HomeMy WebLinkAbout12 December
JEFFERSON COUNTY BOARD OF HEALTH
MINUTES
Thursday, December 20,2001
Board Members:
Dan Titterness, Member - County Commissioner District #1
Glen Huntingford, Member - Coun!} Commij'J'ioner DÙtrict #2
Richard Wqjt, Member - County Commissioner District #3
GeoJ!r~y Masâ, lvlember - Port Town.rend City Counâl
Jill Buhler. Chairman - Hospital Commissioner District #2
Sheila If/esterman, Vice Chairman - Citizen at La'lf,e (City)
Roberta Frissell - Citizen at La'lf,e (County)
StatfMembers:
Jean Baldwin, Nur.ring Service.r Director
Larry Fqy, Environmental Health Diret'tor
Thomas Locke, MD, Health qffìcer
Vice Chairman Westerman called the meeting to order at 2:40 p.m. All Board and Staff members were
present with the exception of Chairman Buhler and Commissioner Huntingford. Member Masci moved
to approve the agenda. Commissioner Wojt seconded the motion, which carried by a unanimous vote.
APPROVAL OF MINUTES
Member Masci moved to approve the minutes of October 17, 2001 with one correction, noted by Dr.
Tom Locke on Page 3, paragraph 4 under Bioterrorism Preparedness: In the last sentence, the words
"There is no way to" should be replaced with "We can. " The date of the minutes should also be
corrected from October 17 to October 18, 2001 Commissioner Wojt seconded the motion, which carried
by a unanimous vote.
PUBLIC COMMENT
New resident, Fernando Caneo said he is happy to be here, but has no other comment. David Sullivan
said he is concerned about how the 0% increase in the County budget will affect healthcare and is
curious how the Board will respond to the changes.
OLD BUSINESS
ComparinI! Sewage Svstems Article: Larry Fay complimented Linda Atkins, David Christensen and
Staff for putting together this project, funded by a grant from the State Department of Health to reduce
nitrogen, which resulted in getting the article published.
Member Masci moved to direct Staff to write a letter of commendation to both Linda Atkins and
Dave Christensen on behalf of the Board for getting the article published. Commissioner W ojt
seconded the motion, which carried by a unanimous vote.
HEALTH BOARD MINUTES - December 20, 2001
Page: 2
Local Board of Health Workshop Report: Member Frissell discussed the highlights of the workshop
she attended in October.
.I Keynote speaker Tom Milne, Executive Director of the National Association of County and City
Health Officials [NACCHO] reported the Centers for Disease Control (CD C) is creating a new
resource center to aid environmental health, looking at bio-terrorism, infectious diseases and
smoking. Mr. Milne characterized public health preparedness and awareness in Washington State
as far better than in other States. Nationally, there has been a significant switch in outlook and
approach to public health issues as a result of the events of September 11, 2001, moving public
health to the forefront for the first time and creating an opportunity to build public health
infrastructure. Mr. Milne's handouts were given to Jean Baldwin.
.I Washington State Secretary of Health Mary Selecky's presentation, coming in the midst of the
anthrax scare, made the point that law enforcement must determine whether something is a
credible threat.
.I Scott Lindquist, Kitsap County Health Officer stressed the importance of communication among
Health Departments, emergency management personnel as well as the need for ongoing training
for emergency room staff to recognize these diseases. In considering whether county-wide
forums could be held to provide information to the media, he said his Department used a full-
page ad in the newspaper to educate the public and also prepared a video for in-house training.
He recommended that 9-1-1 operators be given a list of questions to aid screening of credible
threats, and suggested Health Departments learn new terminology in order to better communicate
with police (e.g., credible threat = probable cause).
.I Methamphetamine labs were discussed at the workshop and Member Frissell was struck by the
range of services needed when meth labs are destroyed. For example, contamination is limited to
the lab area only but there is economic impact on other renters and landlords when their
properties are used for labs. While the meth-making technique has changed (chemicals no longer
need permeate and ruin a structure for further habitation), there is still the potential for explosion,
fire as well as great health risks and serious issues related to child abuse and neglect. Member
Frissell strongly believes that mental health services for individuals are essential to changing
behavior. One suggestion was that local Boards of Health address coordination between agencies
by becoming a convener and determining what is happening in this County so we can reach these
kids before they make decisions about substance abuse.
Describing the workshop as time very well spent, Member Frissell recommended as many Board
members as possible try to attend in the future.
Vice Chairman Westerman asked whether other Boards have expanded to include citizen participation?
Member Frissell said that while a few have, she believes our Board's constitution is unique in that
regard. Dr. Locke said to his knowledge only Kittitas County has taken a similar step, but added that he
believes there is strong support in Clallam where the Board is examining the issue. Member Frissell said
she has communicated that having non-commissioner members can help de-politicize some of the issues.
HEALTH BOARD MINUTES - December 20, 2001
Page: 3
Hearing Examiner Decision re: Port Ludlow Sewers: Larry Fay said this item is mostly for
information and relates to the Board's discussion a few months ago about sewer extensions in Port
Ludlow and consideration as to whether the current on-site sewage regulation and policy work are for,
against or neutral in promoting sewer extensions. He said this case is a little different in that ORM
(Olympic Resources Management, now Ludlow Development) has applied to the County for a short plat
of the property and proposed developing this property with septic systems. While there was no argument
from Environmental Health that lots and the soil requirements are suitable for a septic systems, the
ordinance gives preference to sewers when they are available. In this case, the question is not one of
availability but cost.
The Hearing Examiner's recommendation to the Community Development Department, on approval of
the plat, was to require that they extend sewers to the lots they are creating. The Hearing Examiner was
clear that they were correct in making sewer extension a requirement of the plat. As of the final date of
the appeal period, Ludlow Development had not asked for a review of this issue. Mr. Fay believes this
decision will set the stage for what local development can expect in the future. In response to a question
about the attitude of the people attending the hearing, Mr. Fay said it was the first one at which there was
a showing of public support.
NEW BUSINESS
Bio-terrorism Preparedness Update: Jean Baldwin reported that the Department is on the waiting list
for a table-top exercise. Having completed several Emergency Management Plan exercises with JPREP,
the sheriff, and law enforcement, they have come up with some resolutions about how to respond to
anthrax. Locally there were five suspicious packages or letters that went to the State lab to be
investigated, a number considered high for a small county. And although they all tested negative, the
two and a half months of handling this matter cost the County $4,500. She said this expense raises the
question, what would happen if the County was to increase its surveillance and awareness, and continue
to meet twice a month with the hospital? She noted that Jefferson County Safety Officer Mark Bowes
did several training sessions about how to handle the mail and the Nurse Communicable Disease
Coordinator also attended to provide information on the diseases and risks. With this being the first
opportunity to put the plan into action, it revealed some difficulty with interpretation.
Dr. Locke said the local concern has been on suspicious mail and the anthrax threat, which in the scheme
of bio-terrorist incidents is probably the easiest to manage because it is treatable and is relatively
straightforward to diagnose, and there is no person-to-person transmission. Given this, however, there
remains an incredible expense to respond to the events. Much of what was thought to be known about
anthrax - that it required large doses to contract and that cross contamination through mail was a virtual
impossibility - has been proven wrong. He believes the lesson we have learned from anthrax, in terms of
bio-terrorism, is that weaponized infections are enormously more dangerous than the naturally occurring
forms of the infections. He believes this has put pressure to find out about small pox and plague and
other biological weapons. It has also applied pressure to improve coordination among response agencies
for an all-hazards approach and made this a front-burner issue in terms of working with the hospital on
infectious disease threats more generally. In addition to bio-terrorism, there are also concerns about
HEALTH BOARD MINUTES - December 20, 2001
Page: 4
antibiotic resistant infections and new emerging diseases. He noted we would almost certainly have
occasion to use any system we develop for the naturally occurring infections.
Dr. Locke reviewed the many things occurring at the state level since the Board of Health last met. The
SBOH held a hearing in October and information from this session was incorporated in a report adopted
in mid-November, the executive summary of which was included in the Board's agenda packet. He
called to the Board's attention the report's recommendations because he believes the whole point of a
preparedness assessment is to ask the question "Are you ready to deal with this problem?" If the answer
is no, then "What is it that we need to do and what are the priority tasks to be accomplished?" The
SBOH's answer was No - there is not adequate protection.
Referring to the State Board of Health Resolution No. 01-001, Vice Chairman Westerman, said the
measure seems to support funding levels that provide for adequate state and public health. She asked
what is to be done with the resolution?
Dr. Locke said he would prefer to answer the question by reviewing some of the recommendations listed
on page 6 of the Final Report titled "Response Capacity During a Health Emergency" because they are
more specific.
Number 2 asked the Governor and State agencies to advocate for the federal funding, which has
now been decided.
Number 3 refers to what the State will do with federal funding - expanding response capacity not
using it to offset cuts in State contributions to existing programs.
Number 4 also addresses the budget issue in that the capacity for bio-terrorism or biological
emergency response at a local level essentially involves mobilizing people to do the kinds of
intensive surveillance, investigation, vaccine and medicine distribution, and quarantine activities
that really only public health can accomplish. It comes down to how many appropriately trained
staff we have. He noted the ways Washington public health departments have maintained
themselves by cobbling together different kinds of programs and contracts from different state
and federal agencies. This pays for the public health nurses and the epidemiologic capabilities
and the environmental health specialists, items very much threatened in the state budget.
The most noticeable element to begin with is the misnamed "1-695 backfill." This funding gap
was created when the legislature repealed the motor vehicle excise tax and displaced a source of
money that used to come primarily from cities, but that had been a stable part of public health
since the 1970s. Without this, we are at pre-1970s funding levels and are probably worse off now
than ever. Rather than continuing that funding through the biennium, the Governor's budget
proposes to stop it all together six months short of the end of the biennium.
Number 5 deals with the issue of flexible versus categorical funding. Much of the funding
received from state and federal agencies has a lot of strings attached to it. Since this makes
mobilizing that capacity for communicable disease efforts much harder, we need flexibility.
HEALTH BOARD MINUTES - December 20, 2001
Page: 5
Recommendation 6 focuses on the Medicare system. Medicare has lost its excess capacity and
virtually all hospitals are "lean and mean" in staffing and bed support. At any given time there is
only an excess of 40-50 intensive care beds in the entire Seattle area system - so there is little, if
any, surge capacity. Even a small release of Botulinum toxin would require at least 10,000
respirators and a huge intensive care capacity to keep people alive until the effects of the toxin
wore off. While we would not propose to have 10,000 ICU beds, currently the ICU surge
capacity is zero. This would also be a real problem in the event of an influenza pandemic.
Item 7 deals with a need to identify and set priorities.
Item 8 is mostly a federal issue but one we are becoming more and more aware of, related not
just to bio-terrorism but all communicable diseases. The vaccine production system is breaking
down and we are seeing the effects in public health. Vaccine production is not attractive to the
pharmaceutical companies in an environment where the worldwide market for vaccines is about
$3 billion and the market for Viagra is $5 billion.
The final recommendation, Number 9, asks if the Board is looking at its own statutory authority,
but it very much overlaps with the statutory authority of local Boards of Health. We have seen
that our current system for notifiable conditions is really not adequate to deal with the urgency of
reporting bio-terrorism outbreaks.
Dr. Locke said these are the priorities that emerged after a fairly detailed review by the State Board of
Health. He urged the Board to review the whole report, stressing that there are certain issues that can
only be dealt with on the community level. When asked what an individual can do to protect him or
herself (against anthrax, smallpox or botulinum) he tells people the only way to be safe and secure is to
have a functional public health system at the community level.
Member Frissell asked what steps can be taken to give the public the kind of information they would
need?
Dr. Locke said although he could not attend, he heard the Clallam hospital's bio-terrorism forum was
well received. Efforts have been geared toward the medical staff and continuing education presentations.
Jean Baldwin talked about the significant amount of work that needs to be done with the hospital in
dealing with infectious disease, quarantine, moving vaccine, and all the players involved. Another step
being taken locally is a Memorandum of Agreement (MOAs) between Jefferson, Kitsap and Clallam
Counties.
Dr. Locke provided a draft resolution, which is an opportunity for the Board of Health to formally
support any or all of the recommendations.
Member Masci moved to adopt the resolution dated December 20, 2001. Commissioner W ojt
seconded the motion. During discussion of the motion, Dr. Locke clarified that resolutions will be
grouped and forwarded to the Governor, the legislature, and the State Board of Health. The
motion carried by a unanimous vote. RESOLUTION NO. Ol-Ol-HB
HEALTH BOARD MINUTES - December 20, 2001
Page: 6
Vice Chairman Westerman said because of the challenges in the County budget and inadequate
resources to support current levels of service, she asked whether this Board, as a local action, would like
to discuss making specific recommendations for the County to come up with additional funding for the
Health Department?
Commissioner Titterness asked how to address the funding issues given that the issues are bigger than
just the Board of Health?
Vice Chairman Westerman would like to see the Board of Health come out publicly in support of trying
to find a stable funding mechanism for the Health Department. She believes part of the reason the Board
was expanded was to support that process. While there is huge pressure not to raise taxes, she feels the
Board of Health should do more than to pass general resolutions which sound good, but do not really
produce the needed results.
Commissioner Titterness said he believes the general attitude is that there can be support if you identify
a specific goal for which you can generate public support, but you have to have the authority to target
that goal. He pointed out that the Board of Health doesn't have that authority.
Dr. Locke said he believes it is already a priority on a state and local level to find a stable, dedicated
source of public health funding. The proposed solution is connected to a public utilities tax. If people
want public health security, this would be the way to vote it in.
Commissioner Wojt commented that he believes the other aspect to which Member Westerman was
referring was that people have to realize that you don't gear up after the disease threat. It is our
responsibility to educate people on what they are getting for their dollar and that the cycle of funding
does not necessarily correspond to the cycle of disease.
Member Masci responded that when the legislators appeared at a law and justice council meeting, they
were proposing a utility tax for law and justice issues. He noted even within the County there are
competing interests for the elusive utility tax and its assignment for specific needs.
2002 Data Steering Committee Fact Sheet: Member Frissell and Member Masci recognized Kellie
Regan and Dr. Chris Hale's efforts in compiling the information. Member Masci then reviewed data
which was broken into three areas: Birth/Material Child Health Indicators, Socio-Economic Indicators,
and Population Indicators.
Member Masci noted that our rapid growth in the 65+ and 85+ age ranges is atypical in Washington, and
identifies us as a special needs population. He also noted a big spike in the over 45-55 range. He
believes we are fortunate to have all of this valuable data, noting that more will be available in about
three months.
Jean Baldwin said Kellie Regan and Dr. Chris Hale are also developing an environmental health
satisfaction survey which is expected to be available in January and that will quantify many of the
Environmental Health measurements. Larry Fay said the goal of the survey is to better gauge what is and
is not working.
HEALTH BOARD MINUTES - December 20, 2001
Page: 7
Update of 2002 Stratee:ic Plan with Bude:et Shortfall Impacts: Due to insufficient time remaining, the
Board agreed to spend a significant portion of the next meeting on this topic. Commissioner Titterness
said it appears, based on revenue projections, that the County will have to severely cut expenses or find
additional revenues.
Letter to the Editor: Vice Chairman Westerman requested the Board's permission to identify herself as
a Board of Health member in writing a letter to the editor regarding her support of an affordable housing
project. She believes the Board of Health should discuss whether they can corne up with guidelines or a
policy about whether members can speak out on behalf of an issue. Given the data the Board is receiving
and the tremendous pressure that elected officials corne under, she feels that there will be an increasing
desire to speak out on some of these issues and that public officials need support.
While the Board expressed no concern about an individual member making statements on their own behalf,
there were several comments and concerns about referring to the Board of Health. One suggestion was that
a member could state "this is not necessarily a position of the Board," however it was thought that even this
use of the Board's name implies advocacy and might lead people to think that there is a Board position
favoring one project or another.
Member Frissell said the organizations in which she has been involved ask that members not use their name
unless they are referring to stated and agreed-upon policies.
HEALTH BOARD MINUTES - December 20, 2001
Page: 8
AGENDA CALENDAR/ADJOURN
Update of 2002 Strategic Plan with Budget Shortfall Impacts and Report on Access Project.
2002 AGENDA ITEMS
./ CONTINUED STABLE FUNDING TO REPLACE MVET
./ ACCESS HEALTH CARE
./ PROGRAM MEASURES (Genetic Research and Public Health Implications)
./ METHAMPHETAMINE SUMMIT
./ PERFORMANCE STANDARDS & COMMUNITY ASSESSMENT
./ TOBACCO PREVENTION AND COALITION
./ FLUORIDE
./ TRANSIT AND PUBLIC HOUSING
./ BIOTERRORISM READINESS & PLAN
./ AGING POPULATION
./ WATER
./ MATERNAL CHILD PREVENTION GOALS (0-3)
Meeting adjourned at 4:25 p.m. The next meeting will be held on Thursday, January 17,2002 at 2:30
p.m. at the Jefferson County Health and Human Services Conference Room.
JEFFERSON COUNTY BOARD OF HEALTH
f¿J:~lif/¿
Roberta Frissell, Member
(Excused)
Jill Buhler, Chairman
S~~~µ~
Sheila Westerman, Vice-Chairman
(Excused)
~mber
Dan Tittemess, Member
RESOLUTION NO. Ol-Ol-HB
Whereas RCW 70.05.060 assigns to the Jefferson County Board of Health
"supervision over all matters pertaining to the preservation of the life and health of the
people within its jurisdiction" and requires the Board to "(p )rovide for the control and
prevention of any dangerous, contagious or infectious disease within the jurisdiction of
the local health department";
Whereas the Jefferson County Board of Health has reviewed the "Response Capability
during a Health Emergency - A Review of Selected Issues" adopted by the Washington
State Board of Health on November 14,2001;
Therefore Be It Resolved, that the Jefferson County Board of Health concurs with the
findings of the State Board on the need for enhanced preparedness for biological
emergencies and supports the State Board's recommendations for improving state and
local preparedness.
Adopted this 20th Day of December, 2001
JEFFERSON COUNTY BOARD OF HEALTH
fLu i2ù4 CÎ~
h@Buhler, Chair
J~ uJ1h{u~
Sheila Westerman, Vice Chair
() éÆ)
ti~~
Dan Tittemess, Member
eJ -,
Geoffrey Masci, Member
-
~w¡1!£¿~
Roberta Frissell, Member
ATTEST:
rY0411ct
HEALTH
DEPARTMENT
360/385-9400
ENVIRONMENTAL
HEALTH
360/385-9444
DEVELOPMENTAL
DISABILITIES
360/385-9400
ALCOHOUDRUG
ABUSE CENTER
360/385-9435
FAX
360/385-9401
JEFFERSON COUNTY BOARD OF HEALTH
Thursday, December 20, 2001
2:30 - 4:30 PM
Main Conference Room
Jefferson Health and Human Services
To: Board of Health Members
From: Cathy Avery, Assistant to Dr. Thomas Locke
Re: Addendum to Board of Health packet
Erin Lundgren
BOCC Office
PO Box 1220
Port Townsend W A 98368
(O) I'~? fù I;J. '7 'il fì í? r"--,
ill) ~ ~ ie.. 'i \Vf Ii::': C1 \
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DEe 13 2001 L~/
JEFFERSON COUNTY
BOARD OF COMMISSláNERS
Jefferson Count Health and Human Services
OCTOBER", DECEMBER 2001
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 program for the public:
1. "Bioterrorism scare in PT", 2 pages, Peninsula Daily News, October 14,2001
2. "Bioterrorism scare reaches U.S. Capitol", Peninsula Daily News, October 16,2001
3. "Flu shot clinics announce schedules", P.T. LEADER, October 17, 2001
4. "Those at risk can receive flu vaccine", Peninsula Daily News, October 18,2001
5. "Line up for flu shot clinic", P.T. LEADER, October 31, 2001
6. "Jefferson budget cuts 'shocking"', Peninsula Daily News, October 28,2001
7. "Flu shots already given to 1,000 county residents", P.T. LEADER, November 7, 2001
8. Ad: "The Great American Smoke Out", P.T. LEADER, November 7, 2001
9. "Tests show no anthrax on PA letter", Peninsula Daily News, November 14, 2001
10. "County budget may cut jobs", P.T. LEADER, November 14,2001
11. "Peninsula joins 'Smokeout"', Peninsula Daily News, November 15,2001
12. "CDC head speaks at health policy meeting", Peninsula Daily News, November 18,
2001
13. "Clallam mulls bioterror safety", Peninsula Daily News, November 21,2001
14. "Mail scare fIZzles at Courthouse", Peninsula Daily News, November 23,2001
15. "The business of recycling", P.T. LEADER, December 5, 2001
16. "Reading study may aid toddlers and parents", Peninsula Daily News, December 6,
2001
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Scare: Letters from· PA
CONTINUED FROM Al
During the operation, the
crew wore self-contained
breathing apparatuses.
Browne described the pow-
der appeared to be a "caustic... sent fr01I;l a Port Angeles bank,
acidic" substance. Owen Sald. .
The discovery came in the Owen said ~he female clerk
wake of anthrax scares was not wearmg gloves when
throughout the state and she. handled the. two let~rs,
United States in recent days. and that no,', poliCY, reqwnng
R.J. Preston, a postal employees to w~~oves.,.or
inspector at ,the U.S. Postal any ~ortofresplI'atory ~eV1ce
Service's northwest division was m place at the post office.
headquarters in Seattle; char- The bank from which the
acterized the hazardous-mate- letters were sent and to whom
rial teams being called to Port t~ey were addreSsed was not
Townsend as a precautionary disclosed.
gesture. After the powder wasdis-
He added that his office had covered, Owen, who was on
received "hundreds" of calls duty at the. time, put on plastic
from concerned citizens and gloves and put the mail in a
postal workers on Saturday separate container with a lid.
alone. She moved the container to an
empty office and called local
authorities. .
Within 15 minutes, the Port
Townsend Fire Department
had evacuated the building,
including five postal clerks
and several mail carriers, one
customer and a worker from
Hanson Electric, which has an
office on the second floor of
the building.
Reports In S~attle area
In the Seattle area, haz-
ardous-materials teams have
responded to a half-dozen
reports of strange substances
- both liquid and powder _
turning up ih the mail and
elsewhere since Thursday.
None of the materials has
tested'h positive for anthrax,
thoUgh some tests were still '
under,.way.
The'· Port Townsend inci-
dent, occurred just after the
post office opened at 10 a.m.
Saturday, 'when a clerk came
upon two letters covered in
residue, said Tammy Owen,
custonie.rservice supervisor.
Oweii said that it appeared
the yellow powder was not
from inside the letters, but
had possibly come from
another package or elsewhere.
"The powder seemed like it
The ~ort Townsend post -
office had been on high alert
throughout the week, Espen-
son said.
Espenson said he has
received several e-mails from
higher-ups in the· postal ser-
vice over the past several days
regarding how to identify and
handle suspicious mail.
Employees at the Port
Townsend office had been
briefed twice 'in the past sev-
eral days on how to handle'
such mail.
, "They handled it exactly
Stationed throughout day the way they were told handle
it," Espenson said. , " '
Two Port Townsend police Owen! said all mail on the
officers ~ere stationed Olyµ¡pic Pe$sulais first sent
t~oughout the day on either to Tacoma,' where it is ,sorted
sId.e ?f the V(ashington- Street' electronically,beforeit goes to
bUlI~g, WhICh was co~doned the individual. post officee.
off WIth c~>nes and yellow plas- '
tic ribbon. Fire, Department,
personnel were also present
throughout the day. ,
"We're 'in containment
mode right now," said officer
Ed Green. . .
Around 3 p.m., an inspector
was the result of something
falling on the envelope, ~ Owen
said. "It was a yellow powdery
residue. "
The letters àppeared to be
with'the postal service's
. Northwest' division - who
declined tò give' his' name --:-
arrived ·from·, his home:.i'in
Marysville. Postal inspectors
serve as federal .law enforce-,
merit agents for ,the' U.S;
Postal Service., ,
After' leSrnuig the details'
,on what had been found, the
inspector conferred with the
Port Townsend Fire ,Depart-
ment"and a decision ,was. made
, tò call in the WäShirigoon State
Patrol Statewide Incident
Response Team to handle the
envelöpes. '
High alert all week
""'-
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l
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'......
I
C2.
'-....
Bioterrorism scare
reaches U.S. Capitol
æ; America =
RETALIATES
THE AsSOCIATED PRESS
WASHINGTON - A letter sent
to Senate Majority Leader Tom
Daschle tested positive for anthrax
on Monday as the bioterrorism scare
rattling the nation reached the halls
of Congress.
The discovery of anthrax in
Washington followed earlier
instances in Florida, New York and
Nevada in which at least 12 people
were exposed to spor~ of the poten-
tially deadly bacteria.
Monday night, another case of the
disease was announced in New York.
The 7-month-old child of an ABC
News employee has tested positive for
anthrax, ABC News President David
Westin said. The child is expected to
recover. New York poli<;e commis-
sioner Bernard Kerik said news agen-
cies throughout the city were being
. Airstrikes continue pounding
targets around Kabul/C1
..
inspected for anthrax contamination.
The piece of mail in Daschle's
office, which contained a powdery
substance, was dispatched to an Army
medical research facility at Fort Det-
rick, Md., for further examination
said Capitol Police Lt. Dan Nichols. '
The Fort Detrick findings could
be available as early as today, offi-
cials said. Nichols and others
warned that the ihitial tests were
not necessarily accurate.
TuRN TO 'I'ERRoR/A2
Scare: Study response
CONTINUED FROM Al
Jefferson County Commu-
nity Health Director Jean
Baldwin said she will discuss
anthrax and other concerns at
Friday's meeting of the Jeffer-
son-Peninsula Response-
Emergency Preparedness
group, known as J-Prep.
"We're having' a meeting
with J-Prep to review bioter-
rorism concerns and our erner-
gency response," she said.
"The CDC (Centers for Dis-
ease Control in Atlanta) talks
about being calm but also
aware of certain kinds of pack-
ages,"
No anthrax recorded
Tim Church, communica-
tions director for the state'
Health Department, said test
"results' are typically relayed
back to the original source,
and no substance found in
Washington state has tested
for anthrax.
"We give the results to the
local law enforcement agency,
.. but if we did have a positive
anthrax test in Washington,
we will let people know,"
For information regarding
the threat of anthrax and
what to do with suspicious
materials, visit the Jefferson
County Emergency
Management Web page at
http://cdem.cojefferson. wa
,us.
Church said.
"It won't be something that
quietly comes out, If anything
tests positive, we'll hold a
press conference, but for
everything else, the local agen-
cies will handle."
Baldwin said the deadly
form of anthrax found back
East last week has to be pro-
'pelledinto a victim's respira-
tory system.
"It is most dangerous if it's
in air, It has to be propelled,"
Baldwin said.
"That's very difficult to do,
thank heavens."
In Seattle on Monday, some
downtown streets were closed
early Monday after a security
guard found a container of
powder in the 76-story Bank of
America building, the city's
tall es t.
Initial tests were negative
and the streets were reopened
about 90 minutes later, said
Seattle Fire Department
spokeswoman Helen Fitz-
patrick.
Bathroom find
The Bremerton ferry termi-
nal was shut down for more
than five hours on Sunday
after a passenger noticed a
handful of white powder on
the floor of the women's bath-
room.
, But the powder tested neg-
ative for any hazardous mate-
rials, said Washington State
Patrol Lt. Helmut Steele,
Ferry 'service was not affected.
Initial tests also came back
negative on a white powder
found on a seat on the ferry
Wenatchee at Colman Dock in
Seattle on Saturday night. The
material was sent to the state
Department of Health lab for
further analysis.
----
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The Associated Press con-
tributed to this report.
Wednesday, October 17, 2001 _~~
Flu shot clinics announce schedules
b ':1) nil.: \'0 :1 11 t., 10 he first III
line for a flu shol so (hey dOIl't
feel lousy or miss work or school.
However. there IS a good reason
10 Jet hlgh-mk people go to the
front of (he line, according to
public heallh officials, High-risk
people are much more likely to
suffer complications. be hospital-
ized or even die from the disease.
Those at high risk include
anyone 65 or older; children and
adults with chronic pulmonary or
cardlOvascular conditions, in-
cluding asthma, as well as those
with diabetes, renal dysfunction
or immunosuppressIon: residents
of iong-term care facilities; chil-
dren receiving long-term aspirin
therapy: women in their second
or third trimester of pregnancy
during the flu season; and medi-
cal providers who provide direct
care to any of the above persons.
Due to delays in vaccine ship-
ments, if you do not fit into these
categories, you are encouraged to
wait, states Dr, Maxine Hayes,
Washington state health officer.
"We know everyone wants to
dvoid the inconvenience and dis-
comfon of getting the flu, but we
must all take the necessary steps
to let our most vulnerable resi-
dents get the shot first," she says,
Protection develops about two
weeks after getting immunized,
and flu activity in Washington
usual I) does not pèak until Jallu-
aryor Fehruary,
'p. r Lf3rD e-(è
IO-/1-o{
The weèk of Oct. 14-20 is
National Adult Immunization
Week, This is a time when the
heaith department emphasizes
the need for adults to get up to
date on all their immunizations.
With the delay in shipments of
the vaccine this year, it is impor-
tant to focus on getting your flu
shot at the right time and check-
ing to seeif you need a pneumo-
coccal vaccine, advises Hayes.
Check with your health care pro-
vider about what immunizations
you may need.
"Keeping a permanent life-
time immunization record card is
the best way to ensure you know
what immunizations you have
had," says Hayes.
The bottom line is this:
. High-risk people: Get vac-
cinated as soon as flu vaccine
is available, and check to see
if you also need a pneumococ-
cal vaccine.
. Healthy people: Wait until
at least mid-November to get
your flu shot.
Private clinics
Many local physicians have
influenza vaccine available in
their clinics during October.
Please check with your provider.
The following providers have
announced influenza vaccine
clinics:
. Jefferson General Medical
Group. 834 Sheridan, Port
Townsend: For established pa-
tients only, Da[es and times [0 be
announced later.
. Olympic Primary Care,
1010 Sheridan, Port Townsend:
For established patients only,
Call for an appointment.
. Port Townsend Family Phy-
sicians, 934 Sheridan, Port
Townsend: For established pa-
tients only, 9-11 :30 a.rA. on two
Saturdays, Oct. 20 and Nov. 3,
Health department clinics
Jefferson County Health and
Human Services sponsors flu
vaccine clinics throughout the
county beginning in November,
Both influenza and pneumonia
vaccines will be available, Check
your records for dates of previ-
ous pneumonia immunizations.
Because many groups and ac-
tivities utilize the Tri-Area Com-
munity Center, health
department flu clinics for the Tri-
Area take place in the Lutheran
Church of the Redeemer. It is
located off Chimacum Road, be-
tween Hadlock and Chimacum,
south of the Little League fields,
Health department clinics
charge $10 for influenza vaccine
and $14 for pneumonia vaccine,
Medicare and Medicaid clients
are asked to bring their Medicare
cards or Medicaid coupons to the
clinics for accurate billing infor-
mation, Community Health Plan
of Washington clients,must go to
their primary care physician or
pay cash for ¡he vaCCIIl:lIllHl,
Additional dalèS \vill be an-
nounced as more vaccine be-
comes available.
· Jefferson County Health
Department: Friday, Nov, 2. 9:}0
a,m.- 12:30 p,m,
· Brinnon Booster Club Mon-
day, Nov, 5, 10:30 a,m,-12:30
p,m. & 1:30-3 p,m.
· Lutheran Church of the
Redeemer (Tri-Area clinic):
Wednesday, Nov,}. 9:30 a,m,-
1 p,m,
· Gardiner Commun¡(y Cen-
ter: Tuesday, Nov, 20. 10 a,m,-
noon,
Other clinics
· Safeway, 442 Sims Way.
Port Townsend: Saturdays and
Sundays, Nov. 3-4 and Nov, lO-
ll, 11 a,m,-5 p,m, Influenza
costs $15; pneumonia costs S25,
Medicare will be billed,
QFC and the Bay Clinic are
collaborating to offer influenza
vaccine clinics this year at the
locations listed beJow, Influenza
costs $15: Medicare \'0 ill be
billed,
· Bay Clinic, 121 Oak Ba)
Road, Pon Hadlock: Friday-Sat-
urday, Oct. 19-20, and Saturday,
Oct. 27,10 a.m,-4 pm,
· Port Ludlow Bay Cluh. 120
Spinnaker Place, Port Ludlow
Friday. Oct. 26. 10 a,m,-4 pm,
· Quilcene Community Cel1'
tel', Quilcene: TUèsday. Oct. 2,1,
11 a,I11,-5 p.m,
A4 THuRsDAY, OcrOBER 18, 2001
Those at risk
.
can receive
flu vaccine
Officials want P eöple with chronic
heal thy people me.dical conditi.o~s,
. resIdents and VIsItors
to Walt for shots olderthan age 65, long-
term care residents,
healthcare workers and
pregnant women in the
second or third trimester
are. . . encouraged to get a
flu shot as soon as possible.
By BRENDA IlANRAHAN
Pf~NJNSIII.A DAII.Y N¡.:ws
Vaccines for people at high-
risk of contracting influenza _
commonly called the flu - are
now availab1e at various com-
munity agencies and stores in
Clallam and Jefferson counties.
Delays in delivery and con-
cerns of vaccine shortages have
officials from the state Depart-
ment of Health strongly
encouraging healthy people to
wait until later in the year to
get a flu shot.
"Most clinics have received
only partial donations of the
vaccine, II Department of
Health Health Educator Cindy
Gleason said.
"We expect to have enough
flu vaccine to meet state pro-
gram needs. II
Flu season
The high-point of the flu
season for the state doesn't
begin until January, allowing
healthy people to wait for the
second or third batch of vac-
cine to be delivered, officials
said.
"There will be plenty of time
'for others to get their flu shots
before flu season," Gleason
said.
People with chronic medical
conditions, residents and visi-
tors older than age 65, long-
term care residents, healthcare
workers and pregnant women
in the second or third trimester
are classified as high risk and
are encouraged to get a flu shot
as Soon as possible.
Pharmacists reported most
people are adhering to the
request by health officials, with
the majority of those getting
the vaccine being older than
65. . '
The average price for the flu
vaccine is $15, officials said, An
additional pneumonia shot
costs $25. Both shots are cov-
ered by Medicare.
Delivery of vaccine depends
on which manufacturer an
agency orders from, Gleason
said.
VaC4:"n,~tioi1' .
: , .;, , ' ,r' :~':\¡;4%~:),.\': " .' '
PENlNSUL4ÐAU.,yþ:iEWS '
Vaccinations ~e being; J. '.
offered in'JeffeJ:.son Coun~y'
at the following:loç~t!ons: > "", .' p
. Jèfferson County '. " <cärr'
Health Department...,... 615." '., . a ~way Fooçt~d D~lJg ,
Sheridan St.; PortTownsend,' ...,... . hi~gtQ.f.I9J., ''i,
9:30 a.m. to 12:~ ~':n'¡' Nov;· : Seqúlm,tÒz'EÚ:Q~ijQ'i,.
2." ,.;>' 2,Nov.'16~ and:11 a:I1'i'7to;;q;\
· Brinnon 8?oster Cl~b , ..' p.m.. NoV, 3 and Nov.J7, , ,
Corey Lane. Bnnnon, 10.~ ':,' .Sateway FooQ ,and ,Drug
a.m. to 12:~ p.m; ~nd l:~ " '., " ,t7o,f?Òrt)\ng~l~ p:laza, ' "
p.m. to 3 p.m., Nov.5,.: '.'.' , Þort Ar1geJès;,I1QOn to 7 p.m., '
· Lutheran Church of the ", Oct. ,la~ .11 a;m. to 5 .
Redeemer"""" 45 Redc:!emer ,< ',' . ".', ' .,' .
Way, Port Hadlock,,9~30a.~.' p.m~, QWa~ Fo9d~~d Drug
to 1 p.m., ~9v, 7,. * ~i.'.". 'L;.:.'Thlrd$ti-l?PTt Allge-!
· Gardiner CÖt'(1fI.l,UMY'I'·'· ':o.o'on' "t'o', "7' ','p" 'm' .~ ~ 26' ',; ,
, ·L· ·11 ·Ro'd" es, ' .., v..... ,
Cent~r ....;, 626 I Y, a '11 a. '.,. , . .:ZZ;
Gardmer, 10 a,m, to noon., '" ..'.'. ".. g,'ãnd ;11
Nov. 20. " ':.'. ..' ,'nf.o~ " ò'i'i"~&';;;':I": ..
· Saf~way FO,od an,d,Drug ':.:a"r¡·~imIS;Pharm~cy·' ,424'
- 442 SIms Way, Port EastSeco'nd~à, Port Ange-
To\Vn3senNd, 114aN·m. t01í ~~d" les;':rp.m!itp;S p.m.; Oct.·19. '
. Nov., ' ov. .' ~ ()v. ,,:".,. ForkS Commùnity Hos--
Nov. 11. "', , ¡:o:.r.B " AI.' J W"y
.Bt:1Y Clinic ' .. 121 c>ak pital , .....,." ogal,ollle ..., q_
Bay Road Port Hadlock,10 .' For~. ..t~ ~.p."1.. MC?n .
4' 0 t 19 Oct ,dajthr ,Fnday. ,
a.m. to p.m., c., '.' ': Offi'a(öther health
20 and Oct. 27. . ...' .' d h '
. Port Ludlow Bay Club, '. care clinics, stores ,an p, ar-
- 120 Spinnaker Place, Port, macieswjll ann9µn~ clinics
Ludlow, 10 a'.m. to 4' p.m., as they receive ~aC?lneS,
".'-"". ",;::
,
Port Townsend &. Jefferson County Leader
Line up for flu shot clini&
Au shot clinics in Jefferson
County are being scheduled, with
health officials urging that high-
risk people be first in line for the
service.
Those at high risk include
anyone 65 or older; children and
adults with chronic pulmonary or
'cardiovascular conditions, in-
cluding asthma, as well as those
with diabetes, renal dysfunction
'or immunosuppression; residents
of long-term care facilities; chil-
,dren receiving long-term aspirin
,therapy; women in their second
or third trimester of pregnancy
,during the flu season; and medi-
cal providers who provide direct
care to any of the above persons.
Private clinics
Many local physicians have
influenza vaccine available in
10-3/-01
their clinics. Please check with
your provider. The following
providers have announced influ-
enza vaccine clinics:
· Jefferson General Medical
Group, 834 Sheridan, Port
Townsend: For established pa-
tients only. Dates and times will
be announced later.
· Jefferson Medical Associ-
ates, 617 Sheridan, Port
Townsend: Every day for estab-
lished patients age 65 and over.
Call for an appointment.
· Olympic Primary Care,
1010 Sheridan, Port Townsend:
For established patients only.
Call for an appointment.
· Port Townsend Family Phy-
sicians, 934 Sheridan, Port
Townsend: For established pa-
tients only, 9-11 :30 a.m. Satur-
day, Nov. 3.
. Other clinics also have flu
vaccine available for their pa-
tients. Call your provider.
Health department clinics
Jefferson County Health and
Human Services sponsors flu
vaccine clinics throughout the
county beginning in November.
Both influenza and pneumonia
vaccines will be available. Check
your records for dates of previ-
ous pneumonia immunizations.
Because many groups and
activities utilize the Tri-Area
Community Center, health de-
partment flu clinics for the Tri-
Area take place in the Lutheran
Church of the Redeemer. It is
located off Chimacum Road,
south of the Little League fields.
Health department clinics
charge $10 for infl uenza vaccine
and $14 for pneumonia vaccine.
Medicare and Medicaid clients
are asked to bring their Medicare
cards or Medicaid coupons to the
clinics for accurate billing infor-
mation. Community Health Plan
of Washington clients must go to
their primary care physician or
, pay cash for the vaccination.
Additional dates will be an-
nounced as more vaccine be-
comes available. Call 385-9429
for information.
· Jefferson County Health
Department: Friday, Nov. 2, 9:30
a.m.-I2:30 p.m.
· Brinnon Booster Club: Mon-
day, Nov. 5, 10:30 a.m.-12:30
p.m. & 1 :30-3 p.m.
· Lutheran Church of the Re-
deemer (Tri-Area clinic): Wednes-
day, Nov. 7, 9:30 a.m.-l p.m.
· Gardiner Community Cen-
ter: Tuesday, Nov. 20, 10 a.m.-
noon.
Pharmacy-sponsored
clinics
· Safeway, 442 Sims Way,
Port Townsend: Saturdays and
Sundays, Nov. 3-4 and Nov. lO-
11, 11 a.m.-5 p.m. Influenza
costs $15; pneumonia costs $25.
Medicare will be billed.
.' QFC, 189.0 Irondale Road,
Port Hadlock: Thursday, Nov, ],
11 a.m.-5 p.m. Influenza costs
$15; pneumonia costs $30. Medi-
care will be billed,
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Flu shots already given
to 1,000 county . residents
Flu shots have been adminis-
tered to more than 1,000
Jefferson County residents fitting
the definition of "high-risk" pa-
tients, and the second wave of flu
shot clinics is just beginning.
Getting a flu shot is an impor-
tant way to fight the flu, but some
people may find they have to wait
their turn; high-risk patients have
priority,
The Washington State Depart-
ment of Health urges healthy
people under the age of 65 to wait
until mid-November or later to
be vaccinated. Shipping and pro-
duction schedules mean that
stocks of flu vaccine will arrive
in partial shipments through No-
vember and'December.' ';'
Jane Kurata, a public health
nurse with Jefferson County
Health & Human Services, said
providers have been asked to pri-
oritize initial shipments for high-
risk patients, including the elderly.
"Washington's flu season usu-
ally starts in January or Febru-
ary, so there is plenty of time for
healthy people under age 65 to
be vaccinated," Kurata said.
11-7-ðf
Pr . (l;4;1) eC
Approximately 79.6 million
doses of flu vaccine will be' pro-
duced tlús year, more than in pre-
vious years, but some will not be
delivered until December.
Those at high risk include
anyone 65 or older; children and
adults with chronic pulmonary or
cardiovascular conditions, in-
cluding asthma, as well as those
with diabetes, renal dysfunction
or immunosuppression; residents
of long-term care facilities; chil-
dren receiving long-tenn aSpirin
therapy; women in their second
or third trimester of pregnancy
during the flu season; and medi-
cal providers who provide direct
care t9.~~o.fnW a,bqyÿ' persons. ,
Jefferson County Health & ;
Human Services will continue to '
hold flu vaccine clinics through-
out the county in November and
December. Both influenza and
pneumonia vaccines will be
available. The health department
advises checking records for
dates of previous pneumonia
immunizations. As more vaccine
arrives, more clinic dates will be
announced.
QFC cooperated with the
health department to offer its own
flu shot clinics in Port Ludlow,
Port Hadlock and Quilcene.
From Oct. 10 through Nov. 1,
QFC administered 726 flu shots
to people fitting the "high risk"
definition.
Michael Son, pharmaéy
manager for the QFC store in
Bellevue, helped the Port
Hadlock QFC phannacy staff
the Jefferson County clinics.
"The response is really phe-
nomenal," Son said. "Your
health department is awe-
some," he noted, in providing
help and referral infonnation.
Port TownseI):çl~~~rl~Af,~,)of1~¥.
store offered flu, shots on NoV;, 3~
4 and will re~at'-the:seI'Yícetlïis
conùng weekend, Nov. 10-11, 11
a.m.-5 p.m. Dave O'Connor at
the store pharmacy didn't have
specific numbers, "but it was a
steady stream all weekend. They
ran out of vaccine," he said.
The health department's first
flu shot clinics Friday, Nov. 2 and
Monday, Nov. 5 provided nearly
400 inoculations.
The following health depart-
ment flu clinics are scheduled:
· Tri-Area clinic at Lutheran
Church of the Redeemer, Wednes-
day, Nov. 7, 9:30 a.m.-1 p.m.
· Jefferson County Health &
Human Services, Port Townsend,
Wednesday, Nov. 14,9:30 a.m,-
12:30 p.m.
. Gardiner Community Cen-
ter, Tuesday, Nov. 20, 10 a.m.-
noon.
. Quilcene Community Cen-
ter, Thursday, Nov. 29, 10:30
a.m.-12:30 p.m. and 1:30-3 p.m,
Health department-sponsored
clinics are $10 for influenza vac-
cine, and $14 for pneumonia vac-
cine. Medicare and Medicaid
clients are asked, to bring 'their
Medicart'cards or Med.icaid'cou-
pons to the clinics for accurate
billing information. Community
Health Plan of Washington cli-
ents must go to their primary care
physician, or pay cash for the
vaccination.
Call 385-9429 for the latest
flu clinic schedule, or check the
Jeffferson County website,
www.co.jefferson.wa.us.
WEDNESDAY, NOVEMBER 14, 2001 A3
Tests show
no anthrax
on PA letter
Suspect
bacteria
not found
By BRENDA HANRAHAN
PENINSULA DAILY Nr:WS
PORT ANGELES -
Prelimi-
nary
anthrax
tests on a
letter
received by
a local reSI-
dent who
became ill
after open-
ing it nave
come back
negative, L k
Clallam oc e
County
health officials said Tues-
day that testing included a
microscopic examination of
the letter at the Washing-
ton State Public Heath
Laboratory in Shoreline,
Illness not from letter
"I can conclusively say
that her ilJ ness is not from
the letter," Ciallam County
Health Officer Dr, Tom
Locke said.
But the lab is continu-
ing to monitor the culture
to see if anything grows on
it, Locke said,
Additional results could
be released today,
"With anthrax, you
would expect to see growth
after 12 hours," Locke
said. "The culture has
been monitored for four
days and it would be
highly unlikely for prelimi-
nary results to change."
On Nov. 7, police and
fire officials were called to
the Port Angeles post
office, 424 E, First St"
after a woman - on the
advice of her doctor -
requested that a letter
with a New Jersey post-
mark be tested,
Officials did not release
the identity of the woman,
Woman became ill
The woman had
received the envelope from
a known source two weeks
earlier and became ill after
opening the letter, officials
said,
Health and postal offi-
cials declined to comment
on the woman's current
medical condition,
Initial testing at the
post office by the Fire
Department determined
the letter was not radioac-
tive,
Health regulations
require the radioactivity
test before items are taken
to the Shoreline laboratory.
Locke said there have
been no illnesses reported
from letters coming from
New Jersey,
Locke said the 22 con-
firmed or suspicious cases
of anthrax in other states
all involved people who
worked in environments
where anthrax was
detected.
All postal items tested
in Washington state have
tested negative for
anthrax, and Locke said it
would be highly unlikely
that routine mail items are
contaminated,
"We are still urging peo-
ple to follow suspicious
mail criteria set by the FBI
and U.S, Postal Service,"
he said,
County budget may cut jobs
By Shelly Testerman
Leader Staff Writer
When it comes to naming
the largest expense category in
Jefferson County government,
County Administrator Charles
Saddler doesn't hesitate: "Our
biggest cost is people," he said.
So paring 2002 budget ex-
penses is going to involve ask-
ing all county departments to
make a 1 percent reduction in
2002 personnel costs and a 2.5
percent reduction in all other
costs. Some "discretionary" pro-
grams may be cut as well.
If allowed to continue, the
trend of 5 percent growth in
salary/benefit expenses and 4
percent growth in overall costs
means the county could face a
$1.5 million shortfall in 2006.
The 2002 base budget, for-
mulated with numbers submit-
ted by county departments,
lists nearly $12.1 million in ex-
penditures but only $11.6 mil-
lion in revenues.
And while the budget could
be easily balanced this year,
county officials are concerned
with forecasted declines in state
funding and constraints placed
on local property tax revenues
with the passage of Initiative
747.
~r. LE.APEL
1/-/4--61
"The bear in the
living room is
salaries and
benefits."
Dan Tittemess
county commissioner
Slimming the county's per-
sonnel ranks could be part of a
long-tenn strategy to decrease
expenditures.
When the Board of County
Commissioners met Friday
with Saddler and Deputy
CÇ.unty Administrator Gary
Rowe, Saddler said the board
had the prerogative to target
specific staff positions, for
elimination, but he recom-
mended leaving that respo.!}si-
bility to the department heads.
The board readily agreed.
However, Commissioner
Glen Huntingford scrutinized a
list of unfilled positions - rang-
ing from sheriff's deputies to an
enforcement officer for the De-
partment of Community Devel-
opment - saying, "We need to
take a look at these and cut 'em
out."
Those unfilled positions that
are essential - such as a build-
ing inspector - may be subject
to tradeoffs, with their funding
contingent on not funding other
proposed positions, Huntingford
suggested.
Staff positions are not the
only target of the budget-cutting
scythe.
"The bottom iine is we're go-
ing to have to be looking at the
shedding of various programs
and services that we provide,"
Saddler said Friday.
Although county govern-
ments are mandated to provide
many programs, many are pro-
v~ded at the commissioners' dis-
cretion.
"Discretionary" expendi-
tures include the county's con-
tributions to the Washington
State University Learning Cen-
ter in Port Hadlock, the animal
shelter and neighborhood
parks.
"It pains me to say it, but
parks and recreation is the big-
gest discretionary expense we
have in county government,"
Saddler said.
Commissioner Dan Titterness
interrupted Saddler's discussion
of expendable programs with
this comment:
"I think you've done an ex-
cellent job of dancing around the
bear in the living room," the
commissioner said, "and the
bear in the living room is sala-
ries and benefits."
Although the county has tip-
toed around the large and un-
friendly beast every ~udget
cycle, Titterness said a "reor-
ganization" of county govern-
ment may now be necessary in
order to prepare the county for
the next few fiscally challeng-
ing years.
"I'd like to see some proposal
for reducing staffing somewhere.
It looks to me like we're going
to have to face that," Titterness
said. "If we don't face it this
year, next year it's going to be
worse."
Saddler is scheduled to
present his proposal for a bal-
anced budget by Nov. 21.
Peninsula joins 'Smokeout'
Drive urges young, old puffers
to drop tobacco like a bad habit
By BRENDA HA."<RA.HAN
Pr::\¡:\SL'LA DAlLY NEWS
In observance of today's
Great American Smokeout,
officials in Clallam County
have orgamzed a no-smoking
campaign dubbed "Commit to
Quit: Do it For Yourself, Do it
For Your Family"
The Tobaccã-Free Clallam
County Community Coalition
will host an informational and
celebratory meeting in the
basement conference room of
the Clallam County Court-
house, 223 E, Fourth St" from
4 p,m, to 530 p,m,
"We will hand out various
mformational pamphlets
about smoking and invite peo-
ple who have successfully quit
to share their stories," said
Rene Martinez, Clallam
County Department of Health
and Human Services tobacco
prevention specialist.
~DJ
{(-IÇ"-ol
"Smoking is really an addic,
tion and should be treated like
one." she said, "It is amazing
how fast results from quitting
smoking can be seen,"
Clallam County health offi-
cials estimated 12,500 adults
and 1,200 youths smoke, In
Jefferson County, approxi-
mately 5,200 adults and 540
youths smoke,
In addition, 1,500 adults
and 500 children and teen-
agers use smokeless-tobacco
products in Clallam County,
In Jefferson County, 640
adults and 230 youths use
smokeless tobacco,
Each year, 150 Clallam
County, residepts will die of
tobacco-related illnesses. Fifty
people are expected 'to die
from related complications in
Jefferson County.
One of the greatest prob-
lems in Clallam County is
"Smoking is really an
addiction and should be
treated like one, It is
amazing how fast results
fr~m (wining smoking c¡n
be seen,"
RENE MARTINEZ
Clallam County health OffiCIal
smoking by pregnant women,
That can cause low birth
weight and greater suscepti-
bility to asthma and upper res-
piratory infections, Martinez
said,
Health effects
Studies show that some
positive effects kick in about
20 minutes after a person
stops sr;nokÜ:¡,g. TÞßir: pulse
and blood pressure, rates
return to normal and the tem-
perature o( their hands and
feet increases as circulation
Improves.
About 8 hours after a per-
son stops smoking, the oxygen
level in their blood increases
and the carbon monoxide leve!
in blood drops, After 24 hours,
the chance of a heart attacK
begins to decrease
Stopping smoking ,'dI1
d"l'l'PtlSl' till' i,k,'I,h,,,,d ,I
heart disease and lung. ml)uth,
larynx, esophagus, bladder.
kidney and pancreatic cancer,
she said,
There are several help lines
available to people who cannot
make it to todav's meeting,
Martinez said, - ~
The state Department of
Health can be reached toll-free
by calling 877-270-STOP
Spanish-speaking residents
should call 877-2NO-FC\fE
Locally, Clallam County
stop-smoking oftìcials can be
contacted at 360-565-2608
In addition to C!ailam
health services. there are SEV-
eral support groups mc]uding
The Sequim Support Group
For Quitting, Stop Smoking
Now, West End Quit Tobacco
Class, and Makah Groups,
CDC head speaks at
health policy meeting
THE AssoCIATED PRESS
SEATTLE - During a
crisis, local and state public
health agencies need to take
the lead, and the federal gov-
ernment will follow in sup-
port, the head of the Centers
for Disease Control and Pre-
vention said Saturday.
But the public health sys-
tem has long been under-
funded, although things .'
could change in light of the
events foJ]owing Sept. 11, Dr.
Jeffrey Kaplan said via a
teleconference link at the
National Conference of State,
Legislatures' 5th annual con-
ference on health policy in.,
BUt the public
health system has
long been
underfunded although
things could change in
light of the events
following Sept. 11.
Seattle.
The federal health care
agency "is only as strong as
the local and state health
departments," Kaplan said
from CDC headquarters in
Atlanta. '.,
He said local and state
public health agencies must
be prepared for emergencies
such as an anthrax outbreak
- a criminal action that
can't be predicted and may
be repeated until the person
sending the tainted letters
that "has caused four deaths
is caught.
The CDC also has scram-
bled to be prepared to back
up those agencies.
"We'J] be next to them,
with them, in support of
them, II Kaplan said.
State health departments
should be funded in the
same manner as the fIre
department or police depart-
ment, Kaplan said.
pöAl
/I-l~-ot
~
Clallam mulls biòterror safety
Heal th, emergency officials discuss
anthrax risk, response capabilities
By EMELINE COKELET
PE\'I!\SL'L-\ DAILY ~EWS
PORT A.\iGELES - Clal-
lam County health officials
and emergency responders are
working to finalize county pro-
tocol on bioterrorism threats,
With anthrax still a threat,
the county is seeking to modify
the newly adopted state Board
of Health policy for dealing
with bioterrorism, county
Health Officer Dr, Tom Locke
told the county Board of
Health on Tuesday.
"We've been modifying that
protocol to fit with our local
circumstances," Locke said.
Washington has a disaster
preparedness system, which is
mostly for natural disasters,
chemical spills and mass casu-
alty events, Locke said,
Last week, the state health
board adopted a bioterrorism
response protocol to be added
to its plan,
"\{olhat we're trying to do is
bring that system up to speed
with the unique category of
deliberate infectious disease
outbreaks, which is what
PÞN' II-JJ~IJ!
bioterrorism is all about,"
Locke said.
On Tuesday, Locke met
with county emergency man-
ager Joe Ciarlo, Port Angeles
Fire Department Chief D,!'ln
McKeen and two county envi-
ronmental health officials to
finalize emergency bioterror-
ism protocol for county "first
responders" - members of law
enforcement, fire districts and
county personnel that respond
to potential bioterrorist
threats.
Recent anthrax scares
The county's protocol is
based on experience in han-
dling recent anthrax threats,
including a package a woman,
brought to, the Port Angeles
post office that she" thought
came from a New .rèrséy post
office where inhalat~n
anthrax was present earlier
this month, Locke said,
"This was the first time
that particular situation had
come up in the state," Locke
said,
The package tested negative
for anthrax and other diseases,
The local response to that
threat was what "we had envi-
sioned doing," Locke said,
The county developed its
first bioterrorism emergency
protocol Oct. 16, just seven
days after the nation's first
anthrax-laced letter was
mailed, Locke said.
Modifications
The county has continued
to mod.ify its response since
then, he said.
"We've been modifying it as
things develop."
Tuesday's revised protocol
will be presented to county
first responders next week,
Locke said.
With flu season starting,
Locke told the Board of Health
that some people exhibiting
flu-like symptoms might mis-
take them as signs of anthrax.
Anthrax symptoms are
almost indistinguishable from
upper respiratory infections
and flu-like illnesses, though
people with anthrax usually
don't get runny noses or sore
throats, he said.
"We're telling people that
unless they've had some kind
of exposure out on the East
Coast (to facilities that have
received anthrax), that reallv
their risk of anthrax is virtù·
ally zero."
County health officials havè
sent Centers for Disease Con-
trol information to doctors and
healthcare providers about the
differences between anthra.x
and the common cold,
"We're trying to help physi-
cians be prepared for those
questions," Locke said,
Jefferson County Sheriff's deputies Don Johnson, left, and Alex MI~ discuss a plastic bag
containing a suspicious letter discovered Monday In the Treasurer. OffIce.
/
Mail scare
/
fizzles at
Courthouse
Mystery dust
found to have
mundane origins
By PHILIP L. WATNESS
PENINSULA DAlLY NEWS
PORT TOWNSEND - Powder-
covered tape and discolored stains on
a green envelope prompted a scare at
the Jefferson County Treasurer's
Office in the county Courthouse,
The envelope, which arrived in
Monday morning's mail, had all the
unusual markings of a suspicious let-
ter.
A worker put it into a plastic bag
and contacted county Safety Officer
Mark Bowes,
County officials contacted the U.S.
Postal Service in Seattle, which sent
an investigator to the return address
listed on the letter.
An elderly man explained that he
had spilled gin on the envelope,
which contained his property tax
payment.
Then he sealed it with double-
,sided tape. To reduce the sLickinesa
he put talcum powder on the tape.
No one was evacuated, and the
emergency response wasn't near the
level a week ago when a worker at
the Post Office discovered a yellow
powder outside an envelope with a
Port Angeles return address,
That scare prompted local author·
ities to cordon off the building and to
call in a Washington State Patml
hazardous materials response team,
No toxic threat
That letter was sent to the state
Health Department lab Ïor analvsls,
The stud v 'found no [OXIC lhreat.',n¿
the post ¿mce reopened around n0nn
Monday,
Treasurer Judi :Y!orris said the
false alarm nevertheless 81"'wed ""I'
staff knew what to do w,th a ;;usp'-
cious envelope.
"We're relieved that it wasn't anv-
thing, but It was smart to take P"~'-
cautioo," she said,
"We know what works and doesn '[
work, and we will know exactly what
to do the next Lime,"
Morris said the envelope was one
of hundreds of green payment
envelopes.. provided for the return of
property tax payments,
She said the office will receive
anywhere from 300 envelopes to 500
envelopes daily for about the next
two weeks.
The payment deadlin... is Oct, ,31.
.- --Deputy County Administrator'
Gary Rowe said the precautions
taken by the Jefferson County Trea-
surer's Office were appropriate,
"We hope it won't happen again,
but we will be better prepared if it
does," he said.
fDtJ
( D '- 2:' - 0 ,
ITlie busíriess-óf recycling
A little effort goes a long way to help local recycling program
By Molly Pearson
Jefferson County
EnVIronmental Health Oepartmen\
Hey, taxpayer - can we talk about
garbage for a minute?
Jefferson County's garbage system
cosrs more rhan $2 million a year to
operare, Guess how much of that money
comes from your taxes? Not one cent.
Dumping fees paid ar the Jefferson
County Transfer Station on Jacob Miller
Road, either by the garbage companies
or by people themselves, fund the en-
tire system, By "system" I mean oper-
ating the transfer station, hauling the
garbage rwice daily to a pennitted land-
fill, monitoring the closed landfill for
env!ronmental protection, paying off the
bond used to seal off the nasty old land-
fill, running the recycling program and
the Moderare Risk Waste Facility, pro-
viding solid wasre education to the pub-
lic, paying solid waste raxes, and
administering the system,
One of rhe most confusing aspecrs of
a community recycling program is deal-
ing with all the different "grades" of
materials. Since the products have such
low value to begin with, clean sorting
becomes more critical than ever.
A recent Leader letter to the editor
referred ro the always-changing location
of the public recycling bins, In the ler-
ter, the writer pointed out that the bins
have migrated from the Safeway park-
ing lot to several different locations at
the Port of Port Townsend Shipyard.
This migratioJ} has caused confusion.
Both Safeway and the port have been
helpful in our recycling contractor's ef-
forts to extend this service to the com-
munity. While the sites take up' plenty
of space and create traffic flow problems
and safery issues, both the port and
Safeway have made great efforts to ac-
commodate these recycle stations, The
ongoing unsightliness of the area around
the sites continues to be the major rea-
son why the bins must be moved.
Because of our community's size
and isolated location, we can't take
advantage of all regional markets. It
just doesn'l make any sense to ship
green glass or mixed plastic bottles to
Seattle when the payback is less than
zilch. We can only cost-effectively
handle the materials that pay for them-
selves in processing and shipping
costs, 'Tis true, we cannot handle all
the materials you may have been used
to in a more urban area. or in anorher
state. For a county of irs size, how-
ever. Jefferson County offers a com-
prehensive range of services. far more
rhan are required by state law,
Remember, user fees at the transfer
station pay for the system. No tax money
of any kind, Hence, any costs associated
with sorting out the wrong materials.
which happens on a daily basis here,
slows the program down and makes it
unstable. Unacceptable items left at the
recycling stations. or garbage tossed in
the bins, translares into hi h costs for
Skookum employee Malt Hall, the recycling truck's driver, holds the two most com-
monly accepted recyclablð beverage containers: No. 2 translucent (milk Jugs) and
No.1 plastic (an apple JuIce Jug). No locaUax money of any kind supports the local
recycling system, so any costs associated with sorting out the wrong materials
hurt the program.
Aèceptable Not Acceptable
· Milk jugs . Colored plastic drinking jugs.
· Clear plastic drinking jugs . Bleach, oil or other non-food
· Clear glass drinking containers containers, even if labeled as
· Cardboard, even with packing ~ No.1 recyclable
tape and address labels . Wine bottles
· Holiday gift wrap . Green glass
· "Ghost poop" packing material
· Plastic of any kind, including
shopping bags and product
shrink-wrap
· Nothing with food contanúnation
our recycling contractor, responsible for
its own garbage bills.
John Burke. Skookum's manager of
operations, explains: "Presently,
Skookum employees service the sites at
least twice a day in a major effort to keep
the sites clean, Unfortunately, experi-
ence shows us that this is not enough,
"Our employees," Burke continued,
"take great pride in offering what we
believe tD be a vital service ro rhe com-
munity, Lasr year alDne, we recycled
paper producrs that. according to our
buyer, were the equivalent of 333,000
60-foot fir trees. That wDuld be a 6-by-
12-mile area of planted trees!"
Please. people. take the time to use
rhe bins correctly, Don't leave your
recylables outside Ihe bins if they 're full.
They're full because the poor driver is
busy cleaning up the junk at the last site,
Here's John, again: "There are a
few steps you can rake to help us im-
mensely. Put your materials in the
bins, not on the ground, If possible.
bring your recyclable's directly to our
Jacob Miller Road site, Break down
all cardboard before putting it in the
bin. Rinse your cans, plastic bottles
and glass containers. Do not toss caps
and lids on the ground."
Helpful tips
· Put materials in recycling bin.
not on ground beside bin,
· Break down all cardboard be-
fore putting it in bin,
" '. Rinse your cans, plastic bottles,
glass containers.
· Do not toss caps and lids on
ground.
If an item you have is not I¡sred on
the bin: guess what? They don't want
it. Find a way to reuse ir or throw it
Dut in your own garbage, The recy-
cling contractor doesn'l want green
glass, mixed plastics, flowerpots. old
toys, used clothing, furniture, com-
puter components, Duckets of cement.
kitchen sinks or dead cats,
A cleaner, easier option for you.
the resident. is to sign up for curbside
pickup of your garbage and recycling.
Pickup is available throughout the
county, and the rates are reasonable.
The materials all end up at the san.~
place, the Jefferson County Transfer
Station and Recycle Center, where
they are readied for market and sold
by our con tractor,
We, as voracious consumers
(c'mon, you know you are). owe it to
our community to be diligent and r¿-
sponsible when it comes to public ser-
vices, Think of garbage as a utility.
You may balk at paying your water
and power bill, but you do it. You
probably grudgingly pay your phone
bill. Perhaps you happily pay your
cable, satellite or Inrernet connection
bills. These are all services you need
or want, What service is more basic
than responsible handling of your
daily garbage?
I'm done begging here, Do the right
thing, people! You have questiDns. com-
plaints and/or comments" Call Dr write
us anyrime. John Burke can be reached at
Skookum, 385-7678 (jo!uX@skookum.org),
and Molly Pearson is at 379-4458
(mpearson@co,jefferson,wa.us). Hey.
dDn't hesitate; we live for this,lf every-
one would pick up one extra item left
behind. we could all take pride in our
recycling efforts, If we don 't, it may not
be long before our migrating recycling
sires disappear altogether,
---
\:)
~
N;
---
County to buy new recycling baler
Jefferson County is going out 10
bid on a new recycling baler that will
alJow the current onsile recycling op-
eration to conrinue another five to 15
years,
The counry has $115,000 budgeted
for the baler, which replaces a unit pur-
chased in 1989, The existing baler has
experienced high maintenance costs and
downrime and is no longer considered
reliable. reported Frank Gifford, county
public works director,
The current recycling operation at the
Jefferson County Transfer Station on
Jacob Miller Road outside Port
Townsend requires the baler to be op-
erational five days per week year-round,
The option of rebuilding the current
baler would require diversion of
recyclables for several weeks. not con-
sidered a viable option,
Earlier this year the county helped the
recycling program by laying asphalt
around the recycling bins. The pew sur-
face helps employees of Skookum. the
recycling program contractor. 10 keep
the recycling area clean,
J
~\J
(;4
~
....J
t--:-
Çi.
PENINSULA DAILY NEWS
Reading study may aid
toddlers and parents
] efferson research seeks best way
for elders to help children learn
By PHILIP L. WATNESS
PENINSULA DAILY NEWS
PORT TOWNSEND
University of Washington
researcher Colleen Huebner
knows parents can use a
proven reading method to help
develop their toddlers' lan-
guage skills.
What she doesn't know is
the best method for teaching
parents how to use the "Hear
and Say Reading Program."
"We have all these scientific
studies showing the positive
effect of the reading tech-
nique, but the current ques-
tion is how do we deliver the
information to a whole com-
munity of parents," she said.
That's why she's calling on
parents of 2-year-olds
throughout Jefferson County
to participate in a unique
research study to find the best
way to get parents to properly
use the technique.
"Jefferson County is an
ideal county for this project,"
Huebner said in an interview.
"First of all, the births per
year average is 215, so it's fea-
sible in terms of reaching an'
entire county.
"Also, within the county,
there's a range in families in
terms of income and the other
interesting thing is some par-
ents live in town and some live
in more rural areas."
The privately funded
$100,000 study will engage
parents of 2-year-olds in one of
three alternative methods of
learning the "hear and say"
reading ~thod.
3 different groups
They will either participate
in small, in-person groups
twice during the eight-week
study, use a videotape in con-
junction with telephone coach-
ing, or just use a videotape.
"This teaches parents how
to maximize their children's
reading development," she
said. "It's fun. It's easy to
learn, and it's effective."
Jefferson County parents
with 2-year-old chilcfren
should have received an infor-
mational packet in the mail
inviting them to participate in
the university School of
Health research project.
All parents need do is
return a consent form
enclosed in the information
packet.
Parents who haven't
received the packet can call
360-379-4471 to sign up or
learn more information.
Parents need to sign up by
Dec. 20 to participate in the
study, which commences in
January.
The study has been funded
by the University of Washing-
ton's Center for Mind, Brain
and Learning, and is being
conducted with help ofthe Jef-
ferson County Health Depart-
ment, Port Townsend Library
and Jefferson County Literacy
Council.
Huebner describes the
Hear and Say Reading Pro-
gram asa "very interactive
reading style where the child
is doing most of the talking.
This uses storybooks to help
the child's language and pre-
reading skills. It's not
intended to teach them to
read."
Oeadllne looms
Parents will read to their
children using the method at
least once a day for eight
weeks, then report their expe-
rience to Huebner or her assis-
tant, Karmen Meier.
The researchers will assess
each child's vocabulary using a
standardized language test
and will audiotape parents
reading to their children.
"We take language for
granted, but when it's
impaired, it has devastating
consequences in how we think
about ourselves or how we
achieve," Huebner said.
"It's a deceptively simple
achievement achieved appar-
ently effortlessly, but we can
support that development and
I think we should."
'þJ)J
/¡;¿-0-{) (
JEFFERSON COUNTY BOARD OF HEALTH
Thursday, December 20,2001
2:30 - 4:30 PM
Main Conference Room
Jefferson Health and Human Services
AGENDA
I. Approval of Agenda
II. Approval of Minutes of Meetings of October 18,2001
III. Public Comments
IV. Old Business and Informational Items
1. "Comparing Sewage Systems" article from Linda Atkins, David
Christensen
2. Local Board of Health workshop, October 25-26, 2001: Report from
Jill Buhler and Roberta Frissell
3. Hearing examiners decision in Port Ludlow sewers - Larry
V. New Business
1. Bio-terrorism Preparedness Update: Jefferson County Plan, State Board
of Health Report and Resolution, and Discussion/Action on Local
Resolution - Jean, Tom
2. 2002 Data Steering Committee Fact Sheet - Geoff, Roberta
3. Update of 2002 Strategic Plan with Budget Shortfall Impacts - Jean,
Larry
VI. Agenda Planning
V. Adjourn
Next Meeting: January 17, 2001
Main Conference Room
Jefferson Health and Human Services
JEFFERSON COUNTY BOARD OF HEALTH
FT MINUTES
DRA Thursday, October 17, 2001
DR~
Board ÑÜmbm:
Dan Titternm, ZvIember - Counry Commi.r.rioner DÙtrict #1
Glen Huntingford, Member - Coun!y Commi.rsioner Di.rtrir:t #2
Richard Wo/f, Member - Counry Commi.r.rioner Di.rtrict #3
Geoffrry Marci, Member - Port Town.rend Ci!; Council
Jill Buhler, Chairman - Hospital Commi.r.rioner DÙtrict #2
ShÚ/a We.rterman, Vice Chairman - Citizen at Lar;ge (Ciry)
Roberta Fri.mii - Citizm at Lar;ge (Counry)
StajfMembm:
Jean Baldwin, Nur.ring Smim Director
Larry Fay, Environmentai Health Dimtor
Thomar Locke, lvID, 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 Vice Chair Westerman. Member Masci moved to approve the agenda.
Commissioner Huntingford seconded the motion, which carried by a unanimous vote.
APPROVAL OF MINUTES
Member Masci moved to approve the minutes of September 20,2001 with one correction noted by
Member Frissell on Page 2, paragraph 5: In the last sentence, the words "of not" should be replaced with
"under." Commissioner Huntingford seconded the motion, which carried by a unanimous vote.
PUBLIC COMMENT
Dale Wurtsmith read his letter to the Board restating his recommendation that all properties with on-site
sewage systems be required to have an Evaluation of an Existing System (EES) inspection, including
those systems currently monitored by PUD as well as homes sold under the PUD contract. He feels the
septic tank must be inspected to determine if the system is functioning satisfactorily, Looking only at a
pump chamber for an indication of failure is reactive rather than preventive. He stressed that
homeowners should be allowed to choose to have their system monitored by someone other than the
PUD. He also pointed out that he cannot compete with the County inspection at a cost of $100.
In response to questions from the Board, Larry Fay explained the difference between an EES, an
Advanced EES, and a real estate inspection. He noted a provision in the on-site sewage code which says
that an EES is not required if monitoring is being provided by the PUD.
Member Masci expressed support for requiring an EES at the time of sale. He suggested a privatization
model for on-site inspections in which the fees could be included in the property closing costs.
HEALTH BOARD MINUTES - October 17. 2001
Page: '")
Chairman Buhler expressed concern about liability and potential delays to the closing.
Larry Fay said price is an issue for many who would prefer to wait for the cheaper public inspection
rather than use a private service. He noted that at a cost of $100 per inspection, the County is not
covering its costs. Before considering ordinance or policy changes, he asked to clarify whether the main
objective is to promote private sector inspections or accomplish a particular level of inspection. He then
talked about the arrangement with the PUD for on-site sewage inspection, tracking and notification. He
believes we should begin thinking of this relationship in terms of a utility, with the County providing
permitting and regulatory (compliance) functions. He mentioned that Staff has talked about scheduling a
Board of Heal th workshop to assess the relationship with the POO and discuss these issues.
It was the Board's feeling that all inspectors should use the same forms for reporting and tracking and
that the same reporting requirements apply to the POO and the private sector.
Commissioner Huntingford expressed concern about the inspector taking on an enforcement role,
checking the site and drawing on the plot plan any new buildings or additions whether or not they relate
to the function of the septic system.
Mr. Fay responded that the inspection form notes the number of bedrooms under which the system was
originally permitted. He asked if the inspector should ignore an obvious addition to a structure if the
system is currently working. He believes it may be good to clarify in a policy what factors an inspector
considers. It was agreed that this could be a future agenda topic.
Grace Chawes thanked the Department for the article in The Leader on how to check your mail. She
asked how prepared the Health Department, hospital, and County are for a smallpox outbreak (training
of doctors, nurses and staff; methods of educating/informing the public; and preparations by mental
health professional to address public fears). She would like to see these topics covered in the newspapers
so that the public knows what discussions and preparations are occurring. She recommended that retired
health professionals be trained and utilized to assist in an emergency.
Chairman Buhler talked about some of the collaborative efforts by the hospital and the County.
Jean Baldwin reviewed the two main sources of information for the public: the County's new emergency
management website and staff at the County Health Department. Other measures include distributing
information from the CDC to healthcare and medical service providers, labs, pharmacies, law
enforcement, and the general public. She noted that aside from personal contacts, they have access to
state and national databases of retired physicians and nurses. The emergency management system also
provides access to additional resources.
OLD BUSINESS
(Re)AdoDtion of Amendments to Ordinance No. 08-0921-00 Onsite Sewaee DisDosal Svstems Rules
and Re2Ulations: Larry Fay explained that due to insufficient public notice of the code revisions, the
revisions approved by the Board last month have been resubmitted for approval by the Board.
HEALTH BOARD MINUTES - October 17. 2001
Page: 3
Member Masci moved to adopt amendments to Ordinance No. 08-0921-00 Jefferson County On-
site Sewage Code as presented and approved by the Board at the last meeting. Commissioner W ojt
seconded the motion, which carried. Commissioner Huntingford abstained.
NEW BUSINESS
Report from the 2001 Washin~on State .Joint Conference on Health: Referring to budget
information provided in the agenda packet from Mary Selecky, Dr. Locke said the biggest challenge is to
preserve effective Public Health programs while maintaining and building up capacities to respond to
public health emergencies. Currently, the State budget is $1 billion in the hole and departments are being
asked to make further budget cuts. He noted that bio-terrorism was a major focus of the conference.
Bio-terrorism Prenaredness - National. State and Local Efforts: Dr. Locke talked about local
responses, proactive and reactive strategies to address local concerns about the risk of anthraX. Targeted
outreach efforts have initially focused on hospital staff and healthcare providers. The Center for Disease
Control is setting the standard for public health guidelines. Of the potential risks, anthrax ranks below
HIV, multi-drug resistant TB, and the West Nile virus. There is little argument on the need to gear up the
infectious disease control system. While anthrax threats have averaged about 80 a year throughout the
90s, they were 100% pranks or hoaxes. He said the threat of anthrax is being monitored on a day-to-day
basis. He believes the Jefferson-Peninsula Regional Emergency Planning Committee (JPREP) meeting
tomorrow will be well attended.
Dr. Locke then talked about the County's likely response to new agents and probable bio-terrorism
scenarios. A big concern, and one that has been used in table-top exercises across the nation, is covert
introduction of a contagious agent. There is a need to develop criteria for evaluating potential threats,
although the biggest challenge in dealing with an actual bio-terrorist incident is building up a competent
emergency workforce. It was noted that the County is equipped for passive surveillance only and will be
challenged if there is a long-term bio-terrorist attack. There is no way to build up local capacity to
contain an event, but it is believed that federal resources will become available to gear up surveillance
systems.
There was discussion regarding the Board of Health's role during this period. Dr. Locke suggested that
the Board educate itself on these issues and concerns. Depending on how events play out, it may be up
to local Boards of Health to enforce state mandatory infection control procedures as well as getting
tougher with surveillance. The Board expressed interest in receiving the same information being
circulated to doctors. Dr. Locke agreed to include the Board in distributions of emergency and general
information, including forwarding links to potentially helpful websites. Member Masci suggested that all
those with a state health license be included in the distribution of information.
Charles Saddler reported that at tomorrow's JPREP meeting, an action plan for a bio-terrorist type
incident will be presented. He noted that the County has an all-hazard emergency operations plan with a
critical incident command structure designed to be implemented for manmade or natural disasters or
HEALTH BOARD MINUTES - October 17, 2001
Page: 4
weapons of mass destruction. He indicated there has been much discussion about how best to
communicate with the public when conventional wisdom would indicate that the risk for this area is low.
The County has updated its website and it is considered the best tool for getting out timely and very
accurate information.
During discussion about how best to disseminate information, Member Frissell suggested showing data
such as the comparative risk of death from influenza as opposed to anthrax. She also recommended the
County begin talking with the public about steps they can take, such as getting flu shots, updating their
earthquake kit, etc. There was support for adding to the website a statement such as "while there is no
problem in Jefferson County, you may obtain information on bio-terrorism...." Noting that not everyone
has a computer or reads the newspaper, Commissioner Huntingford suggested a newsletter be sent from
the Board of County Commissioners to Jefferson County residents to let people lmow the issues being
addressed and where to call for information. Charles Saddler said a tri-fold bulletin is being prepared.
Member Masci suggested the insert be placed in the City utility bill.
.Jefferson Countv Strate~!ic Plan and Public Health Standards - Prioritization Exercise: Jean
Baldwin and Larry Fay reviewed materials included in the agenda packet to aid in the prioritization
exercise, which included the County's strategic plan, the County resolution adopting the plan, and
example of the Law & Justice Committee's plan, and two matrixes. Mr. Fay then explained the matrix
linking public health standards on which the State Board has been working to the County's goals and
strategies.
The Board then considered how best to prioritize the five most important things that need to be
addressed in the area of Public Health for Jefferson County. The decision was to use as a basis for this
exercise the matrix prepared of the County's goals and strategies and Washington State Department of
Health's key measurement standards. The Board then prioritized the five key areas as defmed by the
Washington State Health Department. Following individual Board rankings, the collective priority
rankings were as follows:
1. Assuring safe and healthy environment for people,
2. Protecting people from disease,
3. Prevention is best: promoting healthy living,
4. Understanding health issues, and
5. Helping people get the services they need.
Member Masci moved to accept the prioritized list as above, using the strategic plan from the
State. Member FrisselI seconded the motion which carried by a unanimous vote.
Charles Saddler noted that since the Board has chosen to use the same goals and strategies as defmed by
the Washington State Department of Health, this ranking shows the financial and budgetary priorities.
HEALTH BOARD MINUTES - October 17, 2001
Page: 5
AGENDA CALENDAR / ADJOURN
Due to a Commissioners' conflict with the date of the next regular meeting, the Board agreed to cancel
its November meeting. If by November 15, it is determined that a meeting is necessary, a tentative date
of November 29,2001 at 1:30 p.m. in Commissioner's Chambers was set.
2001 AGENDA ITEMS
1. CONTINUED STABLE FUNDING TO REPlACE MVET
2. ACCESS HEALTH CARE
3. PROGRAM MEASURES (Genetic Research and Public Health Implications)
4. METHAMPHETAMINE SUl\1MIT
5. PERFORMANCE STANDARDS & COMMUNITY ASSESSMENT
6. TOBACCO PREVENTION AND COALITION
7. FLUORIDE
8. TRANSIT AND PUBLIC HOUSING
9. BIOTERRORISM READINESS & PLAN
10. AGING POPULATION
11. WATER
12. MATERNAL CIDLD PREVENTION GOALS (0-3)
The meeting adjourned at 4:25 p.m. The next meeting will be held on Thursday, December 20,2001 at
2:30 p.m. at the Jefferson County Health and Human Services Conference Room.
JEFFERSON COUNTY BOARD OF HEALTH
Jill Buhler, Chairman
Geoffrey Masci, Member
(Excused Absence)
Sheila Westerman, Vice-Chairman
Richard Wojt, Member
Glen Huntingford, Member
Roberta Frissell, Member
, Dan Titterness, Member
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Inside this issue: AESO Entry Forn!i~~r î
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Comparing Sewage Systems
Study determines best domestic system for reducing nitrogen
Linda Atkins and Oavid Christiansen
N itrat.: altrog':I1 contamination in Jnnking wat~r, is a
public health concern today throughout the Umted
States.
The C.S, Environmental Protection Agency has set a
maximum II () milligrams per ¡iter) limit for nitrate nitro-
gen in drinking water. :Ylany state and local governments,
including the Washington State Department of Ecology
(WOO E), have developed regulations to protect ground
water from nitrate contamination.
Ground :.lI1Ú surriœ ',vater nitrate contamination has
been associated with on-site sewage systems. This contami-
nation occurs when the systerns are used at high densities
or when ground \vater t10w patterns prevent disbursement
and dilution of sewage effluent into an aquifer.
In JefTerson County. \Vasl1.. public water supply wells
in areas with excessively coarse soils are protected from
excessive nitrogen ¡oading through wellhead protection
regu]ations, These rules require reducing nitrogen from
waste streams on individual septic systems, If it can be
determined that a shallow trench or drip line can enhance
plant growth and reduce nitrogen loading to the aquifer, the
requirement for pretreatment may be unnecessary
Testing available systems
A recent study evaluated technologies approved for
nitrogen reduction based on literature and assessed per-
formance under local soiL climate and raintàll conditions,
To assess nitrogen reduction in on-site se\vage systems,
specialists at Jefferson Cmlnty Health & Human Services
in Port Townsend WasiL evaluated four alternative sewage
disposal systems. They are: a shallow pressurized trench
system. an intermittent sand filter followed by drip irriga-
tion, a pressurized sand-lined bed and a proprietary aerobic
treatment unit followed by drip Irrigation.
The researchers measured the decrease in total nitro-
gen (TN) concentration in the waste stream provided by the
treatment unit and in the soils up and downgradient of the
drain field. They assessed plant uptake in the drain field
and dilution by ground water.
None of the treatment units reached the goal of a 50 per-
cent reduction in TN, Downgradicnt soil \vater samples had
TN concentration 50 percent less than in the dosing chamber.
OvcraJl, the intermittenr sand filter system operated the most
consistently and reduced TN concentration the most.
November 2001
Parameters and procedures
Precipitation in the test area averages between 16 ,md
35 inches (-1-0 and 88 centimeters) annually. This range
occurs because of a "rain shadow" etTect from the Olympic
Mountains that minimizes precipitation over the northeast-
ern part of the county, Elevation ranges from sea level to
495 tèet ( 150 meters) in the study area. which is served by
public water and private wells. Selected study site systems:
· met current sizing and treatment standards,
· were occupied full :ime,
· were in use at least one year.
· had \vaste strength \vithin residential parameters.
· had \vaste flows measured by at least one reliable
method
· were not subject to catastrophic ~vents such JS
flooding and
· hatÏ occupants \vno could oe lmen¡eweJ .lOOLtt
household and landscaping practices.
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Sampling TUDe
Lvslmeter
:-,e:Cim8t,;.:
These devices took samples of untreated effluent and shallow
groundwater.
The study used daily or weekly precipitation and tem-
perature minimurn and maximum records. Above normal
raintàll occurred during the sampling period for the areas
studied. Normal temperatures ranged from 32°F to 7TF
(OCC to 25°C). Each wastewater treatment system was
tested before treatment at the dosing chamber and after
treatment before discharge to a disposal field. The aerobic
treatment unit had no trash trap or other sampling port for
11
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an intluent sample
to he taken. so only
post trcatmcnt sam-
DieS camc from this
system.
Suction lysime-
tcrs and piezometers
were instaì1ed in pairs
5 to :i fcet ( ¡ SO to
240 œntimeters)
upgradient and down-
gradient of the dis-
posal system. One
pair \vas upgradient
and t\VO pairs down
gradicnt to a depth 12
to j 8 inches (30 to 45
centimeters) below
the disposal system.
On the site using
,hallow pressurized
trenches. only suction
lysimeters were used.
:--Io upgradient
soil moisture moni-
toring was attempted
at the site with the
unlined pressurized
sand filttr beds. due
to coarse soil condi-
tions and no docu-
mented sha]JO\v
\vater table. Ports
werc installed in the
dram field beds dur-
ing construction to
allow installation of suction Iysimeters 12 inches (30 cen-
timcters) below the sand lining. Three samples were col-
lectcd within 7 to 10 days to characterize wastewater
quality during weekly cycles, A \Vashington certified labo-
ratory llsed standard methods for sample analysis.
llsed to draw sam-
ples from unsatu-
rated soils,
The piezome-
ters had trouble
obtaining samples in
dryer soils, :--Io di f-
ference was found
in TN concentration
between side-by-
side piezometers
and lysimeters -
with one exception,
Differences between
the upgradient
Iysimeter and
piezometer at the
aerobic treatment
unit site were attrib-
uted to hydrological
and construction
differences.
Data collected
frorn the aerobic
treatment unit site
indicate that the sys-
tem may provide
nitrogen treatment.
However. the instal-
lation did not allow
for testing raw waste
water before treat-
ment. To assess sys-
tem performance via
ongoing operation
and maintenance.
wastewater must be sampled at multiple points in on-site
sewage systems.
At one site, no differences were found between using
suction lysimeters and piezometers for sampling, ,-'\t
another site, differences did occur. Because ground water
flow patterns are complex and temporal variability is high.
future study requires more test replicates to assess the dif.·
ferences.
Test data also indicate that nitrogen concentrations
were reduced in the drain field component of each system,
The reason tor the reduction. whether due to dilution. treat-
ment or a combination of these two mechanisms, remains
undetermined. A multi-season study could help determine
each mechanism's contribution, R
Four Treatment Systems Compared
Total nitrogen summary statistics include mean, standard deviation (std). coefficient of
variation (CV) and number of samples collected (n).
Sand Filter
Pump Treatment
chamber unit
Mean 4.96 92.64
std 4.49 5.51
CI 0.91 0.06
n 9 10
Upgradient
Iysimeter
61.73
7.18
0.12
10
Pooled
downgradient
12.75
5.42
0.42
28
Aerobic Treatment Unit
Unlined Pressurized 5and Filter Beds
Shallow Pressure Trenches
Upgradient Upgradient
Iysimeter piezometer
Mean 22.52 6.31
std 5.31 4.21
CV 0.24 0.67
n 10 10
Siphon Pooled
chamber downgradient
Mean 63.88 45.4
std 18.24 18.7
CV 0.28 0.41
n 9 18
Upgradient Pump
Iysimeter chamber
Mean 4.96 92.64
std 4.49 5.51
CV 0.91 0.06
n 9 10
Data analysis
OveralL no treatment system tested met the goal to
reduce TN SO percent betore discharge into soiL The inter-
mittent sand filter system reduced the most nitrogen. The
average reduction was 34 percent within this treatment unit,
with additional nitrogen reduction measured in the drain
field, The unlined sand filter beds reduced TN an average
26 percent.
Determining the etTect of dilution versus plant uptake
\vill require more study, Nitrogen loading to the aquifer is
reduced by plant uptake - not dilution. Attempts to meas-
ure down gradient soil moisture otfered mixed results,
Researchers determined that a suction lysimeter could be
12
Treatmpnt
unit
Downgradient
piezometer
7.57
1.70
0.22
10
Downgradient
Iysimiter
2.98
1.82
0.61
10
24.30
7.49
0.31
10
Downgradient
Iysimeter 2
61.73
7.18
0.12
10
Downgradient
Iysimeter 3
12.75
5.42
0.42
28
Linda Atkins and David Christensen are Environmental Health
Specialists with the Jefferson County Environmental Health
Division, 615 Sheridan, Port Townsend, WA 98368, USA; 360-385-
9444, fax 360-385-9401, latkins@co,jefferson.wa,us,
November 2001
SUBOO-00005
JEFFERSON CO HEALTII DEPT
~'-{ ÇÄ.y
NOTICE OF
JEFFERSON COUNTY HEARINGS EXAMINER
TYPE B DECISION
Date: November 28,2001
The Jefferson County Hearing Examiner has submitted his written Findings,
Conclusions, and DECISION regarding the following application: SUBOO-00005.
Applicant:
PORT LUDLOW ASSOC LLC
70 BREAKER LN
PORT LUDLOW WA 98365
Project Description: Appeal of a condition for the Type A Administrative Decision for
the Walker Way short plat, which is a re-division of Lot 1 of Port Ludlow No.6 large lot
tract development. The site is presently used as a well site and water storage reservoir
site serving the greater Port Ludlow development. The project proposes to plat the
parcel into two residential lots and a third tract containing the wellhead and reservoir.
The site is served by existing roads with utilities at the eastern edge of the existing
tract.
Parcel Identification Number: 821085001
Project Location: Parcel number 821 085001, Section 8, Township 28 North, Range 1
East, WM at NW Corner of Osprey Ridge Rd. and Walker Way intersection, Port
Ludlow, WA 98365.
For the above project, the Hearing Examiner has:
Based upon the testimony presented at the Open Record Appeal Hearing, a site visit
by the Examiner, the documents and exhibits admitted into the record, and the Hearing
Examiner Findings of Fact and Conclusions of Law, the decision of the Hearing
Examiner is that the appeal of the dedsion of the Subdivision Ordinance Administrator
to require a connection of Lot B to the community sewer as a condition of approval of
the Walker Way Short Plat is DENIED, and the decision of the Administrator is
AFFIRMED.
A .copy ?~ the Examiner's report and decision is attached for information. Appeals of
, thIs decision must be made in writinQ as outlined in the attached instruction sheet.
INSTRUCTIONS FOR FILING APPEALS OF
HEARING EXAMINER TYPE B DECISIONS:
REFERENCE FILE NO. SUBOQ-OOOO5
Final decisions of the examiner may be appealed to the Appellate Examiner by an
aggrieved party of record or agency who participated in the open record hearing.
Appeals of this decision must be made by 4:30 p.m. December 11, 2001 in the
following manner:
Form and Content of the Appeal:
1) An appeal shall be filed with the Clerk of the Board of County Commissioners within
fourteen (14) calendar days after the date of the decision.
2) All appeals shall be filed in writing with the Clerk of the Board of County
Commissioners, shall identify the decision appealed and the date of the dedsion, and
shall contain a summary of the grounds for the appeal.
3) The appropriate fee as set by the Board of County Commissioners in Ordinance No.
12-1209-96 as amended shall be paid upon filing of the notice of appeal. No appeal
will be processed without receipt of the appropriate fee before expiration of the period
for filing the appeal. A file copy should accompany fees payable at the Jefferson
County Department of Community Development.
4) Following receipt of a notice of appeal and payment of the appropriate fee, the
Appellate Examiner shall conduct a closed record appeal.
5) The issues considered in the closed record appeal shall be limited to those spedfied
in the written appeal.
Instructions and requirements for processing an appeal of a Hearing Examiner Type B
dedsion are explained in the Land Use Procedures Ordinance (Ordinance No.
04-0828-98). A copy is available at the Jefferson County Department of Community
Development, 621 Sheridan Street, Port Townsend, WA, 98368. (360) 379-4450,
Project Planner: J SMITH
"1
1
BEFORE THE HEARING ExAMINER FOR JEFFERSON COUNTY
2
Irv Berteig, Hearing Examiner
3
4
RE: Port Ludlow Associates appeal
of a condition of approval
requiring a connection to the
community sewer system.
6
Walker Way Short Plat
) File No. SUBOO-COOOS
)
)
)
) FINDINGS, CONCLUSIONS,
)
) AND DECISION
)
)
BACKGROUND INFORMATION
5
7
8
9
10
Port Ludlow Associates LLC [PLA] proposed a short plat· as a re-
11 division of Lot 1 of Port Ludlow No.6. The proposal is to create tw
12 residential lots with a third tract for the wellhead and reservoir.
13 The short plat was approved with a Condition that both residential
14 lots, "A" and "B", connect to the community sewer system. The appeal.
15 by PLA is to the condition as it applies to Lot "B".
16 PROCEDURAL INFORMATION
17 Notices:
Mailed:
October 16, 2001
18
Posted:
October 16, 2001
19
Publication:
October 17, 2001 (Port Townsend-
20
Jefferson County Leader) .
21 Site Visit: November 6, 2001.
22 Open Record Appeal Hearing Date:November 6, 2001.
23 The hearing was opened at 2:15 p.m. in the Courthouse First Floor
24 Conference Room. After the procedures were explained, testimony was
25 accepted. A verbatim recording of the public hearing was made. The
26 tape is maintained in the Jefferson Permit Center file.
27 Participants:
28 , Jerry Smith, Associate Planner, Jefferson County
29 Larry Fay, Environmental Health, Jefferson County
Walks' 'Nay Short Piat Appeal
SUBOO-OOOO5
. Page I
Port Ludlow Associates LLC
Findings, Conclusions
and Decision
I Marc Dorsey, Project Engineer for the Appellant
2 Ryan Tillman, PE, short plat engineer for the Appellant
3 William Funke, community participant
4 Ruth Altis, adjoining neighbor outside the MPR.
5 Otber parties present but not testi:fying:
6 Robert P. Balck, 192 Montgomery Ct, Port Ludlow, WA 98365
7 Greg McCarry, 70 Breaker Lane, Port Ludlow, WA 98365
8 Everett G. Johnson, 64 Ames Lane, Port Ludlow, WA 98365
9 Lenetta Johnson, 64 Ames Lane, Port Ludlow, WA 98365
10
Brad Newell, 141 Jackson Lane, Port Ludlow, WA 98365
Judy Newell, 141 Jackson Lane, Port Ludlow, WA 98365
Jim Ryan, 901 Walker Way, Port Ludlow, WA 98365
Pat Ryan, 901 Walker' Way, Port Ludlow, WA 98365
Conrad Yunker, 230 Pioneer Drive, Port Ludlow, WA 98365
11
12
13
14
15 Jim Laker, 612 Ranier Lane, Port Ludlow, WA 98365
16 Ruth Altis, 300 Coursey Lane, Port Ludlow, WA 98365
17 Janet Jacobson, 121 Coursey Lane, Port Ludlow, WA 98365
18 Philip Durnell, 186 Cr 5996 Cabool, MO
19 Katherine Funke, 75 Scott Ct, Port Ludlow, WA 98365
20 Shirley Kadish, 41 Foster Lane, Port Ludlow, WA 98365
21 Merland Moseson, 211 Montgomery Lane, Port Ludlow, WA 98365
22 Serene E. Moseson, 211 Montgomery Land, Port Ludlow, WA 98365
23 Larry Smith, PLA, 70 Breaker Lane, Port Ludlow, WA 98365
24 Shari Hagely, PLA, 70 Breaker Lane, Port Ludlow, WA 98365
25 Sally Smith, PO Box 65435, Port Ludlow, WA 98365
26 Theodore Wright, Jr., PO Box 65245 Port Ludlow, WA 98365,
27 Sally & Gary Robin, 41 Libby Ct, Port Ludlow, WA 98365
28 Ryan Tillman, PE, PO Box 1375, Port Hadlock, WA 98339
29 Carl J. Jespers, 73 Pathfinder Ln, Port Ludlow, WA 98365
Wolker Way Short Plot Appeal
SUB00-00005
Page 2
Port Ludlow Associates LLC
ñndings, Conclusions
and Decision
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 1.
1 Susan H. Null, 60 Dunsmuir Rd, Port Ludlow, WA 98365
2 Eve McDougall, 30 Foster Lane, Port Ludlow, WA 98365
3 Stanley Kadish, 41 Foster Lane, Port Ludlow, WA 98365
4 The Hearing Examiner closed the public hearing at 3:30 p.m., and held
5 the record open to receive specified documents.
6 TABLE OF EXHIBITS:
7
EXHBITS DOCUMENT DATE
1 Administrative Report together with a copy of the 10/30/2001
file containing 119 Log Items
2 Walker Way Short Plat Appeal Statement and letter 9/6/2001
with arguments attached. [Also marked Ex A]
3 Tillman Engineering Map showing features and 6"/2000
dimensions. Scale: 1"",200' [Also marked Ex B]
4 Letter from F. Michael Krautkramer, Principal 8/9/2001
Hydrogeologist re implications of septic system
[Also marked Ex C]
5 Property line map of Port Ludlow, annotated [Also No date
marked Ex D]
6 Letter from Mark Dorsey, PE, project Manager to 11/6/2001
Hearing Examiner presenting additional arguments
7 Memorandum of Understanding between Olympic Water & 10/4/1999
Sewer, Inc. , and Jefferson County BOCC
8 NPDES Waste Discharge Permit No. WA0021202 5/18/2001
Effective: 7/1/2001 - Expiration: 6/30/2006
9 Resolution 42-00 to enter into a development 5/8/2000
agreement with land owned by Pope Resources
10 Sewer Extension Agreement between OWSI and Owner No date
11 Reduced copy of Basic Site Plan of Walker Way Short No date
Plat annotated in red by Ruth Altis
·12 Memorandum from North Bay Lot Owners Association 11/6/2001
13 Letter from Ludlow Maintenance Commission ,6/26/2001
14 Public hearing sign up sheet 11/6/2001
8
9
FINDINGS OF FACT
26 Administrator ("Administrator") with the following condition:
The Walker Way Short Plat was approved by Subdivision Ordinance
27 SEWAGE DISPOSAL: The ~wo (2) residential lots (A&B) within the
Walker Way Short Plat shall connect to the community sewer system
28 owned and operated by Olympic Water and Sewer, Inc (OWSI).
29 This condition is the subject of the appeal as it applies to Lot B.
Walker Way Short Plot Appeal
SUBOO-OOOOS
Page 3
Port Ludlow Associates LLC
Findings, Concfusions
and Decision
1
2.
The Administrator's Findings of Fact 1 and 32 are excerpted her
2 for convenience:1
3 Fact 1) Under the prov~s~ons of the Port Ludlow Master
P2a~ned Resort Code, the subject property is within the Single
4 Family Tracts - 1 dwelling unit per 2.5 acres designation. The
proposed lot size is 4.5 acres and 2.5 acres. The proposed short
5 plae properey is within the water and sewer service boundary of
the Olympic Water and Sewer Company. The Washington State Health
6 ~eparement approved Sewer Plan anticipates connection to all lots
creaced within the utilities service boundary. Subject to
7 condition, the proposal will be in compliance with this
c=-;,:erion.
8
Fact 32) Sewage disposal for the 2 new residential lots is
ava;,lable from Olympic Water and Sewer, Inc. according to the
Occober 4, 1999 Memorandum of Understanding regarding provision
of sewer service within the boundaries of the Port Ludlow Master
Planned Resort. In support of connecting both lots to the
existing sewer system, the MOU provides n.. .that the sewer system
w;,ehin the Port Ludlow MPR has capacity to serve the population
allocated and the level of development authorized in the
Jefferson County Comprehensive Plan.' Olympic Water and Sewer,
Inc. provided a letter dated August 6, 2001 with an attached
supplemental letter from Robinson and Noble, ground water and
environmental geologists. The Robinson & Noble letter provided
an evaluation of implications of a septic system on Lot B of the
Walker Way Short Plat to the water resource and well at the
applicant's Well 4N site. The Department of Environmental Health
provided the following response to the above correspondence:
"I have reviewed the letter from Larry Smith dated 8/6/01 and the
Robinson and Noble letter of 8/9/01. Environmental Health has
recommended that these proposed new lots are within the
boundaries of the Port Ludlow Master Planned Resort and the
~udlow sewe=- service area and should be required to connect to
sewe=- even though the lots as configured may meet the minimum
requirements for septic systems. Article 8.15.010 of the
Jefferson County Code, which was in effect at the time of the
subdivision application, requires connection to an approved
sepeic when sewer is not available. In other words, connection
to sewer is the regulatory preference when sewer is available.
Ie is my understanding that, through the Master Planned Resort
designation and the development agreement with the county, Ludlow
Utilities has indicated that sewer service is available to all
properties within the MPR, therefore ~eptic would not appear an
option. "
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
3.
The Appellant states that the condition would lower the propert
26 value of Lot B because it is approximately 1,200 feet from the nearest
27 sanitary sewer line.
The Appellant assigns error to the
28
29
1 Log Item 104, Walker Way Short Plat Decision, II. Findings of Fact.
Walker Wav Short Plat Aopeal
SUBOO-OOCC5
Page 4
Port Ludlow Associates LLC
Findings. Conclusions
and Decision
\
"
1 Administrator's Findings of Fact 1 and Fact 32, and makes the
2 following arguments:2
3
a.
Regarding Fact 1 - OWSI Comprehensive Sewer Plan: The
4 Appellant argues that the OWSI Sewer Plan is not "a policy document
5 that would mandate all properties to connect to the sewer system,"
6 that "the statement that 'the proposal will be in compliance with thi
7 criterion' is incorrect."
8
b.
Regarding Fact 32 - Sewer Availability: The Appellant
9 disagrees that sewers are available, based on an argument that
10 "available" must be considered with some criteria. Appellant cites
11 other jurisdictions that qualify availability with some distance
12 criteria--in all cases shorter distances than the existing situation.
13
c.
Regarding Fact 32 - Financial Feasibility: The Appellant
14 argues that "available" must include "timely and reasonable" as
15 criteria, and suggest that reasonable includes financially feasible.
16 The Appellant used another area within the MPR as an example of
17 distances and cost to extend a sewer main 2,800-LF to Lot 8 of Port
18 Ludlow Division 1 at a cost of $200,000 to illustrate the effect of
19 applying the contested condition to such an example.3
20
d.
Regarding Fact 32 - MOU: The Appellant argues that the
21 Memorandum of Understanding intended that "... all property owners
22 within the Master Planned Resort (MPR) would have an opportunity to
23 obtain sewer service on a first-come, first-serve basis. The MOU did
24 not state a requirement that all properties be connected to sewer."
25
e.
Regarding On-site Septic System: Appellant states that
26 size and soil conditions of the property meet all applicable criteria
27
28
29
2 See Exhibit 2 and Log Item 107 for complete text of arguments.
3 Testimony by Mark Dorsey, PE, and Exhibit 6 for complete text of arguments.
Walker Way Short Plat Appeal
SUBOO-OOOOS
, Page 5
Port Ludlow Associates LLC
Findings. Conclusions
and Decision
1 for an on-site system. Appellant also notes that in accordance with
2 WAC 246-272-07001 the local health board may require connection to
3 sewer to protect public health, but point out that there are no publi
4 health issues that would require the connection.
5 4.
The Staff Administrative Report contains background information,
6 a chronology, and detailed responses to the Appellant's appeal
7 arguments, are adopted as Findings..
8 5.
Larry Fay, Jefferson County Environmental Health, testified tha
9 he had reviewed the Robinson & Noble letter (Exhibit 4J and did not
10 disagree with their conclusions.
11 6.
william Funke testified that he was part of the group that
12 mediated the differences between parties regaräing the MPR and the
,13 OWSI Sewer Extension Agreement.'
14 7.
Ruth Altis, adjoining property owner to the north, submitted an
15 annotated copy of the proposed short plat to show her well location
,16 and other features.'
17 8.
The Examiner requested that three documents referenced in the MP
18 and other documents submitted by the Appellant be made part of the
19 record. Those documents were collected and sent to the Examiner
20 (received November 10, 2001, whereupon the Record was closed).
21
22 REVIEW CRITERIA
23 Appeals of administrative decisions that are questions of law ar
24 reviewed de novo, and are evaluated under the error or law standard
25 with weight given to the Department. Issues of fact are reviewed for
26 substantial evidence. The burden of proof rests with the Appellant.
27
28 · Exhibit 1 and Log Item 118
29
5 Exhibit 10
, Exhibit 11
Walker Way Short Plat Appeal
SUBO'o-OOOO5
Page 6
Port Ludlow Associates LLC
Findings, Conclusions
and Decision
1
CONCLUSIONS OF LAW
2 1.
The matter before the Examiner is narrow to the appeal of the
3 Administrator's short plat condition requiring that Lot B of the
4 proposed Walker Way Short Plat be connected to the community sanitary
5 sewer system.
6 2.
While the Port Ludlow Master Planned Resort Ordinance is at the
7 heart of this appeal, it must be viewed in the larger context of the
8 Growth Management Act--in particular the provisions for master planne
9 resorts. The Legislature placed emphasis on avoiding unplanned and
10 uncoordinated growth, recognizing land is scarce and land us~
11 decisions are largely permanent.7 The Legislature states that (a]
12 master planned resort means a self-contained and fully integrated
13 planned uni t development. [emphasis added] The Growth Management
14 Hearings Board views this use of the term "planned unit developmentH
15 as a type of zoning treatment,S and as "a generic term for a regulato
16 technique which allows a developer to be excused from otherwise
17 applicable zoning regulations in exchange for submitting to detailed,
18 tailored regulations. The technique is characterized by flexibility."
19 Utilities, such as sewers, must be limited to meeting the needs of th
20 MPR. Moreover, an MPR and a service provider (OWSI in this instance)
21 are authorized to enter into agreements. to Under this context of the
22 Growth Management Act provision, the Port Ludlow MPR consists of trade
23 offs to allow flexibility in exchange for assured sewer service and
24 elements of a self-contained, fully integrated development.
25
26
7 RCW 36.70A.010 Legislative Findings
8 HEAL v. Growth Management Hearings Bd., 96 Wn. App. 522, 979 P.2d 864 1999).
9 ~ citing Schneider Homes, Inc. v. City of Kent, 87 Wn. App. 774, 775-76,
942 P.2d 1096 (1997) and Barrie v. Kitsap Cy., 84 Wn.2d 579, 585, 527 P.2d
1377 (1975).
w RCW 36.70A.360(2J
27
28
29
'Nolker Way Shon Plot Aopeal
S¡:9GO-OOOO5
Page 7
Port Ludlow Associates LLC
Findings. Conclusions
end Decision
1 Conclusions Regarding Appellant's Arguments:
2 3.
Fact 1 - OWSI Comprehensive Sewer Plan: The legislative basis
3 for the regulation of sewer systems is Chapter 90.48 RCW. The
4 Department of Ecology [DOE] has the primary pollution control
5 responsibility, 11 and has the responsibility to review and approve
6 plans for sewerage systems.u
DOE considers RCW 90.48.,110 to include
7 "general sewer plans" as within its scope of review responsibility.u
8 DOE defines the "general sewer plan" as a comprehensive plan for a
9 system of sewers, including subjects addressing cost distribution and
10 financial feasibility of plan implementation.u Therefore, the OWSI
11 Comprehensive Sewer Plan is a policy document. Moreover, it must hav
12 considered the defined elements, including financial feasibility, to
13 have been approved by DOE. While not containing an explicit policy t
14 require sewer connections, the OMSI Sewer Plan envisions sewer servic
15 to all of the Port Ludlow MPR. The Appellant's argument is not
16 persuasive.
17 4.
Fact 32 - Sewer Availability: While the Appellant agrees that
18 connection to sewer is the regulatory preference; the arguments
19 regarding "availability" are misdirected. The ordinances cited are
20 not parallel to the Walker Way Short Plat case. For instance:
21 · Port Anqeles. The provision applies only to a building permit on a
22
single lot existing on January I, 1995; and moreover, is an:exception
23
that must meet all of series of conditions.15
24
25
11 RCW 90.48.030 Jurisdiction of department. The department shall have the
jurisdiction to control and prevent the pollution of streams, lakes, rivers,
ponds, inland waters, salt waters, water courses, and other surface and
underground waters of the state of Washington.
U RCW 90.48.110
13 WAC 173-240-010 Purpose
14, WAC 173-240-020 (f)
15 PAMC 13.61.090 Private Wastewater Disposal System Allowed - When.
26
27
28
29
'.^'¡ all Po,,', oy Short P'at Appeal
S U BO:) -oJOC-DS
Page 8
Port Ludlow Associates LLC
Findings. Concfusions
and Decision
1 . Port Townsend. All new development must connect to sewers when located
2
within 260 feet of a line; however, subdivisions, short subdivisions
3
and planned unit developments must connect to sewers regardless of its
4
location. 11
5 · Kitsap Countv. An existing building or one under construction must
6
connect to a public sewer if it is within two hundred feet.I7 Other
7
developments proposing septic tanks within urban and semi-urban
8
designations on the county's comprehensive land use plan will be
9
subject to review for determination of sewer feasibility by the Kitsap
10
County department of public works.IS
11 Other jurisdictions around the State have similar regulations. Short
12 subdivisions are simply treated differently than single lots. The
13 Appellant's examples do not support his argument.
14 5.
Pact 32 - Fin.ancial Peasibility: The Appellant's argument
15 regarding cost is misleading. The cost to extend a sewer main 2,800
15 feet may be $200,000 when it includes the cost of installing the sewe
17 pipe, manholes, engineered construction plans, record drawings and
18 connection fees, pavement removal, pavement restoration, and traffic
19 control. The cost to serve one lot at the end of a fully developed
20 sewer main is not relevant.
21 6.
Pact 32 - MOU: Related regulations, ordinances and other
22 instrtlments must be read together to ascertain their meaning and
23 applicability. The recitals of the MOU between OWSI and Jefferson
24 County clearly interrelate the sewer system, Port Ludlow MPR, the
25 Jefferson County Comprehensive Plan, and the sewer system capacity to
26 serve the customers within the MPR boundary and at a high standard.
27
28
u PTMC 13.22.010 A & 8(1)
17 KCC 13.12.020
IS KCC 13.12.025
29
WC:lke- Way Short Plat Appeal
SU8GC...JOOO5
Page 9
Port Ludlow Associates LLC
Findings. Conclusions
and Decision
1 The six statements are clearly binding between the parties. The MOU,
2 read together with the purpose and operations of the approved general
3 sewer plan, indicates that service to all lots was intended. While
4 there is no explicit mandate that all parties be connected to sewer
5 (as argued by the Appellant), there is also no policy or provision fo
6 on-site septic system as an exception. The Appellant's argument
7 fails.
8 7.
Regarding On-site Septic System: The Appellant is correct that
9 an on-site septic system, as designed by Ryan Tillman considering the
10 existing soils, and with the separation from the well head, would meet
11 minimum requirements. The responsible Jefferson County Health,
12 official acknowledges as such, but still recommends that Lot B be
13 connected to sewer.
14 Summary Conclusions:
15 8.
Th~ function of comprehensive plans and the purpose of master
16 planned resort legislation form a thread of reasoning throughout the
17 above conclusions. The trade-offs allowed through the Port Ludlow MP
18 are significant--even considering only the low density imposed outsid
19 the MPR boundary.
20 9.
As noted in Conclusion 5 above, the Appellant's arguments
21 regarding financial feasibility are invalid. However, the arguments
22 point out the probability that approval of the appeal would set a
23 precedent and the extent of such a precedent would pose throughout
24 MPR.
25 10.
The Appellant's arguments are not persuasive, and the appeal mus
26 be denied.
27
28
29
Wolke' Way Short Plat Appeal
S U 800...."'0005
Page 10
Port Ludlow Associates LLC
Findings. Conclusions
and Decision
, .
1
DECISION
2
Based upon the testimony presented at the Open Record Appeal Hearing,
a site visit by the Examiner, the documents and exhibits admitted int
the record, and the above Findings of Fact and Conclusions of Law, it
is hereby the decision of the Hearing Examiner that the appeal of the
decision of the Subdivision Ordinance Administrator to require a
3
4
5
6
7
connection of Lot B to the community sewer as a condition of approval
8
of the Walker Way Short Plat is hereby DENIED, and the decision of th
Administrator is AFFIRMED.
9
10
DATED this 27ù day of November 2001.
11
12
~~
13
14
Irv Berteig
Jefferson County Hearing Examiner
15
16
ib
17
18
Transmitted by the Jefferson Count Permit Center to the following:
19
DATE TRANSMITTED:
20
Marc Dorsey, PE, 70 Breaker Lane, Port Ludlow, WA 98365
21
Ryan Tillman, PE, PO Box 1375, Port Hadlock, WA 98339
William Funke, 75 Scott Ct, Port Ludlow, WA 98365
Ruth Altis, 300 Coursey Lane, Port Ludlow, WA 98365
Robert P. Balck, 192 Montgomery Ct, Port Ludlow, WA 98365
Greg McCarry, 70 Breaker Lane, Port Ludlow, WA 98365
22
23
24
25
26
Everett G. Johnson, 64 Ames Lane, Port Ludlow, WA 98365
Lenetta Johnson, 64 Ames Lane, Port Ludlow, WA 98365
Brad Newell, 141 Jackson Lane, Port Ludlow, WA 98365
Judy Newell, 141 Jackson Lane, Port Ludlow, WA 98365
27
28
29
Walker Way Short Plat Appeal
SUBOO-OOCOS
Page 11
Port Ludlow Associates LLC
Findings, Conclusions
and Decision
-
1
Jim Ryan, 901 Walker Way, Port Ludlow, WA 98365
Pat Ryan, 901 Walker Way, Port Ludlow, WA 98365
Conrad Yunker, 230 pioneer Drive, Port Ludlow, WA 98365
Jim Laker, 612 Ranier Lane, Port Ludlow, WA 98365
2
3
4
5 Janet Jacobson, 121 Coursey Lane, Port Ludlow, WA 98365
6 Philip Durnell, 186 Cr 5996 Cabool, MO
7 Katherine Funke, 75 Scott Ct, Port Ludlow, WA 98365
8 Shirley Kadish, 41 Foster Lane, Port Ludlow, WA 98365
9 Merland Moseson, 211 Montgomery Lane, Port Ludlow, WA 98365
10 Serene E. Moseson, 211 Montgomery Land, Port Ludlow, WA 98365
11 Larry Smith, PLA, 70 Breaker Lane, Port Ludlow, WA 98365
12 Shari Hagely, PLA, 70 Breaker Lane, Port Ludlow, WA 98365
13 Sally Smith, PO Box 65435, Port Ludlow, WA 98365
14 Theodore Wright, Jr., PO Box 65245 Port Ludlow, WA 9'8365,
15 Sally & Gary Robin, 41 Libby Ct, Port Ludlow, WA 98365
16 Carl J. Jespers, 73 Pathfinder Ln, Port Ludlow, WA 98365
17 Susan H. Null, 60 Dunsmuir Rd, Port Ludlow, WA 98365
18 Eve McDougall, 30 Foster Lane, Port Ludlow, WA 98365
19 Stanley Kadish, 41 Foster Lane, Port Ludlow, WA 98365
20
21
22
23
24
25
26
27
28
29
Walker Way Short Plat Appeal
SUBOO-QOOOS
Page I 2
Port Ludlow Associates LLC
Findings. Concfusions
and Decision
t;
-
:' .... .~
--
STATE OF WASttlNGTON
WASHINGTON STATE BOARD OF HEALTH
7702 Sf Quince Street · PO Box 47990
Olympia, Washington 98504-7990
Washington State Board of Health
Resolution No. 01-001
WHEREAS, the State Board of Health's mission includes suggesting policies likely to better promote,
protect, maintain and irnprove the health of Washingtonians;
WHEREAS, Washington State faces potential health threats that include terrorist attacks involving the
use of explosive and conventional weapons, the use of biological agents and other weapons of rnass destruction,
epidemics of new and re-emerging diseases, and the proliferation of disease organisrns that are resistant to
antimicrobial agents;
WHEREAS, state and local public health and health care systems will be among the first responders in
the event of any major disaster or disease outbreak;
WHEREAS, state and local public health and health care professionals will be critical to the successful
resolution of a major health event such as a bioterrorism attack;
WHEREAS, a long-term erosion in funding of the public health systems in this country has resulted in
a progressive loss of public health system capacity to provide essential services;
WHEREAS, efforts to contain health-care costs by limiting excess capacity in the health care system,
combined with workforce shortages, have reduced the nation's and the state's surge capacity;
WHEREAS, the federal government rnay make a significant investment in building capacity to respond
to bioterrorist attacks and related events; however, federal funds for bioterrorisrn response have not, in the past,
reached the state and local jurisdictions at a level commensurate with their role; and
WHEREAS, recent state and local budget cuts have resulted in cuts in state and local public health
programs and pending cuts threaten to further reduce state and local support for the public health infrastructure
BE IT RESOLVED that the Washington State Board of Health, in order to protect the health of the
residents of Washington, supports efforts by all levels of government to place a clear priority on maintaining,
and enhancing when necessary, funding levels that provide for adequate state and local public health and health
care capacity to respond to a health emergency such as a major disease outbreak or terrorist attack.
APPROVED this 14th Day of November, 2001
Linda Lake, Chair
State Board of Health
STATE OF WASttlNGTON
WASHINGTON STATE BOARD OF HEALTH
1102 Sf Quince Street · PO 80x 47990
Olympia, Washington 98504-7990
Final Report
Response Capacity During
A Health Emergency-
A Review of Selected Issues
Board Sponsor: Thomas Locke, MD, MPH
Lead Staff: Craig McLaughlin
November 2001
For more infonnation contact Board staff at:
Telephone: (360) 236-4110
Fax: (360) 236-4088
E-mail: wsboh(ZV,doh.wa.gov
Web site: www.doh.wa.gov/sbohl
.iÞ¡<,,-<-..dzõ.t S lA 1«.1) h-.c/ð 5 "cd
Adopted by the Washington State Board of Health on November 14,2001.
1ðfoJ ~~ CÃ U~
. ~ tVf tM-J2-~ ðL
WJr~ -
Washington State Board of Health
Response Capacity During A Health Emergency-A Review of Selected Issues
"Health security is as basic a right
of Americans as police and fire protection.
And in times of crisis such as this,
it is clear to all that health security
is synonymous with national security."
-Donna Shalala,
President, University of Miami
and former Secretary, Health and Human Services
Page 2
November 2001
Washington State Board of Health
Response Capacity During A Health Emergency-A Review of Selected Issues
Executive Summary
On December 15,2000, Virginia Governor James S. Gilmore, III released the second
annual report of the "Gilmore Commission" on terrorism response capabilities, His cover
letter seemed prescient. "Weare impelled by the stark realization that a terrorist attack on
some level inside our borders is inevitable," he wrote, "and the United States must be
ready."
The threat of a terrorist attack resulting in mass casualties is no longer theoretical.
Neither is the use of biological weapons against civilian populations. Unfortunately,
terrorism is not our only worry. This country and this state also face possible threats from
the unintentional spread of disease-new diseases, re-emerging diseases we thought we
had controlled, and familiar diseases such as malaria and tuberculosis that are developing
resistance to antimicrobial treatments.
When introducing the Frist-Kennedy Public Health Threats and Emergency Act of2000,
Senator Edward Kennedy called new and re-emerging diseases, antibiotic-resistant
microbes, and bioterrorism the "Three Horsemen ofthe Modem Apocalypse." He added:
"Today we face a world where deadly contagious diseases that erupt
in one part of the world can be transported across the globe with the
speed of a jet aircraft. The recent outbreak of West Nile Fever in the
New York area is an ominous warning of future dangers. Diseases
such as cholera, typhoid and pneumonia that we have fought for
generations still claim millions of lives across the world and will pose
increasing danger to this country in years to come. New plagues, like
Ebola virus, Lassa Fever and others now unknown to science may one
day invade our shores."
Whether the disaster is a naturally occurring disease outbreak, a mass trauma event along
the lines of the September 11 tragedy, a natural disaster, or the use of weapons of mass
destruction by terrorists or conventional militaries, the first response to a health
emergency will come from the local and state level.
Many experts and organizations have called for a more "robust" public health system in
response to emerging bioterrorism threats. They note that the public health programs and
activities needed to respond to a bioterrorism attack-disease surveillance, laboratory
testing, risk communication, vaccine distribution, public education, environmental
monitoring, and more-are the very programs public health uses quietly every day to
create a safer and healthier nation.
How prepared is the public health and health care infrastructure to respond to a
bioterrorism attack, a mass casualty event, or a significant disease outbreak? From a
global perspective, the answer, according to at least one longtime, well-regarded
observer, is unavoidable and unequivocal: As a global community, we are not prepared.
Page 3
November 2001
Washington State Board of Health
Response Capacity During A Health Emergency-A Review of Selected Issues
From a national perspective, the view of public health preparedness is less gloomy but
still not encouraging. Last year, the Centers for Disease Control and Prevention asked
itself, in response to a congressional inquiry, "is public health's infrastructure up to the
task, prepared for the global health threats of the 21 st century?" It concluded,
"Unfortunately, the answer is no." A host of studies, expert pronouncements,
assessments, field exercises, and real-world events support the CDC's conclusion.
The state of Washington is regarded among public health professionals as having a high-
perfonning network of state, academic, and local public health agencies. When it comes
to preparing for bioterrorism and other major disease outbreaks, Washington is ahead of
most other states. The state, however, is part of the national infrastructure and shares both
its strengths and its weaknesses.
In 2000, the Washington State Department of Health, as part of a joint Department of
Justice and CDC nationwide effort, conducted a Public Health Emergency Preparedness
Assessment. It asked the 39 counties to answer a series of questions based on the Draft
Public Health Emergency Standards. "In general," DOH concluded, "Washington's local
public health systems are not adequately prepared for a major biological emergency."
A survey of emergency departments at all hospitals in federal Region X-which includes
Washington along Oregon, Idaho, and Alaska-attempted to assess whether hospitals are
prepared to respond to chemical or biological attacks. Less than 20 percent had response
plans in place and only 6 percent had enough physical resources to respond to a
theoretical attack using the nerve gas Sarin. Slightly less than half had an isolated
decontamination unit, while only 12 percent had supplied air-line respirators or self-
contained breathing apparatuses. The researchers concluded that emergency departments
are generally not prepared to respond to an attack using biological or chemical weapons.
One area of particular concern in Washington State is the surge capacity of the health
care system. Historically, Washington has had a highly efficient health care delivery
system with little excess capacity during times of nonnal utilization. In recent years, cost
containment efforts have squeezed excess capacity out of the system. Washington
hospitals, like hospitals nationwide, strive to eliminate excess capacity for financial
reasons. Washington's comparatively low federal Medicare and Medicaid reimbursement
rates, a by-product of the state's historically efficient health care delivery system, have
made health care facilities and medical practices increasingly less profitable, as have
overhead costs associated with meeting administrative requirements. Practitioners appear
to be leaving the state and professional schools are not able to recruit and train enough
new professionals to keep up with demand. Severe staffing shortages exist across the
state for many health careers.
Part of the reason that state and local public health and health care systems, including
emergency medical systems, are underprepared for a major health event is a lack of
adequate, stable funding. The United States spends nearly 15 percent of its gross national
product on health care, but only a tiny fraction, an estimated I percent of total health care
expenditures, goes to the public health system. Many public health experts would
Page 4
November 2001
Washington State Board of Health
Response Capacity During A Health Emergency-A Review of Selected Issues
consider it a significant victory if 3 percent of health care expenditures consistently went
to community-based, preventive public health activities.
Of the money that does go to personal health services, an ever-increasing share is devoted
to expensive, high-tech procedures and pharmaceuticals. Disproportionately few dollars
go to primary and emergency care-the professionals and facilities that would be among
the first responders in a bioterrorist attack or major infectious disease outbreak.
In the wake of recent attacks, the federal government has shown heightened interest in
funding public health and health systems, even at the risk of returning to deficit spending
during an economic downturn. The administration has requested an emergency
appropriation of $1.5 billion for bioterrorism preparedness. Yet less than 10 percent of
that would go for state and local health preparedness.
Patrick Libbey, president of National Association of County and City Health Officials
and director of the Thurston County Public Health and Social Services Department, has
described the kind of essential local programs not funded by the administration proposal.
"We must be able to conduct active syndromic surveillance for
disease, to do immediate, on-the-scene epidemiological investigations,
to develop and test local bioterrorism plans, to coordinate community
responses, and to maintain the round-the-clock vigilance and
readiness that all our nation's communities expect."
NACCHO estimates that the public health system needs an initial investment of $835
million at the state and local level for disaster preparedness as well as ongoing funding
sufficient to sustain this effort.
In Washington State, the financial picture at the state and local level is not encouraging.
Funding for state and local services has been and continues to be jeopardized by a host of
factors, including Initiative 601 spending limits, the repeal of the motor vehicle excise
tax, an economic downtown, inflation in the cost of government services, growth in the
populations eligible for these services, and now, Initiative 747 restrictions on local
property tax increases.
On October 9 and 10,2001, the Washington State Board of Health heard briefings from
national experts, state and local public health officials, and hospital personnel about state
and local capacity for responding to a health emergency such as a bioterrorism attack.
The Board also reviewed briefing materials assembled by staff and heard informally from
dozens of attendees at the October 8-10 Washington State Joint Conference on Health.
This report represents an additional phase of the Board's response to the current crisis.
The Board has identified, during its meetings and research, several specific programmatic
areas where the capacity of the public health systems can and should be improved. In this
rapidly evolving national context, the Board offers these specific recommendations for
Washington State's emergency preparedness planners.
Page 5
November 2001
Washington State Board of Health
Response Capacity During A Health Emergency-A Review of Selected Issues
The primary purpose of this report, however, is to exarnine, in broad terms, the role and
readiness of the public health and health care systems. Based on its hearings and research,
the Board makes the following recommendations.
1. State policymakers and planners should embrace an "all hazards," public health-
oriented approach and fully integrate the state's public health, EMS, and health
systems (including representatives of Tribal health programs) into planning and
exerCIses.
2. The governor and state agencies should continue to work aggressively with the
state's congressional delegates to make sure bioterrorism preparedness funds
reach the state and local levels where they can be used to build critical public
health, EMS, and health care infrastructure sufficient to provide initial response to
biologic threats and emergencies.
3. State budget writers should use federal funding for disaster preparedness to
expand response capacity at the state and local level-not to offset cuts in state
contributions to existing programs.
4. State budget writers should protect funding for state and local public health
(including local capacity funds and the 1-695 backfill). These funds sustain most
of the existing public health capacity that would be mobilized to respond to
bioterrorist attacks or other disasters. Diverting funds from existing public health
programs to supplement emergency response capabilities will not result in needed
improvements and may further erode the ability of local health jurisdictions to
effectively respond to an emergency.
5. State budget writers should consider ways to make Department of Health funding
more flexible (less categorical funding and fewer provisos) so the department can
move funds between programs to respond to emergencies.
6. Efforts to reduce state spending on health insurance and health care purchasing
should be tempered by the recognition that we need to increase surge capacity and
provide additional resources that might be called on during a health emergency.
(This is in addition to the need to ensure ongoing access to health care for all
Washington citizens.)
7. State policy makers must address the deficiencies identified in the current
emergency response system for bioterrorist threats and identify clear priorities for
system enhancement. If priority enhancements cannot be funded through federal
programs, the state must consider any and all options to make adequate funds
available.
8. Federal and state governments must recognize that their fundamental duty to
protect public health includes assurance of adequate supplies of essential
vaccines. If private pharmaceutical companies entrusted with this essential task
fail, as they have repeatedly, to produce adequate vaccine stocks, governments
must look to federalization of vaccine manufacture as a last recourse to assure that
current shortages are addressed and future breakdowns in the production are
averted.
Page 6
November 2001
Washington State Board of Health
Response Capacity During A Health Emergency-A Review of Selected Issues
9. The Board should initiate a review, in partnership with DOH, local health
jurisdictions, and other affected parties, of the adequacy of current board rules
concerning reporting of notifiable conditions, isolation and quarantine, and the
emergency powers of local health officers. The Board should also detennine the
role it sees for itself in development of state legislation defining emergency health
powers.
Adequate preparedness for biologic emergencies cannot be accomplished in weeks or
months. It will require sustained efforts over years or decades. Strategies will have to be
continuously modified to deal with changing threats. As of the date of this report,
Washington State has not sustained a direct bioterrorist attack. We do not know how
much time is available to us to prepare for such an event. Responsible public health
policy development requires that we heed the warning issued by the Gilmore
Commission regarding the inevitability of such attacks.
Should Washington State be so fortunate as to avoid a devastating attack, the investment
in restored public health capacity will repay itself many times over in improved control of
other deadly communicable diseases. If Washington State should become the next target
of a bioterrorist attack, the costs of failing to make this investment will be measured in
casualties, catastrophic economic disruption, and the potential for unprecedented panic
and social unrest.
The State Board of Health urges all elected officials and state agencies to recognize the
seriousness of this threat, the urgency of building adequate response capability, and the
need for bipartisan cooperation and multi-agency collaboration to rise to this challenge.
The citizens of Washington State have put their trust in their institutions of government to
provide essential public health and safety services. To fail to meet the challenge of
bioterrorism preparedness would truly be a betrayal of trust.
Page 7
November 2001
Jefferson County Health & Human Services
Emergency Management Team
Bioterrorism Plan
For Infectious Disease
~OYE:\I BEH. ;2001
IN DEX
· Joint Incident Action Plan - Special Circumstances
· First Responders - Law Enforcement
~ 1L
· ~!l~~~~~tS?u~eal~,~ ~."Human ~~~ices Res~onse
· Communicable Disease Fact Sheet - Anthrax
· Bioterrorism Incident Command
· Bioterrorism Response Plan
~"""'(7' JW¡ .) fiII-_..!..lJIS.
· Resource Numbers
Joint Incident Action Plan
SPECIAL CIRCUMSTANCES
Special Circumstances
Joint Incident Action Plan
I Incident
I Nation-wide Terrorism Alert
I Date Prepared
I October 26, 2001
I Operational Period ¡Immediate to December 31,2001 (or as conditions warrant)
Strategy
Increase readiness for coordinated response to terrorist incidents (actual, hoax,
or co -cat; lessen ublic anxiet with a consistent res onse strate
Control Objectives
1. Maximize inter-agency communication, coordination, and resources
2. Stick with the plan
3. Every incident will be treated as a CREDIBLE THREAT until
otherwise determined
Organization
1. Law Enforcement is Lead Agency (criminal investigation)
2. Unified Command is Law Enforcement, Fire/EMS and Health
3. Lead ma chan e to Health in recove hase ublic health issues
I Resources
IN / A
Execution Level 1 Site Specific (suspicious object - single indeterminate threat)
1. Dispatch Law Enforcement (criminal investigation - use
Biological Agent Threat Investigation guidance to determine
credible threat)
2. Emergency Management can coordinate external resources
and provide logistics support as needed
3. Incident Command is on-scene (law enforcement is lead)
4. Release of information coordinated by P.I.O. (all levels - Joint
Information protocols if needed)
Level 2 General threat, multiple sites, or unusual
community anxiety
1. Law Enforcement, Fire/EMS and Public Health deployed as
needed
2. EOC activated at Level 2
3. Incident Command is at EOC
Level 3 Maior credible threat or actual major occurrence
1. EOC activated at Level 3 staffing
2. Unified Command is at EOC
3. Law Enforcement, Fire/EMS, Task Force(s) deployed by
Operations
Safety Message
· Use EXTREME CAUTION to prevent additional casualties or exposure
· Beware of secondary devices - explosive or bio-chemical
· Do not exceed traininç¡-experience levels
First Responders
LAW ENFORCEMENT
Joint Incident Action Plan
Biological Agent Threats Investigation
THREAT INDICATORS AND INVESTIGATION
Basic Threat Indicators
Circumstances
· Leaking powdery substance
· No return address
Mailed from foreign country
· Foreign or excessive postage
Badly typed or written
Misspelled words
Restrictive markings
No specific addressee
Protruding wires
Shrink-wrap
Excessive tape or string
· Oily stains, discoloration
Crystallization
Strange Odor
Signs of tampering
Odd shape
Excessive weight
SUSPICIOUS MAIL
OR PACKAGE
DISPATCH CENTER
ADVISE HEALTH DEPT. and
EMERGENCY MANAGEMENT
(Information only at this time)
DISPATCH
LAW ENFORCEMENT
ASSUME COMMAND
(Criminal Investigation)
FIRST RESPONDER
Treat all threats as a CREDIBLE
threat until determined otherwise
Process as a CRIME SCENE
DETERMINE THE
CREDIBILITY OF THE THREAT
PRECAUTIONS
Do not move the object
Isolate, if possible
o Close the door
o Section off the area
Section off the area
Evacuate the immediate space
Prevent additional exposures
Secure the perimeter
Anyone that has contact with the
package should wash thoroughly
with soap and warm water
INJURIES
REQUEST EMS RESPONSE
NO
DISPATCH may offer pre-arrival
instructions to the calling party
USE POWERPHONE Training
Bulletin BIOLOGICAL AGENT
THREATS
·
Leave the item undisturbed
Do not handle
Do not open, smell or taste
Do not shake or empty contents
Cover with anything (trash can, etc.)
Evacuate the room
Close the door or section off the area
Anyone who has come in contact
should wash hands thoroughly with
soap and warm water
·
·
Other
Is the sender unknown to the
addressee?
Has the addressee received
threats/suspicious packages
previously?
Is there a reason the addressee
would be a possible target of
threats/retaliation?
Is there a stated or implied threat
(on the envelope or enclosed?)
Is the addressee a high threat
potential (e.g. public official, law
enforcement agency, etc.)?
YES
Was the sender able to provide a plausible explanation for the condition of
the package or the contents (personal visit from law enforcement)?
EMS WILL USE HAZMAT
PROCEDURE
LESS THAN CREDIBLE
THREAT
Refer Exposure Worries Or
Other Health Related
Questions To Health
Department
Item May Be Packaged and
Maintained As Evidence Until
Threat Of Infection Has Passed
YES
GO TO CREDIBLE THREAT
PROCEDURES ON PAGE 2
Joint Incident Action Plan
Biological Agent Threats Investigation
From Page 1
EMERGENCY MANAGENT
(Level 1 support)
REQUEST
"CREDIBLE THREAT"
NOTIFICATIONS
SUPERVISOR
As Needed
NOFTIFY F.B.I.
FOR INCIDENT TRACKING
COUNTY HEALTH
DEPARTMENT
INCIDENT COMMAND
Identify persons who may have
been exposed, identify
witnesses, obtain statements,
document
NEEDED ON-SCENE?
Maintain site security
Health Department can provide
guidance for exposures
HEALTH DEPARTMENT
Must obtain permission to ship
suspect items to state lab
Refer public health related
inquiries to the Health
Department
Emergency Management can
provide logistics and support
Information Officer can assist
on-scene if req ested
Request WSP HASMAT unit to
respond to package item and
transport
PUBLIC INFORMATION
OFFICER
(Media coordination)
WILL THE ITEM BE SHIPPED
TO STATE LAB?
As Needed
NO
YES
Package item and maintain as
evidence until threat of .. I-
infection has passed
,Ir
Refer recipient to Health
Department for guidance
YES
DOES RECIPIENT STILL
HAVE CONCERNS?
WERE LAB TESTS
POSITIVE?
YES
,..
Notify F.B.I.
Continue criminal investigation
Advise the recipient(s)
document the incident.
Debrief the responders
Jefferson County Health & Human Services
RESPONSE
THE
PUBLIC HEM.THNII
~~ - "'< - ~,
CALL TO HEALTH DEPARTMENT FROM
FIRST RESPONSES I EMERGENCY MANAGEMENT
OR LAW ENFORCEMENT
·:·Is it a credible threat?
o If yes, call State Lab, 360-361-2914. Tell them when, and by whom,
it will be delivered.
Give fact sheets to staff of office on Anthrax. (See attachment from
Lisa)
o If no, give fact sheets to staff of office on Anthrax and be available for
questions.
·:·Lab to call results to: Lisa McKenzie 9:00a.m. - 4:30 p.m.
(360) 385-9400 or after hours:
o Jean Baldwin
· (cell) 360-531-1736
· (home) 360-379-9403
o Tom Locke
· (cell) 360-808-3333
· (home) 360-683-9152
· (pager) 360-582-8353
·:·Negative Results:
o Jean or Tom to call Dispatch to tell:
· Law Enforcement or Charles Saddler ~-379-9453
· Employer
· Emergency Management Team
.:. Positive Results: Same as above, but initiate Communicable Disease
·:·Code Staff and Management time to BARS 790
Information for People Involved in Evaluation of a Threatening Mail Item
11/6/2001
1. A piece of mail found in the facility in which you work or visited is being investigated for
biologic threat agents such as anthrax. The item will be sent to the State Public Health
Laboratory. Test results will be available under most circumstances within 24 hours. Your
supervisor will be notified of the test results as soon as they are available.
2. All strains of anthrax that have been detected in the United States are treatable by a wide
range of antibiotics. Individuals who have a confirmed exposure to anthrax will be provided
with antibiotics to prevent infection.
3. Any individual who has had direct contact with the suspicious material should wash their hands
with liberal amounts of soap and water. Avoid use of irritating disinfectants or vigorous
scrubbing that might injure your skin. If there is visible contamination of your clothing, change
your clothes and place the contaminated clothes in a sealed plastic bag until laboratory results
are available. People who have been heavily exposed to a suspicious material may also wish
to take a shower with soap and warm water to remove all potential contamination. No
additional decontamination is necessary unless the laboratory identifies a biologic agent.
4. Feeling anxious and upset is a normal reaction when a person confronts an uncertain health
risk. We encourage people to talk to others about their feelings. Laboratory information will be
available within 24 hours and anthrax is a highly treatable infection if treatment is started early.
Anthrax is not spread by person-to-person contact; you do not have to avoid contact with
family or friends.
5. The risk of exposure to anthrax in Washington State is currently very low. At this time none of
the suspicious mail items tested in Washington State have contained anthrax or any other
biologic agent.
If you have questions about this information, please call Jefferson County Health & Human Services
at 360-385-9400.
Communicable Disease Fact Sheet
ANTHRAX
-~~~
Communicable Disease Fact Sheet
Anthrax
What is anthrax?
Anthrax is a serious infectious disease caused by a bacteria called Bacillus anthracis. It is a disease
most commonly seen in animals, especially hoofed animals such as cows, sheep, goats and horses.
Humans occasionally become infected with anthrax when they eat meat or handle the wool, hair or
bones of an animal infected with anthrax. There are 2000-5000 cases of anthrax worldwide, and
about 5 cases a year in the United States. Experts believe that anthrax is among the diseases which
could be used as a biological weapon.
How would someone get anthrax and what are the symptoms?
The illness a person gets when they are infected with Bacillus anthracis depends on how the bacteria
got into the person's body. There are three different types of anthrax disease:
· Inhalational anthrax is the most serious form of anthrax and is caused by inhaling Anthrax
bacteria into the lungs. Initial symptoms usually begin 1-6 days after infection, but can occur as
late as 60 days after exposure. Symptoms include fever, headache, cough, difficulty breathing,
chills, weakness, and chest discomfort. Without treatment, severe breathing problems and
death usually result. Inhalation anthrax is NOT contagious (spread person-to-person).
· Cutaneous anthrax is caused when the anthrax bacteria come into direct contact with skin
that has a cut or break in it. Cutaneous anthrax begins within 1 to 7 days after exposure and
first causes a raised, itchy bump that resembles an insect bite. Within 1-2 days after the
appearance of the bump, a small blister develops. This blister then becomes a painless sore
with a black center. Lymph glands in the area of the infection may swell.
· Intestinal anthrax is caused by eating meat from an animal that has died of anthrax or by
drinking other foods or liquids contaminated with anthrax bacteria. It causes nausea, vomiting,
fever, pain in the abdomen, and diarrhea. Intestinal anthrax symptoms appear within 1 to 7
days after exposure.
If untreated, each of these forms of anthrax can spread to the blood, brain, or spine and cause severe
illness or death.
Testing and Diagnosis of Anthrax
· Law enforcement and Public Health authorities determine if an anthrax threat or suspicious
substance represents a credible threat and is potentially dangerous. If so, the letter or parcel
involved can tested for anthrax. Treatment of persons exposed in such circumstances is
usually postponed until laboratory results are available.
There is no laboratory test to test for anthrax before symptoms begin.
Nasal swabs are sometimes obtained during investigations of confirmed or likely anthrax exposures,
but are not useful or available outside of these circumstances. Persons with a documented or likely
anthrax exposu re AL WAYS receive preventive antibiotics.
Treatment for Anthrax
The preventive treatment for anthrax consists of antibiotic treatment alone or in combination
with anthrax vaccine.
· The duration of antibiotic treatment is 30-60 days, depending on whether anthrax vaccine is
used.
· When available, the anthrax vaccination series consists of 3 or more doses of anthrax vaccine.
QUESTION: How willi know if I have been exposed to anthrax?
· Persons are considered exposed to anthrax if they have inhaled or come into direct
contact with anthrax bacteria.
· There are tests to detect anthrax in the environment or substances and these tests will be
done as rapidly as possible by Public Health to determine if anthrax is present.
. Environmental testing to detect anthrax can provide preliminary results within several hours
and final results in about 2 days.
QUESTION: What should I do until environmental anthrax test results are available?
In most instances the likelihood of true exposure to anthrax is extremely small and no treatment is
needed.
· If evidence suggests that a true anthrax exposure has occurred, Public Health will
make recommendations for antibiotic treatment of persons exposed to anthrax until
results of laboratory tests are available.
· Antibiotic treatment should be stopped if environmental tests show no exposure to anthrax
has occurred.
· If a true anthrax exposure is confirmed, antibiotic treatment must continue for the duration
specified in Public Health recommendations, usually 30 days or longer.
QUESTION: When an exposure to anthrax is not thought to have occurred, treatment is not
recommended.
However, while the situation is being investigated any person who may have been exposed to
anthrax and becomes ill with the symptoms described above should seek medical attention
immediately and notify Public Health at the phone number listed at the end of this form. Antibiotics
can be given to treat illnesses consistent with anthrax symptoms until the results of laboratory testing
to detect anthrax are available.
QUESTION: What can I do to protect others when I have been exposed to anthrax?
· Take off the clothes you were wearing when you were exposed, place them in a sealed
plastic bag. These clothes can either be thrown away, or they can be washed in hot water
and soap. People who handle the contaminated clothes before laundering should be sure
to wear gloves and protective clothing. Avoid shaking the clothes when placing them in the
plastic bag or in the washing machine.
· Take a shower and clean your skin and hair thoroughly with warm water and soap to
remove anthrax bacteria.
o Once you take these steps, you will pose no risk to others.
o If you subsequently develop a sore on your skin, cover the sore with clothing or a
bandage and see your health care provider immediately.
o If you are recommended for preventive treatment, please be sure to follow the treatment
advice exactly.
QUESTION: What can be done to decontaminate surfaces contaminated with anthrax?
· The job of cleaning an area contaminated with anthrax will be left to public safety experts.
QUESTION: What should I do if I become ill?
· If you develop any of the illness symptoms described above, get medical attention
immediately and notify Public Health.
· Bring this sheet or mention you have been exposed to anthrax when you seek medical
care.
Report all cases to:
Jefferson County Health Department
615 Sheridan Street
Port Townsend, Washington 98368
(360) 385-9400
Adapted from Public Health - Seattle and King County
BIOTERRORISM
INCIDENT COMMAND
Jefferson County Health & Human Services
BIOTERRORISM INCIDENT
COMMAND
Tom Locke
Initiated by call to Tom from Emergency
Management or Police or Dispatch
, r
May Delegate to:
I
Jean, Larry or Lisa
Call emergency Management if not already involved
Bioterrorism
Response Plan
Jefferson County Health & Human Services
Infectious Disease Response Plan
And Laboratory Results
Information to Public,
MD's, Pharmacies, ER
Lisa, Tom
Community Coordination
with
JPREP and JCHHS Staff
Julia
Press contact - Tom in
his absence, Jean,
Lisa or Larry
Immunizations
Jane
Contact Tracing
Denis, Wendy
RESOURCE NUMBERS
Resource Numbers
· Emergency Management
o 360-395-3831, option 1
· Emergency Operations Center
o 360-385-3831 option 7
· Department of Health EPI Line for Questions
o 206-361-2914
o 877 -539-4344
· Bob Hamlin
o 360-385-3831 ext. 528
o (cell) 360-460-0500
o (home office) 360-457-1496
o (residence) 360-452-1552
o (pager) 360-681-5997 - 24 hours
· Bob Minty
o 360-385-3831 ext. 529
o (home office) 360-797-7809
o (residence) 360-797-8742
· Port Townsend Fire Department, Ed Edwards Fire Chief
o 1310 Lawrence Street, Port Townsend
o 360-385-2626
· Chimacum Fire District #1, Chuck Boggs Fire Chief
o P.O. Box 537, Chimacum
o 360-
· Quilcene Fire District #2
o P.O. Box 433, Quilcene
o 360-
· Port Ludlow Fire District #3
o 101 South point Road, Port Ludlow
o 360-
· Brinnon Fire District #4
o P.O. Box 42, Brinnon
o 360-
· Gardiner Fire District #5
o 2000 Old Gardiner Road
o 360-
· Port Townsend Fire District #6
o 3850 Cape George Road
o 360-
· Sheriff
o 360-385-3831
Jefferson County Board of Health
Assessment Highlights Fact Sheet
December 2001
Birth/Maternal Child Health Indicators (vital statistics database)
· Births to Unmarried Mothers, 2000
· Medicaid paid delivery, 2000
· Medicaid paid delivery, 1999
· AFDC/TANF Participants, 2000
· Low Birthweight rate (1996-2000)
· Non-Smoking Mothers, 2000
· First Trimester Prenatal care, 2000
· First Trimester Prenatal care, 1998
Comments:
· In 2000, 87 births to unmarried mothers accounted for 42% of all births.
In 2000, 62.3% (127) of all Jefferson County births were funded through Medicaid. This is a 7.8%
increase from the 1999 total of 54.5%.
· Jefferson County Medicaid-paid deliveries has been greater than 45% during all years 1992-2000.
· Jefferson County participation in AFDCIT ANF programs has continued to drop from the 1992
14.2% (33) to the 2000 total of 1.4% (3).
· Mothers who smoked during pregnancy gave birth to low birthweight babies at a rate greater than
twice that of non-smoking mothers; 8.6% and 3.6% respectively for 1996-2000.
· In 2000, 73.2% (153) of mothers reported not smoking during pregnancy.
· In 2000,77.3% (160) of mothers reported beginning prenatal care in the first trimester; in 1998,
87.1 % (171) of mothers reported beginning prenatal care in the first trimester.
Jefferson
42%
62.3%
54.5%
1.4%
5.1%
73.2%
77.3%
87.1%
Jefferson
$34,662
$33,446
$174,700
78.1
W A State
28%
33.5%
32.5%
3.2%
5.8%
86.5%
82.6%
83.0%
WA State
$50,182
$48,289
$176,900
108.4
Socio-Economic Indicators
· Estimated Median Household Income, 2000 (not from census)
· Estimated Median Household Income, 1999 (not from census)
· Median House Sales Prices, 2000
· Housing Affordability
Comments:
· $34,662 was the 1998-2000 Jefferson County median household income as compared to $50,152
in Washington State. Jefferson County households earn an estimated 30% less than Washington
State households.
. 174,700 is the median house sale price in Jefferson County, nearly equal to the Washington State
average $176,900.
· The Jefferson County housing affordability index is 78.1 compared to 108 for Washington State.
Given this climate of economic disparity, first time homebuyers, most often young families, are
probably unable to afford to purchase homes in the county. '
Population Indicators (all from US 2000 census)
· Growth Rate, 1999-2001
· Population Age 65+ 2000
· Population Age 85+ 2000
· Median Age, 2000
Comments:
· The county's growth rate seems to have slowed to a rate below that of the state.
· Jefferson County population of 65+ is nearly twice that of the state.
· Jefferson County population of 85+ is one and one-half times that of the state.
Jefferson
1.7%
21.1%
2.1%
47.3.
WA State
2.5%
11.2%
1.4%
35.6
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CASTLE HILL CENTER . 615 SHERIDAN . PORT TOWNSEND, WA 98368
The Honorable Patty Murray
United States Senate
Washington, DC 20510
'rhe Honorable l"1arla Cantwell,
The Honorable Norm Dicks
Dear Senator Murray:
I am a local public health official, and I work every day on the front lines to avert public health crises. I am writing to
urge you to ask the Appropriations Committee to provide $835 mi1lion in funding to improve the state and local public
health capacity to respond to an act ofbioterrorism. We need this funding at the local level to respond quickly and
effectively to an event ofbioterrorism.
In light ofrecent events, the nation is asking the question, "Are we prepared for an act ofbioterrorism?" The answer is,
"Not nearly enough." Local public health departments have long experience in responding to infectious disease outbreaks
and other local emergencies with public health implications. We have made progress and learned important lessons about
the challenges ofbioterrorism preparedness in the last few years. But we have a very long way to go to achieve the
capacities we need to detect and respond to an act ofbioterrorism as quickly as possible, to prevent the spread of disease
and save as many lives as possible.
Investment in our state and local public health capacity is the critical next step to prepare our community for a potential
act ofbioterrorism. So far, our nation's bioterrorism preparedness activities have been limited, but worthwhile. We are
not starting from scratch. We have found that the systems needed to build and prepare us to respond to bioterrorism acts
will also be valuable in our daily efforts to monitor and respond to the outbreak of disease in our communities.
Even Port Townsend has had to close the Post Office and the County Treasurer's Office while law enforcement
and public health determined the potential threat. Jefferson County public health nurses and physician have done
iu-services to local law enforcement, physicians, hospital and fire departments in one week. Bioterrorism is not an
acute outbreak, but has become a chronic threat that will require intensive staffing changes. As a small health
department we cannot now respond to chronic outbreaks, the ongoing investigations and active surveillance work.
We also have a legislative framework in place for expanding our general public health preparedness. The Public Health
Threats and Emergencies Act of 2000, which has not yet been funded, establishes a process for systematically defining
what our federal, state and local public health systems need to do, for assessing what they already can do, and for filling in
the gaps. I urge you to ask the Appropriations Committee to provide $835 million in funding to allow this process to
move forward swiftly.
We wish that it hadn't taken a catastrophe to call public attention to the fact that, just as we must keep our military
defenses strong, so must we also keep our public health defenses strong.
Sincerely,
, '----:> .,
~c..,~~ 15 e:JJ:.U----·-
Jean Baldwin, MSN, PHND
Community Health Director
Jefferson County Health & Human Services
HEALTH
DEPARTMENT
360/385-9400
ENVIRONMENTAL
HEALTH
360/385-9444
DEVELOPMENTAL
DISABILITIES
360/385-9400
ALCOHOUDRUG
ABUSE CENTER
360/385-9435
FAX
360/385-9401
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MEMBERSHIP BOOK5TORE NACCHO TOOLS PROGRAMS
NEWS AND UPDATES
.. PRESS RELEASES
Congress Earmarks $865 million for State and Local Public Health
Capacity
12/20/01
The House of Representatives today ratified supplemental spending to
address bioterrorism. Senate passage is expected by the end of the day.
These funds are in addition to the regular FY2002 appropriations for
HHS, on which Congress also agreed this week. The supplemental
spending is part of the $40 billion that Congress voted to spend shortly
after September 11. The total to be spent on public health and
bioterrorism activities is $2.5 billion, of which $865 million is earmarked
for state and local capacity. The conference report language that
specifies how these funds are to be spent appears below. The
references to Sections 319B, 319C and 319F refer to last year's Public
Health Threats and Emergencies Act, which provides for grants to states
and localities to assess core public health capacity(319B), grants to
improve core public health capacity (319C) and grants for bioterrorism
preparedness (319F). Congress authorizes the Secretary (of the
Department of Health and Human Services) to waive the competitive
aspect of these grants and requires that a plan for expending the funds
be provided 15 days following enactment.
This legislation represents a significant accomplishment for NACCHO
and meets our legislative objective of providing funding for core local
public health capacities alongside bioterrorism preparedness. as well as
gaining flexibility for HHS to get funds out rapidly.
THANK YOU to all of you who were so responsive and active in
advocating for this funding. Your dedication during such a hectic and
trying time has been the key to our collective effectiveness as voices for
local public health.
Language from Congressional conference report on bioterrorism
spending:
"The agreement includes $865 million for upgrading state and local
capacity, instead of $423,000,000 as proposed by the House and
$1,000,000,000 as proposed by the Senate. The conferees concur with
language in the House report recommending that a portion of this
funding be provided under the authority of Sections 319B, 319C and
319F of the Public Health Service Act, as amended.
The conferees believe that a portion of this funding should be available
immediately to meet the needs of state and local health departments as
a result of the September 11, 2001 attacks and other subsequent events
related to terrorism. The conferees also believe that a portion of this
fundinq should be qranted under the authority of the Public Health
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NACCHO - News and Updates
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Threats and Emergencies Act, which calls for assessments of public
health needs, provides grants to State and local public health agencies
to address core public health capacity needs, and provides assistance to
State and local health agencies to enable them to respond effectively to
bioterrorist attacks. The Secretary is requested to provide a plan to
distribute this funding within 15 days of enactment of this Act. The
conferees concur with language contained in the House report directing
the Secretary to provide a report on the State of the Nation's public
health and medical preparedness for bioterrorism.
The conferees further believe that the peer review of competitive grants
required under 319C, while desirable under normal circumstances,
should be waived, at the discretion of the Secretary, to expedite funding
to address gaps in public health preparedness."
If-I lACK If-I 11'IucIC 10 fOP 11'1
12/20/01
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DRAFT RESOLUTION
Whereas RCW 70.05.060 assigns to the Jefferson County Board of Health
"supervision over all matters pertaining to the preservation of the life and health of the
people within its jurisdiction" and requires the Board to "(p )rovide for the control and
prevention of any dangerous, contagious or infectious disease within the jurisdiction of
the local health department";
Whereas the Jefferson County Board of Health has reviewed the "Response Capability
during a Health Emergency - A Review of Selected Issues" adopted by the Washington
State Board of Health on November 14,2001;
Therefore Be It Resolved, that the Jefferson County Board of Health concurs with the
findings ofthe State Board on the need for enhanced preparedness for biological
emergencies and supports the State Board's recommendations for improving state and
local preparedness.
Adopted this 20th Day of December, 2001
Signatures