HomeMy WebLinkAbout03 March
JEFFERSON COUNTY BOARD OF HEALTH
MINUTES
Thursday, March 21, 2002
Board ¡ì1.em ber.r:
Dan Titterness, AIember - County Commissioner District #1
Glen Hlf1ztÙzgford, Member - COlf1z~y Commissioner District #2
Richard Lf7qil, Member - C014n~y Commij'jioner District #3
Geqff~y Masci, Vice Chairman - Port Townse¡¡d City Council
]ill BuNer. Member - Hospital Commissioner District #2
Sheila Uí'esterman. Chairman - Citizen at Large (City)
Roberta Fri-r-rell, Member - Citizen at LArge (County)
Staff l\dem ber.r:
Jean BaldzvÙz, Nursing Services Director
LArry Fqy, Environme¡¡tal Health Dim10r
ThomaJ Locke, MD, Heall/.! Officer
Chairman Westerman called the meeting to order at 2:30 p.m. All Board and Staff members were
present, with the exception of Commissioner Wojt.
APPROVAL OF AGENDA
Member Masci moved to approve the Agenda. Commissioner Titterness seconded the motion, which
carried by a unanimous vote.
APPROVAL OF MINUTES
Member Masci moved to approve the minutes of February 21, 2002 with one correction to page one,
paragraph one, which should state "Chairman Westerman called the meeting to order" rather than
"Chairman Buhler." Member Buhler seconded the motion, which carried by a unanimous vote.
PUBLIC COMMENT - None
OLD BUSINESS
Complaint Response Procedure: Commissioner Titterness inquired about the status of the
Complaint Response Procedure. Larry Fay said Risk Management is reviewing the document, with the
County Prosecutor doing a final review. He agreed to follow-up with Deputy County Prosecutor David
Alvarez.
HEALTH BOARD MINUTES - March 21, 2002
Page: 2
NEW BUSINESS
2002 Legislative Session Report - Bills. Backfill. Bonds And Bioterrorism: Dr. Tom Locke
reported that a number of bills will have significant, but not immediate impacts dealing with changes in
health care codes and the roles of local Boards of Health, and can be dealt with by the Board over time.
Most surprising to report is that backfill funding will remain through June 2003. This means the County
will not have to dismantle about 50% of communicable disease control capabilities in the State. Even
though the State remains in crisis because funding will not continue past the end of the biennium, there
will be additional time to come up with a more comprehensive, stable funding source for essential public
health services. Local public health people are working hard on a federal bioterrorism plan to make
Washington State eligible for $20 million a year in federal bioterrorism preparedness funds, the deadline
of which is one month away.
Commissioner Huntingford asked whether the $20M earmarked for Washington State would fill some of
the other funding gaps? Dr. Locke explained that almost no federal money could be transferred or used
to fund other areas of public health. Although it was originally thought that these funds would go to the
State for distribution, the Federal guidelines are 80% local, 20% State and any state-wide plan has to
have the consultation and endorsement of local health.
Jefferson County Behavioral Risk Factor Surveillance System œRFSS) Report: Jean
Baldwin recognized that funding for this study came from the City and the Health Department.
Dr. Chris Hale then provided background on the BRFSS, which is designed and carried out by the
Centers for Disease Control. She explained how the survey was administered, noting the remarkably
high success rate of 80% to the 170-question survey. After explaining how the data is organized, she
summarized the findings under the following six message statements:
1.
Adults in Jefferson County generally enjoy better health than the State average.
· Life expectancy is consistently higher than Washington State - 79 years as opposed to 77.
· On the self-reported health status, Dr. Hale noted the Fair/Poor response is high and
comes from the 18-34 age range. She noted this is one of the first indicators that this age
group looks different from the rest of the County - and not in a good way.
Of the first standard quality of life indicators, physical health looks similar to the State
average and mental health looks better than the State. In terms of adult health, indicators
look very good.
.
2.
Adults in Jefferson County generally have as good or better access to health care as the
State average.
· Ninety percent of the adult population has some kind of health insurance. This varies
dramatically by age, with the 18-34 year olds most often without health care coverage.
While 85% reported they have a person they go to for medical care, no question asked
how far they have to travel to see that doctor. Commissioner Huntingford suggested that
it might be interesting to review bridge closure information from the Department of
Transportation to try to answer this question.
.
HEALTH BOARD MINUTES - March 21, 2002
Page: 3
3.
4.
· Eighty-eight percent indicated they had a place they could go if they were sick or needed
health advice.
· The percentage of those seeing a doctor in the past year for a routine check-up - 75% -
was significantly higher than the State average of 68%. Vice-Chairman Masci noted that
the remaining 25% are those who are served by public health.
· Although 29% have been told they have high blood pressure, compared with the State
average of 22%, when compared with age-specific rates there is no difference.
· Sixty-seven percent reported they have used a home blood stool test kit, as opposed to
41 % of the State.
· Seventy-two percent of the adults made a dental visit in the last year, compared with 67%
of the State. The exception is the 18-34 year olds.
In general, among Jefferson County adults, rates of behaviors that predict good health are
higher, and rates of behaviors that predict poor health are lower.
· In this County, only 16% of adults now smoke, which is significantly less than the State
(21 %) or Kitsap County (23%).
Twenty-nine percent consider themselves at risk for health problems related to being
overweight as compared with 36% seen for the State.
Only 13% reported being at risk for health problems associated with physical inactivity,
compared with 27% of the State. In line with the new guidelines to be physically active at
least 5 days a week for at least 30 minutes a day, surprisingly, 87% of those who are
physically active are active at that recommended rate.
Thirty-four percent of those considered heavy drinkers also currently smoke. There was
also a strong association between heavy drinking and being overweight.
·
·
·
Jefferson County's drinking patterns are different from the State.
· Sixty-eight percent consumed alcohol in the past 30 days, compared with 61 % in the
State.
A larger proportion of men than women consumed alcohol. However, for both men and
women, consumption was significantly higher than the State.
The more years of education, the more likely you are to drink alcohol. Jefferson County is
extremely well educated.
When looking at alcohol consumption over the last 30 days, Jefferson County is very
different from the State. Those consuming 1-5 days per month was 49% as opposed to
60% in the State, those consuming 6-10 days and 11-20 days were similar to the State
percentages, but 24% said they consumed alcohol 20 days or more, compared with 8% of
the State. Most of that 24% consumed alcohol 30 of the past 30 days. These rates are
similar with European drinking patterns.
Of those respondents who drink, men drank 14 out of the last 30 days, and women drank
9.1 out of 30. The average number of drinks consumed per day was 1.7 - males drank an
average of 2.0 drinks per day while women drank 1.5 drinks.
Seventeen percent of County adults were heavy drinkers, which is significantly lower
than that for the State, 23%.
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HEALTH BOARD MINUTES - March 21,2002
Page: 4
5. County residents report higher rates of childhood abuse than the State average, and this
abuse affects their adult functioning. Dr. Hale prefaced this data by saying that for some time
there has been concern in the public health community about domestic violence and considerable
concern about the life-long effects of children seeing violence. She noted that when asking about
current experience with violence, the rates were so low the data was not usable.
· The percentage of those saying they were punished violently was 9%, slightly higher than
the State response of 7%.
· Twelve percent reported being sexually abused before the age of 18, compared with 9%
in the State.
· To the question of whether they saw a parent or guardian abused, 11 % answered yes.
· 25% reported having seen or experiencing physical or sexual abuse, compared with 20%
in the State, which is statistically significant.
· People younger than 65 were more likely to report abuse than 65 and older.
· Those with four plus years of college reported being physically abused at lower rates than
those with under 4 years.
· Women in Jefferson County were more likely to report sexual abuse than men. 18% of
women reported sexual abuse, compared with 14% in the State.
· People with childhood histories of any abuse reported, on average, more days of poor
health in the previous 30 days than people without such histories.
Vice-Chairman Masci mentioned that these statistics can also become predictors of not only medical
health needs, but law and justice needs.
6. Households with children younger than 18 have unusually dense concentrations of adults
who reported health care access problems and who smoke, drink heavily, and themselves
have childhood histories of abuse.
Dr. Hale said the goals of Healthy People 2000 are "optimizing life expectancy, optimizing quality of
life and to reduce disparities." Populations that have been identified as being radically different from the
rest of the population are households with children under the age of 18 and the 18-34 age group. In data
yet to be analyzed, there are some indications that these groups are not only different from other citizens
of the County, but are different than others of the same age groups in the State.
Dr. Hale summarized the survey findings by saying households in Jefferson County with children under
18 are disproportionately likely to have adults in those households who have abuse histories. She noted
the maternal child health indicators in Jefferson County remind her of Cowlitz County, which has some
of the worse health rates in the State. She recognized the expense of the survey ($25,000 - $32 per
respondent for data collection alone) and said the data should be useful over the next five years. She
added the 18-34 age group information is expected within a week.
Vice-Chairman Masci commented that he believes the project was a good investment. Other data can
now be compared with this fundamental database to make knowledge-based policy decisions. Dr. Hale
mentioned that Kellie Regan is now trained to do an in-house study and could create a sub-base of
questions.
Member Frissell pointed to the need for data on the jail population and school age children.
HEALTH BOARD MINUTES - March 21, 2002
Page: 5
Jean Baldwin said the next projects listed on the Data Steering Committee report are the prenatal risk
assessment survey of all county residents giving birth in 2002, a jail survey and school district survey.
Dr. Hale added that the prenatal risk survey will be largely based on the survey of women who gave birth
and include three questions of the respondent's childhood experience of abuse. Ms. Baldwin said that
four out of five school districts will participate. She noted that the data from the survey can only be
released on a county-wide basis. However, schools will have their data to release if they so choose.
In response to questions from Commissioner Huntingford about the ages of children to be surveyed and
whether students could opt out, Kellie Regan explained that the health needs survey is for 6t\ 8t\ 10th
and 12th grades, and she believes it is a passive parental consent, which provides an opportunity to
exempt the child.
The Board was impressed with the depth of analysis and thanked Dr. Hale, Jean Baldwin and Kellie
Regan for an incredible job.
Vice-Chairman Masci and Jean Baldwin then proposed convening a series of workgroups as a way of
presenting this information to others in the community (e.g. law and justice, healthcare providers, senior
services). Chairman Westerman asked that Staff propose a list of workgroups, so the Board can discuss
it at the next meeting.
Chairman Westerman and Member Buhler talked about their personal experiences as respondents in the
telephone survey. They said interviewers were friendly, professional, and nonjudgmental.
Chairman Westerman commented that this is the first time since she has been on the Board there has
been good, dependable information despite steadily dwindling resources. It is important to commit to
continuing this process because the situation will get increasingly difficult and the number of those at
risk groups is going to rise as resources go down. She encouraged the Commissioners to continue with
this process, recognizing that as they make difficult decisions, it will be vital to have valid information
with which to face difficult policy choices.
Vice-Chairman Masci moved that the Board of Health request that the County Commissioners
authorize expansion of this process to a jail survey, the structure and format of which would be
recommended through a team of Jean Baldwin, Kellie Regan and Dr. Hale. Member Frissell
seconded the motion.
Dr. Hale said she has insisted that any data collection has to be vetted by an institutional review board.
With the particular precautions around a jail population, such action would be absolutely necessary
before they could get the ~ork done.
Vice-Chairman Masci noted that because the existing data is paid for, the cost for this small additional
component would be minimal. Due to City/County policy making and the cost of criminal justice, he
stressed the importance of making good decisions and having good data on which to make those
decisions.
The motion carried. Commissioners Huntingford and Titterness abstained.
HEALTH BOARD MINUTES - March 21, 2002
Page: 6
Vice-Chairman Masci moved that the Board send a letter to the four school districts encouraging
them to participate in the health needs survey. Jill Buhler seconded the motion, which carried by a
unanimous vote.
Prenatal Risk Assessment Monitoring (PRAMS): Jean Baldwin reported that Staff has met
with both the hospital and the State and have come to agreement on the questions to be asked. The
hospital's financial support of the assessment will be encouraged. On April 2, the Environmental Health
customer satisfaction survey will begin and will include customers, realtors and designers. Regarding
maternal child health, Staff is in the process of a lengthy review of the Best Beginnings Project which in
July will reach the end of the 3-year contract with the University of Colorado. There will be some chart
review and evaluation of Family Planning to see if it is filling the access need for those 1,300 served, the
majority of whom are 18-34. Dr. Hale will be presenting the BRFSS data at a Substance Abuse
Committee community training session for the public and professionals on April 30th looking at
Methamphetamine treatment strategies.
Chairman Westerman commented that the expanded Board is a perfect opportunity to de-politicize
community and environmental health issues. She urged staff to present policy or program ideas to the
Board so that it can discuss how to apply the resources we have toward the issues, even if extra meetings
are needed to continue to address these problems.
Members Frissell and Buhler both spoke in favor of the County Commissioners using the Board as a
resource.
Commissioner Huntingford said his biggest fear with the expanded Health Board was that the County
Commissioners would make decisions based on a broader knowledge of what is going on in Jefferson
County. While the Board of Health may someday be upset that the County Commissioners did not listen
fully to their recommendations, he believes the Board understands better the issues with which the
County Commissioners faced such as the difficult decisions about whether to layoff people or add new
programs. He spoke in favor of the BRFSS as a good investment.
Pull Tab: Commissioner Titterness reported that a representative group showed up at the
County Commissioner hearing to speak on the issue and share their perspective. They commented that
there was not enough profit to take the full amount of the tax allowed. The County Treasurer also
researched the topic with another County and found that when the tax was implemented - about 40%
who were in the business of pull tabs got out. The issue was sent back to Gary Rowe for a
recommendation. Vice-Chairman Masci said the City Council has yet to discuss the matter.
Chairman Westerman said although it is never easy to begin, it is something to consider if it provides a
steady funding source for a program for a needy population. She said the Board could provide more support
for the County Commissioners if desired.
AGENDA CALENDAR/ADJOURNMENT
April Agenda Topic: Review the 18-34 year old BRFSS data.
HEALTH BOARD MINUTES - March 21,2002
Page: 7
Joint Board Meeting: Dr. Locke explained that Staff is trying to schedule a joint meeting with the
Hospital Commissioners. After the last meeting, the Board of Health was going to work on critical health
services, deciding what are the essential services and looking at the data collected to see what information
it provides. The Hospital was focused on patching gaps in health services. The biggest goal is to get
organized for the next health summit. Staff will continue to try to coordinate a meeting.
The meeting adjourned at 4:40 p.m. The next meeting will be held on Thursday, April 18, 2002 at 2:30
p.m. at the Jefferson County Health and Human Services Conference Room.
JEFFERSON COUNTY BOARD OF HEALTH
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(Excused Absence)
Richard W ojt, Member
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Roberta Frissell, Member
Erin Lundgren
BOCC Office
PO Box 1220
Port Townsend W A 98368
Jefferson County
Board of Healtä ~ rì" rc: r ~n.1 ~~ ¡-
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APR 0 2 2002
JEFFERSON COUNT'!
BOARD Of COMMfSSfOHERS
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Agenda
&
Minutes
March 21, 2002
JEFFERSON COUNTY BOARD OF BEALm
Thursday, March 21, 2002
2:30 - 4:30 PM
Main Conference Room
Jefferson Health and Human Services
AGENDA
L Approval of Agenda
ID. Approval of Minutes of Meetings of February 20, 2002
IV. Public Comments
v. Old Business and Informational Items
VI. New Business
1. 2002 Legislative Session Report - Bills, Backfill, Tom
Bonds, and BioT
2. Jefferson County Behavioral Risk Factor Surveillance
System (BRFSS) Report
- Introduction: Data Steering Committee Reps
- Survey Report
-Action Items: Subcommittees and Next Steps
GeofflRoberta
Chris Hale
3. Prenatal Risk Assessment Monitoring (PRAMS) Jean/Chris
VII. Agenda Planning
1. Joint Board Meeting
VIII. Next Meeting:
April 18, 2002 2:30 PM - 4:30 PM
JEFFERSON COUNTY BOARD OF HEA.I¡:JH
l\~f1 MINUTES U~A
ORr" Thursday, February 21, 2002 "1Fr
Board Members.'
Dan TitterneJI, Member - County Commissioner District # 1
Glen Huntingford, Member - County Commirtioner District #2
Richard W qjt, Member - County Commissioner DÙtrict #3
Geoffrry Masci, Vice Chairman - Port Townsend City Council
Jill Buhler, Member - Hospital Commissioner District #2
Sheila Westerman, Chairman - Citizen at LA~e (City)
Roberta Frisse/l, Member - Citizen at LAr;ge (Coun!YJ .
StqfJMembers.·
Jean Baldwin, Nursing Services Director
LArry Fqy, Environmental Health Director
Thomas Locke, MD, Health Officer
Chairman Buhler called the meeting to order at 2:30 p.m. All Board and Staff members were present,
with the exception of Commissioner Huntingford.
APPROVAL OF AGENDA
. Vice Chairman Masci moved to approve the Agenda. Commissioner Wojt seconded the motion, which
carried by a unanimous vote.
APPROVAL OF MINUTES
Member Buhler moved to approve the minutes of January 17,2002. Member Frissell seconded the
motion, which carried by a unanimous vote.
PUBLIC COMMENT
Charles Chase asked for an update regarding health issues on property located on the Egg and I Road,
which he brought to the Board's attention at the January meeting.
(See later in minutes: Chronology ofGaikowslci Complaint)
OLD BUSINESS
Letters to Board of County Commissioners and Port Townsend City Council Re: Gamblin!! Tax
Receiµts and Public Health Funding: Chairman Westerman asked if there were any comments on the
draft letter to the County Commissioners concerning the proposed gambling tax receipts and public
health funding?
"i
HEALTH BOARD MINUTES - February 21, 2002
Page: 2
Commissioner Titterness referred to the language inRCW 9.46.113, "...shall use the revenue from such
tax primarily for the purpose of enforcement of the provisions of this chapter by the county, city or town
law enforcement agency." This language appears to be inconsistent with the Board's original request.
Dr. Tom Locke and County Administrator Charles Saddler explained that the courts have used a broad
interpretation of this language and ruled that general support of law enforcement has a chilling effect on
illegal gambling, thus meeting the requirements of the statute. Because the tax has to be used for law
enforcement rather than public health, the letter asks to use these funds to offset other general fund
dollars for public health.
. Member Buhler pointed out that the last paragraph stating "maintain support for Jefferson County Public
Health systems during this period of crisis" does not sound like a request for ongoing support.
Dr. Locke explained that Public Health sees this as a symptom of a larger problem. If a dedicated source
of funding were found to replace lost municipal and county dollars and stabilize the public health
system, it is likely that the governing bodies might choose to reallocate this funding.
The Board suggested revising the letter to say, "during this period of uncertain public health funding"
rather than "during this period of crisis.'"
Vice Chairman Masci expressed fear that these funds could easily become diverted to another use over
time. He suggested a memorandum of understanding be approved between the City and County
clarifying that the gambling tax would be used for law enforcement so that other funding can go towards
public health.
County Administrator Saddler suggested the Board might want to relay this fear to both governing
bodies, asking that this intent be specified in an interlocal agreement with the level of funding calculated
on a formula basis.
Chairman Westerman agreed with the concern that funds could easily be reallocated over time and
recommended staff consider alternatives to ensure that the funds are specifically used for public health.
Commissioner W ojt moved that staff send the letter as amended. Vice Chairman Masci seconded
the motion, which carried by a unanimous vote.
Chronolou:y of Gaikowski Complaint: At the January 17, 2002 Health Board Meeting, Charles Chase
asked that something be done regrading the condition of his neighbors property on Egg & I Road in
Chimacum.
Chairman Westerman acknowledged that the Board received a timeline of activities on this matter and
noted an incorrect date. She expressed concern about the time that elapsed between the first site visit and
first notice. She asked for Board comments about the timeline.
Member Buhler asked whether there is documentation of further site visits?
HEALTH BOARD MINUTES - February 21, 2002
Page: 3
Larry Fay assumed staff has never been on the property. Because there was no response to the notice of
violation sent last September nor was the situation corrected, he believes staff would recommend this as
an opportunity to test the new civil infraction procedure from the On-site Sewage Code.
County Administrator Saddler said he believes this matter might develop into a criminal infraction.
Larry Fay said it would initially be a civil infraction to be ruled on by a judge, however if there is a lack
of compliance, the party may be held in contempt of court.
Vice Chairman Masci said if the goal is to remove the health danger from one piece .of property, fines
may not solve the problem. He is curious about the possibility of cleaning up the property and billing the
owner. It was suggested that staff investigate how Clallam County is handling such matters.
There was discussion of the County's enforcement authority. Dr. Locke indicated the Board of Health
has legislative authority to pass ordinances and resolutions for the abatement of nuisances.
Larry Fay said the law offers a broad defmition of a nuisance but nothing specifying how to abate one.
In response to questions about the effectiveness of ticketing to solve the problem, he used as an example
how Animal Services issues tickets - if a fine is paid but the problem is not remedied, another ticket is
written.
Vice Chairman Masci asked if there is support for drafting an enforcement ordinance for the Board of
Health?
Member Buhler asked if the Board is required to prove that the nuisance is a health hazard?
Dr. Locke said he believes it has to be health-related. In other words, a nuisance detrimental to public
health. There was Board support for a suggestion by Dr. Locke that staff first research what other Boards
of Health and Counties have done. J.
Chairman Westerman was supportive of the Board of Health, rather than the County Commissioners,
pursuing a fast track enforcement solution. Expressing interest in citizen complaints being addressed
promptly, she requested stipulating a response timeline in the policy.
Larry Fay responded that while there may be a need for a mechanism, he would discourage a specific
timeline. Each situation is different and a clear violation might not be able to be determined in 60 days.
Commissioner Wojt suggested writing the code so that indigence cannot be used as a defense.
County Administrator Saddler said the availability of a grant program could be part of the County's
record, which would be in the documentation submitted to the Court.
Larry Fay explained the County would soon finalize its standardized complaint response procedure,
establishing tracking, investigation, and enforcement measures as well as providing staff with
investigator certification training.
HEALTH BOARD MINUTES - February 21, 2002
Page: 4
NEW BUSINESS
Fee Committee Report re: Proposed Fee Increase: Chairman Westerman reviewed her experiences as
Chair of the Ad Hoc Fee Advisory Board under direction of the County Commissioners. After
considering their underlying charge that the fees should cover 100% of the delivery cost and 75% of the
administrative cost, some members forcefully disagreed with this approach. In later meetings, a number
of issues arose that seriously damaged the process. Several members had been led by a Commissioner to
believe that they did not have to honor the process as outlined. Some members proposed staff not be
allowed to participate. Members also violated the ground rule that they would not review each fee
individually by, at one point, taking control of the ~eeting to dq just that.
Chairman Westerman went on to report that even with two additional meetings, there was not enough
time allotted to complete the task. It would also have been helpful had the meetings been recorded. She
does not feel good about many of the specific recommendations produced by the committee because
they were made outside of the underlying direction. Some members did not support the group process or
the ultimate recommendations. A member agreed to circulate a draft report for Committee input before
delivering a final version to the County Commissioners. Chairman Westerman believes the County
Commissioners were brave to try to address the situation and hope they have the courage to move
forward.
David Sullivan commented that the experience was worthwhile. He and others learned a lot about the fee
structure. Some members felt if the County could cut costs, maybe fees would not need to be raised. - .
Others were concerned about affordable housing and the lack of control over rising costs in general. Still
others were concerned about employment. There was no agreement on where to cut the budget. While
members were aware of possible competition for funding, they did not want to raise the cost of a
building permit plan review or fill the empty planner position. The group had difficulty understanding
the connection between paying fees and maintaining the expected level of service. Each person wanted
an opportunity to express their individual view and submit their own report, so it will be hard to produce
a report summarizing the different opinions.
Chairman Westerman said members wanted vote tallies on each of the recommendations because there
were many close votes. It is her understanding that the Board of Health can set Environmental Health fees.
For the purpose of discussion, Vice Chairman Masci moved to submit to the County
Commissioners a recommendation that the Board of Health review and set the Environmental
Health fees. Commissioner Wojt seconded the motion. Staff noted that there are roughly 75 individual
fees covering solid waste, onsite sewage and food. The same rationale could be presented to the Board of
Health that was presented to the Fee Committee, which is that the County Commissioners would like the
fees imposed by the Building and Community Development Department and the Health Department to
pay for the delivery of the service and 75% of the administrative costs.
Commissioners and Mr. Saddler commented that because loss in revenue are already being felt, it may be
most efficient this year to run the fees through the County Commissioners rather than the Board of
Health. It was noted that the report by the Fee Advisory Committee is nearly 30 days overdue, but there
was Commissioner interest in postponing a decision until after examining that report.
HEALTH BOARD MINUTES - February 21, 2002
Page: 5
Vice Chairman Masci amended his motion to reflect that this review would take place beginning
next year. Commissioner Wojt seconded the motion as amended. There was further discussion about
the charge of the Fee Committee, which was to confirm that staff correctly interpreted the task given to
them by the County Commissioners, making fees cover the cost of the services provided. It was
recognized that the process was not as successful as it could have been because members of the Fee
Committee either did not agree with the philosophy or were unhappy with the specific results.
County Administrator Saddler pointed out that there will likely be a major mid-year revision of the
Health Department budget. The County may even need to revisit fees this year. The motion carried by a
unanimous vote.
Public Health Fundin~ Crisis: Dr. Locke said that the press packet from the February Conference in
Olympia contained many warnings from the Association of Local Public Health Officials and Health
Officers, often referring to public health in the state with this particular backfill funding as "the bottom of
a house of cards." It appears inevitable that the State legislature will fail to supply the needed money,
leaving the public at risk in certain areas of the State, especially regarding the communicable disease
programs. Dr. Locke talked about the severe budget loss in some Counties. New revenue forecasts reflect
a shortfall in the current biennium of up to $1.5 billion, which pales in comparison to what is expected in
the next biennium.
Jean Baldwin reported that some legislators mistakenly believe that federal anti-terrorism funding will
replace the $26 million in lost MVET funds. Although there may be some funding for staff exercises and
training, because the federal bio-terrorism funds are categorical, it is unlikely any of the bio-terrorism
money will show up in the budget.
Community Health Partnerships and Regional Public Health Service Coordination: Jean Baldwin
reviewed that at the last meeting, the Board was interested in having further discussions on fiscal matters.
There was also a desire not to have policy driven explicitly by the budget. With the potential for laying
off staff and closing programs, the Board also suggested investigating regional partnerships. Staff met
with Bremerton / Kitsap Health District and Clallam County and agreed to work on: 1) budget shortfalls
and maintaining a minimum amount of safety in public health for the communities; 2) efficiency studies
for clinical services; 3) regional bio-terrorism response; 4) training for hospitals and medical staff by Drs.
Locke and Lindquist; 5) program evaluations, billing, tracking and infrastructure; 6) reviewing new or
current programs before negotiating with State Departments of Health, Ecology, and Social and Health
Services; 7) developing ten shared indicators to track long-range community health; 8) fee structures; and
9) exploring a three-county arrangement to share resources on drug labs and drinking water issues.
Commissioner Wojt asked if the State legislature has been told that counties need a free hand to utilize
funds to provide minimum staff? Staff responded that the only non-categorical money counties are
receiving are the funds that are going away. The rest is categorical federal pass-through funding.
Jean Baldwin reported having a series of meetings with the hospital about the impacts of the
Department's closure of programs and cutback of services. They also discussed areas of future
HEALTH BOARD MINUTES - February 21, 2002
Page: 6
collaboration. The hospital expressed interest in certain findings from the Data Steering Committee and
the prenatal risk survey. She commented that it is staggering to think that if local public Health
Departments do not provide services, the State Department of Health, by statute, would be responsible for
providing them. She just received notice that about $60,000 in cuts, that were not expected until later, are
coming now.
County Administrator Saddler noted that the hits to operational capabilities will be more significant than
the reports have indicated - a 30-35% reduction. With the local Board of Health and Health Department
having liability, at what point will we say we can not do it and ask the State to take it over?
Jean Baldwin, as incoming chair for WSALPHO, said they wlIl define public health core issues that must
be funded. While they could close family planning, maternal child health, foot care, and other
unmandated programs, they will have to close out basic programs and hold the state accountable. Some
counties have said they will only do TB prevention.
Dr. Locke reviewed RCW 70.05.060 - Powers and Duties of Local Board of Health which he believes is
an important reference. Staff agreed to continue to provide budget updates. The Department may be in a
budget shortfall by June and a long-range planning session may be needed.
Community Delinquency Prevention Grant: Jean .Baldwin distributed a draft letter of support from the
Board for a juvenile justice grant which will enable the continuation of the OLDSlBest Beginning
Project. CommissionerWojt moved that the Board approve the letter of support. Vice Chairman
Masci seconded the motion, which carried by a unanimous vote.
Bioterrorism Preparedness Tabletop Exercise Follow-up Report: Dr. Locke noted that the agenda
packet included a copy of the January training exercise. The exercise was a good opportunity to appraise
how the Department worked in action, the biggest benefit being that it allowed other agencies to see how
dependant they would be on the local Health Department in a biologic emergency. At the end of the
exercise, they identified areas to work on: surge capacity, clear agency roles, and more collaboration
between the Health Department and the Hospital. It also underscored the importance of quick
communication to the media. A summary of the discussions and recommendations will be mailed to the
group. Once a local plan is complete, regional response planning will begin, which is where federal
funding is targeted. Several officials are frightened that it is not a matter of if, but when an biologic
emergency will occur. Based on this exercise, he believes there is a lot of talent with which to confront an
emergency.
Customer Survey: Larry Fay suggested this item be tabled until the next meeting. A telephone survey
instrument is being designed to regularly evaluate the on-site sewage program. The Board was asked to
submit questions it might want to ask Environmental Health clients.
HEALTH BOARD MINUTES - February 21, 2002
Page: 7
AGENDA CALENDAR / ADJOURN
Budget Shortfall Impacts and Update from Dr. Chris Hale on BRFSS.
The meeting adjourned at 4:35 p.m. The next meeting will be held on Thursday, March 21,2002 at 2:30
p.m. at the Jefferson County Health and Human Services Conference Room.
JEFFERSON COUNTY BOARD OF HEALTH
Sheila Westerman, Chainnan
Jill Buhler, Member
Geoffrey Masci, Vice Chairman
Richard W ojt, Member
(Excused)
Glen Huntingford, Member
Roberta Frissell, Member
Dan Titterness, Member
Board of Health
New Business
Agenda Item # 2
Jefferson County Behavioral Risk -
Factor Surveillance System
(BRFSS) Report
March 21, 2002
".~~
Staff Report BOH on Jefferson County Data Steering Committee 2001-02
March 21, 2002
Ongoing Process of Designing community indicators.
* Data are used to guide knowledge-based decisions about public policy. Strategic Planning is based on fiscally responsible
budgets.
* Jefferson County Data Steering Committee has been asked to review very detailed information, interpret the data, and
discuss strategies for sharing with the community & policy makers.
* Committee represents a several community agencies, government officials, and citizens.
* Completed evaluating vital statistics data through 2000 (birth, death, morbidity, mortality)
* Completed evaluating data from the short form of the 2000 Census(long form, which has detailed socioeconomic data is
due to begin public distribution in June 2002
Next Projects for the Data Steering committee
* Additional data needed - prenatal risk assessment survey of all county residents giving birth in 2002
o Jail survey and search through OWl, DV records
o Four Jefferson County school districts health and substance abuse survey 4-02
Next Projects or reports to Board of Health
* JCHHS program evaluation I customer satisfaction (are current programs meeting community needs identified in data)
o Survey of all EH customers and community realtors / designers to begin in 4/02
o Maternal Child Health - MDS, clients - 6/02
o Abstracting of Family Planning Clinic records - 7/02
* Work Groups-
o Family violence, Law & Justice
o Health care access, hospital, JCHHS, MDS
o Substance Abuse, Substance Abuse Board
o Seniors, OAAA, MDS, hospital
* Reports to the community
o Press - staff will submit short interpretation of data to the 2 papers. They may choose to do feature articles
o Substance Abuse Committee 4/30/02 Community Methamphetamine training with the community numbers
o Law & Justice meeting (5/02)
o Focused presentations to School administrators and teachers, hospital commissioners, physicians...
* Policy implications / schedule
1. Complete tasks of work groups utilizing the data steering committee and other community members' information
forums
2. What are ongoing measurements of community success, or indications of need that should be used by the County
Strategic Plan?
3. Program review / Health Department services, community human services and others? Measure program outcomes
over time. Evaluate effectiveness. These programs were chosen to because of documented community needs, and
their responsiveness to those needs should be measured.
4. Community education around ways to become healthier.
3/21/2002
JEFFERSON COUNTY 2001 BEHAVIORAL RISK FACTOR SURVEY
1. What is it?
The Behavioral Risk Factor Surveillance System (BRFSS) questionnaires consist of
modules or small groups of questions developed by the US Center for Disease Control
and Prevention (CDC) beginning about 1985. These questions all have validity and
reliability sufficient to meet the standard of scientific acceptability. The focus of modules
was originally on health care access and chronic disease risk factors, but in more recent
years it has been expanded to include modules on firearms, family violence, and
environmental health.
The Jefferson County BRF'SS questionnaire was administered to a random sample of
603 county residents betvveen April 1 and December 31, 2001. Although the sample
size might seem small, in fact it gives a statistically accurate portrait of the county's
adult population and allows us to calculate rates that are valid within a range of ±.4%.
The method used is the same used by political parties and other large organizations
that routinely do public polling.
Jefferson County's BRFSS questionnaire contained the following modules:
Self-reported health status
Health insurance coverage and access to a provider
Additional access questions getting at actual use of health care services, delay,
or lack of available care
High blood pressure knowledge and prevention behaviors
Cigarette and other tobacco use
Alcohol consumption
Firearms
Physical activity
Colorectal screening
Oral health
Environmental health
Family violence
The Jefferson County demographic questions, like those used by BRFSS generally, had
information that could be used to determine whether or not a person was ovefV\l6ight
based on body mass index (8MI). The county questionnaire also added questions
identical to those on the census about where respondents had lived five years earlier,
where they worked, and their one-way commuting time from home.
2. How is the data analysis organized?
We first calculated the prevalence rate of each risk factor or characteristic. That is,
what percent of the population had each factor or characteristic.
3121/2002
We next looked for statistical differences between these rates by five demographic
characteristics:
age (18-34 years old, 35-64 years old, 65+ years old)
education (used as a measure of socioeconomic well-being and defined as high
school or less, some post-secondary, 4+ years of college)
residence (ZI P code 98368 or other)
recent arrival in the county (lived here five years ago or lived elsewhere five
years ago).
Finally, we looked for statistically significant differences in rates between measures in
the BRFSS survey. For example, in assessing routine medical care and use of
preventive services, we compared those with a regular health care provider with those
not having a regular provider. We also compared the major health risk behaviors -
being overweight, physically inactive, currently smoking, heavy drinking - with each
other and with the major risk factors or other conditions.
3. How will the results be made public?
There will be two meetings of thè Data Steering Committee to review these findings,
March 8 and 20. A report will be made in the March 21 Board of Health meeting. Other
dissemination efforts will occur after those three meetings.
3/21/2002
Jefferson County 2001 BRFSS
Adult Health
Adults in Jefferson County generally enjoy better health than the state
average.
·
Life expectancy in Jefferson County has been higher than life expectancy in
Washington State for the past 20 years (Figure 1). For 1995-99, life
expectancy here was almost 79 years, compared with just over 77 years for
the state. The theoretical maximum life expectancy, given the current state of
medicine and technology, is considered to be 81-83 years.
·
Self-reported health status is a powerful predictor of a person's overall health.
22% of Jefferson County residents said their health was excellent, 35% said it
was very good, 27% said it was good, and 16% said it was fair or poor (Figure
2). These levels of self-reported health status are essentially the same as the
state percentages, except for the last one which is significantly higher (worse)
than the 12% of Washington State's adult population who rated their health
fair or poor.
· Adults were asked how many days in the past 30 their physical health was
not good. Sixty-three percent of county residents said "none", compared with
61 % of the state; 11 % of county residents said one or two compared with
14% of the state, and 26% of county residents said three or more compared
with 25% of the state (Figure 3). None of these differences is statistically
significant.
· Adults were asked how many days in the past 30 their mental health was not
good. Sixty-six percent of county residents said "none", significantly higher
(better) than the 60% of the state who said "none" (Figu re 4). Ten percent of
county residents said one or two, compared with 13% of state residents, and
24% of county residents said three or more compared with 27% of state
residents. The state and county rates are not significantly different for the last
two.
· Respondents were asked how many days in the past 30 they had been
limited in their usual activities by either poor physical or poor mental health.
Seventy-eight percent of county adults said "none", 14% said seven or fewer,
and 8% said more than seven (Figure 5). These rates are not significantly
different from the state rates.
Figure 1. Life Expectancy at Birth, Jefferson County and Washington State, 1980-84 through 1995-99
Period
1980-84
1981-85
1982-86
1983-87
1984-88
1985-89
1986-90
1987-91
1988-92
1989-93
1990-94
1991-95
1992-96
1993-97
1994-98
1995-99
3/21/02
Jefferson County
76.8
77.9
77.6
77.9
77.7
77.0
76.7
77.1
77.6
78.1
78.4
78.7
78.2
78.3
78.3
78.8
Washington State
75.1
75.3
75.5
75.6
75.6
75.8
75.9
76.2
76.4
76.5
76.6
76.8
76.8
76.9
77.1
77.3
Figure 1. Life Expectancy,
Jefferson County and Washington State,
1980-84 through 1995-99
Source: Deaths: Vital Statistics database, Jefferson County Health Department. Population 1980 and
1990, US Census; 1981-89, Office of Financial Management intercensal estimates; 1991-1999, OFM
intercensal projections. 1980-1990 figures are final; 1991-99 figures are provisional.
81.0
79.0
._n___.__..__..__..................._..____.............................................-.-...--..................................................--............................--.--.....--............-...--..
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ã:i 7
.. 7.0
III
:>;
g 75.0
.s
u
~ 73.0
w
~ 71.0
...J
...
o
S 69.0
III
>- 67.0
65.0
v
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Jefferson County
Washington State
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Figure 2. (Q1X1) Would you say that in general your health status is...
Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
Excellent
Very good
Good
Fair/Poor*
Jefferson County
22%
35%
27%
16%
Washington State
22%
38%
28%
12%
Figure 2. Self-reported health status,
Jefferson County 2001 BRFSS and
Washington State 2000 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001
BRFSS; Washington State. CDC website
100%
90%
80%
70%
60%
50%
40%
30%
22% 22%
20%
10%
0%
Excellent
¡_JeffersOn County DWashington State I
38%
Very good
Good
ì
l___ *County rate is significantly higher (worse) than state rate.
3/21/02
16%
12%
Fair/Poor*
Figure 3. (Q1X2) For how many days during the past 30 days was your physical health not good?
Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
None
One or two
Three or more
100%
90% .
80%
70%
60%
50%
40%
30%
20%
10%
0%
3/21/02
Jefferson County
63%
11%
26%
Washington State
61%
14%
25%
Figure 3. For how many days during the past 30 days
was your physical health not good?
Jefferson County 2001 BRFSS and
Washington State 2000 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001
BRFSS; Washington State, CDC website
I_ Jefferson County 0 Washington State I
63%
61%
26%
25%
14%
None
One or two
Three or more
Figure 4. (Q1X3) Now thinking about your mental health, which includes stress...
Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
None*
One or two
Three or more
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
3/21/02
Jefferson County
66%
10%
24%
Washington State
60%
13%
27%
Figure 4. For how many days during the past 30 days
was your mental health not good?
Jefferson County 2001 BRFSS and
Washington State 2000 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001
BRFSS; Washington State, CDC website
I_ Jefferson County 0 Washington State I
66%
60%
13%
27%
None*
One or two
Three or more
*County rate is significantly higher (better) than state rate.
Figure 5. (Q1X4) During the past 30 days for about how many days did poor physical or mental
health keep you from doing your usual activities?
Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
None
Seven or fewer
More than seven
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
L
Jefferson County
78%
14%
8%
Washington State
77%
16%
7%
Figure 5. How many days during the past 30 days were
you limited in your usual activities?
Jefferson County 2001 BRFSS and
Washington State 2000 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001
BRFSS; Washington State, CDC website
I · Jefferson County 0 Washington State I
78%
77%
16%
8%
7%
None
Seven or fewer
More than seven
3/21/02
3/21/2002
Jefferson County 2001 BRFSS
Health Care Access
Adults in Jefferson County generally have as good access to health care as the state
average, or they have better access.
·
Health insurance is needed to access most health care services. Ninety percent of people
in Jefferson County have some form of health insurance, the same as the state rate (Figure
1 ).
·
Having one doctor or health care provider is important in accessing health care services.
Eighty-five percent of county adults have one doctor or health care provider, about the
same as the state average, 83% (Figure 2).
·
Having one particular place to go when you need health care is also important. Eighty-
eight percent of county residents have such a place (Figure 3). Comparable rates for the
state will be available early in the summer.
· An annual, routine physical is an important protective aspect of health care. Seventy-five
percent of county adults had a routine physical within the previous 12 months, significantly
higher (better) than the state rate, 68% (Figure 4). Thirteen percent of county residents
had a routine physical within the past two years, about the same as the state rate, 15%.
Only 13% of county residents had a routine physical more than two years ago, significantly
lower (better) than the state rate, 17%.
· Eighty-six percent of adults said they or another adult in their household had not
experienced difficulty or delay in getting health care, and 14% said they had (Figure 5).
Comparable rates for the state will be available early in the summer.
· Twenty-nine percent of county adults have been told they have high blood pressure,
significantly higher (worse) than the state rate, 22% (Figure 6). Other data, not presented
here, indicate that this apparent excess occurs because the county population is older than
the state, and a diagnosis of high blood pressure becomes more common as a population
ages. Age-specific rates of blood pressure diagnosis among county residents are not
significantly different from those of the state.
· An important health care recommendation to detect colorectal cancer early, when more
than 90% can be treated without recurrence, is that people age 50 and older use a home
blood stool test kit (under a doctor or health care professional's direction). Sixty-seven
percent of adult respondents in Jefferson County age 50 and older had used such a kit,
significantly higher (better) than the state rate, 41 % (Figure 7).
· An annual dental visit is recommended for oral health. Seventy-two percent of county
adults had made a dental visit within the past year, a rate significantly higher (better) than
the state rate, 67% (Figure 8).
Figure 1. (Q2X1) Do you have any kind of healthcare coverage?
Jefferson County and Washington State 2001 BRFSS
Yes
No
Jefferson County
90%
10%
Washington State
90%
10%
Figure 1. Do you have any kind of health care
coverage? Jefferson County 2001 BRFSS and
Washington State 2000 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS;
Washington data from CDC website
100%
90% 90%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
.Jefferson County DWashington State
10% 10%
Yes No
L_
..-
--~--
3/21/02
Figure 2. (Q2x6) Is there one doctor or health provider who you usually go when you need
routine medical care? Jefferson County 2001 BRFSS & Washington State 1996
Yes
No
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
I
L_____
3/21/02
Jefferson County, 2001 Washington State, 1996
85% 83%
15% 17%
Figure 2. Is there one doctor or health care provider
you usually go to when you need routine medical
care? Jefferson County 2001 and Washington State
1996 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS;
Washington data from CDC website
85%
Yes
83%
.Jefferson County, 2001
DWashington State, 1996
17%
No
Figure 3. (Q19x1) Is there one particular clinic, health center, doctor's office, or other place
that you usually go if you are sick or need advice about your health?
Jefferson County 2001 BRFSS
Yes
No
Jefferson County, 2001
88%
12%
Washington State, 2001
Figure 3. Have one particular place you go to for care.
Jefferson County 2001 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS
100%
90%
88%
0%
12%
80%
70%
60%
50%
40%
30%
20%
10%
Yes
No
l__
3/21/02
Figure 4. (Q19x5) How long has it been since you last visited a doctor for a routine checkup?
Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
Within the past year*
Between one and two years
More than two years ago*
Jefferson County
75%
13%
13%
Washington State
68%
15%
17%
100%
90%
80%
75%
70% 68%
60%
50%
40%
30%
20%
10%
0%
Figure 4. How long has it been since you last visited
a doctor for a routine checkup?
Jefferson County 2001 BRFSS and Washington State
2000 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS;
Washington data from CDC website
¡_JefferSOn County DWashington State I
17%
15%
Within the past year*
Between one and two years
More than two years a90*
*County residents significantly more likely to have checkup within past year and significantly less
likely to have had one 2+ years ago.
L-_~_____
3/21/02
Figure 5. (Q20x2) In the last 12 months did you or any adult in your household?
experience difficulty or delay in obtaining health care? 2001 BRFSS
Yes
No
Jefferson County, 2001
14%
86%
Washington State, 2001
N/A
N/A
I 100%
90%
80%
70%
60% ~
50%
40%
30%
20%
10%
0%
;
j
I
I
L
3/21/02
Figure 5. Did you or any adult in your household
experience difficulty or delay in obtaining health care?
Jefferson County and Washington State 2001 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS
86%
14%
Yes
No
Figure 6. (Q4X1) Have you ever been told by a doctor, nurse or other health care professional that
you have high blood pressure? Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
Yes*
No
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
3/21/02
Jefferson County
29%
71%
Washington State
22%
78%
Figure 6. Have you ever been told by a doctor, nurse or
other health care professional that you have high blood
pressure? Jefferson County BRFSS, 2001 and
Washington State BRFSS, 1999
Source: Jefferson County - Department of Health & Human Services, 2001
BRFSS; Washington State 1999 BRFSS. CDC website
I_Jefferson County DWashington State I
78%
29%
0%
22%
Yes*
No
*Significantly more adults in county than in the state were told they had high blood pressure
Figure 7. (Q17x1) Have you ever used a home blood stool test kit?
Jefferson County 2001 BRFSS and Washington State 2000 BRFSS (respondents age 50+ only)
Yes*
No
Jefferson County
67%
33%
Washington State
41%
59%
Figure 7. (Q17x1) Have you ever used a home blood stool
test kit? Jefferson County 2001 BRFSS and Washington
State 1999 BRFSS respondents age 50+ only
Source: Jefferson County - Department of Health & Human Services, 2001
BRFSS; Washington State data from CDC website
100%
90%
80%
70% 67%
60%
50%
40%
30%
20%
10%
0%
Yes*
I_Jefferson County DWashington State I
59%
41%
33%
No
~-'--~
'County rate is significantly higher (better) than the state rate.
3/21/02
Figure 8. (Q21x1) How long has it been since you last visited a dentist or a dental clinic
for any reason? Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Dental visit for any reason within the past year
Jefferson County Washington State
Yes* 72% 67%
No* 28% 33%
Figure 8. Dental visit for any reason within the last
year*,Jefferson County 2001 BRFSS and Washington
State 1999 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS;
Washington data from CDC website
100%
90%
80%
72%
70%
60%
50%
40%
30%
20%
10%
0%
I
I
L_
Yes*
'County rate is significantly higher (better) than the state rate.
J
.Jefferson County DWashington State
67%
33%
No*
3/21/02
4/16/2002
Jefferson County 2001 BRFSS
Risk and Predictive Behaviors
In general among county adults, rates of behaviors that predict good health
are higher, and rates of behaviors that predict poor health are lower.
· Cigarette smoking is among the very worst risk-taking behaviors, because it is
associated with so many diseases. Only 16% of Jefferson County adults
smoked cigarettes in 2001, significantly lower (better) than the rates seen in
either Kitsap County (23%) or the state (21 %, Figure 1).
· Being overweight puts people at risk for a number of conditions that can-
cause poor health. Only 29% of county adults were overweight when body
mass index (the relationship of height and weight) was computed, a rate
significantly lower (better) than the state rate, 36% (Figure 2).
· Being physically inactive (neither engaging in physically demanding work nor
having any leisure time activity or being active fewer than three times a week
for at least 20 minutes/time) is associated with conditions that can cause poor
health. Only 13% of county adults were physically inactive, a rate significantly
lower (better) than the state rate, 27% (Figure 3).
· Alcohol consumption can be protective: adults who drink an average of 1-2
drinks on most days, moderate drinkers, have lower death rates than those
who abstain. But the highest death rates are among heavy drinkers, those
who consumed five or more drinks at one time in the past 30 days.
Seventeen percent of county adults were heavy drinkers by that standard, a
significantly lower (better) rate than that for the state, 23% (Figure 4).
· The presence of anyone risk behavior is associated with threats to good
health. Multiple risks represent even greater threat. We evaluated all
possible combinations of the risks cited above and found
o Among those who currently smoke, 34% reported heavy drinking within
the previous 30 days (Figure 5). This is twice the average prevalence.
o Among those who are overweight, 27% reported heavy drinking within
the previous 30 days (Figure 6). This is almost 60% above the
average prevalence of heavy drinking among all county adults.
o Among people who are overweight, 18% were physically inactive
(Figure 7). This is significantly above the county's average inactivity
level among adults, 13%.
Figure 1. (Q10x2) Do you smoke everyday, some days, or not at all?
Jefferson County BRFSS, 2001; Kitsap County BRFSS, 1998 and Washington State BRFSS, 2000
Jefferson County*
Current Smoker 16%
Kitsap County
23%
Washington State
21%
Figure 1. (Q10x2) Currently Smoke,
Jefferson County BRFSS, 2001,
Kitsap County BRFSS, 1998,
and Washington State BRFSS, 1998
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS;
Washington data from CDC website; Kitsap data from Bremerton-Kitsap County Health
District, Office of Assessment.
100%
90%
80%
70%
60%
50%
40%
30%
23% 21%
20% 16%
10%
0%
Jefferson County*
Kitsap County
Washington State
County rate is significantly lower (better) than Kitsap and state rates.
4/16/02
Figure 2. At risk for health problems related to being overweight?
(NHANES definition,BMI >=27.8 for males, >=27.3 for females)
Jefferson County and Washington State 2001 BRFSS
Jefferson County*
Washington State
29%
36%
Figure 2. At risk for health problems related to
being overweight? Jefferson County and
Washington State 2001 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
90%
80%
70%
60%
50%
401'0 1 36%
I
30% ~ 29%
20%
0%
10%
Jefferson County*
Washington State
County rate is significantly lower (better) than the state rate.
i
J
4/16/02
Figure 3. At risk for health problems related to physical inactivity?
(No physical activity or <3 times/week, 20 minutes day)
Jefferson County and Washington State 2001 BRFSS
Jefferson County*
Washington State
13%
27%
Figure 3. At risk for health problems related to
physical inactivity? Jefferson County 2001 and
Washington State 2000 BRFSS
-1
I
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
90%
80%
70%
60%
50%
40%
30%
27%
13%
i
¡
Washington State I
I
----~
20%
0%
10%
I
I
l
Jefferson County*
County rate is significantly lower (better) than the state rate.
4/16/02
Figure 4. (Q11x3) Consumed 5+ drinks of alcohol at least once in past 30 days
Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County·
Washington State
I--
I
I
I
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
17%
23%
Figure 4. Consumed 5+ drinks of alcohol at
least once in past 30 days, Jefferson County
2001 BRFSS* and Washington State 1999
BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
23%
17%
Jefferson County*
Washington State
---._----
County rate is significantly lower (better) than the state rate.
"---.-----
4/16/02
------.--..----
-1
I
Figure 5. Heavy drinking (5+/time)* among current smokers.
Jefferson County BRFSS, 2001.
Current Smoker
Non-Smoker
Heavy Drinker (5+1time)
Heavy Drinking No Heavy Drinking
34% 66%
15% 85%
Figure 5. Heavy drinking (5+/time) and smoking*,
Jefferson County BRFSS, 2001
Source: Jefferson County Department of Health & Human Services BRFSS, 2001
100%
90%
. Current Smoker
o Non-Smoker I
85%
80%
70%
66%
0%
15%
60%
50%
40%
34%
30%
20%
10%
Heavy Drinking
No Heavy Drinking
·Difference is statistically significant, p<.01
4/16/02
Figure 6. Heavy drinking (5+/time)* and overweight.
Jefferson County BRFSS, 2001.
Overweight by BMI
Not overweight
Heavy Drinker (5+1time)
Heavy Drinking No Heavy Drinking
27% 73%
15% 86%
Figure 6. Heavy drinking (5+/time) and
overweight by BMI*,
Jefferson County BRFSS, 2001
Source: Jefferson County Department of Health & Human Services BRFSS, 2001
100%
90%
80%
70%
60%
50%
40%
30% 27%
20% 15%
86%
73%
0%
10%
Heavy Drinking
No Heavy Drinking
"Difference is statistically significant, p<.01
4/16/02
Figure 7. Physical inactivity among overweight respondents.
Jefferson County BRFSS, 2001.
Physically Active
Physically Inactive
Overweight
82%
18%
Not Overweight
90%
10%
Figure 7. Physical inactivity among people
overweight by BMI*,
Jefferson County BRFSS, 2001
Source: Jefferson County Department of Health & Human Services BRFSS, 2001
. Physically Active
o Physically Inactive
100%
90%
90%
0%
18%
10%
82%
80%
70%
60%
50%
40%
30%
20%
10%
Overweight
Not Overweight
'Difference is statistically significant, p<.05
4/16/02
April 16, 2002
TO: Board of Health
FROM: Kellie Ragan
SUBJECT: Risk and Predictive Behavior BRFSS Module
Enclosed is the revised Risk and Predictive Behavior BRFSS Module. The one that you
received on March 21, 2002 contained construct errors related Figure 7.
Please feel free to recycle the March 21 version.
Thank you.
3/21/2002
Jefferson County 2001 BRFSS
Alcohol Consumption
Jefferson County's drinking patterns are different from those of the state.
· The health effects of alcohol are complex. Those who abstain from alcohol have
higher mortality rates than those who drink in moderation (1-2 drinks at one time).
However, some people are unable to drink in moderation. Heavy drinking (defined
as consuming five or more drinks at one time in a 30 days period) is a risk factor for
poor health.
. Sixty-eight percent of the county's adult residents consumed at least one drink of
alcohol in the 30 days before the survey (Figure 1). This is significantly higher than
the state rate, 61 %.
· Within the county, 73% of men drank alcohol in the past 30 days compared with 63%
of women; the difference is statistically significant (Figure 2). Alcohol consumption
rates within gender are also significantly higher among county residents than the
state averages.
. Within the county, alcohol consumption rates within the past 30 days increase with
education. Sixty percent of those with a high school education or less consumed
alcohol in the previous 30 days compared with 65% of those with some post-
secondary education, and 77% of those who had four years or more of college _
(Figure 3). All of these differences are statistically significant. Alcohol consumption
rates at all education levels are also significantly higher in the county than in the
state.
· County residents drink on more days in a 3D-day period than the state average.
Forty-nine percent of those who drink do so on 1-5 days of the past 30 compared to
60% for the state (Figure 4); the difference is statistically significant. Twelve percent
drank on six to 10 days compared with 14% in the state, and 15% drank on 11-20
days compared with 17% in the state; neither difference is statistically significant.
Twenty-four percent of county residents drank on 20+ days compared with 8% in the
state; this difference is also statistically significant. Most people in this category
drank every day in the past 30 days.
· On average, county residents drank on about 12 in the past 30 days (Figure 5). Men
drank on more days (14.4) than women (9.1); the difference is statistically significant.
· On average, county residents consumed 1.7 drinks on days when they drank (Figure
6). Men drank an average of 2.0 drinks, and women drank 1.5 drinks. The
difference is statistically significant, and the levels of drinking reported are at the
recommended gender-specific protective rates.
· Heavy alcohol consumption, drinking five or more drinks at one time in the past 30
days, is considered a risk factor for poor health. Seventeen percent of county adults
were heavy drinkers by that standard, a significantly lower (better) rate than that for
the state, 23% (Figure 7).
Figure 1. (Q11x1) Consumed alcohol in past 30 days
Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County
Washington State
68%
61%
Figure 1. Alcohol consumption in past 30 days,
Jefferson County 2001 BRFSS*
and Washington State 1999 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
90%
80%
70%
68%
0%
61%
60%
50%
40%
30%
20%
10%
Jefferson County
Washington State
County rate is significantly higher than the state rate.
3/21/02
Figure 2. (Q11x1) Alcohol consumption by gender
Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County
73%
63%
Washington State
67%
55%
Male
Female
Figure 2. Alcohol consumption by gender,
Jefferson County 2001 BRFSS* and
Washington State 1999 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
90%
'_Jefferson County DWashington State I
80%
730/.
70%
67%
63%
60%
55%
50%
40%
30%
20%
10%
0%
Male
Female
Gender difference is statistically signficant, p=.05; state/county differences significant for both genders
3/21/02
Figure 3. (Q11x1) Alcohol consumption by education
Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Washington State
53%
61%
Jefferson County
60%
65%
o
High school or less
Some post-secondary
4+
o
Figure 3. Alcohol consumption byeducation*,
Jefferson County 2001 BRFSS and
Washington State 1999 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
I .Jefferson County DWashington State I
90%
80%
77%
70%
70%
65%
61%
60%
60%
53%
50%
40%
30%
20%
10%
0%
High school or less
Some post-secondary
4+ years of college
-Difference between levels in county is statistically significant, p<.001; state/county rates
significantly different at all levels
3/21/02
Figure 4. (Q11x1) Number of days in past 30 days when alcohol was consumed
Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
1-5 days
6-10 days
11-20 days
20+ days
Jefferson County
49%
12%
15%
24%
Washington State
60%
14%
17%
8%
Figure 4. Number of days in past 30 when alcohol was
consumed*, Jefferson County 2001 BRFSS
and Washington State 1999 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
90%
80%
70%
60%
60%
50% 49%
40%
30%
20%
10%
0%
1-5 days
I · Jefferson County
DWashington State I
24%
17%
14%
6-10 days
11-20 days
20+ days
·At 1-5 days. county rate is significantly lower than state rate; at 20+ days, county
rate is significantly higher than state rate.
3/21/02
Figure 5. (Q11x1) Mean number of days in past 30 days when alcohol was consumed
by gender, Jefferson County 2001 BRFSS (range=1-30 days)
All respondents who drank
Jefferson County
11.8
Males
Females
15.0
13.0
11.0
9.0
7.0
5.0
3.0
1.0
-1.0
3/21/02
14.4
9.1
Figure 5. Mean number of days in past 30 when alcohol
was consumed by gender*, Jefferson County 2001
BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS
14.4
11.8
9.1
All respondents
who drank
Males
Females
-Males and females significantly different, p<.001.
Figure 6. (Q11x2) Mean number of drinks on days when alcohol was consumed
by gender, Jefferson County 2001 BRFSS (range=1-12)
All respondents who drank
Jefferson County
1.7
Males
Females
2.0
1.5
Figure 6. Mean number of drinks on days when alcohol
was consumed* by gender, Jefferson County 2001
BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS
3.0
2.5
2.0
2.0
1.7
1.5
1.5
1.0
0.5
0.0
All respondents
who drank
Males
Females
'Males and females significantly different, p<.001.
3/21/02
DRAFT
Figure 7. (Q11x3) Consumed 5+ drinks of alcohol at least once in past 30 days
Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County*
Washington State
17%
23%
Figure 7. Consumed 5+ drinks of alcohol at least
once in past 30 days, Jefferson County 2001
BRFSS* and Washington State 1999 BRFSS
Source: Jefferson County Department of Health & Human Services, 2001 BRFSS; Washington
State data from the CDC website.
100%
90%
80%
70%
60%
50%
40%
30%
23%
20%
17%
0%
10%
Jefferson County*
Washington State
County rate is significantly lower (better) than the state rate.
3/21/02
3/21/2002
Jefferson County 2001 BRFSS
History of Childhood Abuse
County residents report higher rates of being abused in childhood than the
state average, and this abuse affects their adult functioning.
·
Nine percent of adult residents said as children (before the age of 18), they
had been punched, kicked, choked, or received a more serious physical
punishment from a parent or other adult guardian (Figure 1). This is about
the same as the state level, 7%.
· Twelve percent of county residents said someone had touched them in a
sexual place or made them touch someone when they did not want to
compared with 9% of state residents (Figure 2).
· Eleven percent of county residents said they had seen or heard one of their
parents or guardians being hit, slapped, punched, shoved, kicked, or
otherwise physically hurt by their spouses or partners (Figure 3). Comparable
state data will be available early in the summer.
· An abuse index to assess any childhood experience of abuse. Overall, 25%
of county residents reported at least one abuse experience in childhood -
(Figure 4). This is significantly higher (worse) than the state rate, 20%.
· Rates of reporting a childhood history of abuse were significantly lower
(better) among the oldest respondents. Twenty-six percent of county
respondents age 18-34 and 29% of those age 35-64 reported a childhood
history of abuse compared with only 15% of those age 65+ (Figure 5).
· Respondents with four or more years of college reported significantly lower
(better) rates of physical abuse in childhood (6%) than those with a high
school education or less (13%) and those with some post-secondary
education (11 %, Figure 6).
· In both the state and county, women had significantly higher (worse) rates of
reporting a childhood history of sexual abuse than men. Five percent of men
in both samples reported a childhood history of sexual abuse compared with
18% of women in the county and 14% of women in the state (Figure 7). The
county rate for women is significantly higher (worse) than the state rate.
· People with childhood histories of any abuse reported, on average,
significantly more days of poor health in the previous 30 days than people
without such histories (Figure 8).
3/21/2002
o All respondents averaged 4.3 days of poor physical health, but people
who also reported childhood histories of any abuse averaged 5.7 days
while those without such histories averaged 3.8 days.
o All respondents averaged 2.9 days of poor mental health, but people
who also reported childhood histories of any abuse averaged 4.7 days
while those without such histories averaged 2.3 days.
o All respondents averaged 2.2 days of impaired functioning, but people
who also reported childhood histories of any abuse averaged 3.3 days
of impaired functioning while those without such histories averaged 1.8
days.
. People with childhood histories of sexual abuse reported, on average,
significantly more days of poor mental health or poor functioning in the
previous 30 days than people without such histories (Figure 9).
o All respondents averaged 2.9 days of poor mental health, but people
who also reported childhood histories of sexual abuse averaged 6.2
days while those without such histories averaged 2.5 days.
o All respondents averaged 2.2 days of impaired functioning, but people
who also reported childhood histories of sexual abuse averaged 3.9
days of impaired functioning while those without such histories
averaged 1.9 days.
. People with childhood histories of seeing a parent or guardian physically
abused reported, on average, significantly more days of poor mental health.
All respondents averaged 2.9 days of poor mental health, but people who
reported seeing a parent or guardian physically abused averaged 5.0 days of
poor mental health but those without such histories reported 2.0 days (Figure
10).
Figure 1. (Q27X1) Before you were 18 was there any time when you were punched, kicked, choked
or received a more serious physical punishment from a parent or other adult guardian?
Jefferson County 2001 and Washington State 1997 BRFSS
Yes
No
Jefferson County
9%
91%
Washington State, 1997
7%
93%
Figure 1. Punished violently before age 18,
Jefferson County 2001 and Washington State 1997
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS; Washington
data from WA State Department of Health
100%
90%
80% I_Jefferson County DWashington State, 19971
70%
60%
50%
40%
30%
20%
10%
9%
7%
0%
Yes
3/21/02
93%
No
Figure 2. (Q27X4) Before you were 18 did anyone ever touch you in a sexual place or
make you touch them when you did not want to?
Jefferson County 2001 and Washington State 1997 BRFSS
Yes
No
Jefferson County
12%
88%
Washington State
9%
91%
Figure 2. Sexually abused before age 18,
Jefferson County 2001 and Washington State 1997
BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS; Washington
data from WA State Department of Health
100%
90%
80% ¡_Jefferson County DWashington State I
70%
60%
50%
40%
30%
20%
12%
10%
9%
0%
Yes
3/21/02
91%
No
Figure 3. (Q27X7) As a child did you ever see or hear one of your parents or guardians being hit,
slapped, punched, shoved, kicked, or otherwise physically hurt by their spouse or partner?
Jefferson County and Washington State 2001 BRFSS
Yes
No
Jefferson County
11%
89%
Washington State
coming
coming
Figure 3. As a child, saw parent or guardian
physically hurt, Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
100%
90%
80%
¡_Jefferson County DWashington State I
70%
60%
50%
40%
30%
20%
11%
10%
0%
0%
Yes
3/21/02
89%
0%
No
Figure 4. (Q27X1, 27x4, 27x7) As a child did saw or experienced physical or sexual abuse
Jefferson County 2001 and Washington State 1997 BRFSS
Yes
No
Jefferson County
25%
75%
Washington State
20%
80%
Figure 4. As a child, saw or experienced physical or
sexual abuse, Jefferson County 2001 * and
Washington State 1997 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS; Washington
100% data from W A State Department of Health
80%
70%
60%
50%
40%
30%
20%
10%
I_Jefferson County DWashington State I
80%
25%
0%
20%
90%
Yes
No
County rate is significantly higher (worse) than the state rate.
3/21/02
Figure 5. (Q27x1, 27x4, 27x7) History of abuse by age
Jefferson County 2001 BRFSS
18-34 years old
35-64 years old
65+ years old*
Reported any kind of abuse as child
26%
29%
15%
Figure 5. Any reported abuse in childhood, by age*,
Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services. 2001 BRFSS
100%
90%
80%
70%
60%
50%
40%
30% 26% 29%
20%
15%
10%
0%
18-34 years old
35-64 years old
65+ years old*
*People age 65+ reported significantly less abuse than those in other ages, p<.01
3/21/02
Figure 6. (Q27X1) History of physical abuse as a child by education
Jefferson County 2001 BRFSS
High school or less
Some post-secondary
4+ years of college*
Reported physical abuse as child
13%
11%
6%
Figure 6. Reported history of physical abuse as a
child, byeducation*,
Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
100%
90%
80%
70%
60%
50%
40%
30%
20%
13%
11%
0%
6%
10%
High school or less
Some post-secondary
4+ years of college*
People with 4+ years of college reported significantly lower rate p<.01
3/21/02
Figure 7. (Q27X4) Reported sexual abuse before age 18, by gender
Jefferson County 2001 BRFSS and Washington 1997 BRFSS
Males
Females
Jefferson County
5%
18%
Washington State
5%
14%
Figure 7. Reported history of sexual abuse as a
child, by gender*, Jefferson County 2001 and
Washington State 1997 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS;
Washington data, WA Department of Health
100%
90%
80%
70%
60%
I_Jefferson County DWashington State I
50%
40%
30%
20%
18%
10%
5%
5%
14%
0%
Males
Females
'Difference by genderwithin state and county is statistically significant, p<.05; state-county difference is
significant for females only.
3/21 /02
Figure 8. (Q1X2-1X4) Average (mean) days of limitation, by history of child abuse,
Jefferson County 2001 BRFSS
Average days in past 30 of...
Poor physical health*
Poor mental health*
Impaired functioning*
All
4.28
2.88
2.15
Any abuse as child
5.72
4.73
3.25
No abuse as child
3.83
2.33
1.83
Significance
p<.05
p<.001
p<.05
Figure 8. Average days of poor health in past 30
days, by history of abuse as a child,
Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
7.00
I_All DAny abuse as child aNo abuse as child I
6.00
5.72
5.00
4.73
4.28
3.00
4.00
2.00
1.00
0.00
Poor physical health*
Poor mental health*
Impaired functioning*
·statistically significant difference. see table
3/21/02
Figure 9. (Q1X2-1X4) Average (mean) days of limitation, by history of child sexual abuse,
Jefferson County 2001 BRFSS
Average days in past 30 of... All
Poor physical health 4.28
Poor mental health* 2.88
Impaired functioning* 2.15
Sexual abuse as child
5.60
6.23
3.90
No abuse as child
4.14
2.52
1.94
Significance
n.s.
p<.001
p<.05
Figure 9. Average days of poor health in past 30
days, by history of sexual abuse as a child,
Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
7.00
I_All DSexual abuse as child IINo abuse as child I
6.23
6.00
5.60
5.00
4.28
1.00
4.00
3.00
2.00
0.00
Poor physical health
Poor mental health*
Impaired functioning*
*statistically significant difference. see table
3/21/02
Figure 10. (Q1X2-1X4) Average (mean) days of limitation, by history of seeing abuse
as a child, Jefferson County 2001 BRFSS
Average days in past 30 of...
Poor physical health
Poor mental health*
Impaired functioning
All
4.28
2.88
2.15
Saw parent abused
5.29
5.01
3.32
Did not see parent abused
4.23
2.66
2.03
Significance
n.s.
p<.05
n.s.
Figure 10. Average days of poor health in past 30
days, by history of seeing parent abused,
Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
7.00
[ .AII DSaw parent abused III Did not see parent abused I
6.00
5.29
5.01
5.00
4.28 4.23
1.00
4.00
3.00
2.00
0.00
Poor physical health
Poor mental health*
Impaired functioning
·statistically significant difference, p<.05
3/21/02
3/21/2002
Jefferson County 2001 BRF55
Households with Children Younger than 18
Jefferson County households with children younger than 18 have unusually dense
concentrations of adults who reported health care access problems and who smoke,
drink heavily, and themselves have childhood histories of abuse.
· Respondents were asked how many children younger than 18 lived in their homes.
595 people answered that question; 417 (70%) had no children younger than 18
living in their homes, and 178 (30%) had at least one.
· Overall, 74% of Jefferson County adults had had a routine checkup within the past
year, but only 65% of adults living in households with children younger than 18 had
(Figure 1).
· Seventy-one percent of county adults had their teeth cleaned in the past year, but
only 65% of households which included children younger than 18 had (Figure 1).
· Forty-two percent of all adults said cost was a barrier to seeing the dentist, but that
figure rose to 68% of adults whose household included children younger than 18
(Figure 1).
· Sixteen percent of all adults currently smoke cigarettes, but 24% of adults whose
households include children younger than 18 smoke (Figure 2).
· Seventeen percent of all adults are heavy drinkers (that is, consumed five or more
drinks of alcohol at one time in the past 30 days), but 28% of adults whose
households include children younger than 18 are heavy drinkers (Figure 2).
· Twenty-five percent of adults reported experiencing some type of abuse in their
childhood. Among households currently including children younger than 18, that rate
rose to 33% (Figure 3).
· Nine percent of adults reported experiencing physical abuse in their childhoods.
Among households currently including children younger than 18, that rate rose to
15%.
· Eleven percent of adults reported seeing a parent or guardian physically abused
during their (the respondents') childhood. Among households currently including
children younger than 18, the rate was 16%.
Figure 1. (Q13x6) Selected health care access measures and
presence of children <18 in household, Jefferson County 2001 BRFSS
Adult had routine physical in 12 months*
Adult had teeth cleaned in last year*
Cost was barrier to seeing dentist*
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
All households
74%
71%
42%
Children <18
65%
65%
68%
No Children <18
78%
74%
26%
Figure 1. Selected health care access measures and
presence of children <18 in household,
Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services. 2001 BRFSS
.AII households o Children <18 IZINo Children <18
74%
0%
78%
65%
*AII differences are statistically significant.
3/21/02
74%
71%
42%
68%
26%
Adult had routine physical Adult had teeth cleaned in Cost was barrier to seeing
in 12 months* last year* dentist*
Figure 2. (Q13x6) Selected adult risk factors and presence of children <18
in household, Jefferson County 2001 BRFSS
Current smoker*
Heavy drinker*
All households
16%
17%
Children <18
24%
28%
No Children <18
13%
13%
Figure 2. Adult risk factors and presence of children
<18 in household, Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
100%
90%
.AII households
DChildren <18
IZI No Children <18
80%
70%
60%
50%
40%
30%
28%
24%
0%
17%
20%
13%
13%
10%
Current smoker*
Heavy drinker*
*AII differences are statistically significant.
3/21/02
DRAFT
Figure 3. (Q13x6) Adults reporting childhood abuse histories and presence of
children <18 in current household, Jefferson County 2001 BRFSS
Any reported abuse as a child*
Physical abuse*
Saw parent abused*
All households
25%
9%
11%
Children <18
33%
15%
16%
No Children <18
21%
7%
9%
Figure 3. Adults reporting childhood abuse
histories and presence of children <18 in current
household, Jefferson County 2001 BRFSS
Source: Jefferson County - Department of Health & Human Services, 2001 BRFSS
100%
90%
80% .AII households o Children <18 IZI No Children <18
70%
60%
50%
40%
33%
30%
20%
10%
0%
Any reported abuse Physical abuse* Saw parent abused*
as a child*
*AII differences are statistically significant.
3/21/02
Board of Health
Media Report
March 21, 2002
Jefferson County Health and Human Services
FEBRUARYro.J MARCH 2002
NEWS ARTICLES
These issues and more are brought to you every month as a collection of news stories regarding
Jefferson County Health and Human Services and its programs for the public:
1. "Running out of time: Deaths outpace births in Jefferson, Clallam counties",
2 pages, Peninsula Daily News, February 24,2002.
2. "Marrowstone residents hot, cold for PUD", P.T. LEADER, February 27,2002.
3. "Commissioners reaffirm their support for county administrator", P.T. LEADER,
February 27, 2002.
4. "County well drilling could be restricted", P.T. LEADER, March 6,2002.
5. "Quilcene spruces self up", Peninsula Daily News, March 1 0, 2002
6. "Quilcene coordinates cleanup", P.T. LEADER, March 13,2002
7. "Everyone shares the air: keep it clean", P.T. LEADER, March 13,2002
8. "County plans drastic steps to fIX budget", Peninsula Daily News, March 12,2002.
9. "County budget $1 million short: Commissioners OK hiring freeze", P.T. LEADER,
March 13,2002.
10. "County launches 'EnviroStars' program", P.T. LEADER, March 13,2002.
11. "County, environmentalists settle", P.T. LEADER, March 13,2002.
12. "Elected officials seek input on county administrator evaluation", P.T.· LEADER,
March 13,2002
13. "Top county executive terminated", Peninsula Daily News, March 14,2002.
14. "Jefferson to review crisis response plans", Peninsula Daily News, March 14,2002
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Wednesday, February 27,2002 . A 4
Commissioners reaffirm their
support for county administrator
By Philip l. Watness
Leader S taft Writer
Jefferson County Administra-
tor Charles Saddler has the back-
ing of at least two of his bosses
following a discussion Monday.
Commissioner Richard Wojt
broached the subject of
Saddler's job security because
he said he'd been hearing ru-
mors that the commissioners
were unhappy with the
administrator's perfonnance.
"I'm hearing questions of
whether we can afford a county
administrator and whether we are
getting an advantage from hav-
ing a county administrator," Wojt
told his fellow commissioners.
"The advantage is that we get
focused direction to the staff, so
the strategies the board decides
on. we have somebody to bring
the ideas together."
Commissioner Glen Hunting-
ford said he was initially opposed
to the idea of hiring a county ad-
ministrator when consultant Ken
Lynn of Bainbridge Island rec-
ommended the new position ap-
proximately three years ago. That
led to the hiring of Saddler, who
is approaching two years in the
job this March.
Huntingford declined to com-
ment on Saddler's performance
Tuesday, but Monday he said one
of the other elected county offi-
cials had complained that Sad-
dler had dismissed a suggestion
that budget savings could be
accomplished by reducing
employees' hours rather than
cutting positions.
"He apparently said he was in
charge and he was laying down
the law," Huntingford said. "If we
stay on the same route, we'll get
very little cooperation on budget
issues."
Commissioner Dan Titterness
said Saddler has his support,
though he is concerned the
administrator's office has too
many deputies.
"I support Charles Saddler
and the work he's doing, and I
. understand some people are not
comfortable with what he has
said," Tittemess said. "We're fac-
ing difficult budget problems,
and he's stuck in the middle as
the administrator, but I don't see
any immediate changes coming."
Saddler took exception to
Huntingford's characterization of
his comments to another elected
official, but when the commis-
sioner began speaking specifics,
Wojt said he thought the discus-
sion should take place in execu-
tive session. On Thesday, the
commissioners discussed
Saddler's performance evalua-
tion, which is due on his second
anniversary March 1.
Saddler said the county
government has to make dra-
matiç changes in operations,
and much of it will fall on
employees because salaries
and benefits consume 80 per-
cent of the budget.
"If you just reduce people's
hours, that doesn't take care of
the budget matter," Saddler said.
"We have an $800,000 deficit in
an $11 million budget. It's going
to have to be people."
Saddler said his office won't
be immune to personnel cut-
backs. He said he plans to reduce
the number of deputy adminis-
trators from two to one this year.
That can be accomplished if
Deputy County Administrator
David Goldsmith decides to re-
tire following 26 years with the
county. Goldsmith said he will
decide in June whether to retire.
Saddler said that might save
some money, but Goldsmith's
duties as risk manager and hu-
man resources director will have
to be covered by someone, so
cost savings aren't guaranteed.
"The county administrator's
office is set up so the office is
pretty top-heavy - there is some
concern there," Titterness said.
"We've asked that to be looked
at, and I'm fairly confident that
will be addressed."
Wojt said his motivation in
raising the subject was tosend a
clear signal to department direc-
tors, including elected officials,
that the commissioners have no
plans to scrub the county admin-
istrator position.
"We are going to have to say
to all the elected officials and the
staff that the administrator posi-
tion is solid," he said. "We need
to send that message out loud and
clear so we can get on with insti-
tuting policies."
Saddler said the dissensioh
among elected officials and de-
partment directors wasn't unex-
pected, especially given the
daunting economic conditions
that indicate Jefferson County
will have an $800,000 hole in
its budget if cuts aren't made
and/or user fees and taxes in-
creased.
"It was inevitable because
this is the first time the county
has gone to the administrative
fonn of government," Saddler
said. "They went willingly, but
it was a change in government
without unaniini1y."
Huntingford said the county
commissioners and admin-
istrator's office will also bear
some of the pain of cutbacks.
"The county really has to
take a hard look at itself bud-
get-wise, and we also need to
look at ourselves," Huntingford
said. "We 're asking everyone to
look at what's mandated and
what's not. We aren't mandated
to have an administrative posi-
tion."
Saddler said he has .saved
the county more money than
his $82,400 annual salary. He
discovered the county had been
under-billing Port Townsend
for jail services by $125.000
per year. Combined with other
"found" money, Saddler said
he recouped $131,500 in his
first year as administrator.
"There's no reason to be-
lieve we'd have discovered it
without Someone like me in
this position," he said.
tf
County well drilling
could "be restricted
Jefferson County Water Re-
source Specialist David
Christensen outlined a plan for
addressing potential seawater in-
trusion of wells for the county
commissioners Monday.
The plan is a response to an
order by the Western Washing-
ton Growth Management Hear-
ings Board that the county
idèntify areas susceptible to sea-
water intrusion and develop a
plan to limit the threat.
The plan designates any land "
/'
t T. LGA-f) ER-
3- b -() 2..-
within 1,000 feet of marine
coastlines as Critical Seawater
Intrusion Zones. Wells would be
prohibited from within 100 feet
of the zones, or 1,100 feet from
the shoreline.
The county commissioners
plan to appoint a citizens task
force to review and refine the
proposal. The new regulations
would then go through the usual
public hearing process for adop-
tion into the county's Unified
Development Code. .
, ,'. "{. ", .:',... . .'. ,",. .' . : " '.~~.
March 10. 2002
I Quilcene
spruces
self up
5
Townsfolk razing
derelict buildings
Quilcene: Clean
By STUART ELLIOTr
PENINSULA DAILY NEWS
QUILCENE - Property owners and com-
munity volunteers have set to work tearing
down several derelict buildings along U.S.
Highway 101 as a means of sprucing up down-
town Quilcene.
Armed with handtools, crowbars and elbow
grease to remove a collapsed three-car garage
at the southern end of town, a group of more
than 20 people started working last week.
In the coming weeks, a burned-down house
will be demolished, junked cars towed away
and other garbage removed from the quarter-
acre site that contains two rental properties
abandoned for the last four years.
"As you enter town, its the first thing you
see," said Kit Siemion, a licensed massage
practitioner who has a business next door. "It
was an eyesore."
CONTINUED FROM Al
"They weren't aware of the
condition of the property,"
Siemion said. "When they were
approached by the county and
community members, they
were active and cooperative
about helping to clean it up."
Start of a community trend?
Molly Pearson, environmen-
tal educator at the Environ-
mental Health Department,
hopes the clean-up effort is the
beginning of a trend.
"One of the things I'm
always looking for is whenever
we can get government, indus-
try and community together
like this," she said.
Pearson spends much of her
job investigating illegal dump-
ing area, she said.
It's common to fInd illegal
'dumps in remote ateas:on state
"Department ·.of'· Nàtural
ResOurces' hind or láhd' oWned
by Olympic Resourc~' Manage-
ment.
But her department also tar.
Volunteer effort
Siemion, who led the effort to clean up the
area, got together volunteers from the Cross-
roads Recovery Center and others in the com-
munity last Saturday to help tear down the
structure and remove trash like stoves, bikes,
wires, old roo!i¡:¡LIµ1!i bags of garbage that
had gathered in the area over the years.
"The community was very supportive,"
Siemion said.
The first clean up effort - Siemion said
she will target other areas but won't say
where yet - came about after the property
passed from the previous owner to Partner
Mortgage Corp. of Mercer Island.
"The man who had owned it previously had
been approached, and would not help at all,"
Siemion said.
Annie Ricker, who owns property adjoining
the site, said the area had become a de facto
dumping ground over the years.
':At one point, I had a Dumpster there, but
after it was gone, people continued dumping,"
she said. "It was just habit."
Trash bin costs
Siemion had filed complaints with the Jef-
ferson County Environmental Health Depart-
ment over the property, and the department
contacted the mortgage company about clean-
ing up the site once the property changed
hands.
The Mercer Island company has already
paid for trash bin costs and plans to pay for
asbestos removal and costs to take down one
of the buildings at some point over the next
several weeks, Siemion said.
, TURN 1'0 Qrm,rR"""/A?
gets chronic garbage dumping
that takes place in residential
areas.
County code specifies that
garbage must be kept in con-
tainers, she said.
But the county has histori-
cally had little power in terms
of enforcing that policy, Pearson
said.
"We basically just send out a
letter," she said.
Environmental health offi-
cials are currently developing
an ordinance that would give
the county the ability to issue
tickets and fines to chronic
trash offenders and eventually
drag them into Jefferson
County District Court.
"If we find out there is a pol-
icy violation," she said. "This
would give us some clout."
The ordinance is currently
being reviewed by county
administrators and the prose-
cuting attorney's office.
It is expected to come before
Jefferson County commission-
ers for consideration during the
next month, Pearson said.
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Edition' March 12, 2002
County plans
drastic steps
to fix budget
Pay cuts, hiring
freeze among
likely actions
BY STUART ELLIOTI'
PENINSULA DAILY NEWS
Jefferson County commissioners
are weighing midyear budget cuts
and a hiring freeze as the county's
revenue position worsens amid a
slowing state economy
Two months after the county's
2002 budget was adopted, a county
budget committee recommended
Monday ~hat more than $400,000 in
additional cuts be made this year to
the $12.1 million general fund bud-
get.
"It appears that our budget
deficit will be considerably worse
than projected," Jefferson County
Central Services Director Gary
Rowe told commissioners.
"We're talking about a significant
shortfall. "
Commissioners could take action
as soon as this afternoon to .shore up
. ··the budget:- --"~ ,. --." '. ..
Recommerid~ct1t8 include a hir-
ing freeze, salary and" benefit reduc-
tions for county employees, and a
midyeár belt tightening that would
include anywhere from 5 percent to
25 percent cuts in such areas as
. training, equipment supplies and
professional services.
Slumping revenues
The projected shortfall is a result
of a slowing economy that means
less tax revenues and less money
from the state.
Revenue predictions show the
county could gather $400,000 less
than originally projected this year in
sales tax, private harvest tax, and
interest earned on money it cur-
rently has in reserve.
Commissioners will consider a
resolution today at 3 p.m. at the Jef-
ferson County Courthouse to freeze
new employment positions and
require review by county commis-
sioners before any vacant posts are
filled.
The proposed salary reductions,
totaling $219,000, would include
reducing management salaries by 4
percent, reducing the number of
hours for contract employees and
clerk hirings by 4 percent, and
reducing overtime by 25 percent,
among other measures, according to
the report.
Situation review
Elected and appointed officials
are scheduled to meet April 17 to
review the budget situation and
make recommendations on balanc-
ing the budget over the next several
years, during which there is
. expected to be similar shortfalls.
Projected revenue for 2003 is
expected to be around $11.1 million,
nearly $1 million less than this
yeár's $12.1 million total budget.
The situation is also compounded
by the elimination of so-called"
"backfill" money that the state gave
cities and counties to make up for
losses from Initiative 695, which
reduced car tab fees.
Elimination of the funds in 2003
will mean a loss of $239,000 for the
county, the report said.
TuRN TO BUDGET/A2
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County budget
$1 million short
Commissioners OK hiring freeze
By Philip L. Watness
Leader Staff Writer
Dire financial forecasts have forced
the Jefferson County commissioners to
look for cuts in all departments and re-
think property tax increases.
The tirsl move came Thesday after-
noon with ä unaminous decision for a
hmng freeze on all coumy jobs. effec-
live immediately. Any job openings
deemed "mission critical," such as an E-
911 radio dispatcher, could still be filled.
Deputy County Administrator Gary
Rowe told the commissioners Monday
he expects 2002 revenues eannarked for
¡he general fund to be $1 million less
than anticipated last fall. The current
budget expected $12, 178,360, but Rowe
eSlimaled Ihe revised revenues will be
S 11.375.873.
The county will earn $200.000 less
In Interest earnings. receive $136,500
Ie» In timber tax revenue and get
S¡jû,OOO less In sales taxes, Rowe es-
llmated.
Costly administration
Elected officials meet, see page A 10
Another $239.914 will likely not be
forthcoming from state coffers due to the
state's budget shortfall. That /lmQ\lf)t Þad
been provided this year to maÍce"'u'p for
revenue lost to the motor vehicle excise
tax rollback caused by voter approval of
Initiative 695. The vehicle tab fee roll-
back was ruled unconstitutional by the
Washington Supreme Court, but the state
Legislature decided not to keep the old
higher fees.
Rowe provided a list of potential cut-
backs that included a 3 percent salary
reduction for all elected officials effec-
tive in 2003 (the three commissioners
cannot reduce their salaries this year), a
4 percent salary reduction for all em-
ployees. a 25 percent reduction in over-
time hours and a $15,208 reduction in
benetits.
See BUDGET. Page A 10
A 10' Wednesday, March 13, 2002
t
Budget: Cuts
Continued from Page A 1
All that combined would re-
alize a $219,254 reduction in
expenditures.
"The reduction in expendi-
tures is for a full year, but to
accomplish a 4 percent cut, you
have only six or seven months
to do that;' Rowe said. "TQ do
. that. you'd have to double these
numbers."
Rowe also presented the
commissioners with a grocery
list 'of places to tighten the bud-
get belt, including reducing
supplies, professional seIV.ices,
travel and training, and sub-
scriptions and memberships to
outside organizations. The belt
would also be pulled tight on
Public Works, E-911 dispatch
seIVices and Health and Human
Services, with 5 percent reduc-
tions in general fund transfers.
All that would save another
$193,869. leaving a gaping
$519,281 hole in the current
budget.
Rowe proposed removing a
$171,620 general fund transfer
to the Central SeIVices Depart-
ment for construction and reno-
vation; a $40,000 transfer to
Public Works' special projects;
a $51,893 transfer to Commu-
nity Services; and another
$34,583 transfer for flood and
stormwater management by
Public Works. In addition, the
county could eliminate $25.000
in support of the after-school
program popular in Quilcene,
and another $25,000 for non-
departmental expenses.
That would save another
$383,721 - still far from the
needed $1 million.
The county could realize
another $177 ,404 through a
$64,000 contribution by the
City of Port Townsend to sup-
port the WSU Cooperative Ex-
tension seIVices and a $117.404
reduction by spinning off
,/
county recreation programs
Uunior soccer, junior hoop.
summer camps, etc.) to the new
Jefferson County YMCA.
though the entire amount likely
wouldn't be realized because
the YMCA has asked for county
financial support during its for-
mative years. The commission-
ers haven't indicated whether
they support the idea. At thÌs
point, it is just one of many
options Rowe proposed they
consider.
With all that, the county cof-
fers would still be $200,000 shy
of matching expenditures with
lower revenues.
Property tax hike?
The commissioners will
consider placing a hiring freeze
on all departments and have
begun discussing whether to
increase property tax revenues
up to the fun 13 percent allowed
by state law (1 percent per year
for this year and beyond, but 6
percent for each of the past two
years when the commissioners
decided against collecting the
maximum allowed by law).
"That gives you the scope,
or scale, of the budget we need
to consider," Rowe said.
County Administrator
Charles Saddler said the com-
missioners shouldn't expect
departments to be able to come
in under budget as they have in
past years because they have
already factored in 2 percent
reductions in personnel and
non-personnel costs.
The department heads
have also been looking at
their programs to determine
which are mandated by state
law. The commissioners have
scheduled a full-day retreat
April 17 at the WSU Commu-
nity Learning Center, 201 W.
Patison. Port Hadlock, to re-
view their findings.
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County; environmentalists settle
Jefferson County has agreed
to address several environmental
issues in the coming year under
a negotiated settlement with the
Washington Environmental
Council (WEC).
The council had appealed nu-
merous provisions of the
county's Unified Development
¡ Ç?9e,; ~z:!aining .~~ fJ.9.9.,~P'~~s,
wildlife and wetlands. ,
The agreement, firialized
March 5, settles a lawsuit which
had been brought by WECalleg-
ing that the county had failed to
follow provisions of'the law
which require the county to pro-
tect salmon habitat and other
critical areas from the harmful
impacts of development and
other activities.
"This agreement is a real win
for both the envirQnment and the
county," said Jerry Gorsline,
WEC policy associate. "It shows
that environmentalists and local
rp r: LEA-D6fZ
. '3 /(?:> -0 '2-
government officials engaged
in constructive dialogue can
produce creative solutions that
protect the environment and
address the concerns of local
government."
County Civil Deputy Pros~
ecuting Attorney David Alvarez
agreed: "I think it's a good com-
· ; .efqffiÌ~9j ~M~~)H :~~ 1.9: l?f9Ceed
with wlíat we w8,I).t~d to do any-
way. It stops the legal process so
we can focus on science and data
gathering."
The agreement calls for
Jefferson County to initi¡¡te a
project to identify and map flood
hazard areas and river meander
patterns of the maJor eastern
county rivers, followed by an
update of its regulations to bet-
ter protect fish and wildlife in the
floodplain. The county will also
follow a policy developed by the
state Department of Ecology for
replacing wetlands that are dis-
turbed by new development. It public health, public safety and
will develop a process for classi- the property damage resulting
tying and protecting state prior- from development in areas prone
ity and locally important specie~ to floodingoþ,azards."
and "thèir habitat, using..a land- . Gorsline said the environmen-
scape-based approach where tal council's dispute with
possible. Jefferson County focused on
Beginning with Chimacum methods to achieve the county's
Creek, the county will initiate a stated goals to protect and en-
",collab<:>fatiY,~¡ßtalq~~çJAAr,.effort .À~9~'r'f~tl¡µ1~~ µ~h and wildlife
to· devel()p, a, systexµatic, YÇllun- habitat.
tary watershed-based program to "We have a lot of work to do
address the impacts of agricul- to implement this agreement,"
ture on salmon habitat. If the said Dave Christensen, county
voluntary approach is not imple- natural resources division man-
mented within two years, the ager. "We're looking forward to
county will adopt new regula- working with WEC to put this on
tions to address the impacts of the ground. We actually began
agriculture on fish and wildlife down this pathway last year, when
habitat. we obtained state funding to iden-
"This settlement will benefit tify the best remaining salmon
all residents of the county," said habitat in eastern Jefferson
County Administrator Charles County. Our next projects will
Saddler. "Not only will it im- include wildlife habitat mapping
prove fish and wil4life habitat, and improving knowledge of flood
but'it also will reduce risks to hazard areas."
I
Port Townsend &; Jefferson County leader
Elected officials seek input on
county administrator evaluation
: By Philip L. Watness
leader Staff Writer
The Jefferson County com-
missioners met Tuesday in an
extraordinary executive session
with all of the other elected offi-
cials to discuss the pending an-
nual job evaluation of County
Administrator Charles Saddler.
"At least one elected official
said if he was a commissioner,
he would eliminate the coünty
administrator position," County
Commissioner Dan Titterness
said Thesday.
Several elected officials re-
frained from stating that to a re-
porter, but they did say they
expressed criticism of Saddler's
performance over the past year,
particularly regarding budget
. matters.
"We definitely wanted to con-
3 ,,-t ?> --() ::L
vey any concerns we had had over
the last two or.three years, and
there' were a lot of them," said
County Clerk Marianne Walters.
The two-hour meeting in-
cluded all the elected officials:
judges, sheriff, prosecuting attor-
ney, treasurer, auditor, assessor
and clerk of court.
Treasurer Judi Morris said the
officials expressed their desire to
have input on Saddler's evaluation.
"I think it's appropriate for us
to share wim the commissioners
our perceptions of Charles' per-
formance," she said. ,"Some ap-
preciate his role and some think
some things could be done in a
different maÍmer.~'
Auditor Donna Eldridge said
the meeting was an opportunity
for elected officials to impress
upon the commissioners their
desire to be involved throughout
the budgeting process, as they
have been accustomed to doing
in previous years.
"The Jefferson County elected
officials have always worked well
together," Eldridge said. "We
wanted to have some input on
Charles' performance evaluation
as county administrator."
Titterness said the officials
provided useful information that
would be considered as tþe com-
missioners draft Saddler's evalu-
ation, which could be complete
by the end of the week. An ex-
ecutive session to re-view
Saddler's job performance was
scheduled for Wednesday.
"Some are dissatisfied with
things and others were compli-
mentary," he said. "Some had
comments on the current county
administrator, but they also gave
the clear message that the county
administrator's office is top-
heavy, and that's no secret."
Walters said the potential $1
million budget deficit demands
that the commissioners cut their
own expenditures as weB as
those of other departments.
"The county is at a real piv-
otal point right now," she said.
"They've got to make some lead-
ership decisions. They will ask '
us to make tough decisions, and
they need to look in their own
camp first."
Assessor Jack Westerman ill
said the elected officials pre-
sented both the pros and cons of
Saddler's performance.
"This was not a beat-up ses-
sion," he said. "We knew that
we're going through a process-
the budget scenario has just been
finished - and we felt the board
could use our input."
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13
Jefferson to review
crisis response plans
BY JOSH BELZMAN
PENINSULA DAILY NEWS
Is Jefferson County a target
for international terrorists?
Those responsible for devel-
oping the county's emergency
response are busy updating
their plans to contend with
new, manmade threats and
applying for homeland-security
funds from the federal govern-
ment.
Some of those efforts will be
outlined Friday when the Jef-
ferson-Peninsula Regional
Emergency Planning Commit-
tee meets at 10 a.m. at the Chi-
macum Fire Department, 9193
Rhody Drive.
The focus of the public meet-
ing will be a féderally required
annual review of the county's
hazardous materials response
plan - one which has under-
gone few substantive changes
in the past year.
But bioterrorism and other
post-Sept. 11 topics also will be
discussed, said Bob Hamlin,
Jefferson County Office of
Emergency Management coor-
dinator.
The county is in the process
;)-lL{,-o ;L-
"Jefferson County has a
pretty low probability of
being a terrorist target, but
that's not to say we
shouldn't be prepared."
BOB HAMUN
Jefferson County
Office of Emergency Management
of developing a terrorism
addendum to its emergency
management plan.
"Jefferson County has a
pretty low probability of being a
terrorist target, but that's not
to say we shouldn't be pre-
pared," Hamlin said.
Fallout from Puget Sound
Hamlin, who has led emer-
gency planning efforts in the
region for lllore than 30 years,
said the greatest threat to Jef-
ferson County comes not from a
conventional or biological
attack, but from urban popula-
tions that might descend upon
it following a terrorist strike in
the Puget Sound area.
"I'm most concerned about
the outward, geometric migra-
tion of a problem," he said.
"The psychological aspect of
some kind of terrorist event will
be worse than the event itself. II
Coordinating a local
response to natural and man-
made emergencies is the charge
of the emergency planning
committee, comprising repre-
sentatives from local govern-
ment, police, fire and medical
agencies. The group's meetings,
held every other month, are
open to the public.
The federal Emergency
Planning and Community
Right-to-Know Act requires the
committee to make public its
hazardous materials. response
plans and records about the
transportation, manufacture,
storage and use of dangerous
materials in the area.
The act also requires. an
annual review of the plans and
an opportunity for public com-
ment.
The community has shown
an increased interest in emer-
gency response matters since
the terrorist attacks, said Mark
Bowes, Jefferson County safety
programs coordinator.