identify workflows to create a successful conversion to new database Work on implementation teams to clean existing data, create work flows and respond to requests from contractor Meet benchmarks identified in scope of work NA NA NA NA NA PASS Create work flows for database NA NA NA NA NA PASS 1 Complaints include all reports from the public and others regarding onsite sewage issues. These range from reports of someone parking or driving on their drainfield, living on property without a permitted septic system to surfacing sewage. **We are not currently able to identify the date that an owner registers for training, only when they complete the Authorization process, therefore the number of people Authorized very closely approximates the number who take the training. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 25 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Onsite Sewage (OSS) Permitting & Onsite Operations and Monitoring (O&M) (cont’d) SUMMARY OF KEY FUNDING/SERVICE ISSUES: Tracking is done with existing data systems to evaluate effectiveness of permitting and monitoring programs. Implementation of the Tidemark database replacement is anticipated in 2018 and 2019. The purchase of the program occurred in June 2018. Assignment of Program Manager from EH and DCD as well as the Steering Committee, Functional Leads, Power Users and Technical Support have been completed. Major considerations for the new program were accessibility on the web and reporting capability for program efficiency and effectiveness. Funding for annual program costs and to update and/or replace the system in the future was established in 2018 via adoption of a Technology Fee that will be added to each fee charged by Environmental Health and the Department of Community Development. Permit activity has remained steady from 2017 - 2018. The addition of staff hours in 2016 to support septic system installation inspection and permit completion to improve customer satisfaction and efficiency was successful. Staff turnover has at times limited our ability to maintain the additional support. The team continues to strive to maintain effective communication with our clients and partners (other state and local departments) to effectively manage workload and requests for information while diligently reviewing and enforcing county code and policies. We look forward to efficiencies gained with the new database and work flow systems. The O&M fee per septic system that is collected via the property tax statement funds all activities associated with the program. Implementation is focused on: sending site specific inspection reminders, follow-up with homeowners on inspection results, training and providing resources to homeowners. Staff follow-up with homeowners on inspection results is critical to the understanding of how systems work and why maintenance and proper operation is important. Previously unknown systems continue to be identified via monitoring inspections, pump reports and sanitary surveys. Records are updated to reflect decommissioned systems and the Assessor and Treasurers offices are notified to remove the O&M Fee. Improvements to the web-based Homeowner Authorization Program will occur in 2019 as our interface with the new permitting database evolves. The capacity of monitoring inspection providers reduced the number of site specific inspection reminders we send during the year. We found that a maximum of 500 reminders every 2 – 3 months is their capacity based on the response rate of property owners. Assistance is provided to property owners to take advantage of the incentives and online training for Homeowner Authorization to complete their monitoring inspection. Outreach:  Septics 101 and 201 classes spring and fall  Incentive/rebate program to assist homeowners in completing inspections and installing access risers and monitoring ports continues to be available via grant $$.  Provide low interest loan information for those with systems that are not functioning properly  Maintain current information on the website regarding classes and other resources for homeowners and professionals  Provide training to professionals in the onsite sewage field  Update brochures and pamphlets Septic System Operation - Monitoring Inspection Follow-up and Complaint Investigation  A triage is used for follow-up letters where deficiencies are identified. Response to these follow-up letters has been excellent and offers an opportunity to give additional information to new property owners. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 26 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Onsite Sewage (OSS) Permitting & Onsite Operations and Monitoring (O&M) (cont’d) PROGRAM STATISTICS PERMITS 2011 Actual 2012 Actual 2013 Actual 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned # of septic permit applications submitted 1 118 147 148 156 163 205 245 245 245 # of Monitoring Inspections/evaluations of existing system (EES) 469 511 641 781 1060 1941 1758 1900 1900 # of systems repaired/upgraded 31 43 40 46 43 42 46 40 45 % of system failures less than 5 years in use 0 0 0 0 0 0 0 0 0 % of failures/major maintenance identified by Professionals <2% <2% <2% <4% <5% 6% 6% 6% 6% # of complaints received* 36 20 60 52 109 67 67 65 65 # of complaints closed** 25 26 25 43 42 166 125 95 100 # of Installers Certified 36 34 31 31 27 27 34 30 34 OPERATION, MAINTANANCE & MONITORING 2011 Actual 2012 Actual 2013 Actual 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned % of existing systems receiving monitoring inspection. 2 3.40% 3.80% 4.7% 5.1% 7.8% 14.4% 14.4% 18% 15% # of previously unknown systems having a monitoring inspection 15+ 854 14+934 204 69 107 19 + 834 65 + 214 20 + 404 45 + 254 % of monitoring inspections resulting in some maintenance needed. 68%5 59%5 63%5 63%5 64% 57% 55% 60% 55% EDUCATION AND OUTREACH 2011 Actual 2012 Actual 2013 Actual 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned # of educational workshops 4 9 20 4 10 7 6 6 6 # of workshop participants – live + online 156 220 410 131 354 237 + 354 156 + 397 500 500 * Includes COM cases created when violation identified during a sanitary survey. **The number of Closed complaints can be greater than Received because cases from previous years may have been closed during the current year. 1Number of applications does not equal approved permits 2 Based on estimated 13,500 systems in the County (from the Local Sewage Management Plan) 4The first number indicates systems that were identified and observed via regular monitoring inspections. The second number indicates systems that were identified (and had some level of observation) via sanitary surveys or pump report and are sites where no previous records exist. 5 Includes inspections where the only maintenance item identified was that the tank needed to be pumped. Previous to 2010 did not include this maintenance item. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 27 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Onsite Sewage (OSS) Permitting & Onsite Operations and Monitoring (O&M) (cont’d) 216 160 148 103 132 138 148 147 186 180 15 9 10 15 15 10 8 16 19 65 0 50 100 150 200 250 300 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 SEPTIC CASES CREATED Septic Permit Applications Monitoring Inspections 295 255 463 469 511 641 781 1060 1941 1948 0 200 400 600 800 1000 1200 1400 1600 1800 2000 1 2 3 4 5 6 7 8 9 10 Monitoring Inspections Completed JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 28 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Solid and Hazardous Waste Program PROGRAMS: Small Business Technical Assistance Program (Local Source Control, EnviroStars Certification), Waste Reduction and Recycling Outreach, Solid Waste Permitting and Enforcement, and Hazardous Waste Investigations. MISSION statement for Solid and Hazardous Waste Program is to:  Enforce Washington State and Jefferson County solid and hazardous waste code  Educate the community about proper disposal and reduction strategies for solid and hazardous waste Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Timely investigation of Solid and Hazardous Waste complaints Investigate within 30 days Contact solid waste (SW) complainant within 30 days Conduct complaint investigation within 30 days Determine if complaint is actionable SW complaints investigated within 30 days 90% 100% 75% 75%* 100% 100% * Funding for Solid Waste enforcement interrupted between July 2017 and December 2017. Very little complaint response conducted, although critical complaints were investigated. Backlog of complaints received and not investigated during this period. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 29 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Solid and Hazardous Waste Program (cont’d) Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 2: Timely resolution of non-abatement solid waste complaints Resolve non abatement solid waste complaints within 90 days Determine type of enforcement response Issue Warning Letter or Notice and Order to Correct Violation (NOCV) Issue citations as needed SW cases resolved within 90 days 60% 75% 60% 75%* 20%* 75% Goal 2.1 Timely Resolution of solid waste “abatement” cases Resolve at least one abatement from the SW “abatement” list per year Obtain warrants of abatements as needed Obtain contractors for cleanup Number of SW abatement cases resolved 0 1 0 0 1 2 * Funding for Solid Waste enforcement interrupted between July 2017 and December 2017. Very little complaint response conducted, although critical complaints were investigated. Backlog of complaint cases were investigated, however a majority of them are still open (Aug 2018) due to staffing issues. * One warrant of abatement obtained in 2018. There are currently 11 cases awaiting a warrant of abatement from Superior Court (Aug 2018). Goal 3: Increase small businesses understanding of waste reduction, recycling, and green alternatives Provide on-site technical assistance to Small Quantity Generators (those businesses that produce less than 220 lbs. of hazardous materials per month) Provide support for Jefferson County businesses to join new EnviroStar program. Pollution Prevention Assistance site visits Hold regular meetings to facilitate exchange of ideas on greening your business Conduct 75 LSC visits per year 73 130 60* 90 40* 80 Certify 5 new EnviroStars 0 3 3 0 5 5 Migrate all current EnviroStars into new program -- -- -- -- 24 5 *Staffing changes and training in 2016 & 2018 contributed to the reduced amount of sites visited. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 30 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Solid and Hazardous Waste Program (cont’d) Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 4: Increase Public Education about pre- cycling, moderate risk waste, and household hazardous waste as identified in the Solid Waste Management Plan Conduct education and outreach to the public on pre-cycling, waste reduction, composting, recycling, and less toxic alternatives Develop presentations to school and community groups # of school-based presentations 24 52 44 60 20 40 # waste reduction campaigns 10 9 10 10 5 10 # of public outreach events 23 19 13 15 10 15 Develop and distribute publications # of waste reduction and recycling articles 13 9 6 10 5 10 # of other publications 2 7 6 5 2 5 *due to a lack of funding, these programs are on hold. Goal 5: Ensure compliance with permits Ensure compliance with SW regulations at permitted sites Conduct one site visit per year % compliant with requirements 100% 100% 100% 100% 100% 100% *there are currently 7 facilities permitted through JCPH JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 31 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Solid and Hazardous Waste Program (cont’d) PROGRAM STATISTICS SOLID WASTE ENFORCEMENT 2014 2015 2016 2017 2018 Projected 2019 Planned Total number of solid waste complaints received 42 33 24 20 50 40 Total number of solid waste violations resolved 31 57 14 18 40 40 # of illegal dumps complaints received 6 9 12 6 4 5 # of illegal dumps complaints resolved 6 9 12 6 4 5 Tons/cubic yards of solid waste removed/recycled through compliance efforts (not including junk vehicles) (these are verified #s, actual #s are higher) 58 95 20 19 20 20 Total number of solid waste violations awaiting legal action/abatement 10 15 4 6 11 10 # of warrants of abatement obtained/completed 0 1 0 1 1 4 # of Jeff. Co. permitted facilities meeting current regulation standards (out of 7) Nav Mag II closed 2017 8 8 7 7 7 7 # of Jeff. Co. exempt facilities inspected/ meeting current regulation standards (out of 4)* 4 4 4 4 4 4* * There are four conditionally exempt facilities but actual number may be higher. These facilities have not been inspected and compliance is assumed. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 32 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Solid and Hazardous Waste Program (cont’d) SOLID WASTE EDUCATION, OUTREACH & SBA 2014 2015 2016 2017 2018 Projected 2019 Planned # of Pollution Prevention Assistance site visits 10 6 10 10 10 10 Total number of active EnviroStars businesses 24 22 24 24 24 24 # of new EnviroStars businesses 0 3 3 0 0 0 # of public outreach events 23 19 13 15 15 15 # of waste reduction and recycling articles 13 9 6 10 10 10 # of waste reduction advertisements 3 23 1 2 2 2 # of other publications 2 7 6 5 5 5 # of Envirostars promotional Ads 2 19 0 15 15 15 # of waste reduction campaigns 6 9 10 10 10 10 # of participants enrolled in waste reduction campaigns 174 880 4,576 4000 4000 4000 # of School-based Education programs delivered 24 52 12 15 15 15 # of students served 480 1,300 1,119 1000 1000 1000 HAZARDOUS WASTE 2014 2015 2016 2017 2018 Projected 2019 Planned ERTS Received/Investigated 4 8 6 6* N/A N/A # Initial Investigations Completed 3 8 6 5* N/A N/A # of Local Source Control Visits 86 130 60 80 40 80 Spill Kits Distributed 7 6 1 2 2 2 * The Green Business program was merged with the EnviroStars program at the State level in 2017. * The Site Hazard Assessment program has been discontinued as of August 31, 2017. All files and open cases were transferred back to Ecology on that date. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 33 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Drinking Water MISSION: The mission of the Drinking Water Program is to protect public health by assuring that residents and visitors to Jefferson County have access to a safe and reliable supply of quality drinking water and that it is reasonably available. By enforcing and monitoring laws regulating public and private water supplies, the Drinking Water Program minimizes the threat of waterborne disease. Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Assure that all new and decommissioned wells are constructed in accordance with requirements established by the Washington Department of Ecology (ECY) or defer enforcement to ECY Inspect at least 50% of all new wells constructed with 50% of these with the well driller present and 100% of all wells being de- commissioned Be available when well start notifications are received to conduct inspections within 3 days of start When a well application is received for a decommissioning, contact the well driller to discuss timing and schedule. Percent of new wells (starts) inspected 60% 71% 86% 81% 50% 50% Percent of inspected wells with driller on site 66% 42% 63% 68% 25% 25% Percent decommissioned well inspected 88% 88% 94% 95% 100% 100% Goal 2: Integrate water adequacy review with compliance with Water Resource Inventory Area (WRIA) 17 and the In-Stream Flow Rule (ISFR) Comply with reporting requirements from ECY by updating database to include means to track ISFR information Determine through review of building permit applications and subdivision potable water review if subject to requirements of ISFR rule (map check and parcel info) Determine the sub-basin and management area in accordance with rule. Add activities and conditions that allow for data tracking Number of reviews in Coastal Management area of WRIA 17 10 14 14 13 17 17 Number of reviews in Reserve Management area of WRIA 17 10 7 6 5 7 7 Number of reviews in Chimacum Sub-basin of WRIA 17 2 4 3 4 5 5 Number of reviews that were exempted from WRIA 17 rule. (ECY decision) 2 3 6 11 10 10 Subdivision lots approved 2 0 0 0 2 2 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 34 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Drinking Water (cont’d) Goal Objective Task Performance Measure 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Plan Goal 3: Integrate water adequacy review with compliance to the Seawater Intrusion Ordinance Comply with the requirements of the (DCD) Jefferson County Seawater Intrusion ordinance and update maps annually Create report in database to determine through quality testing required for building permits and subdivisions potable water review if subject to the requirements Establish new at risk or high risk zones Number of wells that created a new at-risk zone 1 2 1 1 1 Number of wells in a high risk zone 0 0 1 0 1 Number of Hydro-geological assessments reviewed 1 1 1 0 1 Goal 4: Minimize delay of building permits and subdivisions project approval and completing by prioritizing water adequacy review Conduct initial review of all potable water review applications within 14 days of application Create reports in database to establish date of initial review and statistics to better assess issues around timely approval Percent of reviews completed in 14 days 90% 59% 50% 20% 50% Goal 5 Ensure consistent compliance with drinking water requirements Work toward coordination with other permitting agencies. Those agencies include but are not limited to DOH (in-stream flow rule and public water supplies), Washington State Department of Agriculture (food processing permit applications), JC food safety, JC onsite and DCD Establish regular meeting dates and agreements when applications trigger coordination Partner with WSU in ongoing educational workshops along with other regulatory agencies Presentations to public or participation in public forums 1 2 1 1 1 *NR= “need report” these numbers were manually hand counted prior to database update to calculate from activities entered in database. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 35 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – Drinking Water (cont’d) DRINKING WATER PROGRAM STATISTICS BY YEAR Well inspection program 2010 2011 2012 2013 2014 2015 2016 2017 2018 Projected 2019 Planned # of well applications received & reviewed 61 56 36 47 38 43 42 54 50 50 # of new wells start notification (drilled) (includes some well applications from previous years) 62 57 28 23 20 31 21 31 40 40 # of wells decommissioned 13 12 12 20 8 8 17 20 15 15 # of new wells inspected 32 31 16 17 12 22 18 25 20 20 % of new wells (starts) inspected 52% 54% 78% 73% 60% 71% 86% 80% 50% 50% # of inspected wells with driller on site (includes new and decommissioned wells) 25 28 21 13 21 16 24 17 10 10 % of inspected wells with driller on site 55% 65% 85% 76% 66% 42% 63% 68% 25% 25% # of decommissioned wells inspected 13 12 12 19 7 7 16 19 15 15 % decommissioned well inspected 100% 100% 100% 100% 88% 88% 94% 95% 100% 100% Determination of adequate potable water 2015 2016 2017 2018 Projected 2019 Planned # of potable water reviews completed New Categories Added in 2012 90 126 148 140 140 # of reviews complete in 14 days 81 93 30 70 70 % of reviews done within 14 days 90% 74% 20% 50% 50% # of reviews for public water. 59 84 105 100 100 # of reviews for two party wells. 7 8 7 5 5 # of reviews for individual wells. 23 34 36 34 34 # of reviews for rainwater catchment systems. 1 0 0 1 1 # of reviews for shallow/dug wells 1 0 0 0 0 # of reviews for spring water 1 1 0 0 0 # of reviews in High Risk SIPZ Zones with Hydro- geologic assessments 0 0 0 1 1 # of reviews that required Notice to Title for quality 3 0 0 2 2 # of review that required Notice to Title for quantity 3 0 0 1 1 # of reviews in Coastal Management area of WRIA 17 14 14 13 17 17 # of reviews in Reserve Management area of WRIA 17 7 6 5 7 7 # of reviews in Chimacum sub-basin 4 3 4 5 5 # of reviews that were exempted from WRIA 17 rule. 3 6 11 10 10 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 36 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – (cont’d) FORM F BARS #PROGRAM TITLE ESTIMATED 2018 REVENUES BUDGET 2019 REVENUES NET COUNTY EXPENDITURES 2019 (SEE NOTE**)Additional Information 334.03.10.5300 Solid Waste Grant (DOE) - Enf.32,133 40,084 14,658 County General Fund (CGF) and Fees 334.03.10.5350 Solid Waste Grant (DOE) - Edu.25,274 33,424 13,167 CGF and fees 334.03.10.5380 LSC 49,427 80,143 334.03.10.5381 LSC (Indirect)11,982 19,590 334.04.93.5480 PSAP Onsite Systems 38,678 26,817 334.04.93.5481 PSAP Onsite Systems Indirect - 8,670 157,493 208,728 27,825 **Note: Net County Expenditures includes the total annual cost for the program, including administration, minus grant revenue received. LSC & LSC (Indirect) are the same grant just coded to two BARS lines.- - PSAP Onsite Systems & PSAP Onsite Systems Indirect are the same grant just coded to two BARS lines. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 37 of 100 BUDGET/PROGRAM: ENVIRONMENTAL HEALTH – (cont’d) JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 38 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH PROGRAMS: Communicable Disease, Family Health Services, Population & Prevention, and Targeted Clinical Health Services MISSION: The mission of Jefferson County Public Health services is to protect the health of Jefferson County residents by promoting healthy communities and environments. REVENUES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Restricted Fund Balance - - - - - - Reserve Fund Balance 75,000 75,000 75,000 75,000 46,178 (28,822) PHEPR program moved to Admin Division Beg Fund Balance 72,362 30,098 18,167 75,976 94,118 75,951 Taxes - Licenses and Permits - Federal Grants 429,199 532,654 403,301 419,137 332,607 (70,694) One federal grant ended, grants changed to state funding, & Moved PHEPR program to Admin State Grants 297,346 295,645 310,525 361,296 341,922 31,397 Increased State Funding State Entitlements 135,821 177,821 180,487 177,821 177,821 (2,666) Based on projections Intergovernmental 23,109 - - - - - Charges for Goods and Svcs 586,111 491,180 447,063 502,504 499,309 52,246 Based on projections Misc. Revenue, Contributions 2,143 3,210 1,000 3,150 1,000 - Interfund Chg. For Service - Disposition of Capital Assets - Special Purpose Tax 104,043 107,180 110,404 110,407 113,719 3,315 Special Purp Tax increased approx. 3% Transfer from Solid Waste - Other Transfers (one-time/payout)43,219 13,357 - 51,141 - - Transfers for Special one-time only payouts General Fund Revenue 306,962 354,972 441,621 441,621 444,870 3,249 GF increased by approx. 3% and distributed to all divisions Total Revenue 2,075,315 2,081,116 1,987,568 2,218,053 2,051,544 63,976 BUDGET/PROGRAM: COMMUNITY HEALTH JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 39 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH (cont’d) EXPENDITURES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Wages & Benefits 1,401,579 1,241,136 1,259,856 1,308,709 1,340,178 80,322 Step increases for bargaining members and 1.75% for non-bargaining members Supplies 117,003 99,872 101,563 110,611 90,280 (11,283) Based on projections & grant deliverables moved Tool & Equipment - Professional Services 134,151 184,914 193,031 183,975 160,961 (32,070) Ended service contract for med billing Communication 11,016 12,620 12,190 11,581 9,932 (2,258) Based on projections/department allocation Advertising 1,131 6,676 850 9,166 6,340 5,490 Based on projections and projects Travel 10,760 18,417 11,248 13,252 10,243 (1,005) Based on anticipated trainings and conferences Machinery & Equipment - Operating Rents & Leases 720 715 - - 700 700 Specific grant project Insurance - Miscellaneous 9,018 16,079 7,813 16,280 7,679 (134) 2018 rec'd grant funding for training Intergovernmental Services 1,650 1,650 1,650 1,650 3,687 2,037 Based on projections Capital Outlays Interfund Prof Svcs 124,421 186,699 186,792 186,792 166,011 (20,781) Based on projections Interfund Rents & Leases 158,767 161,043 165,509 160,741 145,364 (20,145) New County Cost Allocation Interfund Payment for Svcs - Sub-Total Expenditures 1,970,217 1,929,820 1,940,502 2,002,757 1,941,375 873 Adjustment - 320 - - - - Reserved Fund Balance 75,000 75,000 - 121,178 46,211 46,211 Required Fund Balance - - - - - - Total Expenditures 2,045,217 2,005,140 1,940,502 2,123,935 1,987,586 47,084 Balance Forward 30,098 75,976 47,066 94,118 63,958 16,892 STAFFING:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Annual Hours 33,232.63 29,480.38 30,049.84 29,904.17 30,257.14 FTE’s 15.92 14.17 14.39 14.32 14.49 BUDGET/PROGRAM: COMMUNITY HEALTH JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 40 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease PROGRAMS:, Communicable Disease (CD), Tuberculosis, Immunizations, Travelers Immunizations, Sexually Transmitted Disease, HIV, Syringe Exchange Program, Public Health Emergency Preparedness MISSION: The purpose of the Communicable Disease Health program is to protect Jefferson County residents from serious communicable diseases by providing disease surveillance, investigation and reporting, along with education, screening, treatment, and immunization services. The program interacts with community members, medical providers, the Washington State Department of Health (DOH), Region 2 Emergency Management partners, and other agencies while working toward this purpose. Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Timely investigation of notifiable conditions. Investigate reports of notifiable conditions per DOH disease specific guidelines. Develop & update protocols and forms as needed. Use DOH electronic reporting systems PHRED, PHIMS, and PHIMS-STD, to receive reports and send completed reports to DOH. Total number of communicable disease reports confirmed, interventions applied, and processed for reporting to the State 180 (21 gonorrhea) 201 (42 pertussis) 178 155 165 165 Total number of STD cases reported to the State 103 69 73 68 70 70 Number of chlamydia cases reported to the State: female, male, total Fe: 59 M: 18 T: 77 Fe: 42 M: 15 T: 57 Fe: 41 M: 15 T: 56 Fe: 30 M: 22 T: 52 60 60 Number of gonorrhea cases reported to the State: female, male, total Fe: 13 M: 8 T: 21 Fe: 5 M: 4 T: 9 Fe: 4 M: 7 T: 11 Fe: 6 M: 5 T: 11 8 8 Goal 2: Inform medical providers about current CD trends, outbreaks, and new CD control recommendations. Provide updates, outreach, and training to providers about local, state, and national CD outbreaks and disease control recommendations. Provide reminders about reporting notifiable conditions and using the after-hours reporting number. Number of alerts/updates/newsletters faxed, emailed, or mailed to providers (not including DOH Influenza Updates) 23 8 17 15 15 15 Goal 3: Maintain the low rate of active Tuberculosis (TB) in Jefferson County Encourage appropriate screening and treatment for latent TB infection and active TB disease. Number of clients tested for TB infection with PPD or QFT test; Number of positive tests 149 2 148 2 180 1 145 0 150 1 150 1 Number of clients started on preventive treatment for latent TB infection. 2 1 0 0 1 1 Number of cases of active TB reported 0 0 0 0 0 0 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 41 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease (cont’d) Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 4: Ensure access to vaccines for all children through the federal and state funded Vaccines for Children Program (VFC). Work with DOH to monitor VFC vaccine usage in Jefferson County. Total number of doses of publicly funded vaccine (pediatric), administered by private health care providers and JCPH clinics, supplied and monitored through JCPH immunization program 4613 4724 4627 4278 4450 4450 Number & percent of doses of publicly funded vaccine (pediatric) administered by private health care providers 3967 86% 4222 89.4% 4198 90.7% 3763 88% 3915 88% 3915 88% Number & percent of doses of publicly funded vaccine (pediatric) administered by JCPH 646 14% 502 10.6% 429 9.3% 515 12% 535 12% 535 12% Goal 5: Maintain access to vaccines for international travel, in part to prevent travel associated outbreaks in Jefferson County. Provide travel immunization clinic (includes all disease prevention recommendations, including for malaria and other diseases). Number of clients immunized in travel immunization clinic Adults: 140 Adults: 152 Adults: 174 Adults: 162 Adults: 150 Adults: 162 0 - 18 yr: 31 0 - 18 yr: 55 0 - 18 yr: 36 0 - 18 yr: 42 0 - 18 yr: 40 0 - 18 yr: 40 Total: 171 Total: 207 Total: 210 Total: 204 Total: 190 Total: 202 Number of private supply vaccine doses (routine and travel) administered by JCPH (primarily for adults) 600 781 701 709 700 700 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 42 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease (cont’d) Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 6: Increase the Jefferson County childhood immunization rates. Work with the Community Health Improvement Plan (CHIP) Immunization Workgroup to increase immunization rates. Strategies include working with schools and health care providers. See CHIP Plan for details. See below. Assess childhood immunization rate trends, for children seeing Jefferson County providers, using immunizations recorded in WAIIS. Note: Some children are not in the IIS registry, and some providers in Washington state don’t participate in the registry. The CDC NIS survey is more complete. Completeness of full immunization series for children seeing Jefferson County providers, at age 19-35 months: 4 DTaP, 3 Polio, 1 MMR, 3 HIB, 3 Hep-B, 1 Var, 4 PCV. Jeff Co: 55% (IIS) WA: 56% (IIS) 67% (NIS Jeff Co: 58% (IIS) WA: 58% (IIS) 77% (NIS) Jeff Co: 66% (IIS) WA: 59% (IIS) 76% (NIS) Jeff Co: 64% (IIS) WA: NA as of 8/10/18 Jeff Co: 67% Jeff Co: 69% Percent of children seeing Jefferson County providers having 1 dose of MMR by age 19-35 months (IIS data) Jeff Co: 78% WA: 79% Jeff Co: 80% WA: 82% Jeff Co: 89% WA: 81% Jeff Co: 86% WA: NA Jeff Co: 89% Jeff Co: 91% Percent of children seeing Jefferson County providers having 4 doses of DTaP by age 19-35 months (IIS data) Jeff Co: 69% WA: NA Jeff Co: 66% WA: 68% Jeff Co: 80% WA: 69% Jeff Co: 81% WA: NA Jeff Co: 82% Jeff Co: 83% Assist schools to increase student compliance with Washington State immunization requirements. Provide training and assistance to access WAIIS records for students. Provide schools immunization information for parents. Link schools to updated DOH information on submitting annual immunization report. Percent of Jefferson County kindergarten students that are out-of- compliance for required immunizations, as reported to DOH in school immunization report each fall. Jeff Co: 21.9% WA: 10.9% Jeff Co: 30.5% WA: 8.6% Jeff Co: 11.1% WA: 8.2% Jeff Co: 16.4% WA: 8.0% Jeff Co: 10% Jeff Co: 9% JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 43 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease (cont’d) Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 7: The Family Planning and STD clinics will assist in controlling Chlamydia transmission in Jefferson County. Women seen in JCPH Family Planning clinic who are at higher risk for Chlamydia (age 24 and under, CDC) will be screened for Chlamydia annually. Number of female FP clinic clients age 24 and under screened for Chlamydia 320 311 290 249 270 270 Percent of female FP clinic clients age 24 and under screened for Chlamydia 63.4% 60.3% WA:47.8% US:49.8% 74.2% WA: Medicaid: 51% Commercial: 43% 70.5% WA: NA as of 8/10/18 72% 72% Number of chlamydia cases reported to the State, female, male, total Fe: 59 M: 18 T: 77 Fe: 42 M: 15 T: 57 Fe: 41 M: 15 T: 56 Fe: 30 M: 22 T: 52 60 60 Goal 8: Maintain access to HIV testing in the community. Clients at risk for HIV, without medical insurance, will be tested through the State Public Health Lab, others requesting testing will be tested through the Quest Lab and charged for testing. Number of persons counseled and tested for HIV infection 140 125 152 167 165 165 Goal 9: Prevent the spread of blood borne communicable diseases among injecting drug users and their partners. Promote utilization of syringe exchange program (SEP) services. Number of visits to SEP 350 238 242 308 300 300 Number of syringes exchanged 42,809 35,328 47,790 91,290 99,000 99,000 Goal 10: Prevent fatal opioid overdoses in Jefferson County. Provide overdose prevention education to SEP clients. Provide naloxone, for opioid users, families and friends. Number of naloxone kits dispensed, included training for proper use. New program in 2016. NA NA 45 135 135 135 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 44 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease (cont’d) Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 11: Annual report to BOH for CD Programs. Complete Annual Report Pass/Fail PASS PASS PASS PASS PASS PASS Goal 12: Maintain and enhance Public Health Emergency Preparedness and Response (PHEPR) capacity. Update regional PHEPR Plan, coordinating with Region II partners Clallam and Kitsap Health Departments, local emergency response agencies, Jefferson Healthcare, local health care providers and agencies. Update Public Health Emergency Preparedness and Response Plan PASS PASS PASS PASS PASS PASS SUMMARY OF KEY FUNDING/SERVICE ISSUES: Communicable Disease/Immunizations JCPH CD and Immunization programs address locally identified and defined public health problems. Communicable disease prevention is primarily a locally funded program (county milage was returned from the state to counties for TB control). Immunization funds from the state are primarily in the form of vaccine, this vaccine is provided to primary care clinics that care for children. Foundational Public Health Services funding from the State provided $42,000 for the 2017- 2018 fiscal year, to be split between the CD and Immunization programs. The same allocation will be received for the 2018-2019 fiscal year. State and County funding provides professional staff that prevent, identify and respond to disease outbreaks; and immunization staff that work with the hospital, health care providers, the schools, and local groups sponsoring trips abroad for students. Immunization staff provide routine immunization clinics and international travelers clinics. Staff respond to public requests for information about communicable diseases and screen for reportable illnesses in the process. The CD team continues to work on strengthening the notifiable conditions reporting system through outreach to the Jefferson Healthcare lab, ER, Infection Control Committee, and local providers. The number of communicable diseases reported each year is difficult to predict. The CD/Immunization team must be prepared to respond to outbreaks by working with providers, following up with cases, making sure contacts are identified, educated and treated as appropriate, and getting information to providers, schools and the public. State/Federal funding for the Immunization Program Vaccine Accountability Contract provided $2,003 for the first half of 2018. JCPH completed the eight provider clinic monitoring deliverables for this contract. The DOH Immunization Program transitioned to a new Regional/State service delivery model for these immunization program tasks starting 7/1/18. Local Health Jurisdictions will expand and focus more on efforts to increase childhood immunization rates and will no longer do the clinic vaccine accountability monitoring tasks. JCPH will receive $5,600 for this work for the 7/1/18 - 6/30/19 period. JCPH will also receive $500 for case management of any perinatal hepatitis B cases reported. For comparison, the total immunization funding received from the State for 2017 was $4,707. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 45 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease (cont’d) Immunizations have been identified as a Community Health Improvement Plan (CHIP) priority. JCPH immunization staff will continue to monitor VFC vaccine usage trends and immunization rates in Jefferson County. The data has been affected by the WA Immunization Information System (WAIIS) server capacity, and issues within some modules of the WAIIS registry. As a result, reports of the annual number of doses administered by private clinics may have been inaccurate. DOH planned to have additional server capacity and WAIIS upgrades by the end of 2017, however these upgrades have just been completed in the week of 8/10/18. These upgrades should improve the data reports over time, including the accuracy of immunization rates. JCPH immunization staff will continue to co-chair and participate in the CHIP Immunization Workgroup, focusing on improving immunization rates for children and adults in Jefferson County. CHIP activities and detailed outcome indicators are outlined in the CHIP plan. The Immunization team will continue to update school staff training for using WAIIS to get immunization records for students who don’t have a complete Certificate of Immunization Status on file. JCPH staff will expand work with the schools, provide more resources for parents, and enter out-of-state immunization records into WAIIS. The number of students who are “out-of-compliance”, due to incomplete immunizations or having no immunization record provided to the school, decreased in Jefferson County in the fall of 2016 and increased slightly in 2017. This is one of the CHIP indicators and JCPH will continue to support the schools in their work on this issue. STD The Family Planning and STD clinic follows the CDC's STD testing recommendations. The Family Planning and CD program staff will continue to monitor and explore ways to assure appropriate testing of high risk groups. The electronic medical records program is also being assessed for FP/STD data reports. HIV Prevention HIV/AIDS case management was regionalized in January 2017 and Kitsap Public Health District became the regional provider of HIV case management services for Kitsap, Clallam, and Jefferson counties. A Kitsap staff member, provides services for Clallam and Jefferson counties. Previously, this staff member was employed by Clallam County Health Department and provided services for the two counties. CDC funding currently focuses on prevention programs for high risk populations, based on HIV prevalence. Jefferson County is classified as a low prevalence county, so has not had HIV prevention funding since 2012. The State Public Health Lab continues to do a limited number of free HIV tests for uninsured high risk clients, but there is no funding for JCPH staff time for counseling and testing services. JCPH staff will continue to provide free HIV testing services for low income high risk clients with no medical coverage. As more clients now have Apple Health, more testing is being done through Quest lab. The 2017 annual number of client visits, and syringes exchanged, in the SEP program was higher than in any previous year. The 2018 totals are projected to be higher yet, as 49,780 syringes were exchanged, in the first 6 months (compared to 41,080 in the same period of 2017). DOH provides SEP supplies to supplement our program, however, there is no State funding for staff time. Both the increase number of client visits, and naloxone distribution and training, for opioid overdose prevention, have increased staff time required for this program. Continued funding for naloxone through the Center for Opioid Safety Education at the UW and DOH is likely. If this supply of naloxone does not continue, JCPH will have to explore options for purchasing naloxone. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 46 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Communicable Disease (cont’d) Public Health Emergency Preparedness and Response (PHEPR) Federal funding includes developing response capacity for all hazards emergency response. Response capacity is developed in coordination with Region 2 PHEPR partners Kitsap and Clallam Counties, local emergency response agencies, Jefferson Healthcare, and other health care providers. Public Health staff have been trained in and use National Incident Management System protocols during communicable disease outbreaks. The roles, responsibilities and training have been helpful for managing communicable disease outbreaks. Decreased funding for any program may result in scaling back on services. The Board of Health would be involved in deciding which services would be impacted. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 47 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Population and Prevention PROGRAMS: Drug and Alcohol prevention, School Health, Healthy Community, Health Care Access and Clean Indoor Air Act MISSION: The purpose of the Population & Prevention Programs is to provide health education and public health interventions to county residents in order to promote a healthier community. Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Improve identified social and health indicators for school age youth Convene Prevention Coalition to identify interventions to address drug and alcohol prevention in communities Strategic Plan Milestones- see CPC web page http://www.jeffersoncounty publichealth.org/index.php ?c-p-c Completed CPC Strategic Plan Spring 2014 CPC Strategic Plan update Completed Spring 2015 Reviewed and revised CPC Strategic Plan completed Spring 2016 Rewrote the Strategic plan, including logic model and action plan. Approved June 2017. Revise CPC Strategic Action Plan and Budget as required. Review and rewrite strategic plan, including logic model and action plan per latest HYS data Number of Coalition meetings 12 12 12 12 12 10 Goal 2: Reduce favorable attitudes toward problem behaviors within the youth and adult communities Increase the perception of risk for youth and adults regarding alcohol, tobacco, marijuana and other drug use based on Health Youth Survey (HYS) Implement identified intervention strategies in the Strategic Plan Completed 7 weeks Strengtheni ng Families Parenting Program (SFP) Classes Oct-Nov. 2014 2 Public Awareness events SFP Spring and fall 2015 Complete 3 Public Awareness events Community Assessment of Neighborhoo d Stores spring 2015 7- week SFP classes in 2016 were canceled; Fall of 2016 were held Feb.- Mar. 2017; Public Awareness events (KLO 5/14/2016, Cultural Competency event; planned film event for early 2017). District policy 2121 was reviewed and edited. Coalition Coordinator presented to Board of Education in early 2017. Held 7- week SFP classes in Feb.- Mar. 2017 due to change in leadership; Public Awareness events (KLO 9/2017, Cultural Competency activity at CPC meeting June 2017. Film event Sept. 2017 PTFF. District policy 2121 was presented to Board of Education in early 2017. Board took no action. Winter and Fall 2018 Community and Adult Social Norms Campaign to be conducted in school district catchment area by CPC members. Methods include speaking engagements, flyers, postcards, poster campaign, drug takebacks, Spring 2019 Guiding Good Choices. Film with County Library. April DEA Drug Take Back event. ACES workshops x3 (one may be held in late 2018 before turn of year). HS prevention club to continue. Engage various regional stakeholders. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 48 of 100 Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned National Drug Facts Week participation, Focus groups. Winter and Fall 2018 Community and Adult Social Norms Campaign to be conducted in school district catchment area by CPC members. Methods include speaking engagements, flyers, postcards, poster campaign, drug takebacks, National Drug Facts Week participation, Focus groups. Work with the YMPEP regional strategic planning team to do a community assessment of assets and Positive Social Norms campaign. Continued NFP home visiting program. Work to add “no vaping” to JC smoking ordinances. Capacity building, webpage, provide trainings using Making Connections Toolkit strategies, board of health presentation, evaluation of reach. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 49 of 100 Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned needs, develop goals and strategies, and work on a strategic plan to be submitted to DOH in June of 2018. Goal 3: Enhance overall health and safety of Jefferson County school age children School Health Screening Number of state mandated hearing and vision screenings facilitated by school nurse for students in grades K, 1, 2, 3, 5 and 7 920 initial screening 278 rescreened 102 referred for further evaluation 881 Initial * screenings 258 rescreened 92 students referred for further hearing (44) and vision (48) evaluations 531 Initial screenings 142 rescreened 68 referred for further hearing (15) and vision (53) evaluations No longer applicable No longer applicable No longer applicable Human Growth and Development and HIV AIDS education Number of Human growth and development classes 202 227 73 73 73 73 Numbers of students served in school health classes 861 1064 537 437 437 437 Student Health Care Plans Number of Student Health Care Plans for students with chronic health conditions written by or facilitated by JCPH School Nurse 132 153 75 No longer applicable No longer applicable No longer applicable JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 50 of 100 Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 4: Improve overall health of Jefferson County Residents Provide education regarding Clean Indoor Air Act enforcement with Environmental Health Food Services staff Smoking in Public Places awareness campaign: Newsletters Issued tobacco control informatio n to 21 retailers, Issued 40 “no smoking” signs to retailer upon request distributed at least 30 signs “no Smoking” signs to local businesses based on requests *See Narrative below Including Healthy Communities Grant activities and Community Health Improvement Plan Process Education to business based on complaints by Environmental Health Food Services staff. Education to business based on complaints by Environmental Health, Food Services staff. If complaint, health inspector delivers DOH posters to proprietor who is responsible to post, and inform customers of restrictions as necessary. Technical assistance was provided to 10 local businesses and agencies to adopt policies that include “no Vaping” in their “No Smoking” policy. Education to businesses based on complaints by Environmental Health, Food Services staff. New for 2014- 2015 Updated work plan 2016 See plan for complete activities. Increase opportunity for Physical Activity Strengthen community promotion of physical activity through signage and work site policies Continue to work with school district wellness Committees Partnered with 5 work sites to perform assessment and recommendation report. Provided technical assistance to 3 worksites. Formed wellness committee for 2 worksites. Wrote Healthy eating, active living polices for adoption in 2 worksites, and Lead Chimacum school district Wellness Committee to review and update of Chimacum School District Wellness Policy #6700- adopted by CSD49 June 2018. Provided assessment and recommendation report for 5 work sites Provided technical assistance to 5 worksites. Formed wellness committee for 1 worksites. Wrote Work in this area will continue until September 30, 2018 when the Healthy Communities/ Chronic Disease Prevention grant funding expires. Areas include continued technical assistance to worksites and their wellness committees. JCPH will participate in Work in this area will continue until September 30, 2018 when the Healthy Communities/ Chronic Disease Prevention grant funding expires. JCPH will participate in CHIP Chronic Disease Prevention actives as much as possible after Sept 30, 2018 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 51 of 100 Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned provided tech assistance to implement. Healthy eating, active living polices for adoption in 2 worksites, and provided tech assistance to implement. CHIP Chronic Disease Prevention actives as much as possible after Sept 30, 2018 Impact systems, policies and environmental strategies that increase access to Healthy Foods Wellness Policy at school district level Port Townsend School District approved Wellness policy Chimacum School District active transportatio n Policy Lead Chimacum school district Wellness Committee to review and update of Chimacum School District Wellness Policy #6700. Revised and updated policy was adopted by CSD49 June 2018. Now all four of the county school districts have revised Wellness Policy adopted. Schools are encouraged to review and implement their Wellness Policies with community participation annually. JCPH will participate when funding allows Reduce % of women smoking during pregnancy % of women reporting smoking during pregnancy Smoking Cessation info the Health Care Providers Included decrease in smoking during PG as goal in CHIP. Included strategies to be implemented. All Pregnant women (55) in JCPH Family Health Services were assessed for tobacco use and provided a smoking cessation brief intervention (5 A’s). Promotion of the WA state Quitline, and the SmartQuit smartphone App, was provided to women who use Assess All Pregnant women in JCPH Family Health Services for tobacco use and provide a smoking cessation brief intervention (5 A’s). Promote the WA state Quitline, Assess All Pregnant women in JCPH Family Health Services for tobacco use and provide a smoking cessation brief intervention (5 A’s). Promote the WA state Quitline, JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 52 of 100 Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned tobacco and their family members. SmartQuit App, to women who use tobacco and their family members. 2 Family Health Services team members received further training in Motivational Interviewing. SmartQuit App, to women who use tobacco and their family members. Healthy Community Activities Increase community system polices and environments strategies that promote and reinforce healthful behaviors. Work with Jefferson County Community development updating Comprehensive Development plan Attend Comp plan meetings and provide Community Health related input. Reviewed sections of comp plan that address active transportation and access to healthy food. Met with planners and provided recommendations. Presented to Planning Commission on health in comp planning. Continued work with DCD on comprehensive plan revisions. Reviewed sections of comp plan and made recommendations that address active living, active transportation and access to healthy food. Presented to Planning Commission on health in comp planning. Recommendations were incorporated into comp plan draft that is in process for adoption in 2018. Support process for adoption of Comp Plan recommendati ons to increase healthy eating and active living. Work in this area will continue until September 30, 2018 when the Healthy Communities/ Chronic The Comp Plan update should be complete in 2019. Work in this area will continue until September 30, 2018 when the Healthy Communities/ Chronic JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 53 of 100 Goals Objectives Performance Indicators 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Increase worksite policies, programs and communication related to healthy eating and healthy living Implement 5-2-1- 0 campaign in multiple community sectors including worksites, healthcare, schools, etc. Disease Prevention grant funding expires. JCPH will participate in CHIP Chronic Disease Prevention actives as much as possible after Sept 30, 2018 Disease Prevention grant funding expires. JCPH will participate in CHIP Chronic Disease Prevention actives as much as possible after Sept 30, 2018 Goal 5: Increase access to health care Provide information and assistance for Washington State Health Benefits Exchange health insurance applications New 2013 Number of clients assisted with applications for health insurance 399 Assist with Apple Health applications all Assist with Apple Health applications all year long, average of 3 a week Provided referral to KPHD when answering calls for information over the phone. Assisted and signed up JCPH clients. Continue to provide referrals to KPHD for telephone cases. Continue to assist/sign up JCPH clients. Continue to provide referrals to Sea Mar Clinic in Aberdeen for telephone cases. Continue to assist/sign up JCPH clients. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 54 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Population and Prevention (cont’d) Study/Analysis 2017-2018 results: Jefferson County Public Health (JCPH) delivers programs that promote healthier communities and individuals. The above programs provide universal prevention services to youth, families and businesses in the community. Goal 1 and 2: Improve identified social and health indicators for school age youth and Reduce favorable attitudes toward problem behaviors within the youth and adult communities Nationally, preventing substance abuse and tobacco use have proven to be cost effective. The results of the 2016 Washington State Healthy Youth Survey were released in the spring of 2017 and are used to determine community needs and prioritize services based on funds available. Results were used as part of the Strategic Planning revision for Chimacum Prevention Coalition May 2017 and Action Plan update in Spring 2018. The results of the 2018 HYS will be used to revise and update strategic plan, including logic model and action plan in Spring 2019. The Drug and Alcohol Prevention Program continues to provide integrated prevention services that promote healthy behaviors, prevent harm and support youth and families in the community and in the schools. Washington State Division of Behavioral Health and Recovery (DBHR), now under the Health Care Authority, funding/contracts “Statements of Work” requires development and maintenance of a Prevention Coalition in the Chimacum School District. The Prevention Coalition Coordinator continues to develop and has conducted focus groups among students to choose a new name and logo. In November 2013 DBHR received additional Federal funds through a Partnership for Success grant. This grant ends in September 2018. Additional funds were secured through the Substance Abuse Block Grant, and support one full-time coordinator. Interventions identified in the Coalition’s 2018-2019 Action Plan include parenting programs, drug take backs, partnerships with community stakeholders, and positive social norms campaigns. Dedicated Marijuana Account funding continues and supports the Jefferson County NFP program. Spring of 2017 the Coalition did a comprehensive revision of its Strategic Plan. Activities in 2017/18 were included sustainability and cultural competency trainings. Four coalition members attended two trainings – one on leadership and another on understanding poverty. Implementation Activities included: - Environmental Strategy – Positive Social Norms postcard campaign. - Partnerships with PTFF, Benji Project, and the Jefferson County Library to provide education via film, and provide transportation to and from Benji Project “making friends with yourself” education workshop. - Two DEA drug take backs at which nearly 1000 lbs. prescription drugs were properly disposed. - Update Action Plan Spring 2018. - Continued Coalition development In September, 2017 coordinator achieved the Prevention Professional certificate. 2018-2019 Work with Jefferson County Board of Health to include “No Vaping” in Smoking in Public Places Ordinance for Jefferson County. In January of 2018 began working with the Regional YMPEP team (Clallam, Kitsap, and Jefferson). This is the Strategic Planning year which required JCPH to gather stakeholders together to work through asset and needs assessments. The results of these meetings were used to identify goals and strategies that were included in the regional strategic plan developed by Kitsap (the region lead) and submitted to DOH in June. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 55 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Population and Prevention (cont’d) In 2019 YMPEP work continues. The work’s approach is based on Policy Systems and Environmental change strategies which seek to go beyond programming and into the systems that create community structures. These approaches often work hand‐in‐hand where, for example, an environmental change may be furthered by a policy or system change. Similarly, a policy could be put in place that results in additional environmental changes. It is not a linear process. At the end of the day, an effective PSE approach seeks to reach populations and uncover strategies for sustainable impacts. Efforts may accelerate the adoption or implementation of effective interventions by integrating approaches into existing infrastructures. Such approaches often include advocates, decision and policy makers. Going forward, JCPH will focus on capacity building and integrating youth advocacy strategies. Initially, JCPH planned to implement Teen Against Pot Smoking (TAPS) in the four school districts. A great deal of work was done to this end; however, late in May 2018, DOH determined, due to data collection and status of program, the TAPS program no longer qualified for funding. Goal 3: Enhance overall health and safety of Jefferson County school age children Spring 2015 JCPH Director negotiated School Nursing and Human Growth and Development contracts directly with Port Townsend School District and Chimacum School District for School Year Sept. 2015-June 2016. JCPH hired an addition Public Health Nurse to cover the contract and services. The school nurse provides: staff training so schools meet health and safety needs of students; creates school health care plans for children with chronic health conditions; provide consultation for communicable disease and immunizations; coordinates annual hearing and vision screening; provides information for healthy school environments; and provides individual student health education as needed. Olympic ESD School Nurse Corp contract ended June 2015, except for an Asthma grant for Port Townsend School District that started Fall 2015. Port Townsend School District ended contracting with JCPH for School Nursing and Human Growth and Development classes. District is contracting with a School Nursing Services agency out of Kitsap County for 2016-2017 school year, and continues this practice. JCPH continues to provide Human Growth and Development classes for Chimacum and Quilcene School Districts. Contracts with the schools and some Federal Family Planning Title X funds supported the classes, which are part of the Family Planning Outreach activity. While JCPH no longer provides school nurse services upon the retirement of our school nurse, the health department continues to provide Human Growth and Development classes in the district. Human Growth and Development classes, through contracts directly with the Quilcene and Chimacum school districts, continued through spring 2018 and will continue for the 2018-19 school year. Actual 2017 numbers reflect all classes taught and students served through the 2017-2108 school year. It is projected (and planned) the number of classes taught, and students served would largely remain constant. Goal 4: Improve overall Health of Jefferson County Residents Healthy Community Grant ending September 30, 2018 - Provided technical support for updates to tobacco polices to include language to address vaping for JCPH policy and recommended Jefferson County adopt this same policy. - Continued to assess and provided recommendations and technical assistance to local worksites to update updates to tobacco polices to include language to address vaping, - Successfully encouraged Peninsula College- PT Campus to adopt policy that included “no vaping” in SIPP policy. Providing technical assistance for implementation for this policy at Port Townsend Peninsula college campus. - JCPH continues to promote to medical personnel and the general public the WA State Quitline and the 2Tomoorw Smart Quit smartphone app. and its benefits. JCPH promotes to county employees the tobacco cessation benefits of their health insurer. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 56 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Population and Prevention (cont’d) Healthy Community Grant ending September 30, 2018 - Increase opportunities for physical activity: - Partnered with 5 worksites to assess current policy and make evidence based recommendations for improved policy. JCPH adopted policy, Jefferson County policy adoption is pending. - Continued to work with Department of Community Development in include health language in 2018 update to comprehensive plan for Comp plan. Presented to Planning Commission on health in comprehensive plan. Healthy Eating and Active Living Recommendations are included in the updated 2018 draft of the Jefferson County Comprehensive Plan, scheduled for adoption in 2018. Healthy Community Grant - Increase access to healthy foods - Implemented a county wide 5210 initiative to increase healthy behaviors through systems, policies and environment strategies for four daily health behaviors: 5 for more fruits/veg, 2 hours, or less of recreational screen time, 1 hour of physical activity, 0 sugary beverages. - In collaboration with the Community Health Improvement Planning process, used 2014 Community Health Assessment data to identify Chronic Disease Prevention as a Jefferson Co. Health Priority. The Community Health Improvement Planning process is currently setting goals, objectives and strategies that include increasing the median fruits/vegetable intake of adults and children in Jefferson Co. - Worked with community stakeholders to ensure that the Community Health Improvement Plan included goals to increase access to healthy foods and increase physical activity. Included specific evidence based strategies to ensure these goals are met - JCPH served as an active member on the Jefferson County Food Systems Council. Their mission statement is “Working together to create, expand, and strengthen a local food system that is accessible, healthy, sustainable and economically vibrant.” - JCPH partnered with Jefferson Co. Farmers Market (JCFM) to provide the “Gimme 5”program, a monetary incentive program for WIC participants, seniors and food stamp participants. “Gimme 5” offers tokens that double the buying power of WIC/ Senior Farmers Market Nutrition Program. JCPH partnered with JCFM to submit and received local grants to sustain this program. Expanded partnership to pilot “VegRx” program - healthcare providers ”prescribe” fruits and vegetables to high risk clients to be redeemed at Farmers’ Market. - Promoted “Complete Eats” pilot program for Basic Food (aka Food Stamp) recipient which provided financial incentive for purchase of fruits and vegetables with Basic Food benefits. - Completed partnership with Jefferson Healthcare’s point of purchase display encouraging water consumption and decrease use of sugary beverages. Provided Technical Assistance to the Port Townsend Food Coop for potential implementation of point of purchase education to decrease sugary beverages and increase water consumption. - Continued partnering with Jefferson Healthcare Cardiac department to develop a Self-monitoring Blood Pressure Cuff Lending Library. Community Health Improvement Planning JCPH staff is working with CHIP Workgroups. - Mental Health and Chemical Dependency work group has included goals, objectives and strategies that will address tobacco use in Jefferson county residents. Including “No Vaping” in local “no Smoking” policy will address community norms as a way to address growing vaping public health concern. - Chronic Disease Prevention workgroup and developed goals that include: o Increase the percent of the population who get the appropriate activity levels throughout Jefferson County to >75% by 2020.  An active living section of the JCPH website was completed and updated. This Active Living page includes list of local opportunities for physical activity, and one of the most comprehensive lists of Jefferson County walking trails for downloading by residents.  Promoted the Local 20/20 Port Townsend Walking Times map as walking signage. Partnered with Jefferson healthcare to get the map posted in all clinic rooms at Jefferson Primary Care. These maps will serve as an opportunity to bring up the subject of physical activity in a non-threatening manner, and promote walking . JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 57 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Population and Prevention (cont’d) JCPH continues to be responsible to enforce Washington State’s Clean Indoor Air Act. Environmental Health staff will follow up on any enforcement. Community Health staff will continue to provide education to help businesses comply with the state law. Youth Tobacco Prevention funding focused on educating stakeholders and policy makers about the importance of comprehensive tobacco prevention and control. Additionally, providing technical assistance to agencies and businesses to adopt “no vaping” language for their “no smoking” policy. JCPH staff continued to assist clients enroll in Apple Health, insurance for low income individuals and families, until funding and contracting to assist enrollment in Qualified Health Plans ended March 2015. In 2016, JCPH began referring clients who needed assistance with enrollment in Qualified Health Plans to Jefferson Healthcare (JHC) Financial counseling office, or to Olympic Area on Ageing State Health Insurance Benefits Advisors (SHIBA). Beginning in fall of 2016, SHIBA and JHC quit providing assistance with applications with Qualified Health plans. Kitsap Public Health District (KPHD) took over the Health Benefit Exchange contract to assist with QHP for Kitsap, Clallam, and Jefferson County. Kitsap Public Health District discontinued the practice due to funding and the state now contracts with Sea Mar Clinic in Aberdeen to provide free enrollment assistance. However, anyone who starts an application on line may request assistance at Jefferson Health Care through the HCA Community Specialist. During open enrollment fall 2016, JCPH referred clients needing assistance with QHPs to KPHD via phone. KPHD would arrange to meet clients in person if necessary at JCPH clinic space. JCPH continues to refer clients needing assistance to Sea Mar Clinic in Aberdeen, and lets clients know they can begin an application on line and then seek assistance at JHC. JCPH continues to sign up its own clients for Apple Health. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 58 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Family Health Services PROGRAMS: Family Health/Maternal Child Health (MCH) including Breast Feeding Support, Maternity Support Services/Infant Case Management, Nurse-Family Partnership (NFP), Children with Special Health Care Needs (CSHCN), Women Infants and Children (WIC), and the Child Protective Services (CPS) Contract Programs: Early Family Support Services (EFSS), Early Intervention Program (EIP). MISSION: The mission of the Family Health Services is to offer health education and support to all Jefferson County pregnant women and families with young children as they build a secure foundation for a lifetime of health, learning, and community contribution. Goals Objectives Performance Indicators: 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Improve pregnancy and birth outcomes by helping women improve prenatal health. Provide comprehensive education, risk reduction strategies, and referrals to community services to pregnant women and families about the health risks of: substance use including tobacco, alcohol, prescription narcotics, and illegal substances; domestic violence; mental illness; and adverse childhood experiences. Number of comprehensive health screenings completed (includes ACES Questionnaire and Mental Health Screening) 39 47 Prenatal History Questionna ires completed, 37 ACE Questionna ires completed 43 Prenatal History Questionna ires completed, 15 ACE Questionna ires completed 55 Pregnant women enrolled in MSS. Completed: 1. 20 ACE questionnaires 2. 29 NEAR discussions 3. 24 depression screens Enroll 50 pregnant women in MSS. Complete: 1)25 ACE questionnaires 2)30 NEAR discussions 3)40 depression screens Enroll 50 pregnant women in MSS. Complete: 1)25 ACE questionnaires 2)30 NEAR discussions 3)40 depression screens Nurse Family Partnership, evidenced based nurse home visiting program Number of visits provided in NFP 304 280 295 269 270 270 Number of referrals from NFP to community resources 256 179 330 150 200 200 Goal 2: Improve children’s health, safety, and development by helping parent’s provide competent and sensitive care giving. Educate parents on how to support their infant/child’s health, development and learning. Promote and refer to well child care, immunizations, dental care, and childcare resources. Number of all Family Health encounters recorded in Nightingale Notes, Electronic Medical record system (home visits, office visits and phone calls) 544 522 577 169 infants ≤1 referred to Well child care and immunizations 150 150 Screen children’s developmental growth using standardized tools and refer to community providers for specialized services. Number of children with special health care needs Birth through age 18 referred for Public Health Nurse Case Management. 147 121 104 98 75 75 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 59 of 100 Goals Objectives Performance Indicators: 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 3: Improve overall nutritional health in order to prevent long term chronic diseases Educate pregnant women and families about the benefits of breastfeeding and healthy eating habits Total number of women infants and children served by WIC in Jefferson County (from CIMS report) 812 663 655 550 550 550 Breastfeeding initiation rate in WIC mothers 97% 91% 93% 93% 93% 95% Breastfeeding at 6 months rate in WIC mothers 59% 64% 63% 63% 63% 65% SUMMARY OF KEY FUNDING/SERVICE ISSUES FOR 2018 WIC Program: 1. Continue to work on program outreach and recruitment through community contacts such Farmers’ Market and early learning coalition, JCPH Facebook page with the goal of increasing program enrollment. 2. Maintain Breastfeeding Friendly Clinic Gold Status by following outlined education and policies plan, 3. Staff continues WIC program education as needed, 4. Prepare for new electronic system in 2019 as planned by DOH. The Breastfeeding Tea will transition to the Mom’s Tea in 2018 and will support all moms and babies. Maternity Support Services and Infant Case Management: 1. Continue to work with HCA to meet state program guidelines with focus on meeting full composition of MSS interdisciplinary team staff requirements. The JCPH team has lacked a behavioral health specialist on the team since late 2017, 2. Family Health Services Team Lead and JCPH director/Community Health Director continue ongoing review of general program requirements, staff availability, program recruitment, and program budget. 3. Review program documentation in Nightingale Notes, program goals, and program outcomes with team on regular basis. 4. Support and offer education and training to staff as needed and required for optimal program delivery. MSS, along with WIC, is the “gateway” to Family Health Services. Public Health Nurses and a Public Health Educator deliver the program by offering education, support and referral to pregnant women. MSS, part of the WA state First Steps program, began in the late 1980’s to address issues around pregnancy and birth such as access to early prenatal care and poor birth outcomes. Program guidelines and financial reimbursement to operate the program have largely remained the same in 30 years; program funding has not kept up with the cost of program implementation, presenting challenges to program delivery. Program staffing remains limited by staff availability and program-defined requirements. Our team lacks a behavioral health specialist; the community health worker is limited to providing only maternity support services (not infant case management services) and public health nurses manage NFP and MSS clients in their schedules. Nurse-Family Partnership: Continue participation on Regional NFP team with Kitsap Public Health. Current team membership consists of two nurses and one supervisor from JCPH and three nurses from KPHD. Efforts to explore NFP expansion into Clallam County continue with discussion between JCPH, KPHD, and First Step Family Support Center (Port Angeles). Both sites continue to work on outreach and recruitment to fulfill and maintain caseloads for the program. Team continuously works to maintain program fidelity, support health of moms and babies, remain up to date on program requirements in terms of education, assessment tools and data collection. Outreach and recruitment continue through agency websites, agency Facebook pages, and contact/collaboration with community agencies. Early Intervention Program (EIP): Will end in 2018 as a state program. Children with Special Health Care Needs (CSHCN): CSHCN coordinator participates in the regional Birth to Three Coalition, local Interagency Coordinating Council and Family Health Services team to identify, provide resources and referrals, and case management for Jefferson County children with special health care needs. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 60 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Family Health Services (cont’d) Study/Analysis of 2017-2018 Family Health Services Program Results The programs affiliated with the Family Health Services Program include Nurse-Family Partnership (NFP), Maternity Support Services (MSS), Infant Case Management (ICM), Women Infant and Children (WIC), and Children with Special Health Care Needs (CSHCN). The primary focus of Family Health Services programs are pregnant women and families with young children aged birth to five. With a few exceptions, overall program participation in Family Support Services programs remained stable in 2017. As in the previous year, JCPH maintained a contract with CPS for the Early Intervention Program (EIP) although full participation did not occur because of the lack of referrals from CPS. The EIP contract ends in 9/2018. Two public health nurses left JCPH in 2017, and their departures influenced FHS program delivery and numbers of families served in the year. The CSHCN/school nurse’s retirement in the fall of 2017 presented a program shift from more direct CSHCN child-family- services to CSHCN systems work in the community. While the newly designated CSHCN Public Health Nurse continues to manage CSHCN referrals and provide some case management, her primary role is in systems work, including collaboration with health providers, Birth to Three and other service providers working with families. In 2018 we saw the NFP caseload increase once the new Public Health Nurse hired in August 2017 was able to increase her caseload after she received the required NFP training and started enrolling new NFP clients. The Regional NFP team consists of two nurses from JCPH and 3 nurses from Kitsap Public Health District. JCPH WIC program attained the Gold Level as a Breastfeeding Friendly Facility in 2017 by meeting criteria for Breastfeeding Friendly Washington Clinics based on the Ten Steps to Successful Breastfeeding developed by the World Health Organization, and the American Academy of Pediatrics Ten Steps to Support Parents' Choice to Breastfeed Their Baby (PDF). Kathy Anderson RD, our WIC program coordinator, led efforts to achieve this special designation. Our WIC program served 590 individuals in 2017 compared to a 655 in 2016. WA State and National WIC numbers have followed a similar downward trend in program enrollment in the last few years. In Jefferson County, anecdotal reasons for decreased enrollment include lack of organic food options, transportation and access issues to clinics, and challenges with procuring food in stores. In an effort to increase WIC participation and promotion, JCPH WIC focused on 1. program outreach to agencies and organizations serving families with young children, 2. increasing public information on benefits of WIC program through the County web page, flyers, and posters, 3. adding late afternoon/early evening hours to Port Townsend clinic twice a month to accommodate working families, and 4. collaborating with the Jefferson County Farmers’ Market and other state programs to increase access to fruits and vegetables. About half of pregnant WIC enrolled women participated in Maternity Support Services and received health information and support during their pregnancies and immediate postpartum periods. MSS services included mental health screenings for depression and anxiety, ACEs (Adverse Childhood Experiences) screening and discussion, and referrals to community resources such as medical, dental, health insurance, and immunization referrals. MSS is based on an interdisciplinary team model which includes public health nurses, registered dietician, community health worker (educator for JCPH), and behavioral health specialist. The team lost its contracted behavioral health specialist in late 2017 and replacement of this staff is in consideration. Our current staff of public health nurses, dietician and community health worker (educator) is highly skilled and experienced in assessment, education and treatment in maternal health. The Breastfeeding Tea continues to meet weekly and support breastfeeding moms in a social and community setting. We continue to work towards organizing our data collection to inform our client-centered practice with pregnant and parenting women and their children. We would like to improve assessment and collection of data on tobacco and substance use during pregnancy and postpartum periods and continue to support and promote breastfeeding. Protocols on taking blood pressures, depression screening, suicide assessment, and mandatory reporting for childhood abuse and neglect will be accompanied with staff education. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 61 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Targeted Clinical Health Services PROGRAMS: Family Planning, School Based Health Clinics, Breast and Cervical Health, and Foot Care MISSION: To provide targeted health services, health screenings and prevention services to specific populations with limited access to improve the health of the community. Mission Statement for Family Planning Program: To provide accessible, high quality confidential reproductive health services in a safe, respectful environment. Goals Objective Performance Indicator 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Assure low cost Family Planning Services are provided and accessible for all women Track Family Planning usage pattern Number of annual unduplicated clients served in Family Planning 917 903 826 748 824 825 Number of annual Family Planning clients age 30-39 156 146 151 175 152 160 Number of annual Family Planning Clients age 18-29 410 415 432 341 376 380 Goal 2: Maintain low teen pregnancy rate in Jefferson County Provide access to Birth Control Methods, including LARCs and Emergency Contraception 5 days/ week with an appointment scheduled within a week Annual number of clients under 19 served in Family Planning (from Ahlers report) 356 382 274 218 266 260 Goal 3: Decrease chlamydia and gonorrhea infections in Jefferson County Provide access to CT/NG screening, diagnosis and treatment for Jefferson County residents and their sexual partners. # of female clients annually screened for Chlamydia: <25yo 320 311 290 249 270 270 % of female clients screened for Chlamydia: <25yo 63.4% 60.3% 74.2% 70.5% 72% 72% # of male clients annually screened for Chlamydia 75 71 78 75 78 78 % of male clients annually screened for Chlamydia 82.4% 89.9% 86% 93% 90% 90% JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 62 of 100 Goals Objective Performance Indicator 2014 Actual 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 4: Improve access to health care for high school students in Jefferson County Serve 40% of enrolled students at Port Townsend and Chimacum High Schools through the School Based Clinics Number of annual unduplicated clients served in the Chimacum and Port Townsend School Based Health Clinics 287 283 236 216 230 230 Goal 5: Support seniors’ independence by maintaining walking mobility Maintain community Foot Care program Number of annual foot care clients in community centers and home visits 1979 1760 1738 1777 1885 1850 SUMMARY OF KEY FUNDING / SERVICE ISSUES 2017-2018: Changes with recommended female exam schedules, such as frequency of required Pap smears, continue to affect our total number of visits when compared to previous years; in addition, our increased use of Long-Acting Reversible Contraception (LARCs) methods has further decreased number of clinic visits for our clients. We have noted an increase in LARC method requests beginning 2017, with clients voicing concern regarding uncertainty of health care coverage in the future. At the end of 2016, billing was moved to an outside vendor in Texas, which included a migration of our EHR system into the Cloud. This went “live” in February 2017. By September 2017, serious concerns of confidentiality breaches as well as poor billing reimbursements led to internal discussions about potentially terminating the external billing vendor. When it became clear the vendor was unable to assure teen confidentiality and billing revenues did not improve, JCPH terminated the contract early, without penalty, and reinstated the internal billing process; JCPH has been billing internally since March 2018, with positive results in both revenue and teen confidentiality. JCPH maintains extended clinic hours with evening appointments to increase access for our clients. In January 2018, we received Special Project funding from Washington State Department of Health, to help with access and outreach, and to help insure that clients know how and where to find us. With these grant funds, we were able to contract with Search Engine Optimization (SEO) experts who have helped us re-configure our webpages to optimize online search placement so potential clients can easily see available local Jefferson County Family Planning services. We are completing the upgrades through fall 2018 and hope to increase overall knowledge of our services to our targeted population. In addition, the grant has made social media advertising possible. This is brand new to JCPH. We are currently tracking how new clients have learned of our services and will be evaluating its effectiveness. Unduplicated client numbers overall have increased during the first two quarters of 2018, with resulting increase in projected 2018 client numbers. Additional funding from this Special Project grant allowed hard-wired computers in the clinic exam rooms, which has greatly increased efficiency for providers. Additional equipment was purchased to replace worn, poorly functioning equipment, such as exam tables, IUD instruments, an autoclave, microscope and instrument tables. JCPH continues our partnership with Jefferson Healthcare in operating two school clinics: Port Townsend High School and Chimacum High School. These clinics serve enrolled students seeking Mental Health, Family Planning, and Primary Health Care services. Number of unduplicated students using School-Based Health Centers in 2017 is decreased compared to the past 3 years. Possible factors include: 1) decreasing school enrollment and 2) Health Clinic at Port Townsend is not located in main building and not convenient to students. Discussions with school administration regarding these concerns are ongoing. JCPH has provided expertise to other counties considering establishing school-based health centers. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 63 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH – Targeted Clinical Health Services (cont’d) Family planning services continue in Quilcene twice a month. Outreach continues to south county residents for Family Planning services. Quilcene School District is interested in having a School-Based Health Center; community meetings to discuss needs is planned in the near future to explore this further. State and federal funding for the Breast and Cervical Health Program (BCHP) has been reduced in 2016-2018. Most women who qualified for this program in the past now qualify for free or reduced cost health insurance through the Affordable Care Act. Foot Care: Jefferson County has an aging population; the median age of Jefferson County is 55.1 years, with the median age of WA State 37.8 years. The JCPH Foot Care Program enables our older population to maintain independence and mobility by providing foot maintenance at community centers and in private homes. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 64 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH (cont’d) BARS #PROGRAM TITLE ESTIMATED 2018 REVENUES BUDGET 2019 REVENUES NET COUNTY EXPENDITURES 2019 (SEE NOTE**)Additional Information 332.93.20.2600 Billing Update Incentive 14,000 14,000 212,028 Multiple funding sources, see below (Med. Ad. Match-FP, FP- Clinical/Health Promo) 333.10.55.2800 WIC Nutrition 97,366 95,323 19,997 County General Fund (CGF) Note: $1,500 of expense is separate funding 333.10.57.2800 WIC Farmer's Market 500 500 - 333.93.06.8800 PHEPR 27,452 - - 333.93.06.8801 PHEPR Admin 8,523 - - 333.93.21.2700 FP Title X 27,943 28,322 - 333.93.24.2150 DBHR-PFS 58,447 - - 333.93.26.3220 Immunizations 4,154 7,223 - 333.93.30.4450 Tobacco Prevention 802 - - 333.93.53.3220 Immunizations 915 - - 333.93.73.3220 PPHF Vaccine Management 700 - - 333.93.75.2120 Healthy Communities 35,027 - 333.93.75.4300 Breast & Cervical Health 428 625 1,686 CGF 333.93.75.4450 PHBG Tobacco Prevention 8,948 8,911 - Multiple funding sources, see below 333.93.77.1200 Med. Ad. Match - CH Ad.45,373 54,900 238,492 Admin from Grants, State Block Grant, CGF 333.93.77.1210 Med. Ad. Match - MAM 6,500 6,500 2,800 CGF 333.93.77.2600 Med. Ad. Match - FP 14,566 1,000 - Multiple funding sources, see first row 333.93.77.2800 Med. Ad. Match - WIC - 1,000 115,820 Federal Grant and CGF 333.93.94.3200 Med. Ad. Match - Child Imm.1,000 - - 333.93.94.3900 Med. Ad. Match - CD 1,000 - - 333.93.95.2100 DBHR-SAPT (DASA)31,440 77,558 13,174 Special Purpose Tax - Multiple funding sources, see below (includes program reserve) 333.93.99.2500 CWSHCN 28,919 25,143 - 333.93.99.2501 CWSHCN Admin 6,243 8,129 - 333.93.28.4300 Breast & Cervical Health 508 - - 333.93.99.2260 NFP-MCHBG - 3,473 2,500 CGF 334.04.62.2100 DBHR-SABG (DASA)2,730 6,815 - Multiple funding sources, see above (includes program reserve) 334.04.62.2290 DBHR-DMF NFP 25,897 20,042 1,285 Special Purpose Tax 334.04.67.2220 CPS 471 - - 334.04.91.2600 FP-Clinical/Health Promo 110,647 64,026 - Multiple funding sources, see first row 334.04.93.4450 Youth Tobacco & Vapor Prevention 7,378 7,348 - Multiple funding sources, see above (PHBG Tobacco Prevention) 334.04.93.4900 Marijuana Prevention 34,195 49,179 - 334.04.93.5700 Childhood Lead Inv 500 - - 334.06.91.2250 NFP Activities 163,179 164,765 - 334.06.91.2251 NFP Activities Admin 16,298 16,076 - 782,047 660,858 607,782 **Note: Net County Expenditures includes the total annual cost for the program, including adminstration, minus grant revenue received. NFP Activities and NFP Activities Admin are the same grant just coded to two BARS lines. CWSHCN and CWSHCN Admin are the same grant just coded to two BARS lines. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 65 of 100 BUDGET/PROGRAM: COMMUNITY HEALTH (cont’d) JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 66 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES PROGRAMS: Community Information Activities, Child Development, Group Supported, Individual Employment, Person to Person/ITA, and Community Access MISSION: The mission of Developmental Disabilities is to assure that citizens with developmental disabilities in Jefferson County have the choice, opportunity, and support to achieve full, active, and productive participation in the community. REVENUES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Restricted Fund Balance 28,548 28,548 28,548 28,548 28,548 - Reserve Fund Balance 53,020 45,048 22,765 23,489 13,380 (9,385) Beg Fund Balance - - - - - - Taxes 45,123 46,410 46,284 47,459 47,568 1,284 Based on projections Licenses and Permits - Federal Grants - State Grants 17,979 6,879 27,464 47,033 69,672 42,208 New grant awarded in 2017, continued into 2018, projecting new award in 2019 State Entitlements - Intergovernmental - - - - - - Charges for Goods and Svcs 271,742 265,653 312,284 312,457 348,128 35,844 Based on projections Misc. Revenue, Contributions 21 269 25 17 15 (10) Interfund Chg. For Service - Disposition of Capital Assets 1,710 1,058 150 40 100 (50) Based on projections Special Purpose Tax - Transfer from Solid Waste - Other Transfers (one-time/payout)- - - 3,549 - - General Fund Revenue 3,858 8,974 13,243 13,243 13,640 397 GF increased by approx. 3% and distributed to all divisions Total Revenue 422,000 402,839 450,763 475,836 521,051 70,288 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 67 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES (cont’d) EXPENDITURES:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Add/<Delete>Memo Wages & Benefits 79,408 75,819 82,583 84,924 86,911 4,327 Step increases bargaining members Supplies 829 524 327 427 295 (32) Tool & Equipment 4,938 - - - - - Professional Services 230,615 220,108 275,360 298,676 337,790 62,430 Based on existing clients/grant funding Communication 204 191 228 249 251 23 Based on projections/department allocation Advertising 1,730 21 50 81 80 30 Based on projections Travel 182 326 780 780 1,020 240 Based on projections Machinery & Equipment - Operating Rents & Leases 218 - - 675 750 750 Based on projections Insurance - 4,215 - - - - Miscellaneous 4,452 9,015 3,116 3,573 4,424 1,308 Based on projections Intergovernmental Services - Capital Outlays - - - - - Interfund Prof Svcs 21,184 34,975 39,174 39,174 41,629 2,455 Based on projections Interfund Rents & Leases 4,644 5,608 5,349 5,348 7,025 1,677 New County Cost Allocation Interfund Payment for Svcs - Sub-Total Expenditures 348,404 350,801 406,966 433,908 480,175 73,208 Adjustment - Reserved Fund Balance 45,048 23,489 15,190 13,380 10,377 (4,812) Required Fund Balance 28,548 28,548 28,548 28,548 28,548 - Total Expenditures 422,000 402,839 450,704 475,836 519,100 68,396 Balance Forward 0 0 59 (0) 1,951 1,892 STAFFING:2016 Actuals 2017 Actuals 2018 Adopted 2018 Projected 2019 Request Annual Hours 2,087.99 1,948.52 2,114.40 2,080.01 2,101.05 FTE’s 1.00 0.94 1.01 1.00 1.01 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 68 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Community Information and Education MISSION: The mission of the Developmental Disabilities Community Information & Education Service is to assure that citizens with Developmental Disabilities in Jefferson County have the choice, opportunity and support to achieve inclusive and productive participation in community life. This department implements the following strategic objectives:  Provide advocacy, vision and leadership regarding relevant policies, plans and services to achieve the mission.  Identify new funding sources as State revenue shifts from the Jefferson County DD Program, to maintain quality services for all people with developmental disabilities.  It is important to see the role of the Jefferson County DD Program—not only as a broker of contracted services, but also as a promoter of community connections and opportunities. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Inform and/or educate the general public about developmental disabilities services. To oversee activities which promote public awareness and involvement, community consultation, capacity building, and organizational activities. Use media, local newsletters, campaigns, community forums, workshops/trainings and a public commentary at every Board meeting. # of campaigns, community forums, workshops, trainings, etc. 8 12 8 8 8 Support the Jefferson County Transition Network Group to review gaps, needs and services in order to build goals and objectives that will create a successful Jefferson County off-site Transition Program. # of meetings with partners 4 4 4 4 4 Ensure the accommodation and inclusion of people with developmental disabilities. Participate in local and statewide meetings that relate to developmental disabilities. # of meetings statewide meetings 10 12 10 10 10 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 69 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Community Information and Education (cont’d) Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 2: Continued To inform and/or educate the general public about developmental disabilities services. DD County Coordinator will support and maintain strong working relationships and open lines of communication with County Providers and DD Advisory Board Members. Continue positive networking relationships with the Port Townsend & Chimacum Special Education Directors by supporting effective High School Transition Programs. # of transition guides, transition portfolio workbooks and How to Create a Portfolio Workbook completed 25 30 30 30 30 Support the DD Advisory Board, provide orientation of the DD Program to new Board Members and make available an updated DD Advisory Board Manual. Support a community planning process and/or support Advisory Board participation with Service Information Forms when appropriate. Update DD Advisory Board Manual (Pass/Fail) PASS PASS PASS PASS PASS Organize Advisory Board Participation with Service Information Forms/Planned Performance Measures (Pass/Fail) PASS PASS PASS PASS PASS Continue to staff the Transition Network MTGs that include Adult Providers, School Personnel about the Transition options and Adult Service Systems. # of Transition Network MTGS 4 4 4 4 4 Conduct comprehensive onsite program evaluations; i.e., Program Planning and Evaluation, Health Safety and Regulatory Oversight Compliance, Individual Rights, and Contractual Outcome Attainment. # of evaluations 2 2 2 2 3 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 70 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Community Information and Education (cont’d) Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 3: To provide information, education, and emotional support to families of children with developmental disabilities and to provide referrals to professionals. To promote parent and professional partnerships in Jefferson County. Update the DD Resource Guide, and the Guide to The Working Age Adult Policy and Pathway to Employment. # of Resource and Policy and Pathway to Employment Guides. 150 150 200 200 200 Forwarding Arc Newsletters & Informing Families Newsletters, provide information about health and education services, legislative activity, policy development, conferences, and workshops/trainings. # of newsletters and informational emails sent to Jefferson County families of adults and children with developmental disabilities 120 120 120 120 120 Support a local Parent-to-Parent, (P2P) Program & Counseling Services for People with Developmental Disabilities through partnership with the Arc of Jefferson & Kitsap to have a local presence here in Jefferson County. # of Arc P2P & Counselor office days here in Jefferson County N/A N/A N/A 52 52 Support the local People First Chapter for Adults by providing training and individualized mentoring in self-determination, self-advocacy, and other skills, and by providing outreach, & education at Jefferson County events. Support is also given to increase membership. # of People First/Self- Advocacy meetings 9 2 Local People First Group Ended Took 3 people with DD to Arc Self- Advocacy MTG Speaking with the Arc about Self- Advocacy Group for People in Jeff Co. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 71 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Individual Employment MISSION: The mission of the Developmental Disabilities Individualized Supported Employment Program is to assure that citizens with Developmental Disabilities in Jefferson County have the choice, opportunity and support to achieve inclusive and productive participation in community life. Employment brings benefits to people in terms of opportunities to build relationships and to be seen as a contributing member of society. This department implements the following strategic objectives:  Provide advocacy, vision and leadership regarding relevant policies, plans and services to achieve the mission.  Identify new funding sources as State revenue shifts from the Jefferson County DD Program, to maintain quality services for all people with developmental disabilities. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Assure that each individual can pursue and maintain gainful employment, at or above the state’s minimum wage. Create either a Vocational Client Plan with goals for clients to pursue or maintain gainful employment or a Person Centered Profile which delineates individual skills. Provide client support in the form of on-the-job coaching/training and modification of the work situation while establishing natural supports within the business. # of persons earning wages 22 20 20 19 21 # of persons receiving services 26 24 24 20 23 Provide training and support in social, communication, self-care, and job skills (such as attendance, task completion, problem solving and safety) that are essential to workplace success. Average wage per hour $10.30 $10.20 $11.00 $11.50 $12.00 Supply a variety of vocational vendors to assist persons with developmental disabilities to obtain and continue integrated employment. Average Monthly Hours 21.3 19.2 28 32 32 Average Monthly Wage $219.30 $190.90 $308.00 $368.00 $384.00 Total Hours worked 7,202 5,853 5,503 6,448 6,448 Total Gross Wages $74,181 $59,700 $60,533 $74,152 $77,376 Total County Funding $167,716 $156,422 $151,192 $178,874 179,000 Cost Benefit Ratio 0.28.5 0.25.5 0.41.5 0.45 0.46 Goal 2: Create the opportunity for people with disabilities to make informed choices about the workplace and about future employment options in the community. Conduct a review meeting every six months for program participants. Include an evaluation and update of the Vocational Client Plan goals and objectives. # of 6-month review meetings 52 48 52 52 54 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 72 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Child Development MISSION: The mission of the Developmental Disabilities Child Development Program is to assure that citizens with developmental disabilities in Jefferson County have the choice, opportunity, and support to achieve inclusive and productive participation in community life. This department implements the following strategic objectives:  Provide advocacy, vision and leadership regarding relevant policies, plans, and services to achieve the mission.  Identify new funding sources as the state revenue shifts from the Jefferson County DD Program, to maintain quality services for all people with developmental disabilities.  Maintain funding in the Jefferson County DD Program, to sustain quality services for Children with Developmental Disabilities. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Meet the developmental needs of each eligible child and families related to enhancing the child’s development. Offer services that may include specialized instruction, speech- language pathology, occupational or physical therapy, assistive technology, and vision services. To the maximum extent possible, provide these services in natural environments. Participate with all Early Intervention Services Providers in order to access as many funding sources as possible for specialized therapeutic and/or educational services. # of persons in Child Development 10 10 10 10 10 Support effective communication, cooperation, knowledge and comprehensive partnership between all Birth-to-Three providers in Jefferson County. Total # of Units of Service 120 120 120 120 120 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 73 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Community Inclusion MISSION: The mission of the Developmental Disabilities Community Inclusion Program is to assure that citizens with Developmental Disabilities in Jefferson County have the choice, opportunity and support to achieve inclusive and productive participation in community life. This department implements the following strategic objectives:  Provide advocacy, vision and leadership regarding relevant policies, plans and services to achieve the mission.  Identify new funding sources as State revenue shifts from the Jefferson County DD Program, to maintain quality services for all people with developmental disabilities. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Planned 2019 Projected Goal 1: Increase the participation of people with developmental disabilities in volunteer activities, community events, organizations and connections while enhancing their quality of life & independence. Support and encourage volunteer experiences by acting as a consultant and by assessing client’s interest in volunteer experiences on a monthly basis. Provide training and support in social and communication skills and, when applicable, in job-related skills for the volunteer activities. # of persons in Community Inclusion 3-5 3-5 3-5 3-5 3-5 Assure the creation and continuance of community contribution, connections and relationships. Average Outings Per Month, Per Client 2-5 2-5 2-5 2-5 2-5 Total # of Outings 190 190 190 190 190 Document all progress through the Individual Program Plan or Person Centered Future planning/profile. Average Hours Per Month, Per Client 9 9 9 9 9 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 74 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Group Employment MISSION: The mission of the Developmental Disabilities Group Employment Program is to assure that citizens with Developmental Disabilities in Jefferson County have the choice, opportunity and support to achieve inclusive and productive participation in community life. This department implements the following strategic objectives:  Provide advocacy, vision and leadership regarding relevant policies, plans and services to achieve the mission.  Identify new funding sources as State revenue shifts from the Jefferson County DD Program, to maintain quality services for all people with developmental disabilities. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Create and implement a Vocational Client Plan for each individual. Ensure that workers who have demonstrated a need for ongoing supervision and support can gain and keep employment in regular business and industry settings. Supervise employment and training in regular business and industry settings for groups of no more than eight (8) workers with disabilities. # of persons in Group 4 4 4 4 4 Provide training and support in social, communication, self- care, and job skills (such as attendance, task completion, problem solving and safety) that are essential to success in the workplace Average Wage per Hour $9.47 $9.47 $11.39 $11.50 $12.00 Average Monthly Hours 40.5 44.69 49 40 40 Average Monthly Wage $384 $423 $558 $460 $480 Total Hours worked 1948 2145 2351 1948 1948 Total Gross Wages $18,447 $20,308 $26,786 $22,402 $23,376 Total County Funding $34,560 $34,560 $36,000 $36,000 $36,000 Cost Benefit Ratio .53 .59 .74 .60 .65 Goal 2: Create the opportunity for people with disabilities to make informed choices about the workplace and about future employment options in the community. Conduct a review meeting every six months for program participants. Include an assessment of the need for continued Group Employment Services and an evaluation and update of the Vocational Client Plan goals and objectives. # of 6-month review meetings 8 8 8 8 8 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 75 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES – Individual Technical Assistance MISSION: The mission of the Developmental Disabilities *Individualized Technical Assistance Program is to assure that citizens with Developmental Disabilities in Jefferson County have the choice, opportunity and support to achieve inclusive and productive participation in community life. This department implements the following strategic objectives:  Provide advocacy, vision and leadership regarding relevant policies, plans and services to achieve the mission.  Identify new funding sources as State revenue shifts from the Jefferson County DD Program, to maintain quality services for all people with developmental disabilities. Goal Objective Task Performance Measure 2015 Actual 2016 Actual 2017 Actual 2018 Projected 2019 Planned Goal 1: Identify and address existing barriers to employment through individual assessment and consultation for each identified participant, in order to assist them along their “Pathway to Employment” to competitive gainful employment. Address existing barriers through employment with individual consulting. Provide technical assistance to a client to move further toward gainful employment. # of clients who received technical assistance 1 3 3 2 2 *This service needs to be approved by DDA. JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 76 of 100 BUDGET/PROGRAM: DEVELOPMENTAL DISABILITIES (cont’d) JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 77 of 100 2019 DEPARTMENT BUDGETS: EXPENSE JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD HOURS 56200 10 40 Kirkpatrick, Vicki (J. Baldwin)Public Health Director 40.00 2,088.00 2,088.00 - - - 56200 10 41 Vacant (L. Fleming)PH Assistant 20.00 1,044.00 1,044.00 - - - 56200 10 145 Shaw, Veronica Deputy Director 40.00 2,088.00 2,088.00 - - - Multi 10 221 Fountain, Debbie (E. Laing)Financial Operations Coord 32.00 1,670.40 1,461.60 - 208.80 - 56200 10 325 Fleming, Lori (K. Alexander)Web Maint & Digital Comm Spec 12.00 626.40 626.40 - - - 56200 10 415 Fleming, Lori (K. Alexander)CHIP Exec Director 20.00 1,044.00 1,044.00 - - - 56210 10 15 Marx, Randy EHS III (Temporary Assignment)40.00 2,088.00 - 2,088.00 - - 56210 10 16 Atkins, Linda EHS III 40.00 2,088.00 - 2,088.00 - - 56210 10 47 Parker, Roger (P. Mingo)EHS II 40.00 2,088.00 - 2,088.00 - - 56210 10 205 Satterlee, Dorian (C. Fiedler)EHS I 40.00 2,088.00 - 2,088.00 - - 56210 10 235 Kwansa, Mina EHS II 40.00 2,088.00 - 2,088.00 - - 56210 10 305 Schauer, Denese EHS I 35.00 1,827.00 - 1,827.00 - - 56210 10 410 Vacant EHS I 40.00 2,088.00 - 2,088.00 - - 56210 10 411 Mingo, Pinky EH Manager 40.00 2,088.00 - 2,088.00 - - 56210 10 680 Porto, Susan EHS III 36.00 1,879.20 - 1,879.20 - - 56220 10 20 Vacant (J. Danskin)Clinic Manager - - - - - - 56220 10 23 Vacant (T. Newton)Community Health Director 40.00 2,088.00 - - 2,088.00 - 56220 10 25 McKenzie, Lisa PHN III 40.00 2,088.00 52.20 - 2,035.80 - 56220 10 30 O'Brien, Susan Lead Nurse Practitioner 28.00 1,461.60 - - 1,461.60 - 56220 10 35 Calahan, Aimee (J. Syska)Financial Operations Coord 28.00 1,461.60 - - 1,461.60 - 56220 10 47 Boyd, Margie PHN II 40.00 2,088.00 - 417.60 1,670.40 - 56220 10 75 Kirkegaard, Sarah ARNP 22.00 1,148.40 - - 1,148.40 - 56220 10 76 Obermeyer, Karen M Community Health Educator 40.00 2,088.00 130.50 - 1,957.50 - 56220 10 90 Danskin, Julia (D. Langlois)PHN II 40.00 2,088.00 287.10 - 1,800.90 - 56220 10 100 Jane, Sarah (L. Ceehorne)PHN I 30.00 1,566.00 - - 1,566.00 - 56220 10 120 ZZ Nurse Hire ARNP 3.00 156.60 - - 156.60 - 56220 10 180 Banker, Denise (K. Matlock)Comm Health Educator 40.00 2,088.00 - - 2,088.00 - 56220 10 610 Rafferty, Kimberly J.PHN II 22.00 1,148.40 - - 1,148.40 - 56220 10 627 Umeda, Yuko PHN III 35.00 1,827.00 - - 1,827.00 - 56220 10 630 Anderson, Kathy Nutritionist 20.00 1,044.00 - - 1,044.00 - 56220 10 650 ZZ Nurse Hire Nurse Hire (PHN)- - - - - - 56220 10 660 Luch, Kathy PHN I 22.00 1,148.40 - - 1,148.40 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 78 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD HOURS 56220 10 675 MacKenzie, Mary Jo PHN II 35.00 1,827.00 - - 1,827.00 - 56800 10 30 McEnery, Anna DD Coordinator & 1/10th Coord 40.00 2,088.00 - - - 2,088.00 Multi 10 10 Whitford, Stuart (J. Keefer)Env Health & Water Quality Dir 21.00 1,096.20 - 1,096.20 - - Multi 10 45 Parke, Susan Financial Operations Coord 35.51 1,853.40 1,853.40 - - - Multi 10 50 Marx, Cynde A Medical Records Clerk 35.00 1,827.00 130.50 - 1,696.50 - Multi 10 55 Larson, Aimee (H. Sebastian)Medical Records Clerk 40.00 2,088.00 - - 2,088.00 - Multi 10 130 VonVolkli, Kelly Medical Records Clk - Lead 40.00 2,088.00 626.40 - 1,461.60 - Multi 10 160 Vacant (C. Oppe)Financial Manager 40.00 2,088.00 2,088.00 - - - Multi 10 245 Reynolds, Shirley Financial Support Specialist 25.00 1,305.00 - 1,305.00 - - Multi 10 300 Locke, Dr. Thomas Health Officer 7.50 391.50 130.50 104.40 156.60 - Multi 10 400 Tucker, Laura EHS II 32.00 1,670.40 - 1,454.40 216.00 - Multi 10 412 Pullman, John (C. Allen)EH Tech 25.00 1,305.00 - 1,305.00 - - Multi 10 413 Henley, Alex Permit Tech I 6.00 313.20 - 313.20 - - Multi 10 600 ZZ Clerk Hire Clerk Hire 6.25 326.25 313.20 - - 13.05 56200 10 608 Nutsford, Joeen (S. Grimm)Medical Records Clerk 20.00 1,044.00 1,044.00 - - - Multi 10 670 Matter, Jennifer (D. Banker)PH Assistant 40.00 2,088.00 1,983.60 104.40 - - 56200 10 676 Vacant HRSA Project Coordinator 17.30 903.00 903.00 - - - - - - - - - - - - - - - TOTAL HOURS:74,674.95 17,894.40 24,422.40 30,257.10 2,101.05 FTE'S:35.76 8.57 11.70 14.49 1.01 DEPT FTE %:23.96%32.70%40.52%2.81% JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 79 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD WAGES 56200 10 40 Kirkpatrick, Vicki (J. Baldwin)Public Health Director 52.14 108,877.32 108,877.32 - - - 56200 10 41 Vacant (L. Fleming)PH Assistant 17.61 18,384.84 18,384.84 - - - 56200 10 145 Shaw, Veronica Deputy Director 41.70 87,067.63 87,067.63 - - - Multi 10 221 Fountain, Debbie (E. Laing)Financial Operations Coord 21.34 35,653.57 31,196.87 - 4,456.70 - 56200 10 325 Fleming, Lori (K. Alexander)Web Maint & Digital Comm Spec 21.56 13,502.28 13,502.28 - - - 56200 10 415 Fleming, Lori (K. Alexander)CHIP Exec Director 34.11 35,612.50 35,612.50 - - - 56210 10 15 Marx, Randy EHS III (Temporary Assignment)33.03 68,961.52 - 68,961.52 - - 56210 10 16 Atkins, Linda EHS III 35.06 73,205.28 - 73,205.28 - - 56210 10 47 Parker, Roger (P. Mingo)EHS II 25.97 54,218.40 - 54,218.40 - - 56210 10 205 Satterlee, Dorian (C. Fiedler)EHS I 21.97 45,873.36 - 45,873.36 - - 56210 10 235 Kwansa, Mina EHS II 27.40 57,219.36 - 57,219.36 - - 56210 10 305 Schauer, Denese EHS I 24.98 45,634.75 - 45,634.75 - - 56210 10 410 Vacant EHS I 21.97 45,873.36 - 45,873.36 - - 56210 10 411 Mingo, Pinky EH Manager 32.07 66,952.08 - 66,952.08 - - 56210 10 680 Porto, Susan EHS III 35.06 65,884.75 - 65,884.75 - - 56220 10 20 Vacant (J. Danskin)Clinic Manager - - - - - - 56220 10 23 Vacant (T. Newton)Community Health Director 35.62 74,374.32 - - 74,374.32 - Multi 10 25 McKenzie, Lisa PHN III 37.74 78,801.12 1,970.03 - 76,831.09 - 56220 10 30 O'Brien, Susan Lead Nurse Practitioner 48.84 71,384.54 - - 71,384.54 - 56220 10 35 Calahan, Aimee (J. Syska)Financial Operations Coord 20.83 30,439.25 - - 30,439.25 - 56220 10 47 Boyd, Margie PHN II 35.06 73,205.28 - 14,641.06 58,564.22 - 56220 10 75 Kirkegaard, Sarah ARNP 42.48 48,784.03 - - 48,784.03 - Multi 10 76 Obermeyer, Karen M Community Health Educator 30.26 63,182.88 3,948.93 - 59,233.95 - Multi 10 90 Danskin, Julia (D. Langlois)PHN II 35.06 73,205.28 10,065.73 - 63,139.55 - 56220 10 100 Jane, Sarah (L. Ceehorne)PHN I 28.03 43,892.10 - - 43,892.10 - 56220 10 120 ZZ Nurse Hire ARNP 35.53 5,564.00 - - 5,564.00 - 56220 10 180 Banker, Denise (K. Matlock)Comm Health Educator 25.73 53,718.56 - - 53,718.56 - 56220 10 610 Rafferty, Kimberly J.PHN II 30.16 34,641.24 - - 34,641.24 - 56220 10 627 Umeda, Yuko PHN III 37.74 68,950.98 - - 68,950.98 - 56220 10 630 Anderson, Kathy Nutritionist 33.81 35,297.64 - - 35,297.64 - 56220 10 650 ZZ Nurse Hire Nurse Hire (PHN)- - - - - - 56220 10 660 Luch, Kathy PHN I 31.38 36,036.79 - - 36,036.79 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 80 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD WAGES 56220 10 675 MacKenzie, Mary Jo PHN II 35.06 64,054.62 - - 64,054.62 - 56800 10 30 McEnery, Anna DD Coordinator & 1/10th Coord 29.18 60,927.84 - - - 60,927.84 Multi 10 10 Whitford, Stuart (J. Keefer)Env Health & Water Quality Dir 45.12 49,462.94 - 49,462.94 - - Multi 10 45 Parke, Susan Financial Operations Coord 26.11 48,392.27 48,392.27 - - - Multi 10 50 Marx, Cynde A Medical Records Clerk 20.06 36,649.34 2,617.81 - 34,031.53 - Multi 10 55 Larson, Aimee (H. Sebastian)Medical Records Clerk 19.33 40,363.92 - - 40,363.92 - Multi 10 130 VonVolkli, Kelly Medical Records Clk - Lead 23.39 48,838.32 14,651.50 - 34,186.82 - Multi 10 160 Vacant (C. Oppe)Financial Manager 27.03 56,431.68 56,431.68 - - - Multi 10 245 Reynolds, Shirley Financial Support Specialist 23.39 30,523.95 - 30,523.95 - - Multi 10 300 Locke, Dr. Thomas Health Officer 97.61 38,214.32 12,738.11 10,190.48 15,285.73 - Multi 10 400 Tucker, Laura EHS II 25.03 41,806.53 - 36,400.51 5,406.02 - Multi 10 412 Pullman, John (C. Allen)EH Tech 18.69 24,389.75 - 24,389.75 - - Multi 10 413 Henley, Alex Permit Tech I 17.66 5,529.94 - 5,529.94 - - Multi 10 600 ZZ Clerk Hire Clerk Hire 20.00 6,525.00 6,264.00 - - 261.00 56200 10 608 Nutsford, Joeen (S. Grimm)Medical Records Clerk 18.40 19,213.56 19,213.56 - - - Multi 10 670 Matter, Jennifer (D. Banker)PH Assistant 19.64 41,018.00 38,967.10 2,050.90 - - 56200 10 676 Vacant HRSA Project Coordinator 23.00 20,769.00 20,769.00 - - - - - - - - - - - - - - - TOTAL WAGES:2,247,509.99 530,671.15 697,012.39 958,637.61 61,188.84 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 81 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD LONGEVITY 56200 10 40 Kirkpatrick, Vicki (J. Baldwin)Public Health Director - - - - - 56200 10 41 Vacant (L. Fleming)PH Assistant - - - - - 56200 10 145 Shaw, Veronica Deputy Director - - - - - Multi 10 221 Fountain, Debbie (E. Laing)Financial Operations Coord - - - - - 56200 10 325 Fleming, Lori (K. Alexander)Web Maint & Digital Comm Spec - - - - - 56200 10 415 Fleming, Lori (K. Alexander)CHIP Exec Director - - - - - 56210 10 15 Marx, Randy EHS III (Temporary Assignment)- - - - - 56210 10 16 Atkins, Linda EHS III 2,200.00 - 2,200.00 - - 56210 10 47 Parker, Roger (P. Mingo)EHS II - - - - - 56210 10 205 Satterlee, Dorian (C. Fiedler)EHS I - - - - - 56210 10 235 Kwansa, Mina EHS II - - - - - 56210 10 305 Schauer, Denese EHS I - - - - - 56210 10 410 Vacant EHS I - - - - - 56210 10 411 Mingo, Pinky EH Manager - - - - - 56210 10 680 Porto, Susan EHS III 1,620.00 - 1,620.00 - - 56220 10 23 Vacant (T. Newton)Community Health Director - - - - - 56220 10 25 McKenzie, Lisa PHN III 2,200.00 - - 2,200.00 - 56220 10 30 O'Brien, Susan Lead Nurse Practitioner 1,260.00 - - 1,260.00 - 56220 10 35 Calahan, Aimee (J. Syska)Financial Operations Coord - - - - - 56220 10 47 Boyd, Margie PHN II 1,400.00 - - 1,400.00 - 56220 10 75 Kirkegaard, Sarah ARNP - - - - - 56220 10 76 Obermeyer, Karen M Community Health Educator 1,000.00 - - 1,000.00 - 56220 10 90 Danskin, Julia (D. Langlois)PHN II 2,200.00 302.50 - 1,897.50 - 56220 10 100 Jane, Sarah (L. Ceehorne)PHN I - - - - - 56220 10 120 ZZ Nurse Hire ARNP - - - - - 56220 10 180 Banker, Denise (K. Matlock)Comm Health Educator - - - - - 56220 10 610 Rafferty, Kimberly J.PHN II - - - - - 56220 10 627 Umeda, Yuko PHN III 1,925.00 - - 1,925.00 - 56220 10 630 Anderson, Kathy Nutritionist 500.00 - - 500.00 - 56220 10 650 ZZ Nurse Hire Nurse Hire (PHN)- - - - - 56220 10 660 Luch, Kathy PHN I 1,210.00 - - 1,210.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 82 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD LONGEVITY 56220 10 675 MacKenzie, Mary Jo PHN II 1,575.00 - - 1,575.00 - 56800 10 30 McEnery, Anna DD Coordinator & 1/10th Coord 2,200.00 - - - 2,200.00 Multi 10 10 Whitford, Stuart (J. Keefer)Env Health & Water Quality Dir - - - - - Multi 10 45 Parke, Susan Financial Operations Coord 1,232.00 1,232.00 - - - Multi 10 50 Marx, Cynde A Medical Records Clerk - - - - - Multi 10 55 Larson, Aimee (H. Sebastian)Medical Records Clerk - - - - - Multi 10 130 VonVolkli, Kelly Medical Records Clk - Lead 1,000.00 300.00 - 700.00 - Multi 10 160 Vacant (C. Oppe)Financial Manager - - - - - Multi 10 245 Reynolds, Shirley Financial Support Specialist 750.00 - 750.00 - - Multi 10 300 Locke, Dr. Thomas Health Officer - - - - - Multi 10 400 Tucker, Laura EHS II - - - - - Multi 10 412 Pullman, John (C. Allen)EH Tech - - - - - Multi 10 413 Henley, Alex Permit Tech I - - - - - Multi 10 600 ZZ Clerk Hire Clerk Hire - - - - - 56200 10 608 Nutsford, Joeen (S. Grimm)Medical Records Clerk - - - - - Multi 10 670 Matter, Jennifer (D. Banker)PH Assistant - - - - - 56200 10 676 Vacant HRSA Project Coordinator - - - - - - - - - - - - - - - TOTAL LONGEVITY:22,272.00 1,834.50 4,570.00 13,667.50 2,200.00 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 83 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD BENEFITS 56200 20 40 Kirkpatrick, Vicki (J. Baldwin)Public Health Director 16.78 35,043.12 35,043.12 - - - 56200 20 41 Vacant (L. Fleming)PH Assistant 10.04 10,478.27 10,478.27 - - - 56200 20 145 Shaw, Veronica Deputy Director 13.86 28,945.94 28,945.94 - - - Multi 20 221 Fountain, Debbie (E. Laing)Financial Operations Coord 10.48 17,513.51 15,324.33 - 2,189.19 - 56200 20 325 Fleming, Lori (K. Alexander)Web Maint & Digital Comm Spec 12.25 7,674.66 7,674.66 - - - 56200 20 415 Fleming, Lori (K. Alexander)CHIP Exec Director 12.25 12,791.10 12,791.10 - - - 56210 20 15 Marx, Randy EHS III (Temporary Assignment)12.05 25,170.81 - 25,170.81 - - 56210 20 16 Atkins, Linda EHS III 12.48 26,055.64 - 26,055.64 - - 56210 20 47 Parker, Roger (P. Mingo)EHS II 11.33 23,646.73 - 23,646.73 - - 56210 20 205 Satterlee, Dorian (C. Fiedler)EHS I 10.47 21,857.71 - 21,857.71 - - 56210 20 235 Kwansa, Mina EHS II 10.88 22,722.57 - 22,722.57 - - 56210 20 305 Schauer, Denese EHS I 11.23 20,524.07 - 20,524.07 - - 56210 20 410 Vacant EHS I 10.47 21,857.71 - 21,857.71 - - 56210 20 411 Mingo, Pinky EH Manager 12.60 26,301.70 - 26,301.70 - - 56210 20 680 Porto, Susan EHS III 12.59 23,663.57 - 23,663.57 - - 56220 20 20 Vacant (J. Danskin)Clinic Manager - - - - - - 56220 20 23 Vacant (T. Newton)Community Health Director 13.34 27,849.24 - - 27,849.24 - 56220 20 25 McKenzie, Lisa PHN III 13.04 27,222.37 680.56 - 26,541.81 - 56220 20 30 O'Brien, Susan Lead Nurse Practitioner 15.72 22,976.13 - - 22,976.13 - 56220 20 35 Calahan, Aimee (J. Syska)Financial Operations Coord 10.46 15,288.20 - - 15,288.20 - 56220 20 47 Boyd, Margie PHN II 12.48 26,055.64 - 5,211.13 20,844.51 - 56220 20 75 Kirkegaard, Sarah ARNP 14.69 16,875.62 - - 16,875.62 - 56220 20 76 Obermeyer, Karen M Community Health Educator 11.48 23,965.97 1,497.87 - 22,468.10 - 56220 20 90 Danskin, Julia (D. Langlois)PHN II 12.48 26,055.64 3,582.65 - 22,472.99 - 56220 20 100 Jane, Sarah (L. Ceehorne)PHN I 12.00 18,797.75 - - 18,797.75 - 56220 20 120 ZZ Nurse Hire ARNP 14.44 2,261.27 - - 2,261.27 - 56220 20 180 Banker, Denise (K. Matlock)Comm Health Educator 11.28 23,542.51 - - 23,542.51 - 56220 20 610 Rafferty, Kimberly J.PHN II 12.72 14,607.41 - - 14,607.41 - 56220 20 627 Umeda, Yuko PHN III 13.18 24,073.61 - - 24,073.61 - 56220 20 630 Anderson, Kathy Nutritionist 12.87 13,436.59 - - 13,436.59 - 56220 20 650 ZZ Nurse Hire Nurse Hire (PHN)- - - - - - 56220 20 660 Luch, Kathy PHN I 12.24 14,058.48 - - 14,058.48 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 84 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD BENEFITS 56220 20 675 MacKenzie, Mary Jo PHN II 12.62 23,052.72 - - 23,052.72 - 56800 20 30 McEnery, Anna DD Coordinator & 1/10th Coord 11.25 23,495.79 - - - 23,495.79 Multi 20 10 Whitford, Stuart (J. Keefer)Env Health & Water Quality Dir 15.32 16,792.67 - 16,792.67 - - Multi 20 45 Parke, Susan Financial Operations Coord 10.61 19,669.54 19,669.54 - - - Multi 20 50 Marx, Cynde A Medical Records Clerk 10.15 18,538.29 1,324.16 - 17,214.13 - Multi 20 55 Larson, Aimee (H. Sebastian)Medical Records Clerk 9.89 20,640.12 - - 20,640.12 - Multi 20 130 VonVolkli, Kelly Medical Records Clk - Lead 10.04 20,963.11 6,288.93 - 14,674.17 - Multi 20 160 Vacant (C. Oppe)Financial Manager 11.55 24,108.20 24,108.20 - - - Multi 20 245 Reynolds, Shirley Financial Support Specialist 10.04 13,101.94 - 13,101.94 - - Multi 20 300 Locke, Dr. Thomas Health Officer 10.24 4,010.83 1,336.94 1,069.55 1,604.33 - Multi 20 400 Tucker, Laura EHS II 11.13 18,590.42 - 16,186.48 2,403.93 - Multi 20 412 Pullman, John (C. Allen)EH Tech 9.74 12,714.94 - 12,714.94 - - Multi 20 413 Henley, Alex Permit Tech I 9.88 3,094.16 - 3,094.16 - - Multi 20 600 ZZ Clerk Hire Clerk Hire 1.99 650.79 624.76 - - 26.03 56200 20 608 Nutsford, Joeen (S. Grimm)Medical Records Clerk 10.21 10,661.41 10,661.41 - - - Multi 20 670 Matter, Jennifer (D. Banker)PH Assistant 9.95 20,784.67 19,745.44 1,039.23 - - 56200 20 676 Vacant HRSA Project Coordinator 12.70 11,467.03 11,467.03 - - - - - - - - - - - - - - - TOTAL BENEFITS:883,650.16 211,244.90 281,010.63 367,872.80 23,521.82 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 85 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD SUPPLIES Multi 31 10 Supplies Office Supplies 3,295.00 725.00 1,095.00 1,380.00 95.00 Multi 31 20 Supplies Operating Costs 26,798.00 6,771.00 10,712.00 9,115.00 200.00 56220 31 40 Supplies Pharmaceutical Supplies 79,785.00 - - 79,785.00 - - - - - - TOTAL SUPPLIES:109,878.00 7,496.00 11,807.00 90,280.00 295.00 EQUIPMENT Multi 35 0 Equipment Office Equipment - - - - - - - - - - TOTAL EQUIPMENT:- - - - - PROFESSIONAL SERVICES 56200 41 300 Epidemeologist/Consultant Assessment Services 14,357.00 14,357.00 - - - 56200 41 302 Epidemeologist/Consultant EPI-CHIP 38,900.00 38,900.00 - - - 56210 41 45 Various EH Lab Services - - - - - 56210 41 240 EH-Misc.Professional Services 12,500.00 - 12,500.00 - - 56210 41 300 Various Site Abatement 369,066.00 - 369,066.00 - - 56220 41 19 Infant MH Consultant NFP Program Services 1,980.00 - - 1,980.00 - 56220 41 20 Consolidated Contract FP Surgical Services - - - - - 56220 41 130 Various Lab Services 12,105.00 - - 12,105.00 - 56220 41 190 NFP Contract with Colorado NFP Data 18,312.00 - - 18,312.00 - 56220 41 220 Language Link Translation Svcs 300.00 - - 300.00 - 56220 41 240 CH-Misc.Professional Services - - - - - 56220 41 250 Stericycle Syringe Exchange Services 2,367.00 - - 2,367.00 - 56220 41 270 Medicaid Admin Match Syst Med Admin Match System 6,500.00 - - 6,500.00 - 56220 41 305 e-MDs Electronic Medical Records 14,466.00 - - 14,466.00 - 56220 41 310 Kitsap Health District NFP Nurse 92,156.98 - - 92,156.98 - 56220 41 350 Trizetto Medical Claims Processing 3,600.00 - - 3,600.00 - 56220 41 391 ASAP ASAP Inventory Application 4,740.00 - - 4,740.00 - 56220 41 394 MH Professional Maternity Support Svcs MHP 4,176.00 - - 4,176.00 - 56220 41 395 DBHR Activities Professional Services - - - - - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 86 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD PROFESSIONAL SERVICES 56800 41 45 Skookum-Indiv Employ Individual Employment 134,528.00 - - - 134,528.00 56800 41 60 Chimacum School/Concerned CitizensChild Development B-3 3,750.00 - - - 3,750.00 56800 41 75 Concerned Citizens Community Inclusion 10,300.00 - - - 10,300.00 56800 41 175 Dave Reynolds/Sky Valley JC Choices Website 700.00 - - - 700.00 56800 41 205 Concerned Citizens Child Development B-3 15,600.00 - - - 15,600.00 56800 41 208 Able Opportunities ITA/Person to Person 2,498.00 - - - 2,498.00 56800 41 225 Miscellaneous Community Info Activities - - - - - 56800 41 230 W.I.S.E.Community Info Activities - - - - - 56800 41 241 DD-Misc Professional Services - - - - - 56800 41 245 Skookum Group Supported Employment 37,440.00 - - - 37,440.00 56800 41 285 Concerned Citizens Individual Employment 65,758.00 - - - 65,758.00 56800 41 295 Concerned Citizens Other Services and Charges - - - - - 56800 41 345 Skookum Community Inclusion 17,200.00 - - - 17,200.00 56800 41 350 YMCA Community Info Activities - - - - - 56800 41 460 Various ACAC Activities 50,000.00 - - - 50,000.00 56800 41 462 Skookum Roads to Community Living - - - - - Multi 41 165 Aaron Edwards Web Design Services/Web Maint.7,000.00 - 7,000.00 - - Multi 41 439 CivicPlus Web Maintenance 558.00 110.00 174.00 258.00 16.00 Multi 41 440 The Leader/PDN Advertising 19,535.00 11,340.00 1,775.00 6,340.00 80.00 - - - - - TOTAL PROFESSIONAL SERVICES:960,392.98 64,707.00 390,515.00 167,300.98 337,870.00 COMMUNICATIONS 56220 42 50 Communications EHR Fax 867.00 - - 867.00 - Multi 42 10 Communications Postage 4,860.00 775.00 2,405.00 1,600.00 80.00 Multi 42 30 Communications Other Phone 977.00 40.00 510.00 415.00 12.00 Multi 42 40 Communications Other Communications 9,659.00 2,939.00 253.00 6,467.00 - - - - - - TOTAL COMMUNICATIONS:16,363.00 3,754.00 3,168.00 9,349.00 92.00 TRAVEL Multi 43 0 Travel Travel Reimbursements 19,268.00 3,205.00 4,800.00 10,243.00 1,020.00 - - - - - TOTAL TRAVEL:19,268.00 3,205.00 4,800.00 10,243.00 1,020.00 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 87 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD OPERATING RENTALS AND LEASES Multi 45 10 Miscellaneous Room Rental 1,520.00 - 70.00 700.00 750.00 56200 45 20 Miscellaneous Mail Plus-CHIP 240.00 240.00 - - - - - - - - TOTAL OPERATING RENTS/LEASES:1,760.00 240.00 70.00 700.00 750.00 INSURANCE 56200 46 10 Insurance General Liability Insurance 43,260.00 43,260.00 - - - Multi 46 20 Insurance Insurance Liability-Claims 2,500.00 2,500.00 - - - - - - - - TOTAL INSURANCE:45,760.00 45,760.00 - - - MISCELLANEOUS 56200 47 20 Miscellaneous Confidential Shredding Services 38.00 38.00 - - - 56210 47 60 Public Works Waste Disposal Fees - - - - - 56800 49 35 Miscellaneous Other Training 2,712.00 - - - 2,712.00 Multi 48 0 Miscellaneous Repair & Maintenance 26,540.00 - 26,300.00 240.00 - Multi 49 10 Miscellaneous Printing 1,850.00 - 275.00 950.00 625.00 Multi 49 15 Miscellaneous Subscriptions & Memberships 5,350.00 2,762.00 462.00 1,639.00 487.00 Multi 49 20 Miscellaneous Training/Registration 12,190.00 2,100.00 5,440.00 4,050.00 600.00 Multi 49 45 Miscellaneous Misc/Other Operating - - - - - Multi 49 60 Miscellaneous Permits 800.00 - - 800.00 - - - - - - TOTAL MISCELLANEOUS:49,480.00 4,900.00 32,477.00 7,679.00 4,424.00 INTERGOVERNMENTAL SERVICES 56210 54 10 Payments Septic Rebates 10,000.00 - 10,000.00 - - 56220 52 10 Intergovt'l Payments KCHD-Nightengale Notes 3,687.00 - - 3,687.00 - 56200 52 10 Intergovt'l Services Jefferson Health Care - CHIP 10,919.00 10,919.00 - - - - - - - - TOTAL INTERGOVERNMENTAL SVCS:24,606.00 10,919.00 10,000.00 3,687.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 88 of 100 2019 DEPARTMENT BUDGETS: EXPENSE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 EXPENSE BUDGET HOURS/WK 2019 56200 56210 56220 56800 WAGE/HR EXP BUDGET ADMIN EH CH DD INTERFUND PROFESSIONAL SVCS 56210 91 100 Interfund Prof Svcs Environmental Health Fiscal Fee 121,574.00 - 121,574.00 - - 56210 91 300 Interfund Prof Svcs On Site Septic Assessment 3,800.00 - 3,800.00 - - 56220 91 200 Interfund Prof Svcs Community Health Fiscal Fee 166,011.00 - - 166,011.00 - 56800 91 105 Interfund Prof Svcs DD Fiscal Fee 41,629.00 - - - 41,629.00 - - - - - TOTAL INTERFUND PROF SVCS:333,014.00 - 125,374.00 166,011.00 41,629.00 INTERFUND COMMUNICATIONS Multi 92 10 Rents/Leases - PW Telephone System 23,822.00 3,790.00 5,478.00 14,041.00 513.00 Multi 92 20 Communications Telephone-Long Distance 1,755.00 165.00 848.00 583.00 159.00 - - - - - TOTAL INTERFUND COMMUNICATIONS:25,577.00 3,955.00 6,326.00 14,624.00 672.00 INTERFUND RENTALS/LEASES 56210 95 70 Rents/Leases - PW GIS 8,614.00 - 8,614.00 - - Multi 95 10 Rents/Leases - PW Building Rents 82,622.00 12,763.00 17,594.00 51,514.00 751.00 Multi 95 20 Rents/Leases - PW Info Svcs - Copiers 10,470.00 1,935.00 3,829.00 4,405.00 301.00 Multi 95 30 Rents/Leases - PW Vehicles - Department 20,580.00 876.00 11,844.00 7,260.00 600.00 Multi 95 40 Rents/Leases - PW GEMS 8,430.00 1,402.00 2,042.00 4,219.00 767.00 Multi 95 50 Rents/Leases - PW Info Svcs - Computers 112,558.00 21,609.00 33,773.00 54,751.00 2,425.00 Multi 95 60 Rents/Leases - PW Info Svcs - Records Management 18,330.00 3,049.00 4,439.00 9,174.00 1,668.00 - - - - - TOTAL INTERFUND RENTAL/LEASES:261,604.00 41,634.00 82,135.00 131,323.00 6,512.00 SUBTOTAL EXPENSES:5,001,135.13 930,320.56 1,649,265.02 1,941,374.89 480,174.66 RESERVE FUND BALANCES 50810 0 0 Reserve Fund Balance Public Health Fund 216,000.00 216,000.00 - - - 50810 0 10 Reserve Fund Balance DASA Fund - - - - - 50810 0 10 Reserve Fund Balance DDD Fund 28,548.00 - - - 28,548.00 - - - - - TOTAL RESERVE FUND BALANCE:244,548.00 216,000.00 - - 28,548.00 TOTAL EXPENSES:5,245,683.13 1,146,320.56 1,649,265.02 1,941,374.89 508,722.66 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 89 of 100 2019 DEPARTMENT BUDGETS: REVENUE JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD BEGINNING FUND BALANCE:1,105,380.56 425,901.98 497,253.91 140,296.59 41,928.08 TAXES: 311.1 30 1100 General Property Real & Personal Property Taxes 45,147.00 - - - 45,147.00 311.3 30 1100 General Property Sale of Tax Title Property - - - - - 317.2 30 1100 Leasehold Excise Leasehold Excise Tax 360.00 - - - 360.00 317.4 30 1100 Timber Excise Tax Timber Excise Tax 2,061.00 - - - 2,061.00 - - - - - Total Taxes:47,568.00 - - - 47,568.00 LICENSES AND PERMITS: 321.20 10 5300 EH Licenses & Permits L&P - SW Facility Permits 2,746.00 - 2,746.00 - - 321.20 10 5301 EH Licenses & Permits L&P - SW Facility Permits Admin 916.00 - 916.00 - - 321.20 10 5400 EH Licenses & Permits L&P - Liquid Waste Licenses 149,442.00 - 149,442.00 - - 321.20 10 5401 EH Licenses & Permits L&P - LW Admin 49,355.00 - 49,355.00 - - 321.20 10 5600 EH Licenses & Permits L&P - Food 86,865.00 - 86,865.00 - - 321.20 10 5601 EH Licenses & Permits L&P - Food Admin 28,955.00 - 28,955.00 - - 321.20 10 5800 EH Licenses & Permits L&P - Living Environments 4,433.00 - 4,433.00 - - 321.20 10 5801 EH Licenses & Permits L&P - Living Environments Admin 1,478.00 - 1,478.00 - - 321.20 11 5600 EH Licenses & Permits L&P - FH Online 12,456.00 - 12,456.00 - - - - - - - Total Licenses and Permits:336,646.00 - 336,646.00 - - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 90 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD GRANTS: Federal 332.93 20 1000 DHHR Billing Update Incentive 3,000.00 3,000.00 - - - 332.93 20 1200 DSHS - ARRA Billing Update Incentive - - - - - 332.93 20 2600 Health Care Authority Billing Update Incentive 14,000.00 - - 14,000.00 - 332.93 20 2620 Health Care Authority Billing Update Incentive - - - - - 332.93 20 2920 Health Care Authority Billing Update Incentive - - - - - 333.10 55 2800 DOH-Con Con WIC Nutrition 95,323.00 - - 95,323.00 - 333.10 55 2810 DOH-Con Con WIC Breastfeeding - - - - - 333.10 57 2800 DOH-Con Con WIC Farmer's Market 500.00 - - 500.00 - 333.93 06 8800 DOH-Con Con PHEPR 20,196.00 20,196.00 - - - 333.93 06 8801 DOH-Con Con PHEPR Admin 6,529.00 6,529.00 - - - 333.93 21 2700 DOH-Con Con FP Title X 28,322.00 - - 28,322.00 - 333.93 24 2150 DSHS DBHR-PFS - - - - - 333.93 26 3220 DOH-Con Con Immunizations 7,223.00 - - 7,223.00 - 333.93 28 4300 Seattle/King County Breast & Cervical Health - - - - - 333.93 30 4450 CDC Tobacco Prevention - - - - - 333.93 53 3200 DOH-Con Con Imm. Registry Training - - - - - 333.93 53 3220 DOH-Con Con Immunizations - - - - - 333.93 57 2270 OESD Infant Toddler - - - - - 333.93 73 3220 DOH-Con Con PPHF Vaccine Management - - - - - 333.93 75 2120 DSHS Healthy Communities - - - - - 333.93 75 4300 Seattle/King County Breast & Cervical Health 625.00 - - 625.00 - 333.93 75 4450 CDC Tobacco Prevention 8,911.00 - - 8,911.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 91 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD GRANTS: Federal 333.93 77 1200 Federal Med. Ad. Match - CH Ad.54,900.00 - - 54,900.00 - 333.93 77 1210 Federal Med. Ad. Match - MAM 6,500.00 - - 6,500.00 - 333.93 77 2600 Federal Med. Ad. Match - FP 1,000.00 - - 1,000.00 - 333.93 77 2800 Federal Med. Ad. Match - WIC 1,000.00 - - 1,000.00 - 333.93 77 2810 Federal Med. Ad. Match - WIC BF - - - - - 333.93 77 2900 Federal Med. Ad. Match - SCHOOL HLTH - - - - - 333.93 77 2920 Federal Med. Ad. Match - SBHC - - - - - 333.93 77 3200 Federal Med. Ad. Match - Child Imm.- - - - - 333.93 77 3300 Federal Med. Ad. Match - STD - - - - - 333.93 77 3900 Federal Med. Ad. Match - CD - - - - - 333.93 95 2100 DSHS DBHR-SAPT (DASA)77,558.00 - - 77,558.00 - 333.93 95 2170 DSHS DBHR-Other - - - - - 333.93 99 2500 DOH-Con Con CSHCN 25,143.00 - - 25,143.00 - 333.93 99 2501 DOH-Con Con CSHCN Admin 8,129.00 - - 8,129.00 - 333.93 99 2260 DOH-Con Con NFP-MCHBG 3,473.00 - - 3,473.00 - 331.93 91 1270 HRSA Rural Health Network-CHIP 71,265.00 71,265.00 - - - 331.93 91 1271 HRSA Rural Health Network-Indirect 23,040.00 23,040.00 - - - - - - - - Subtotal Federal:456,637.00 124,030.00 - 332,607.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 92 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD GRANTS: State 334.03 10 5300 DOE Solid Waste Grant (DOE) - Enf.40,084.00 - 40,084.00 - - 334.03 10 5350 DOE Solid Waste Grant (DOE) - Edu.33,424.00 - 33,424.00 - - 334.03 10 5380 DOE LSC 80,143.00 - 80,143.00 - - 334.03 10 5381 DOE LSC (Indirect)19,590.00 - 19,590.00 - - 334.03 10 5390 DOE Site Hazard - - - - - 334.03 10 5391 DOE Site Hazard (Indirect)- - - - - 334.04 62 2100 DSHS DBHR-SABG (DASA)6,815.00 - - 6,815.00 - 334.04 62 2290 DSHS DBHR-DMA NFP 20,042.00 - - 20,042.00 - 334.04 67 2220 DSHS CPS - - - - - 334.04 70 9330 DOT ACAC 60,584.00 - - - 60,584.00 334.04 70 9331 DOT ACAC (Indirect)9,088.00 - - - 9,088.00 334.04 91 2600 DOH-Con Con FP-Clinical/Health Promo 64,026.00 - - 64,026.00 - 334.04 93 4300 State-Seattle/King Co.Breast Cervical & Colon Health - - - - - 334.04 93 4450 Dept of Health Youth Tobacco (Kitsap)7,348.00 - - 7,348.00 - 334.04 93 4900 DOH Marijuana Prevention 49,179.00 - - 49,179.00 - 334.04 93 5200 DOH-Con Con Safe Drinking Water System - - - - - 334.04 93 5480 DOH-Con Con PSAP Onsite Systems 26,817.00 - 26,817.00 - - 334.04 93 5481 DOH-Con Con PSAP Onsite Systems Indirect 8,670.00 - 8,670.00 - - 334.04 93 5700 DOH-Con Con Childhood Lead Inv - - - - - 334.04 99 3250 DOH-Con Con Blue Ribbon - PH Imm - - - - - 334.04 99 3950 DOH-Con Con Blue Ribbon - PH CD - - - - - 334.06 91 2250 Dept of Early Learning NFP Activities 176,829.00 - - 176,829.00 - 334.06 91 2251 Dept of Early Learning NFP Activities Admin 17,683.00 - - 17,683.00 - - - - - - Subtotal State:620,322.00 - 208,728.00 341,922.00 69,672.00 Total Grants:286,526.00 - 35,487.00 251,039.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 93 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD STATE ENTITLEMENTS 336.04 24 1000 Intergovernmental PH Assist-MVET-Admin 48,259.00 48,259.00 - - - 336.04 24 1100 Intergovernmental PH Assistance-LCDF - - - - - 336.04 24 1200 Intergovernmental PH Assist-MVET- CH Admin 29,684.00 - - 29,684.00 - 336.04 24 1201 Intergovernmental PH Assistance-LCDF (CH Admin)38,368.00 - - 38,368.00 - 336.04 24 3200 Intergovernmental PH Assist-MVET-CH Child Imm 7,769.00 - - 7,769.00 - 336.04 24 3205 Intergovernmental PH Assistance-Blue Ribb - Child Imm 15,000.00 - - 15,000.00 - 336.04 24 3210 Intergovernmental PH Assistance-Blue Ribb - Adult Imm 15,000.00 - - 15,000.00 - 336.04 24 3250 Intergovernmental PH Assistance-Blue Ribb - PH Imm - - - - - 336.04 24 3900 Intergovernmental PH Assist-Blue Ribbon - CD 30,000.00 - - 30,000.00 - 336.04 25 3950 Intergovernmental FPHS 13,291.00 - - 13,291.00 - 336.04 25 3250 Intergovernmental FPHS 18,448.00 - - 18,448.00 - 336.04 25 1200 Intergovernmental FPHS 10,261.00 - - 10,261.00 - - - - - - - - - - - Total State Entitlements 226,080.00 48,259.00 - 177,821.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 94 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD CHARGES FOR GOODS AND SERVICES Fees, Interfund and Intergovernmental 341.43 02 1000 Fiscal/Admin Fee Water Quality 112,481.00 112,481.00 - - - 341.43 03 1000 Fiscal/Admin Fee Environmental Health 121,574.00 121,574.00 - - - 341.43 04 1000 Fiscal/Admin Fee Community Health 166,011.00 166,011.00 - - - 341.43 05 1000 Fiscal/Admin Fee Developmental Disabilities 41,629.00 41,629.00 - - - 341.43 06 1000 Fiscal/Admin Fee Chemical Dependency 22,752.00 22,752.00 - - - 341.43 06 1100 Contracts Mgt Mental Hlth/Chem Dep.19,887.00 - - - 19,887.00 341.43 07 1000 Fiscal/Admin Fee Conservation Futures 5,625.00 5,625.00 - - - 341.44 01 8000 Assessment Fee 131 Fund - Mental Hlth/Chem Dep.14,357.00 14,357.00 - - - 341.81 00 1120 Public Records Fees PRR - Admin 50.00 50.00 - - - 341.81 10 1520 Public Records Fees PRR - EH 125.00 - 125.00 - - 341.81 20 1120 Public Records Fees PRR - CH - - - - - 341.81 30 1120 Public Records Fees PRR - DD - - - - - 341.96 10 1200 Personnel Svcs CHIP Proj-Jefferson Healthcare - - - - - 341.96 10 1260 Jeff Healthcare CHIP - - - - - 341.96 11 1260 Jefferson County CHIP 28,876.00 28,876.00 - - - 341.96 12 1260 City of Port Townsend CHIP 14,438.00 14,438.00 - - - 345.11 00 5350 Compost Project Public Works 2,182.00 - 2,182.00 - - 345.29 00 5400 Kitsap Health District Septic Education & Outreach - - - - - 346.21 20 2280 NFP MHCD 1/10 OF 1%63,710.00 - - 63,710.00 - 346.21 20 2620 Jeff Healthcare SBC - FP (Port Townsend)10,359.00 - - 10,359.00 - 346.21 20 2640 Jeff Healthcare SBC - Other (Port Townsend)10,359.00 - - 10,359.00 - 346.21 20 2900 PT School District Port Townsend - - - - - 346.21 20 2920 Jeff Healthcare SBC - FP (Chimacum)10,359.00 - - 10,359.00 - 346.21 20 2940 Jeff Healthcare SBC - Other (Chimacum)10,359.00 - - 10,359.00 - 346.21 20 8000 Assessment Svcs JHC - - - - - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 95 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD CHARGES FOR GOODS AND SERVICES Fees, Interfund and Intergovernmental 346.21 21 2280 NFP Services Kitsap 78,315.00 - - 78,315.00 - 346.21 21 2900 Chimacum School Dist Chimacum - - - - - 346.21 22 2280 NFP Services Tribes - - - - - 346.21 22 2930 Brinnon School Dist Human Grwth&Dev-Brinnon - - - - - 346.21 23 2930 Quilcene School Dist Human Grwth&Dev-Quilcene 3,850.00 - - 3,850.00 - 346.21 24 2930 Chimacum School Dist Human Growth & Dev (Chim)9,343.00 - - 9,343.00 - 346.21 25 2930 Port Townsend School Human Growth & Dev (PT)- - - - - 346.26 60 5340 Abatement Abatement Activities - - - - - 346.26 64 5200 DOH-con con Drinking Water - SS - - - - - 346.26 65 5200 DOH-con con Drinking Water - SS State - - - - - 346.26 66 5200 DOH-con con Drinking Water - TA 1,000.00 - 1,000.00 - - 346.61 30 1100 DSHS DDD - Admin 9,583.00 - - - 9,583.00 346.61 30 4000 DSHS DDD - Comm Info 8,942.00 - - - 8,942.00 346.61 30 6200 DSHS DDD - Group Supported 18,720.00 - - - 18,720.00 346.61 30 6400 DSHS DDD - Indv. Employment 100,143.00 - - - 100,143.00 346.61 30 6600 DSHS DDD-Indv. Tech. Assistance 1,249.00 - - - 1,249.00 346.61 30 6700 DSHS DDD - Comm Inclu Svcs 13,750.00 - - - 13,750.00 346.61 30 6710 DSHS DDD - Roads to Comm Living - - - - - 346.61 31 1100 DSHS DDD - Admin 11,712.00 - - - 11,712.00 346.61 31 4000 DSHS DDD - Comm Info 10,930.00 - - - 10,930.00 346.61 31 6100 DSHS DDD - Child Development 19,350.00 - - - 19,350.00 346.61 31 6200 DSHS DDD - Group Supported 18,720.00 - - - 18,720.00 346.61 31 6400 DSHS DDD - Indv. Employment 100,143.00 - - - 100,143.00 346.61 31 6600 DSHS DDD-Indv. Tech. Assistance 1,249.00 - - - 1,249.00 346.61 31 6700 DSHS DDD - Comm Inclu Svcs 13,750.00 - - - 13,750.00 346.61 31 6710 DSHS DDD - Roads to Comm Living - - - - - - - - - - Subtotal Interfund and Intergovernmental:1,075,882.00 527,793.00 3,307.00 196,654.00 348,128.00 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 96 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD CHARGES FOR GOODS AND SERVICES Fees, Admin Client Fees 346.22 00 7100 Admin Fees Vital Records 12,400.00 12,400.00 - - - - - - - - Subtotal Admin Client Fees:12,400.00 12,400.00 - - - Fees, EH Client Fees 346.23 10 1520 EH Fees Client Fees - Tech/Scanning Fee - - - - - 346.23 10 1530 EH Fees Client Fees - Tech/Scanning Fee 80,709.00 - 80,709.00 - - 346.23 10 5200 EH Fees Client Fees - Drinking Water 10,183.00 - 10,183.00 - - 346.23 10 5201 EH Fees Client Fees - Drinking Water Admin 2,760.00 - 2,760.00 - - 346.23 10 5300 EH Fees Client Fees - SW Tech Asst. - - - - - 346.23 10 5301 EH Fees Client Fees - SW Tech Asst. Admin - - - - - 346.23 10 5350 EH Fees Client Fees - SW Education 3,000.00 - 3,000.00 - - 346.23 10 5400 EH Fees Client Fees - Liquid Waste 28,635.00 - 28,635.00 - - 346.23 10 5401 EH Fees Client Fees - LW Admin 9,545.00 - 9,545.00 - - 346.23 10 5420 EH Fees Client Fees - O&M 279,309.00 - 279,309.00 - - 346.23 10 5421 EH Fees Client Fees - O&M Admin 93,103.00 - 93,103.00 - - 346.23 10 5600 EH Fees Client Fees - Food Fees 13,929.00 - 13,929.00 - - 346.23 10 5601 EH Fees Client Fees - Food Admin 4,643.00 - 4,643.00 - - 346.23 10 5800 EH Fees Client Fees - Living Environments - - - - - 346.23 10 5801 EH Fees Client Fees - Living Enviro Admin - - - - - 346.23 11 5200 EH Fees Client Fees - DCD Water Avail.11,212.00 - 11,212.00 - - 346.23 11 5201 EH Fees Client Fees - DCD Water Avail. Admin 3,695.00 - 3,695.00 - - 346.23 11 5400 EH Fees Client Fees - DCD Bldg Review 20,785.00 - 20,785.00 - - 346.23 11 5401 EH Fees Client Fees - DCD Bldg Rev Admin 6,929.00 - 6,929.00 - - 346.23 11 5800 EH Fees Client Fees - DCD Short Plat 1,814.00 - 1,814.00 - - 346.23 11 5801 EH Fees Client Fees - DCD Short Plat Admin 363.00 - 363.00 - - - - - - - Subtotal EH Client Fees:570,614.00 - 570,614.00 - - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 97 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD CHARGES FOR GOODS AND SERVICES Fees, CH Client Fees 346.23 20 2600 CH Fees Client Fees - FP 9,983.00 - - 9,983.00 - 346.23 20 2620 CH Fees Client Fees - PT SBHC FP 12.00 - - 12.00 - 346.23 20 2640 CH Fees Client Fees - PT SBHC Other 685.00 - - 685.00 - 346.23 20 2910 CH Fees Client Fees - Foot Care 37,520.00 - - 37,520.00 - 346.23 20 2920 CH Fees Client Fees - Chim SBC FP 240.00 - - 240.00 - 346.23 20 2940 CH Fees Client Fees - Chim SBHC Other 555.00 - - 555.00 - 346.23 20 3200 CH Fees Client Fees - Child Imm 2,500.00 - - 2,500.00 - 346.23 20 3210 CH Fees Client Fees - Adult Imm 13,814.00 - - 13,814.00 - 346.23 20 3230 CH Fees Client Fees - Traveler Imm 9,000.00 - - 9,000.00 - 346.23 20 3300 CH Fees Client Fees - STD 5,869.00 - - 5,869.00 - 346.23 20 3400 CH Fees Client Fees - TB 2,479.00 - - 2,479.00 - - - - - - Subtotal CH Client Fees:82,657.00 - - 82,657.00 - Fees, CH Private Insurance 346.24 20 2600 CH Fees Priv Ins - FP 22,364.00 - - 22,364.00 - 346.24 20 2620 CH Fees Priv Ins - PT SBHC 156.00 - - 156.00 - 346.24 20 2640 CH Fees Priv Ins - PT SBHC Other 1,338.00 - - 1,338.00 - 346.24 20 2920 CH Fees Priv Ins - Chim SBHC 541.00 - - 541.00 - 346.24 20 2940 CH Fees Priv Ins - Chim SBHC Other 1,215.00 - - 1,215.00 - 346.24 20 3200 CH Fees Priv Ins - Child Imm 5,850.00 - - 5,850.00 - 346.24 20 3210 CH Fees Priv Ins - Adult Imm 9,081.00 - - 9,081.00 - 346.24 20 3230 CH Fees Priv Ins - Traveler Imm 9,500.00 - - 9,500.00 - 346.24 20 3300 CH Fees Priv Ins - STD 3,565.00 - - 3,565.00 - 346.24 20 3400 CH Fees Priv Ins - TB 800.00 - - 800.00 - - - - - - Subtotal Private Ins Fees:54,410.00 - - 54,410.00 - JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 98 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD CHARGES FOR GOODS AND SERVICES Fees, CH Medicaid 346.25 20 2200 CH Fees Medicaid - MSS 23,878.00 - - 23,878.00 - 346.25 20 2600 CH Fees Medicaid - FP 79,730.00 - - 79,730.00 - 346.25 20 2620 CH Fees Medicaid - PT SBHC 19,522.00 - - 19,522.00 - 346.25 20 2640 CH Fees Medicaid - PT SBHC Other 4,420.00 - - 4,420.00 - 346.25 20 2920 CH Fees Medicaid - Chim SBHC 19,400.00 - - 19,400.00 - 346.25 20 2940 CH Fees Medicaid - Chim SBHC Other 3,366.00 - - 3,366.00 - 346.25 20 3200 CH Fees Medicaid - Child Imm 4,636.00 - - 4,636.00 - 346.25 20 3210 CH Fees Medicaid - Adult Imm 3,271.00 - - 3,271.00 - 346.25 20 3230 CH Fees Medicaid - Travelers Imm 780.00 - - 780.00 - 346.25 20 3300 CH Fees Medicaid - STD 6,063.00 - - 6,063.00 - 346.25 20 3400 CH Fees Medicaid - TB 522.00 - - 522.00 - Subtotal Medicaid Fees:165,588.00 - - 165,588.00 - Total Charges for Goods and Services:1,961,551.00 540,193.00 573,921.00 499,309.00 348,128.00 MISCELLANEOUS 361.40 30 1100 Miscellaneous DNR-Other Interest Earnings 15.00 - - - 15.00 362.50 30 1100 Miscellaneous DNR Timber Leases - - - - - 367.00 00 1000 Miscellaneous Admin - Private Source Donation - - - - - 367.00 20 2600 Miscellaneous CH - Private Source Donation - - - - - 367.00 20 2620 Miscellaneous CH - Private Source Donation - - - - - 367.00 20 2640 Miscellaneous CH - Private Source Donation - - - - - 367.00 20 2920 Miscellaneous CH - Private Source Donation - - - - - 367.00 20 2940 Miscellaneous CH - Private Source Donation - - - - - 367.00 21 2600 Miscellaneous CH - UGN Donor Option 1,000.00 - - 1,000.00 - 367.00 30 1100 Miscellaneous DD - Private Source Donation - - - - - 369.80 00 0000 Miscellaneous Cash Over/Short Adjustments - - - - - 369.90 00 499 Miscellaneous Prior Year Refunds Under $500 - - - - - 369.90 00 1000 Miscellaneous Other Miscellaneous - - - - - 369.90 00 2640 Miscellaneous Mscellaneous PT SBHC - - - - - Total Miscellaneous:1,015.00 - - 1,000.00 15.00 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 99 of 100 2019 DEPARTMENT BUDGETS: REVENUE (cont’d) JEFFERSON COUNTY PUBLIC HEALTH DEPT 2019 Revenue Budget 2019 56200 56210 56220 56800 REV BUDGET ADMIN EH CH DD NON REVENUE 388.80 00 0000 Non Revenue Prior Year Correction - - - - - - - - - - Total Non Revenue:- - - - - DISPOSITION OF CAPITAL ASSETS 395.10 30 1100 Timber Sales DNR Timber Sales DNR 100.00 - - - 100.00 - - - - - Total Disposition of Capital Assets:100.00 - - - 100.00 OTHER FINANCING SOURCES 397.00 00 160 Transfer from G/F Public Health 634,174.00 107,100.00 68,564.00 444,870.00 13,640.00 397.00 00 320 Transfer from G/F S/A Prev. - Spec. Purpose 54,881.00 - - 54,881.00 - 397.00 00 330 Transfer from G/F Public Hlth Nurse - Spec. Purpose 58,838.00 - - 58,838.00 - 397.00 00 505 Transfer-LV Payout Public Health-LV Payout - - - - - 397.00 10 300 Transfer from G/F GF - EH GIS 3,996.00 - 3,996.00 - - 397.00 10 355 Transfer from G/F Public Health (one-time)-Admn - - - - - 397.00 10 360 Transfer from G/F Public Health (one-time)-EH 200,000.00 - 200,000.00 - - 397.00 10 365 Transfer from G/F Public Health (one-time)-CH - - - - - 397.00 10 370 Transfer from G/F Public Health (one-time)-DD - - - - - 397.00 10 401 Transfer from SW Public Works Solid Waste 20,274.00 - 20,274.00 - - - - - - - Total Other Financing Sources:972,163.00 107,100.00 292,834.00 558,589.00 13,640.00 TOTAL PROJECTED REVENUES:4,622,082.00 819,582.00 1,412,129.00 1,911,248.00 479,123.00 TOTAL PROJECTED EXPENSE:5,001,135.13 930,320.56 1,649,265.02 1,941,374.89 480,174.66 ENDING FUND BALANCE:726,327.42 315,163.42 260,117.89 110,169.69 40,876.42 LESS DEPT/DIVISION RESTRICTED RESERVE:244,548.00 216,000.00 - - 28,548.00 LESS PROGRAM/PROJECT RESERVE:354,259.58 88,756.33 208,915.07 46,211.12 10,377.06 PROJECTED AVAILABLE CASH FOR 2020:127,519.84 10,407.09 51,202.82 63,958.57 1,951.36 JEFFERSON COUNTY PUBLIC HEALTH 2019 BUDGET REQUEST Page 100 of 100 2019 SALARY SCHEDULE JEFFERSON COUNTY PUBLIC HEALTH 2019 Budget - Salary Schedule Retirement Soc Sec Emp Sec L & I Post Ret Total WAGE BENEFIT Cost Center BARS Name Title Grade Hire Date Step Date Step 1 Step 2 Hrs/wk Fixed Salary Annual Salary Longevity Medical 12.70%7.65%1.25%Status Hrs x Rate 0.50%Benefits RATE RATE 55310 200 Weissman, Tim (E. Dobrowski)EHS I 29 11/21/2016 11/1/2019 3 4 40 48,390.56 48,390.56 - 11,480.08 6,145.60 3,701.88 604.88 5306 239.62 241.95 22,414.01 23.18 10.73 55310 215 Pokorny, Tami EHS II 35 8/16/2004 5/1/2019 8 9 40 69,112.40 69,112.40 - 9,930.22 8,777.27 5,287.10 622.50 5306 239.62 345.56 25,202.27 33.10 12.07 55310 225 Bachman, Anna (A. Petty)EHS II 32 5/26/2015 5/1/2019 2 3 35 46,672.01 46,672.01 - 10,229.13 5,927.35 3,570.41 583.40 5306 209.66 233.36 20,753.30 25.55 11.36 55310 226 Stone, Brad (A. Watkins)EHS I 29 10/10/2016 10/1/2019 3 4 40 48,497.28 48,497.28 - 11,480.08 6,159.15 3,710.04 606.22 5306 239.62 242.49 22,437.59 23.23 10.75 55310 230 Stenman, Jacquelyn (T. Weissman)EHS I 29 6/20/2018 6/1/2019 1 2 40 46,542.16 46,542.16 - 11,480.08 5,910.85 3,560.48 581.78 5306 239.62 232.71 22,005.51 22.29 10.54 55310 262 Vacant (C. Allen)EHS I 29 1/1/2019 1/1/2020 1 1 40 45,873.36 45,873.36 - 11,480.08 5,825.92 3,509.31 573.42 5306 239.62 229.37 21,857.71 21.97 10.47 55310 405 Dawson, Michael B Water Quality Manager EXE - 18 9/25/2009 5/1/2019 6 7 40 71,732.72 71,732.72 - 9,930.22 9,110.06 5,487.55 622.50 5306 239.62 358.66 25,748.61 34.35 12.33 55310 685 Clerk Hire Clerk Hire - Sumer Intern 56200 40 Kirkpatrick, Vicki (J. Baldwin)Public Health Director EXE - 22 3/15/2016 3/1/2019 11 max step 40 108,877.32 108,877.32 - 11,480.08 13,827.42 8,329.11 622.50 5306 239.62 544.39 35,043.12 52.14 16.78 56200 41 Vacant (L. Fleming)PH Assistant 23 1/1/2019 1/1/2020 1 1 20 18,384.84 18,384.84 - 6,295.41 2,334.87 1,406.44 229.81 5306 119.81 91.92 10,478.27 17.61 10.04 56200 145 Shaw, Veronica Deputy Director EXE - 20 10/1/1990 2/1/2019 9 10 40 87,067.63 87,067.63 - 9,930.22 11,057.59 6,660.67 622.50 5306 239.62 435.34 28,945.94 41.70 13.86 56200 221 Fountain, Debbie (E. Laing)Financial Operations Coord 27 3/16/2017 3/1/2019 2 3 32 35,653.57 35,653.57 - 9,442.38 4,528.00 2,727.50 445.67 5306 191.69 178.27 17,513.51 21.34 10.48 56200 325 Fleming, Lori (K. Alexander)Web Maint & Digital Comm Spec 28 2/15/2016 5/1/2019 1 2 12 13,502.28 13,502.28 - 4,197.43 1,714.79 1,032.92 168.78 5306 71.88 67.51 7,253.32 21.56 12.25 56200 415 Fleming, Lori (K. Alexander)CHIP Exec Director EXEMPT 5/1/2018 5/1/2019 1 2 20 35,612.50 35,612.50 - 6,295.41 4,522.79 2,724.36 445.16 5306 119.81 178.06 14,285.58 34.11 12.25 56210 15 Marx, Randy EHS III (Temporary Assignment)35 5/1/1995 6/1/2019 8 9 40 68,961.52 68,961.52 - 9,930.22 8,758.11 5,275.56 622.50 5306 239.62 344.81 25,170.81 33.03 12.05 56210 16 Atkins, Linda EHS III 35 8/14/1989 8/1/2019 11 max step 40 73,205.28 73,205.28 2,200.00 9,930.22 9,297.07 5,600.20 622.50 5306 239.62 366.03 26,055.64 35.06 12.48 56210 47 Parker, Roger (P. Mingo)EHS II 32 9/2/2014 9/1/2019 3 4 40 54,218.40 54,218.40 - 11,480.08 6,885.74 4,147.71 622.50 5306 239.62 271.09 23,646.73 25.97 11.33 56210 205 Satterlee, Dorian (C. Fiedler)EHS I 29 1/1/2019 1/1/2020 1 1 40 45,873.36 45,873.36 - 11,480.08 5,825.92 3,509.31 573.42 5306 239.62 229.37 21,857.71 21.97 10.47 56210 235 Kwansa, Mina EHS II 32 10/6/2010 7/1/2019 5 6 40 57,219.36 57,219.36 - 9,930.22 7,266.86 4,377.28 622.50 5306 239.62 286.10 22,722.57 27.40 10.88 56210 305 Schauer, Denese EHS I 32 4/1/2013 4/1/2019 1 2 35 45,634.75 45,634.75 - 10,229.13 5,795.61 3,491.06 570.43 5306 209.66 228.17 20,524.07 24.98 11.23 56210 410 Vacant (New)EHS I 29 1/1/2019 1/1/2020 1 1 40 45,873.36 45,873.36 - 11,480.08 5,825.92 3,509.31 573.42 5306 239.62 229.37 21,857.71 21.97 10.47 56210 411 Mingo, Pinky (New)EH Manager EXE - 18 9/4/2018 9/1/2019 4 5 40 66,952.08 66,952.08 - 11,480.08 8,502.91 5,121.83 622.50 5306 239.62 334.76 26,301.70 32.07 12.60 56210 680 Porto, Susan EHS III 35 4/5/1999 11/1/2019 11 max step 36 65,884.75 65,884.75 1,620.00 9,088.44 8,367.36 5,040.18 622.50 5306 215.65 329.42 23,663.57 35.06 12.59 56220 20 Vacant (J. Danskin)Clinic Manager EXE - 15 1/1/2019 1/1/2020 1 1 40 56220 23 Vacant (T. Newton)Community Health Director EXE - 20 1/1/2019 1/1/2020 3 3 40 74,374.32 74,374.32 - 11,480.08 9,445.54 5,689.64 622.50 5306 239.62 371.87 27,849.24 35.62 13.34 56220 25 McKenzie, Lisa PHN III 37 2/12/1991 5/1/2019 11 max step 40 78,801.12 78,801.12 2,200.00 9,930.22 10,007.74 6,028.29 622.50 5306 239.62 394.01 27,222.37 37.74 13.04 56220 30 O'Brien, Susan Lead Nurse Practitioner 44 11/1/1997 11/1/2019 11 max step 28 71,384.54 71,384.54 1,260.00 7,302.22 9,065.84 5,460.92 622.50 5306 167.73 356.92 22,976.13 48.84 15.72 56220 35 Calahan, Aimee (J. Syska)Financial Operations Coord 27 3/5/2018 3/1/2019 1 2 28 30,439.25 30,439.25 - 8,393.39 3,865.78 2,328.60 380.49 5306 167.73 152.20 15,288.20 20.83 10.46 56220 47 Boyd, Margie PHN II 35 9/1/2002 9/1/2019 11 max step 40 73,205.28 73,205.28 1,400.00 9,930.22 9,297.07 5,600.20 622.50 5306 239.62 366.03 26,055.64 35.06 12.48 56220 75 Kirkegaard, Sarah ARNP 42 9/2/2010 9/1/2019 8 9 22 48,784.03 48,784.03 - 5,962.56 6,195.57 3,731.98 609.80 5306 131.79 243.92 16,875.62 42.48 14.69 56220 76 Obermeyer, Karen M Community Health Educator 31 10/16/2007 10/1/2019 11 max step 40 63,182.88 63,182.88 1,000.00 9,930.22 8,024.23 4,833.49 622.50 5306 239.62 315.91 23,965.97 30.26 11.48 56220 80 Vacant (M. Haley)PHN I 32 56220 81 Vacant (K. deVeaux)PHN I 32 56220 90 Danskin, Julia (D. Langlois)PHN II 35 4/8/1991 7/1/2019 11 max step 40 73,205.28 73,205.28 2,200.00 9,930.22 9,297.07 5,600.20 622.50 5306 239.62 366.03 26,055.64 35.06 12.48 56220 100 Jane, Sarah (L. Ceehorne)PHN I 32 8/1/2017 8/1/2019 6 7 30 43,892.10 43,892.10 - 8,917.89 5,574.30 3,357.75 548.65 5306 179.71 219.46 18,797.75 28.03 12.00 56220 120 ZZ Nurse Hire ARNP 3 5,564.00 5,564.00 - 1,720.29 - 425.65 69.55 5306 17.97 27.82 2,261.27 35.53 14.44 56220 180 Banker, Denise (K. Matlock)Comm Health Educator 31 2/24/2014 8/1/2019 4 5 40 53,718.56 53,718.56 - 11,480.08 6,822.26 4,109.47 622.50 5306 239.62 268.59 23,542.51 25.73 11.28 56220 610 Rafferty, Kimberly J.PHN II 35 1/25/2013 2/1/2019 4 5 22 34,641.24 34,641.24 - 6,819.90 4,399.44 2,650.06 433.02 5306 131.79 173.21 14,607.41 30.16 12.72 56220 627 Umeda, Yuko PHN III 37 9/1/1988 2/1/2019 11 max step 35 68,950.98 68,950.98 1,925.00 8,865.16 8,756.77 5,274.75 622.50 5306 209.66 344.75 24,073.61 37.74 13.18 56220 630 Anderson, Kathy Nutritionist 34 11/1/2007 11/1/2019 11 max step 20 35,297.64 35,297.64 500.00 5,516.00 4,482.80 2,700.27 441.22 5306 119.81 176.49 13,436.59 33.81 12.87 56220 650 ZZ Nurse Hire Nurse Hire (PHN) 56220 660 Luch, Kathy PHN I 32 4/16/1991 7/1/2019 11 max step 22 36,036.79 36,036.79 1,210.00 5,962.56 4,576.67 2,756.81 450.46 5306 131.79 180.18 14,058.48 31.38 12.24 56220 675 MacKenzie, Mary Jo PHN II 35 11/1/1997 7/1/2019 11 max step 35 64,054.62 64,054.62 1,575.00 8,865.16 8,134.94 4,900.18 622.50 5306 209.66 320.27 23,052.72 35.06 12.62 56800 30 McEnery, Anna DD Coordinator & 1/10th Coord 30 1/1/1992 1/1/2020 11 max step 40 60,927.84 60,927.84 2,200.00 9,930.22 7,737.84 4,660.98 622.50 5306 239.62 304.64 23,495.79 29.18 11.25 Multi 10 Whitford, Stuart (J. Keefer)Env Health & Water Quality Dir EXE - 20 2/15/2017 2/1/2019 11 max step 40 94,215.12 94,215.12 - 11,480.08 11,965.32 7,207.46 622.50 5306 239.62 471.08 31,986.05 45.12 15.32 Multi 45 Parke, Susan Financial Operations Coord 27 3/29/2000 3/1/2019 11 max step 40 54,517.68 54,517.68 1,400.00 9,930.22 6,923.75 4,170.60 622.50 5306 239.62 272.59 22,159.27 26.11 10.61 Multi 50 Marx, Cynde A Medical Records Clerk 22 4/16/2012 4/1/2019 7 8 35 36,649.34 36,649.34 - 10,229.13 4,654.47 2,803.67 458.12 5306 209.66 183.25 18,538.29 20.06 10.15 Multi 55 Larson, Aimee (H. Sebastian)Medical Records Clerk 22 10/7/2016 10/1/2019 6 7 40 40,363.92 40,363.92 - 11,480.08 5,126.22 3,087.84 504.55 5306 239.62 201.82 20,640.12 19.33 9.89 Multi 130 VonVolkli, Kelly Medical Records Clk - Lead 24 7/10/2006 2/1/2019 11 max step 40 48,838.32 48,838.32 1,000.00 9,930.22 6,202.47 3,736.13 610.48 5306 239.62 244.19 20,963.11 23.39 10.04 Multi 160 Vacant (C. Oppe)Financial Manager EXE - 17 1/1/2019 1/1/2020 1 1 40 56,431.68 56,431.68 - 11,480.08 7,166.82 4,317.02 622.50 5306 239.62 282.16 24,108.20 27.03 11.55 Multi 245 Reynolds, Shirley Financial Support Specialist 24 2/25/2008 2/1/2019 11 max step 40 48,838.32 48,838.32 1,000.00 9,930.22 6,202.47 3,736.13 610.48 5306 239.62 244.19 20,963.11 23.39 10.04 Multi 300 Locke, Dr. Thomas Health Officer 2/16/1996 8 40,761.94 40,761.94 - - 3,118.29 509.52 1501 446.60 203.81 4,278.22 97.61 10.24 Multi 400 Tucker, Laura EHS II 32 3/5/2014 3/1/2018 1 2 40 52,258.16 52,258.16 - 11,480.08 6,636.79 3,997.75 622.50 5306 239.62 261.29 23,238.02 25.03 11.13 Multi 412 Pullman, John (C. Allen)EH Tech 24 2/1/2018 2/1/2019 1 2 40 39,023.60 39,023.60 - 11,480.08 4,956.00 2,985.31 487.80 5306 239.62 195.12 20,343.91 18.69 9.74 Multi 413 Henley, Alex (New)Permit Tech I 22 6/1/2017 6/1/2019 2 3 12 11,059.87 11,059.87 - 4,197.43 1,404.60 846.08 138.25 5306 71.88 55.30 6,713.54 17.66 9.88 Multi 600 ZZ Clerk Hire Clerk Hire 6.25 6,525.00 6,525.00 - - - 499.16 81.56 5306 37.44 32.63 650.79 20.00 1.99 Multi 608 Nutsford, Joeen (S. Grimm)Medical Records Clerk 22 10/23/2017 10/1/2019 4 5 20 19,213.56 19,213.56 - 6,295.41 2,440.12 1,469.84 240.17 5306 119.81 96.07 10,661.41 18.40 10.21 Multi 670 Matter, Jennifer (D. Banker)PH Assistant 23 8/29/2016 8/1/2019 5 6 40 41,018.00 41,018.00 - 11,480.08 5,209.29 3,137.88 512.73 5306 239.62 205.09 20,784.67 19.64 9.95 56200 676 Vacant HRSA Project Coordinator EXEMPT 9/1/2018 9/1/2019 1 1 35 31,119.50 31,119.50 - 10,229.13 3,952.18 2,380.64 388.99 5306 209.66 155.60 17,316.20 23.03 12.82 1,831.25 2,737,035.98 2,737,035.98 22,690.00 489,237.98 340,891.50 209,383.25 28,372.21 11,128.98 13,685.18 1,092,699.10