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HomeMy WebLinkAbout10 October JEFFERSON COUNTY BOARD OF HEALTH MINUTES Thursday, October 19, 2000 Board Members: Dan Harpole, Member - County Commissioner District # 1 Glen Hunting/ord, Alember - CountY CommiJJioner DiJtrict #2 Richard W'qjt, Member - County Commissioner District #3 GeoJ!r~y MaJoi, Member - Port TownJend Ci!; Coundl Jill Buhler, Vice-Chairman - Hospital Commissioner District #2 Sheila lFesterman, Citizen at Large (City) Roberta Frissell. Chairman, Citizen at Large (Coun!J) Staff Members: lean Baldwin, Nur.ring Services Director Lan)! Fqy, Em;ironmental Healtb Director Thoma.r Locke, MD, Health Officer Chairman Frissell called the meeting to order at 1:30 p.m. All Board and staff members were present, with the exception of Member Westerman and Commissioner Harpole. APPROVAL OF MINUTES Commissioner Wojt moved to approve the minutes of the September 21, 2000 meeting. Commissioner Huntingford seconded the motion, which carried by a unanimous vote. OLD BUSINESS On-site Sewage Code: Larry Fay said the adopted version included in the agenda packet incorporates all changes discussed at the last meeting as well as minor editorial changes. The ordinance was then circulated for Board signatures. He announced that individual workshops are being held with real estate agencies and three workshops will be scheduled for installers and designers. Another workshop focusing on the actual permitting process will include the Home Builders Association and individuals involved in real estate land development. Part of that workshop will involve identifying and addressing their concerns and customer service problems with the Department's process. Part of the grant awarded by the State Department of Ecology will be directed towards public education and outreach in the form of workshops with various homeowners and community organizations. A plan has not yet been developed for reaching the rest of the community. Illegal Dumping Action - Linda Sexton: Larry Fay reviewed communications to date with the County Prosecutor's Office regarding enforcement action against Linda Sexton. She has been cited for operating a recycling or disposal facility without a permit and has failed to present a solid waste compliance plan. In the correspondence, Prosecutor Dalzell outlined two suggested approaches for moving forward: 1) beginning a new criminal investigation and issuing a citation; or 2) injunctive relief to enforce the order from the Board. He asked for the Board's direction on how to proceed? HEALTH BOARD MINUTES - October 19, 2000 Page: 2 Commissioner Huntingford questioned why the Board's action to date has not resulted in getting Ms. Sexton before a judge? Larry Fay said while he believes he has presented a case for seeking injunctive relief, it appears Prosecutor Dalzell feels that starting over with a new investigation may be the best opportunity to get Ms. Sexton into court. If there is a finding in the Board's favor, the failure to comply results in contempt of court. Commissioner Huntingford wondered whether the concern about moving forward with the Board's requested action relates to the significant amount of time that has passed since she was originally cited. The court may ask what is the emergency health issue. Member Masci suggested that Prosecutor Dalzell be invited to the Board of Health meeting to present strategies for proceeding. Dr. Locke said the Board of Health has already taken action and at this point it is a law enforcement issue. He suggested that if Prosecutor Dalzell does not wish to pursue prosecution, she should propose an alternative to the Board. Member Masci moved that Staff contact the Prosecutor and communicate the Board's desire to proceed with prosecution for the existing violations. If the Prosecutor has a suggested alternative, she should present that proposal to the Board of Health. Commissioner Huntingford seconded the motion, which carried by a unanimous vote. NEW BUSINESS Washington Restaurant Association Food Worker Card Program: Larry Fay reviewed Jefferson County's history of issuing food handling cards and outlined staff time and cost involved in the current program (roughly $10 per card). New state food safety regulations require participation in a food safety class before taking the exam. While the new training program currently complies with these regulations, the costs associated with administering the exam exceed the statutory limit set at $8 per card. A new certification program proposed by the Washington Restaurant Association would certify qualified restauranteurs to conduct training classes and proctor exams. The aim of the program is to assist the Departments who may otherwise have difficulty conducting classes. A staff concern with this approach is ensuring all training classes are equivalent. Member Masci recommended an approach where the administrative cost of issuing food handler cards becomes part of the trainer certification program through the Washington Restaurant Association. Larry Fay talked about the difficulty of measuring the success of training. Environmental Health Specialist Susan Porto feels an indirect benefit of the County's training program is getting to know and developing relationships with the workers that she sees during regular inspections. The question facing the Department is how to provide a good training program at the least cost to the County? HEALTH BOARD MINUTES - October 19, 2000 Page: 3 Commissioner Huntingford commented that successful training depends largely upon restaurant management providing the resources to protect public health. Larry Fay stated that staff is interested in whether this new training program will offer the public a more flexible training opportunity. Another benefit of the Restaurant Association Program is that it offers training in different languages. There was Board support for keeping the process as simple as possible and not changing the current system if it is working for the County. County Administrator Charles Saddler asked what percentage of people taking the test pass the first time? Larry Fay responded that while he didn't have the actual figures, the Department is running at a much higher success rate than when there was not a training program. Mter further discussion Larry Fay agreed not to pursue the training option and leave it up to the Restaurant Association to investigate whether there is demand from their constituents. State Department of Health 2001 Request Legislation: Dr. Locke reviewed a legislative agenda outline from the State Department of Health that will be submitted to controlling executive agencies. He reviewed what he believes are the significant issues. Additional comments are noted with each item. Proposals for 2001 Agency Request Legislation: .:. Department of Health Funding Authority (the opportunity to partner with the public sector). .:. Drinking Water Programs (currently being reviewed for cutbacks or changing the focus to save money); Larry Fay commented that some of the 15% will be used as pass through to local health departments to fund the Group B water programs currently not funded, .:. Health Professions Account Interest (movement to allow the fund to keep its own interest). .:. Water Recreation and Bathing Beaches (the State may propose pulling this item and leaving it as a local option.) Larry Fay said an agreement currently exists with the State to address pools and spas, but not bathing beaches, through the Water Recreation Program. However, State funding for that program ceased and, in his opinion, eliminated the "partnership." Options for 2% Budget Reductions in 2001-2003 Biennium: .:. Drinking Water Laboratory Testing (water quality testing is handled adequately with the number of private labs. The issue is making sure the State has oversight over the quality of the lab work). .:. Teen Pregnancy, Family Planning, and HIV/AIDS. Jean Baldwin indicated these reductions would result in cuts of about $1,800 and $3,000 per program in Jefferson County. .:. Toxicologist Support. Larry Fay said the State provides critical support in specific instances such as the Norwalk virus. HEALTH BOARD MINUTES - October 19~ 2000 Page: 4 Member Masci moved that the Board of Health send a letter to Mary Selecky of the State Department of Health stating its opposition to reductions in the budget that constitute reductions in funding for local health. Commissioner W ojt seconded the motion, which carried by a unanimous vote. Budget Enhancement Proposals for 2001-2003 Biennium: .:. Child Health Enhancement (the escalating cost of existing vaccines and the addition of new and costly vaccines is destabilizing the system. Child Profile is also a part of this request.) Of the $14,7 million, the cost of Prevnar is in excess of $12.6 million. In response to a question about the rate of infection and mortality. Dr. Locke indicated the Pneumoccocal infections are more an individual health issue rather than a population- based issue. Eleven major new vaccines are being developed in the United States. .:. Shellfish Testing. Larry Fay said growers are responsible for monitoring and testing. For Jefferson County, Vibrio has been a significant issue in the past. Dr. Locke said Vibrio, while naturally occurring in the marine environment, is in the same family as cholera and is dangerous. Dr. Locke mentioned other significant items on the list are: .:. Hepatitis C Surveillance .:. Recreational Water Quality .:. Capital-related enhancements and infrastructure to improve efficiency .:. Death Records Document Management (to fund imaging of records before they deteriorate) Chairman Frissell asked about the extent to which the County is involved in the mooring buoy situation at Mystery Bay? Larry Fay responded that the Board of Health discussed this issue some time ago. The State Department of Health made the County aware that due to the number of mooring buoy permits being issued that the area was approaching the density of a marina. The question that is hard to define is at what point does an area qualify as a marina because of its impact under the Federal shellfish sanitation guidelines? Access to Critical Health Service: Local Health Jurisdiction Roles: Dr. Locke indicated that the Proposed Standards for Public Health included in the agenda packet is additional information for the Board's discussion of critical health services with the Hospital Board. This information will become part of the Public Health Improvement Plan to be published and submitted to the legislature in December 2000. Dr. Locke reviewed the standards which are meant to identify the basic level of health services that should be available to Washington State residents. He believes Standard 3, Plans to Reduce Specific Gaps in Access, is the most challenging. The rest of the information describes the criteria for determining critical health services, proposes a scheme by which local health jurisdictions can measure access, and lists critical health services by type. Member Buhler questioned why prescription services are not listed? HEALTH BOARD MINUTES - October 19,2000 Page: 5 Dr. Locke responded that he believes prescription medicines are a component of other categories of care. While the affordability of prescription medicines might be an appropriate issue to add, it can remain a critical health service in Jefferson County and not be included on the list. Member Buhler suggested that other jurisdiction might recognize it as a problem if it is listed. Dr. Locke said another item missing from the list that may be included is Hospital Services. It is hoped that these standards will provide Boards of Health with a self assessment tool for the health programs they oversee. This list is a starting point for discussion and local Boards of Health will be asked to provide input later. AGENDA CALENDAR / ADJOURN ~ 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 3:30 p.m. The next meeting will be held on Wednesday. November 22 at 1:30-3:30 p.m.. at the Health Department. There will be no Joint Board Meeting in November. JEFFERSON COUNTY BOARD OF HEALTH ILd- fd'iL$ -- .dAtU t!1:~e Roberta Frissell, Chairman IJJl6 cJt,--/ Jilfu~hler, Vice-Chairman _/ !!. JJ . -/ ~ .' c1f~n Huntingford, (Excused Absence) Dan Harpole, Member (Excused Absence) Sheila Westerman, Member A~1idavit of publication STATE OF WASHINGTON) SS COUNTY OF JEFFERSON) NOTICE HEALTH BOARD \ .~\NG.c~,.., The~efferson County Board of Health" 'Meeting sChedLiled for Thursday, October 19, 2000 will be held at the Hospital Auditorium from 1 :30 p.m. to 3:30 p.m. \s\Roberta Frissell, Chairman Jefferson County Board of Health 2307m 10/18 SCOTT WILSON. being sworn. says he is the publisher of the Port Townsend Jefferson County Leader, a weekly newspaper which has been established. published in the English language and circulated continuously as a weekly newspaper in the town of Port Townsend in said County and State, and for general circulation in said county for more than six (6) months prior to the date of the first publication of the Notice hereto attached and that the said Port Townsend Jefferson County Leader was on the 27th day of June 1941 approved as a legal neWSpaper by the Superior Court of said Jefferson County and that annexed is a true copy of the Health Board Meeting Notice October 19, 2000 as it appeared in the regular and entire issue of said paper itself not in a supplement thereof for a period of one OORSSCutivll week~ beginning on the1.BLh-day of Opt"nnpr &endingonthe 18tltlayof October .20.Q.(L.. , 20.illL, and that said newspaper was regularly distributed to its subscribers during all of this period. That the full amount of $ 13.50 has heen paid in full, at the rate of $9.50 ($9.00 for legal notices re- ceived electro tion. publisher Subscribed and sworn to before me thisUL- day of 0 c t 0 be r Notary Public in and for the State of Washington residing at Port Hadlock JEFFERSON COUNTY BOARD OF HEALTH Thursday, October 19, 2000 1:30 - 3:30 PM Board of Health Meeting 3:30 - 5:00 PM Joint Meeting with Hospital District Commissioners Jefferson General Hospital Auditorium AGENDA I. Approval of Minutes of Meeting of September 21, 2000 II. Public Comments III. Old Business 1. Jefferson County On-Site Sewage Code (adopted version) 2. Follow-up Reports - Linda Sexton Case Update IV. New Business 1. Washington Restaurant Association Food Worker Card Program Larry (20 minutes) 2. W A State Dept. of Health 2001 Request Legislation Tom (20 minutes) 3. Access to Critical Health Service: Local Health Jurisdiction Roles Tom (30 minutes) VI. Agenda Planning v. Adjourn Next Meetine: November 16,2000 JEFFERSON COUNTY BOARD OF HEALTH MINUTES D =:OR~f1 Thursday, September 21,2000 'RAFr Board lvlembers: Dan Harpole, lvIember - County Commissioner District # 1 Glen HuntinJford, Member - Coun!J' Commissioner Distnd #2 Richard lV'qjt, Member - COlm!) Commissioner District #3 GeojJrey Masd, Member - Port Town.rend City Coumil Jill Buhler, Vice-Chairman - Hospital Commissioner District #2 Sheila Wl'esterman, Citizen at Large (City) &berta Frissell, Chairman, Citizen at Large (County) S ta' Members: Jean Baldwin, Nur.ring Services Director Larry Fc:;', Environmental Health Dim'tor Thomas Locke, MD, Health Officer RECEIVED OCT 1 0 2000 JllIUlll'~ (I :"'\IIII~ Health & Human SeMces Chairman Frissell called the meeting to order at 1:30 p.m. All Board and staff members were present, with the exception of Member Masci and Commissioner Huntingford. The agenda was revised to reflect the following additions: New Business - Loss of MVET Funds and Old Business - Report on Jefferson General Hospital. APPROVAL OF MINUTES Commissioner Wojt moved to approve the minutes of the August 17, 2000 meeting. The minutes were corrected as follows: Page 4, paragraph 8, the words "and no conventional" should be deleted and on Page 4, paragraph 2, first sentence, the word "for" should be deleted. Commissioner Wojt seconded the motion to approve the minutes as corrected, which carried by unanimous vote. OLD BUSINESS PENINSULA SYRINGE EXCHANGE: Jean Baldwin distributed aNALBOH Newsbriefand a letter sent to providers announcing the opening of the Peninsula Syringe Exchange. The program is open twice a week in Jefferson County and once a week in Clallam County. A time line is being prepared for outreach on infectious disease, Hepatitis C and B, testing and counseling. ILLEGAL DUMPING ACTION: Larry Fay reported that due to a miscommunication with the Prosecutor's Office, the order by the Board of Health regarding Linda Sexton has not yet been implemented. He will be following up immediately with the Prosecutor's Office to clearly outline the formal action desired by the Board of Health. He agreed to investigate whether there is an expiration date on the order and will report back next month. Chairman Frissell commented that a lack of action sends the wrong message. HEALTH BOARD MINUTES - September 21, 2000 Page: 2 STATE AUDIT - JEFFERSON GENERAL HOSPITAL: Vice Chairman Buhler reported the Hospital was re-evaluated on September 16, 2000. A communication from the State indicated that Region 10 of the Healthcare Financing Administration will be notified that the Hospital is now in . compliance with all Medicare conditions of participation. The Hospital will be re-evaluated on October 16, 2000. RESOLUTION OF SUPPORT FOR .JEFFERSON TRANSIT SALES TAX INITIATIVE: As agreed at the last meeting, Commissioner Harpole communicated to the Transit Authority the Health Board's support for Proposition 1. The proposition passed by an estimated 63.5%. The proposition failed in Kitsap County. Member Westerman moved that staff formalize for signature, the Resolution in Support-of Proposition 1 dated August 17, 2000. Commissioner W ojt seconded the motion, which carried by a unanimous vote. NEW BUSINESS LOSS OF MOTOR VEHICLE EXCISE TAX FUNDS (MVET): County Administrator Charles Saddler provided background on the MVET funds as a method of funding health operations. He believes it is appropriate for the Board of County Commissioners to seek assistance from the City of Port Townsend in providing funding for the core health services. He will propose to the Board of County Commissioners that this element be part of the Regional Services Agreement with the City. Member Westerman suggested reviewing the formula used in the past to ascertain the City's share. Charles Saddler agreed and said his intent was to first notify the Health Board of the recommendation. He will then work with Health Department staff to identify the core services and functions and will keep the Board informed of any action. Commissioner Harpole moved that staff draft a letter for the Chair's signature requestlng the City's assistance in funding the core health functions. Commissioner Wojt seconded the motion, which carried by a unanimous vote. HIV INFECTION REPORTING IN WASHINGTON STATE - YEAR 1 STATUS REPORT: Dr. Torn Locke reviewed the background and findings in the report provided in the agenda packet. Requirements of this one-year evaluation were to identify whether the system produces high- quality data that complies with the Center for Disease Control (CDC) standards and whether the system is having any adverse affects. He indicated that while the integrity of the data is high, the completeness standard was 61 % compared with the CDC standard of 85%. This is expected to increase over time. An area outlined for improvement is partner notification. Overall the report was favorable. HEALTH BOARD MINUTES - September 21,2000 Page: 3 ON-SITE SEWAGE CODE ADOPTION HEARING: The Board discussed specific areas for clarification and correction to Draft #5 of the On-Site Sewage Code as follows: . Page 9, 8.15.120 (3) Renewal of Certificate. There was clarification that the renewal application date was changed to March 1 to correspond with the expiration date of April 1. . Page 11, 8.15.140 Sewage system designers. This section should be deleted because it is covered elsewhere in the document. . Page 11, 8.15.150 (1) To clarify that employees of the PUD need to be certified, this item was modified to read" . . . firm or corporation, including public employees, to engage in. . . " . Page 15, 8.15.160 (6)(d). To reserve the County's operation and monitoring options in the future, " . . . the Jefferson County PUD for monitoring. . . "was replaced with" . . . an agency or entity approved by the Department for monitoring. . . " . Page 11, 8.15.150 (3)(c). Change "one year experience" to "one year experience or six months experience plus demonstration of having completed (specified training curriculum)" and check for consistency throughout the document. Earl Green expressed his disappointment that other installers were not in attendance. He likes the current system where the Health Department conducts the inspections and expressed his concern about the inflated cost for engineers writing the design. He recommended that there be a requirement for risers with distribution boxes. Larry Fay responded that new state licensing will allow non-engineers to get into the field of on-site sewage system design. . Page 6, 8.15.090 Under Design, add number (5) to outline a riser requirement on the distribution box. . Index. Review and edit capitalization. . Table 1, Column 5, Row 1 should read "annually" instead of "every three years. . . " . Page 3, 8.15.050 (15) ass: On-site Sewage System be deleted. . Page 9, 8.15.120 (2)(c) "Shall provide" should be deleted. . Page 19, 8.15.200 spelling of Severability to be corrected. . Page 4,8.15.060 (3) Deputy Prosecutor David Alvarez recommended replacement language for this item. There was no opposition to using the recommended language. . Page 14, 8.15.160 (6)(b) To help with public notification on this item, Larry Fay indicated that part of the $84,000 Centennial Clean Water Grant would be used to help implement and provide public outreach. For transfers of ownership, notification will occur through the Assessor's office and Realtors. Member Westerman moved for adoption of the Final Draft of the Onsite Sewage Code as amended and corrected. Commissioner Harpole seconded the motion, which carried by a unanimous vote. It was understood that the date of the final adoption should be September 21, 2000 and that this document as revised could be provided in the next agenda packet for review only unless discussion is needed. HEALTH BOARD MINUTES - September 21,2000 Page: 4 INFLUENZA CONTINGENCY PLAN: Dr. Tom Locke reviewed the County's plan included in the agenda packet outlining the production problem, timing of vaccinations, and priorities for the 1999-2000 season. Specific actions include delaying the Community Vaccination Clinics until November and encourage providers to give priority to high risk patients. Priority should also be given to health care workers having direct contact with clients at high risk for influenza complications. Dr. Locke indicated that part of the CDC's back up plan is that another batch of vaccines is expected to be released in December. He noted that in the United States there are between 20,000 and 40,000 deaths attributed to infl uenza. BEHAVIORAL RISK FACTORS SURVEILLANCE SYSTEM (BRFSS): Dr. Tom Locke provided an overview of the BRFSS system. He talked about the current lack of data, the benefits of the information, and the many components of the BRFSS system. One of the main benefits of this. system, as a core assessment tool, is looking at healthcare access, insurance, and payment plans, etc. Jean Baldwin indicated that the Department has decided to purchase staff time from Kitsap County to update Jefferson County's vital records and vital statistics information. This update will help with preparations for the new census data when available. She also proposed assembling a workgroup of Board of Health members and community volunteers to begin work on this system. The BRFSS project is contingent upon MVET funds and is estimated at $19,000 plus the contract with Dr. Chris Hale. Part of this amount is in the 2001 budget and Jefferson General will be contacted about their interest in partnering on the project. Ms. Baldwin agreed to return to the Health Board with a budget for the BRFSS and cost for using Dr. Hale. REVIEW OF HEALTH DEPARTMENT MANAGEMENT TEAM: Dr. Tom Locke reviewed the temporary staff arrangement that has been in place since the Health Director resigned in June 1999. Because of the budget affects of 1-695, there was a decision to leave the position vacant and reconfigure the Health Department management team as opposed to a staff layoff. He has concerns about being understaffed and management's ability to coordinate and respond to urgent situations. As the one year review approaches and budgets are needed, the management team would like a review of the system through a management team appraisal. The Board of Health's assistance is requested. Standard internal infrastructure evaluations are forthcoming from the National Association of County Health Organizations (NACHO). Jean Baldwin agreed to contact the Health Board members about possible meeting times. HEALTH BOARD MINUTES - September 21, 2000 Page: 5 AGENDA CALENDAR/ADJOURN Chainnan Frissell asked staff to pay closer attention to the public meeting notices in the newspaper. . . . . . . . . . . . . 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 CIDLD PREVENTION GOALS (0-3) Meeting adjourned at 3:20 p.m. The next meeting will be held on Thursday, October 19 at 1:30 p.m., followed by the Joint Board Meeting at 3:30 p.m. at the Hospital. JEFFERSON COUNTY BOARD OF HEALTH Roberta Frissell, Chairman (Excused Absence) Geoffrey Masci, Member Jill Buhler, Vice-Chairman Richard Wojt, Member (Excused Absence) Glen Huntingford, Member Sheila Westerman, Member Dan Harpole, Member Jefferson County Ordinance 08-0921-00 8.15 ON-SITE SEWAGE CODE Adopted September 21,2000 Jefferson County Board of Health SECTION 8.15.010 8.15.020 8.15.030 8.15.040 8.15.050 8.15.060 8.15.070 8.15.080 8.15.090 8.15.100 8.15.110 8.15.120 8.15.130 8.15.140 8.15.150 8.15.160 8.15.170 8.15.180 8.15.190 8.15.200 8.15.210 8.15.220 Jefferson County Ordinance 08-0921-00 8.15 ON-SITE SEWAGE CODE TABLE OF CONTENTS TITLE Authority/Scope Purpose Adoption by Reference Administration Definitions Adequate Sewage Disposal Required No Discharge to Water or Ground Surface On-site Sewage System Permit Design Community On-site Sewage Disposal Systems Inspection Sewage System Installer Septic Tank Pumpers Operation and Maintenance Specialist Operation, Maintenance and Monitoring Areas of Special Concern Appeal/Hearing Enforcement/Penalty Severability Fees Effective Date Conflict Table 1 PAGE 1 1 1 1 1 4 4 4 6 6 7 8 10 11 12 15 15 17 19 19 19 19 20 -1- CHAPTER 8.15 ON-SITE SEWAGE DISPOSAL SYSTEMS 8.15,010 AUTHORITY/SCOPE Pursuant to RCW 70.05 and RCW 43.20, the Jefferson County Board of Health is charged with the duty of protecting the public health and safety of all inhabitants of Jefferson County, and enacting such rules and regulations as are necessary in order to carry out these responsibilities and provide for the enforcement thereof. The provisions of this regulation shall apply to all territory within the boundaries of Jefferson County. 8.15.020 PURPOSE The purpose of these regulations is to assure protection of public health by: (1) Minimizing the public health effects of on-site sewage systems on surface water and ground water; (2) Minimizing the potential for public exposure to sewage; (3) Establishing design, installation and management requirements for on-site sewage systems to accommodate long-term treatment and disposal of sewage; (4) Enhancing protection of environmentally sensitive areas within Jefferson County; and (5) Compliance with the intent of Chapter 246-272, WAC 8.15.030 ADOPTION BY REFERENCE Washington Administrative Code Chapter, 246-272 On-site Sewage Systems Rules and Regulations of the State Board of Health, as now or hereafter amended, is hereby adopted by reference as Rules and Regulations of the Jefferson County Board of Health. 8,15.040 ADMINISTRATION The Jefferson County Environmental Health Director, through authority delegated by the Jefferson County Board of Health and the Jefferson County Health Officer shall administer these regulations. Fees may be charged for this administration. 8.15.050 DEFINITIONS In addition to those definitions set forth in WAC Chapter 246-272 the following definitions shall also apply in this regulation: (1) Areas of Special Concern: Areas of definite boundaries delineated through a public process where the Jefferson County Board of Health determines additional requirements for on-site sewage systems may be necessary to reduce potential failures, or minimize negative impacts of on-site systems upon public health. (2) Community On-site Sewage System: Anyon-site sewage system designed to serve two (2) or more units with design flows of 3,500 gallons per day or less. (3) Commercial On-site Sewage System: Any nonresidential or combined residential/nonresidential on-site sewage system with a design flow of 3,500 gallons per day or less. -2- (4) Department: The Washington State Department of Health (5) Design: An on-site sewage disposal system design shall consist of a complete scale drawing of the site plan showing the proposed sewage disposal system, including all relevant details as specified in WAC 246-272-09010 and 246-272-11501 and 246-272- 11001 and Jefferson County Policies. The design shall use the format and forms provided or approved by the Health Division. Proper identification and location of soil logs and drainfield components at the site are considered to be part of the design. (6) Designer: An individual authorized by the Washington State Department of Licensing to perform design services for on-site wastewater treatment system pursuant to 18.210 RCW. (7) Expansion: A change in a residence, facility, site or use that: (a) Causes an on-site sewage system to exceed its existing treatment or disposal capability; for example, when a residence is increased from two to three bedrooms or there is a change in use from an office to a restaurant; or (b) Reduces the treatment or disposal capability of the existing on-site sewage system or the reserve area; for example, when a building is placed over a reserve area, (8) Fees: Charges as hereinafter authorized by the Jefferson County Board of Commissioners or the Jefferson County Board of Health for issuing permits, making inspections as found necessary, and certifying individuals in the practice of installing, pumping or maintaining/monitoring on-site sewage systems. (9) Health Division: The Jefferson County Health and Human Services Environmental Health Division. (10) Health Officl9r: The local Health Officer of Jefferson County Health and Human Services Department, or a representative authorized by and under the direct supervision of the local Health Officer, as defined in chapter 70.05 RCW. (11) Installer: An individual who has passed the Jefferson County installer's exam, holds a current bond and insurance as specified in 8.15,120, personally holds an Installer's Certificate and directly supervises the installation and/or repair of an on-site sewage disposal system in Jefferson County, (12) Notice of Violation: Written determination that an element or section of these rules and regulations has not been complied with. (13) On-site Sewage System (aSS): An integrated arrangement of components for a residence, building, industrial establishment or other place not connected to a public sewer system which: (a) Convey, store, treat, and/or provide subsurface soil treatment and disposal on the property where it originates, upon adjacent or nearby property; and (b) Includes piping, treatment devices, other accessories, and soil underlying the disposal component of the initial and reserve areas, (14) Operation and Monitoring Specialist: An individual with training, skill and experience in the maintenance/monitoring and operation of ass and who is approved by the Jefferson County Environmental Health Division to inspect and monitor the performance of an ass. -3- (15) Probation: A penalty period where the individual committing the violation shall be subject to additional review, reporting and/or inspection. (16) Proprietary Device: A device or method classified as an alternative system, or a component thereof, held under patent, trademark, or copyright. (17) Pumper: An individual approved and granted a Certificate to operate by the Health Officer to remove and transport wastewater or septage from septic tanks, pump chambers and portable toilets. Said individuals may repair baffles within the septic tank, install or repair risers on septic tanks or pump chambers and install outlet baffle filters in a septic tank, (18) Revocation: The termination of all the rights and privileges associated with a certification. (19) Sewage Disposal Permit: A written permit issued by the Health Officer granting permission for the installation, alteration, expansion or repair of an on-site sewage system. (20) Site Installer: An individual that has passed the installer's exam and maintains an annual Certificate, but is working under the direction and bond of another Certified Installer. (21) Soil Log: A detailed description of soil characteristics providing information on the soil's capacity to act as an acceptable treatment and disposal medium for sewage. (22) Suspension: The temporary termination of all rights and privileges associated with a certification. (23) Violation: A failure to comply with the provisions of applicable laws, rules or regulations including, but not limited to instances or cases when: (a) A Designer submits a permit application or an as-built drawing of an on-site sewage disposal system which contains any significant deviation below the minimum requirements for siting or sizing of on-site waste water treatment. (b) An individual designs, installs or approves an on-site sewage system that is not in accordance with the applicable regulations, or is not fitting the size, shape or topography of the site, within setbacks, as specified in the WAC Chapter 246- 272; specification or approval of inadequate construction material, devices or methods. (c) A system is not installed in accordance with the approved permit. (d) Installer fails to notify the designer and/or the Health Division when site conditions have changed making installation of the approved permitted system impossible or impractical. (e) A pumper disposes of waste from an on-site sewage disposal system or portable toilet at an unapproved disposal site. (f) A designer or installer fails to submit as-built plans as specified in chapter 8.15.110(4). (g) An authorized person fails to submit required reports to the Health Division as specified in the conditions of the on-site sewage disposal permit or in this chapter. (h) A Certificate holder fails to pay fees as specified by Jefferson County Ordinance. (i) A person holding a Certificate or license to install, pump or monitor an OSS fails to report to the Health Division within 24 hours any nonfunctioning on-site components that could result in human contact with sewage effluent. -4- U) An owner fails to complete required 0 & M inspections, comply with the 0 & M schedule in TABLE 1 and/or submit the reports to the PUD. (k) An owner fails to comply with conditions of the on-site sewage permit. 8.15.060 ADEQUATE SEWAGE DISPOSAL REQUIRED (1) Every residence, place of business, or other building or place where people congregate, reside or are employed shall be connected to an approved public sewer. If no public sewer is available, the building sewer shall be connected to an on-site sewage system approved by the Health Officer. Said sewage disposal system shall be built or rebuilt, constructed and maintained in such manner as to meet the requirements as prescribed by the Health Officer in accordance with minimum requirements and standards of WAC 246-272 and this code. Such system may include the use of waterless toilet de,vices in conjunction with an approved graywater system or other proprietary devices approved by Washington State Department of Health. (2) Any unit/facility with the potential to generate waste water by virtue of being equipped with a toilet, sink, shower or other plumbing fixture that is in a water service area or has a well on site, shall be connected to an approved public sewer or shall be connected to an on-site sewage system approved by the Health Officer. (3) Any new or replacement residence or any expansion, as that term is defined in Section 8,15.050(7) of this Code, may be connected to a pre-existing on-site sewage system only when the pre-existing system has hydraulic capacity, sufficient vertical and horizontal separation, an adequate reserve area and satisfies all other requirements to be in compliance with current code. 8.15.070 NO DISCHARGE TO WATER OR GROUND SURFACE Effluent from anyon-site sewage disposal system shall not be discharged directly or indirectly to surface water or upon the surface of the ground, except where expressly permitted by the Health Division or by the Washington State Department of Ecology. 8.15.080 ON-SITE SEWAGE SYSTEM PERMIT (1) No person shall install or cause to be installed a new on-site sewage system, nor perform any alteration, extensions, relocation or connection to an existing on-site sewage system without a valid permit issued by the Health Officer. (2) When applying for a permit to install an on-site sewage system, a detailed to scale construction plan of the proposed system and site is required and shall include all items identified in WAC 246-272-11001 (2)(a). Each application shall contain the information required in WAC 246-272-09001 as a minimum. (3) The minimum i:and area required for approval of an ass permit shall be determined by either Method 1 or Method 2 as established in WAC 246-272. (4) Permits are transferable with property ownership. (5) Any sewage disposal permit issued under this section shall be valid for a period of three (3) years from the date of issuance. (a) The permit may remain valid if the property for which the permit has been issued also has an active building permit for a structure that will be connected to the on-site sewage system, -5- (b) If the system is not installed before the permit expires, a new permit may be applied for, based on standards in effect at the date of the new application. Information as specified in 8.15.090 shall be submitted with any new application. (6) Repair permit. Repair permits shall expire ninety (90) days from the date of issue. Repair permits may be renewed for an additional ninety (90) days if the Health Officer determines it is warranted, (7) Any misrepresentation or inaccuracy in the construction plan or the permit application, whether intended or accidental, shall be considered as grounds for invalidating and voiding any permit issued under this section. The applicant is responsible for the accurate representation of all information presented. (8) For anyon-site sewage system proposed to serve a structure requiring a flood control zone permit under the provisions of chapter 86-16 RCW and chapter 508-60 WAC, or requiring a flood plain certification by Jefferson County under the provision of the Flood Damage Prevention Ordinance, the OSS installation permit shall not be issued until a flood control zone permit or flood plain certification has been issued in accordance with Jefferson County Ordinance 18-1120-95 or subsequent amendments. An OSS installation permit shall comply with the standards in said ordinance, (9) Recording of a Permit. The permit, conditions and Management/Monitoring contract, if required, shall be recorded on the title of the subject property under the following circumstances: (a) A waiver from State or Local Code is applied for and approved; or (b) Combination of lots is required to meet minimum land area requirements of WAC 246-272; or (c) A Management/Monitoring contract is required to meet the conditions of approval to meet a treatment standard, install a proprietary device or disinfection equipment. (10) On-site sewage disposal permits shall comply with regulations and policies established in the Jefferson County Comprehensive Plan, Jefferson County Zoning Code, Critical Areas Ordinance and any other duly adopted land use regulations of Jefferson County, the City of Port Townsend in the case of lands within the city, or the State of Washington. (11) Any pending and all future permits and approvals for the subject property shall be withheld when written notice of noncompliance with Jefferson County Codes has been provided to the applicant. Permits and applications shall be released only upon satisfactory remedy of the non-complying action or activity. (12) No on-site sewage system permit shall be issued for industrial, chemical or hazardous waste disposal. {13) It shall be the responsibility of the owner or owner's authorized representative to fill/cover the holes provided for evaluation of the soils for an installation permit or subdivision review within ten (10) days following notification that the inspection by the Health Officer is complete. The property owner shall be notified in writing when the inspection has been completed. (14) Any OSS not located entirely on the property originating the sewage must be secured by appropriate easements and/or notice to title recorded with the Jefferson County Auditors Office prior to final approval of the system installation. -6- (15) Pending on-site sewage disposal permit applications, (a) Applications for which no decision has been issued within twelve (12) months following the date of application, due to a lack of action by the applicant, shall expire by limitation. (b) The Health Officer may extend the time for action by the applicant for a period not to exceed 180 days upon written request by the applicant showing that circumstances beyond the control of the applicant have prevented action from being taken. No application shall be extended more than once. (c) In order to renew action on an application after expiration, the applicant shall resubmit the application and plans, pay current application fees and meet current rules and regulations, (d) The applicant shall be provided a 30-day notice by certified mail of the pending expiration of a permit application. (e) The statement "Voided - Lack of Action" shall be entered on the record for an expired pending permit application. (f) Plans and other data submitted for review shall thereafter be retained as per the Jefferson County Records Retention Schedule. 8.15,090 DESIGN (1) All on-site sewage disposal systems shall be designed in accordance with these rules, and the criteria in WAC 246-272-11501, by an on-site sewage system designer licensed or holding a practice permit issued by the Washington State Department of Licensing to perform design work pursuant to chapter 18.120 RCW or be a licensed engineer pursuant to RCW 18.43 RCW. (2) Permits shall be issued for wastewater meeting domestic waste strength criteria as defined in the "Design Manual: On-site wastewater Treatment and Disposal Systems," United States Environmental Protection Agency, EPA-625/1-80-012. Pretreatment shall be required for non-domestic/high strength waste streams. (3) The proposed drainfield lateral/bed shall be staked in the field for inspection and review. (4) Septic tanks shall have pumping access ports to ground surface over both compartments and at the outlet to facilitate inspection and maintenance. A homeowner may provide access ports to within 6" of the surface of the ground provided that a written agreement to uncover them for required 0 & M inspections has been recorded with the title to the property. (5) Distribution boxes shall be fitted with risers to grade. Distribution box risers shall be sized adequately to allow visible inspection of liquid level in the box, shall be constructed of durable materials and shall be equipped with secure, tightly fitted lids. 8.15,100 COMMUNITY ON-SITE SEWAGE DISPOSAL SYSTEMS (1) Community on-site sewage systems as defined in this chapter shall be designed in accordance with the maintenance criteria as set forth in the current Washington State Department of Health "Design Standards for Large On-Site Sewage Systems," 1996, or as they may be hereafter amended. (2) Management of community on-site sewage systems shall be by an entity approved by the Health Division, If the lots are individually owned the management shall in all cases be provided by a public entity. A homeowners association is not considered an approved entity for the management of a community on-site sewage system. -7- (3) All lots connected to a community system shall be equipped with a water meter or other approved method for monitoring flows into the system. (4) Sites proposing community systems shall conform to the minimum land area requirements of WAC 246-272. (5) All community on-site sewage systems shall provide an annual report to the Health Division including the following at a minimum: (a) Number of connections to the system and each connection's design flow. (b) Copies of inspection reports consisting of the items detailed in 8.15.150 (7) completed per TABLE 1. (c) Records identifying any maintenance completed on the system components. 8.15.110 INSPECTION (1) The Health Officer may make inspections during construction to determine compliance with these regulations. (2) Final inspection - conventional systems (a) After completion of the work, the installer shall notify the Health Officer of the completion and shall request an inspection. The system may not be covered for 48 hours (2 working days) unless a written notice is provided on the site that an inspection has been completed and the installation is approved by the Health Officer. (b) The Certified Installer shall submit an "as-built" drawing of final construction to the Jefferson County Department of Community Development within ten (10) days of the final inspection request. The Certified Installer shall provide a statement and signature certifying compliance with the approved design and WAC 246-272. (c) The Health Officer may waive the inspection requirement provided installation has been performed by a Certified Installer, AND proper notification of the Health Officer requesting inspection has been provided per (a) above, AND the Designer of the on-site sewage system performs an inspection, AND provided the Designer is not also named as installer of the system. (d) No part of anyon-site sewage system installation shall be put into use until final approval has been obtained from the Health Officer. (3) Final Inspection - Alternative Systems (a) The Designer shall be contacted by the Installer to complete all required inspections per the approved plan, (b) The Designer shall be responsible for all inspections during the construction of the OSS and, within ten (10) days of system completion, shall submit an "as- built" drawing detailing the results of the inspections of the completed system to the Jefferson County Department of Community Development, to the system owner and to the monitoring entity. (c) After completion of the system, when the system is fully functional and the as- built drawing has been submitted, the Designer shall contact the Health Officer to schedule an inspection of the ass. (4) Final approval of on-site systems by the Health Officer can be made only after satisfactory inspection of the installed system, receipt by the Jefferson County Department of Community Development of "as-built" drawings of the final construction, and compliance with conditions of the permit are met. (5) If installation or workmanship of the on-site sewage system does not meet the requirements of this code or conditions of the permit, the Health Officer shall order -8- corrections and cause a subsequent inspection to be made. Fees may be charged for subsequent inspE~ctions. (6) Designer Inspections, Nothing contained herein shall prohibit the Designer of record from requiring additional Designer-performed inspections to insure compliance with the design and regulations. (7) "As-built" Plans. (a) After installation of the sewage disposal system has been completed, a scaled and dimensional "as-built" plan of the sewage disposal system shall be prepared by the Designer or Installer of the system as specified in 8.15.110 (2) and (3) 011 forms provided or approved by the Health Division. (b) The "as-built' plan shall include: (i) Measurements to existing site features enabling the first tank manhole to be easily located, and a dimensioned reserve area (ii) For repaired or altered OSS, the new, repaired or altered components with their relationship to the existing system (iii) North direction indicated (iv) Location of all sewage system components (v) Stub outs (vi) Tightlines (vii) Pump and/or siphon chamber(s) (viii) D-box(s) (ix) Drainfield lines or bed and fill area(s) when applicable (x) Other treatment components -- sand filter, proprietary device, disinfection unit (xi) Driveway -- existing and/or proposed (xii) Building(s) size, shape and placement (xiii) Water line(s) (xiv) Location of utility and/or other easements (xv) Slope(s) -- direction and percent (xvi) Cuts, banks, terraces (xvii) Foundations (xviii) Property lines (xix) Surface waters, springs, wells (xx) Additional information as required for systems that are covered by Washington State Guidelines (xxi) Designer or Installer's signature and date of installation (xxii) Other pertinent information 8.15.120 SEWAGE SYSTEM INSTALLER (1) Certificate Required. It shall be unlawful for any person, firm or corporation to engage in construction, alteration, repair or modification of on-site sewage systems without first having been issued a Septic System Installer's Certificate by the Health Officer. (2) Requirements for Sewage System Installer shall include the following: (a) Application shall be made on forms provided by the Health Officer. (b) Certificate and/or application fees as set forth in the Fee Schedule shall be payable to the Health Division. (c) Written proof showing a minimum of one year experience under the direct supervision of a Certified Installer, Designer or Operation and Monitoring Specialist. Completion of classroom training specific to on-site sewage system -9- installation as approved by the Health Division may be substituted for up to six months of work experience. (d) Such certificate shall be issued only after the applicant has indicated a basic knowledge of the proper installation and function of a sewage system and knowledge of the provisions of this chapter and WAC 246-272 by successful completion of a Health Division examination. (3) Renewal of Certificate. Application is required annually for certificate renewal. All certificate renewal applications, along with the required bond, renewal fee, and verification of continuing education shall be submitted to the Health Officer no later than March 1. The Certificate shall not be issued or renewed if the applicant is found by the Health Officer to be out of compliance or in violation of the provisions of this chapter. (4) Lapse of certification for lack of bond, payment of fees or verification of continuing education shall require completion and passage of the Health Division examination and provision of items identified. (5) An Installer's Certificate is not transferable. (6) An Installer's Certificate grants authority to install anyon-site sewage system approved for use in the State of Washington, EXCEPT in the case of a proprietary device where a special authorization, in writing, is required by the manufacturer or patent holder. (7) Exception. A bona fide resident owner may install an on-site sewage system on his/her own property for his/her own use without obtaining an Installer's Certificate, PROVIDED: (a) that he/she complies with other terms of this chapter, AND (b) that he/she installs no more than one (1) system in anyone (1) calendar year, AND (c) the resident owner does not arrange for, nor contract, nor hire, with or without reimbursement, any person or concern to perform that work, unless that person is a Jefferson County Certified Sewage System Installer as set forth in this section, AND (d) the sewage system is located on the same lot as the residence or situated on adjoining property controlled by the owner and legally listed as an encumbrance, AND (e) prior to beginning installation the Health Officer AND the Designer are contacted to schedule required inspections. (8) Site Installer. A Certified Sewage System Installer may sponsor a site installer to be responsible for compliance with WAC 246-272-13501 (3). The Certified Installer shall inform the Health Officer of the site installer's name(s) and of any changes in employment status of sponsored site installers. Site installers must pass the Installer's exam and maintain their annual certificate. (9) Bond Required. Prior to the issuance of a Sewage System Installer's Certificate, the applicant must be in possession of a bond obtained in accordance with the Special or General Contractors Laws of the State of Washington and provide proof of business liability insurance in the minimum amount of five hundred thousand dollars ($500,000.00). EXCEPT, site installers working for or under the direction of a general contractor who is also a certified installer may have this requirement waived if the general contractor provides a written statement indicating their assumption of responsibility for the individual's work, and agreement to coverage of the individual by the general contractor's bond and liability insurance. -10- (10) Continuing Education, Each installer shall obtain a minimum of eight (8) hours of approved classroom training every two (2) years. Subject matter must be directly related to on-site sewage disposal and be acceptable to the Health Officer. Proof of training shall be submitted annually with application for renewal. (11) Suspension/Revocation. A sewage system Installers Certificate may be revoked or suspended as set forth in 8.15.180 if he/she has been found to be in noncompliance with provisions of this chapter or has performed with negligence, incompetence or misrepresentation. 8.15.130 SEPTIC TANK PUMPERS (1) Certificate Required, It shall be unlawful for any person, firm, or corporation to engage in the activity of cleaning any septic tank, pump chamber, chemical toilet, or removing other accumulations of sewage without first having obtained a Septic Tank Pumper's Certificate from the Health Officer. (2) Renewal of Certificate. Application is required annually for certificate renewal. All certificate renewal applications, along with the required bond, renewal fee, and verification of continuing education shall be submitted to the Health Officer no later than March 1. The Certificate shall not be issued or renewed if the applicant is found by the Health Officer to be out of compliance or in violation of the provisions of this chapter. (3) A Septic Tank Pumper's Certificate is not transferable. (4) Septage Disposal Site Approval. It shall be unlawful to dispose of septic tank pumpings or other accumulated sewage at other than designated and approved disposal sites. (5) Reporting Requirements. (a) Each pumper shall submit to the Health Officer not later than the tenth day of each month a report on a form provided by the Health Division. Said report shall contain the dates, sources, disposal site, and volume of each load of wastes handled from the preceding calendar month. (b) Each pumper shall complete an inspection report at each site where a septic tank or pump chamber is serviced. Inspection reports shall be submitted to the Health Division. Said report shall include at a minimum the fOllowing information: (i) Measured depth of scum and sludge in the septic tank and pump chamber if present. (ii) Condition of tank(s), baffles, risers, screens (iii) Record signs of backflow from drainfield (iv) Record signs of ground water infiltration into tank(s) (6) Pump Tank Requirements, Pumping equipment must be presented to the Health Division for inspection at the time of certificate application and renewal. (a) The pump tank must be of at least 1,000 gallons in capacity and must be in good repair and of cleanable construction. (b) All hoses and pumping equipment shall be kept in a clean and sanitary condition while stored or in transit. (c) All discharge valves shall be in good repair, free from leaks and be fitted with watertight caps. (d) The name of the operating firm shall be prominently displayed on the sides of the vehicle. (7) Bond Required. Prior to the issuance of a Septic Tank Pumper's Certificate, the applicant must post a bond with the Health Division in a form approved by the -11- Prosecuting Attorney of Jefferson County, and executed by a surety company authorized to do business in the State of Washington, in the sum of two thousand dollars ($2,000). (8) Suspension/Revocation. A Septic Tank Pumper's Certificate may be revoked or suspended as set forth in 8,15,180 if he/she has been found to be in noncompliance with the terms of this chapter or has performed with negligence, incompetence or misrepresentation, 8.15.140 OPERATION AND MONITORING SPECIALIST (1) Certificate required. It shall be unlawful for any person, firm or corporation to engage in any operation and maintenance/monitoring inspection required by the Health Division without first having been issued an Operation and Monitoring Specialist Certificate by the Health Officer EXCEPT as noted in 8,15.150 (6)(b). (2) A sewage system Operation and Monitoring Specialist Certificate shall not be transferable. (3) Requirements for Monitoring Specialist Certificate shall include all of the following: (a) Application shall be made on forms provided by the Health Officer. (b) Certificate and/or application fees as set forth in the Fee Schedule shall be payable to the Health Division. (c) Written proof showing a minimum of one-year experience under the direct supervision of a Certified Installer, Designer or Operation and Monitoring Specialist. Completion of classroom training specific to on-site sewage system operation and maintenance as approved by the Health Division may be substituted for up to six months work experience. (d) Written proof of completion of a minimum of sixteen (16) hours of training in on-site wastewater treatment, operation and maintenance at the Northwest On- site Wastewater Training Center or equivalent. (e) Take and pass a written examination to determine the applicant's knowledge of the operation and monitoring requirements for the on-site sewage systems approved by the Washington State Department of Health, excepting those proprietary devices requiring a special authorization from the system proprietor. (4) Scope of Practice. (a) The Operations and Monitoring Specialist may complete regular maintenance of an on-site sewage system including: (i) Measuring levels of sludge, scum and liquid in the system components; (ii) Visual evaluation of the condition of all system components; (iii) Inspect and report the condition of system components; monitoring ports and the surface above the drainfield/disposal area; or (iv) Record information from devices such as cycle counter or operating hour meters and water meters (b) The Operations and Monitoring Specialist may complete the following if authorized by the homeowner: (i) Clean pump screen or outlet baffle screen; (ii) Install and repair septic tank lids, risers and baffles; (iii) Replace pumps, float switches, and check valves intended to prevent the back flow of effluent into the pump chamber, within Washington State Labor and Industry requirements; or (iv) Make repairs to a septic tank or pump chamber to correct a condition of ground water intrusion or leakage. -12- (c) The Operations and Monitoring Specialist shall not: (i) Pump the septic tank and/or pump chamber, EXCEPT in the case where he/she also holds a valid Septic Tank Pumper's Certificate; {ii) Excavate an OSS's drainfield or any drainfield component, EXCEPT as stated in 8,15.140 (4)(b) above, OR in the case where he/she also holds a valid Installer's Certificate; (iii) Alter devices such as cycle counters or operating hour meters without the prior written approval of the Health Division; (iv) Alter or replace any portion of the subsurface disposal component or pretreatment components, EXCEPT in the case where Ile/she also holds a valid Installer's Certificate and a permit has been obtained for such work; or (v) Replace or alter devices that monitor or regulate the distribution of the effluent. (5) The Operations and Monitoring Specialist shall report failure of an on-site sewage system to the Health Division within 24 hours of first identifying the failure. (6) Inspection Reports shall be submitted by the Operations and Monitoring Specialist to the Health Division or other authorized agency within thirty (30) days following the inspection. (7) Only certified Operation and Monitoring Specialists that have also obtained written approval from either the manufacturer or patent holder may operate and maintain proprietary devicl9S governed by this chapter. (8) Continuing Education. Each Operations and Monitoring Specialist shall obtain a minimum of eight (8) hours of approved classroom training pertaining to on-site waste water treatment and disposal every two (2) years, Proof of training shall be submitted annually with application for renewal. (9) Bond Required. Prior to the issuance of an Operation and Monitoring Specialist Certificate, the applicant must be in possession of a bond obtained in accordance with the Special or General Contractors Laws of the State of Washington and provide proof of business liability insurance in the minimum amount of five hundred thousand dollars ($500,000,00). (10) Renewal of Certificate. Application is required annually for certificate renewal. All certificate renewal applications, along with the required bond, renewal fee, and verification of continuing education shall be submitted to the Health Officer by March 1. The certificate shall not be issued or renewed if the applicant is found by the Health Officer to be out of compliance or in violation of the provisions of this chapter. (11) Suspension/Revocation. An Operation and Monitoring Specialist's Certificate may be revoked or suspended as set forth in 8.15,180 if he/she has been found to be in noncompliance with the terms of this chapter or has performed with negligence, incompetence or misrepresentation. 8.15.150 OPERATION, MAINTENANCE AND MONITORING (1) Responsibility of Owner(s). The owner of every residence, business, or other place where persons congregate, reside or are employed that is served by an OSS, and each person with access to deposit materials in the OSS shall use, operate, and maintain the system to elimina.te the risk to the public associated with improperly treated sewage. Owners' duties are included, without limitation, in the following list: -13- (a) They shall comply with the conditions stated on the on-site sewage permit. (b) They shall employ an approved pumper to remove the septage from the tank(s) when the level of solids and scum indicates that removal is necessary. The septic tank shall be pumped when the total amount of solids equals or exceeds one-third (1/3) the volume of the tank. The pump and/or siphon chamber(s) shall be pumped when solids are observed. (c) They shall not use water in quantities that exceed the ass's designed capacity for treatment and disposal. (d) They shall not deposit solid, hazardous waste, or chemicals other than household cleaners in the ass, (e) They shall not deposit waste or other material that causes the effluent entering the drainfield to exceed the parameters of domestic/household waste strength. (f) They shall not build any structure in the ass area or reserve area without express, prior consent of the Health Officer. (g) They shall neither place nor remove fill over the ass or reserve area without express, prior consent of the Health Officer. (h) They shall not pave or place other impervious cover over the ass or reserve area. (i) They shall divert drains, such as footing or roof drains away from the area of the ass. a) They shall comply with inspection requirements in JCC 8.15.150. (k) They shall complete maintenance and repair of the ass as recommended by the monitoring entity. (I) They should not dispose of excess food waste via a garbage disposal. (m) They should not drive, park or store vehicles or equipment over the drainfield or reserve area, (n) They should not allow livestock access to the ass area or reserve area, (2) Breach of Owner's Responsibilities. An owner's or occupier's failure to fulfill any of the responsibilities in 8.15.150 (1) shall be a basis for a Notice of Violation and for the Health Officer to decline to issue approval for further development on the parcel. (3) Notice by the Health Officer. When legal and equitable title are divided between a lender and a borrower (or their successors), only the borrower or borrower's successor need sign applications under this regulation, but the Health Division shall give notice to both the borrower and any lender identified in the Auditor's record who has recorded a lien that has not been released, whenever this regulation requires the Health Officer to give the owner notice. (4) The Health Officer shall be responsible to make available written guidance on the proper maintenance and operation of the ass to the owner. Information shall be made available at the Health Division and the Jefferson County Department of Community Development locations and shall be mailed on a periodic basis to owners of ass by the Health Officer or his/her designated representative. (5) Inspection Requirements. (a) The owner shall ensure that the ass receives an inspection by an approved monitoring entity at the Jrequency identified in 8.15 Table 1, (b) Proprietary Devices and Disinfection Equipment. Existing and proposed systems that include a proprietary device or disinfection equipment in order to meet a treatment standard (or in which Chapter 246-272 WAC or a Washington State Department of Health Guideline requires ongoing operation and maintenance as a condition of approval) shall be inspected at the frequency established in said document. Said inspections shall be completed by personnel authorized by the manufacturer and certified by the Health Division. -14- (c) Multiple Requirements. If the manufacturer, patent holder, state, Health Division, and any other relevant body have differing recommendations or requirements for inspection and maintenance intervals for an ass or any component of the ass, then the owner shall follow the most frequent service interval. (6) Operations and Monitoring Agreement and Contracts. (a) The owner of a conventional ass shall be subject to a permit condition requiring compliance with the inspection schedule specified in Table 1 beginning with the earliest of the following events: (i) The installation of an ass. (ii) The repair of an ass. (iii) The alteration of an ass. (b) Owners of existing conventional systems shall obtain an initial inspection by the Health Division, Licensed Designer or licensed professional engineer and comply with the inspection schedule specified in TABLE 1 beginning with the earliest of the following events: (i) The sale of the property. (ii) The application for a building permit on the site. (iii) The use of an ass as a community ass. (iv) Identification thatan ass is in an Area of Special Concern as designated by the JCBOH. (v) Identification that a system has received a WaiverNariance from State or Local Code. (c) Owners of existing and new ass generating waste water of greater than residential strength, including food service establishments shall be inspected annually by an approved monitoring entity. (d) Owners of existing and new alternative systems shall enter into a contract with an agency or entity approved by the Health Division for Monitoring of the OSS, Inspection frequency shall be completed consistent with Table 1. (7) Operation and Monitoring Requirements. (a) On-site Sewage Systems in Jefferson County shall be inspected and maintained as set forth in TABLE 1 JCC 8.15 by an approved monitoring entity that meets the standards set forth in 8.15.140. (b) Access Required. The owner of the system shall provide access to the system for inspection and maintenance/monitoring as follows: (i) Septic tank. Septic tanks shall be fitted with a pumping access risers to the ground surface over both compartments and over the outlet baffle, EXCEPT, as set forth in 8.15,090 (4). The risers shall have a means to lock or secure the lid against tampering and accidental access. (ii) Pump Chamber. Pump chambers shall have a riser to ground surface over the pump. The riser shall have a means to lock or secure the lid against tampering and accidental access. (iii) Proprietary Devices and Disinfection Equipment. Access shall be provided as determined by the manufacturer or patent holder and shall include access to ground surface for effluent sample collection, observation and inspection of the unit. (c) Fees for inspections and contracts shall be set by the service provider. (8) Inspection Heport. The inspection report shall be submitted to the Health Division on Jefferson County Health and Human Services forms, The inspection report form shall be completed in full for an inspection to be considered valid. -15- 8.15,160 AREAS OF SPECIAL CONCERN (1) As specified in the WAC 246-272-21501. The local Health Officer may investigate and take appropriate action to minimize public health risk in formally designated areas such as the following: (a) Shellfish protection districts or shellfish growing areas; (b) Sole Source Aquifers designated by the U.S. Environmental Protection Agency; (c) Areas with a critical recharging effect on aquifers used for potable water as designated under Washington Growth Management Act, Chapter 36.70A.170 RCW; (d) Designated public water supply wellhead protection areas; (e) Up-gradient areas directly influencing water recreation facilities designated for swimming in natural waters with artificial boundaries within the waters as described by the Water Recreation Facilities Act, chapter 70.90 RCW; (f) Areas designated by the Department of Ecology as special protection areas under chapter 173-200-090 WAC, Water Quality Standards for Ground Waters of the State of Washington; (g) Wetland areas under production of crops for human consumption; (h) Frequently flooded areas delineated by the Federal Emergency Management Agency; and (i) Areas identified and delineated by the local board of health in consultation with the Health Division to address public health threat from on-site systems. (2) Areas of Special Concern may be designated following public notice and hearing by the Jefferson County Board of Health. 8.15.170 APPEAL/HEARING (1) A person aggrieved of a decision of the Health Officer may appeal. Appeals shall be submitted to the Health Division in writing within fifteen (15) days after receiving written notice of the decision of the Health Officer. (2) Notice of suspension and revocation hearings conducted pursuant to JCC 8.15.120, 8.15.130 and 8,15,140 shall be given by the Health Division to the aggrieved person by certified mail, return receipt requested, at least fifteen (15) days before the hearing is to be conducted. The notice shall inform the person of the purpose of the hearing, the date, time and place of the hearing and the substance of the violation. (3) All revocation hearings shall be conducted by the Board of Health. (4) The following guidelines apply to all hearings and appeals conducted by the Board of Health pursuant to this section: (a) Appeals shall be made in writing and shall be signed and dated by the petitioning party. (b) Appeals shall include a brief and concise statement of the law and facts, which affirmatively establish that the Health Officer has committed an error. (c) Appeals shall be transmitted to the Board of Health by the Health Division following receipt from the petitioning party together with all relevant material associated with the Health Officers action, including but not limited to, applications, reports, soil logs, photographs, staff analysis and recommendations. -16- (d) Upon receipt of the appeal materials transmitted by the Health Division, the Board of Health shall conduct a hearing to determine the correctness of the decision by the Health Officer within thirty-five (35) days. The petitioner shall be given seven (7) days' notice by certified mail of the purpose, time, date and place of said hearing, Further, if the petitioning party is a person other than the permit applicant or a permit holder, then notice of the purpose, time, date, and place of said hearing shall likewise be mailed by certified mail to the permit applicant or permit holder. (e) Any hearing conducted pursuant to this section shall be a public hearing and the chairperson of the Board of Health shall open the hearing and take testimony from any interested persons; provided, that testimony in suspension or evocation hearings shall be limited to that presented by the Health Officer, the certificate holder and any witness called by them; provided further, that the chairperson may limit the length of the testimony to a specific amount of time to be applied equally to those interested persons wishing to speak except in suspension or revocation hearings where the Board of Health is authorized to use its discretion. (f) The procedure to be utilized during any hearing conducted pursuant to this section shall be as follows: (i) The petitioning party, permit applicant, or permit holder and the Health Officer, if not the petitioning party, shall be given an opportunity to present evidence, analysis and recommendations. (ii) Members of the Board of Health may direct questions to the petitioning party, permit applicant or permit holder and Health Officer. (iii) The chairperson of the Board of Health shall permit the presentation of testimony by any interested person as set forth in this chapter. (iv) Following presentation of evidence and testimony, the chairperson of the Board of Health shall close the hearing and initiate discussion with other board members on the matters presented. (v) Following discussion, the Board of Health shall make ruling on the appeal. (vi) Under no circumstances shall cross-examination of persons making presentations at the hearing be permitted, notwithstanding that the Board of Health may ask questions as set forth above. (g) Should the Board of Health require additional testimony, it may continue the public hearing to a date and time not to exceed thirty-five (35) days following the date of the initial public hearing; PROVIDED that at the close of the second public hearing the Board of Health may continue its deliberations on the appeal to another time and date not to exceed thirty-five (35) days following the close of the second public hearing conducted to receive additional testimony. In all other cases the Board of Health may continue its deliberations on the appeal to another date and time not to exceed thirty-five (35) days following the close of the public hearing. (h) All relevant evidence is admissible, which in the opinion of the Board of Health is the best evidence reasonably obtainable having due regard for its necessity" availability and trustworthiness; provided that, in passing upon the admissibility of evidence the Jefferson County Board of Health may give consideration to, but shall not be bound to follow the rules of evidence governing civil proceedings in matters not involving trial by jury in the Superior Court of the State of Washington. (i) A full and complete record shall be kept of all proceedings and all testimony shall be recorded. The record of testimony and exhibits together with all papers and requests filed in the proceedings shall constitute the exclusive record for the decision in accordance with the law. -17- U) All decisions shall become a part of the record and shall include a statement of Findings and Conclusions, as well as reasons or basis thereof upon all the material issues of fact, law or discretion presented on the record. (k) Notice of the decision of the Board of Health shall be provided not later than ten (10) days following the date of its decision, (I) The petitioning party, permit applicant, permit holder, or designated agent, and the Health Division shall be notified of the decision of the Board of Health, together with the Findings and Conclusions and the basis therefore by certified mail. 8.15.180 ENFORCEMENT/PENAL TY (1) Civil Penalties, In addition to or as an alternative to any other judicial or administrative remedy provided herein, or by law, any person or establishment who violates this regulation or by each act of commission or omission procures, aids or abets such violation, may be assessed a civil penalty not to exceed fifty dollars ($50.00) for each day of continuous violation to be directly assessed by the Health Officer until such violation is corrected. The per day penalty shall double for the second separate violation and triple for the third and subsequent separate violations of the same regulation within any five (5) year period. (2) Criminal Penalties. Any person who violates any provision herein shall, upon conviction, be guilty of a misdemeanor and subject to a fine of not more than one thousand dollars ($1,000), or by imprisonment for not more than ninety (90) days, or both such fine and imprisonment. Each day any person shall continue to violate or fails to comply with the provisions of this chapter shall constitute a separate offense. (3) Administrative - Certificate Holders. (a) Suspension of Certificate. (i) The Health Officer may suspend any certificate upon making the determination, after a hearing between the Health Officer and the certificate holder, that the holder has performed with negligence, incompetence, misrepresentation or failure to comply with the applicable rules, regulations, guidelines, policies or practices which pertain to water supply and waste water disposal, to have made fraudulent misrepresentation in making application for a certificate or to have made fraudulent misrepresentation in making application for a permit to install an on-site sewage system, either existing at the time of certification or as thereafter enacted. (ii) The Health Officer shall give written notice of the hearing to any person aggrieved who has filed a written complaint with the Health Officer and the affected certificate holder( s). (iii) For the first confirmed violation under this subsection, the suspension period shall not exceed thirty (30) days; and the second violation in any three (3) year period shall result in a suspension of the certificate for a period not less than fifteen (15) days and not to exceed one hundred eighty (180) days. (iv) If the Health Officer suspends a certificate, the certificate holder shall not proceed with any further work in connection with the activity covered by the certificate. (v) The certificate holder shall be notified by certified mail of suspension of the certificate upon determination of a finding that a violation has occurred requiring suspension. (b) Revocation of Certificate. (i) A certificate may be revoked for repeated violation of any of the requirements of these regulations or any other applicable regulation or if, -18- after a hearing with the Board of Health, the holder of such certificate shall be found grossly incompetent or negligent, or to have made fraudulent misrepresentations in making application for a certificate or for a permit to install an on-site sewage system, or should the bond or insurance required herein be cancelled, (ii) The Health Officer shall give written notice of the hearing to any person aggrieved who has filed a written complaint with the Health Officer and the affected certificate holder(s). (iii) The third Notice of Violation issued by the Health Division staff within any twelve (12) month period shall be considered as repeated violations and result in certificate revocation, (iv) If the Board of Health revokes a certificate, the certificate holder shall not proceed with any further work in connection with the activity covered by the certificate. (v) The certificate holder shall be notified by certified mail of revocation of the certificate, upon determination of a finding that a violation has occurred requiring revocation. (vi) If, after revocation of a certificate, the applicant desires to reapply for a certificate, the applicant must wait six (6) months prior to reapplication, Any person whose certificate has been revoked will be required to pay all applicable fees and take and pass the written examination again before issuance of a new certificate. (c) Reinstatement of Suspended or Revoked Certificate. (i) The certificate holder shall make written application for reinstatement to the Environmental Health Director specifying what practices, performance, and conditions that were named as grounds for suspension or revocation have been remedied; and the certificate holder will provide a description of the changes in performance that will occur which will directly avoid the repetition of past violations. (ii) The Environmental Health Director, upon determining that noted deficiencies have been satisfactorily addressed, shall schedule the individual for participation in the next available examination where applicable. Reissuance of the certificate is subject to the individual's successful completion of the application and testing procedure and payment of testing and certification fees as per the Fee Ordinance. (iii) Probation, A period of probation consisting of additional reporting or inspection requirements may be imposed on a certificate holder as a result of violations of these rules or as a condition of operation following suspension/revocation of a certificate. Said period and requirements shall be the decision of the Health Officer and shall be determined after an administrative hearing with the certificate holder. (iv) Appeal. Any person feeling aggrieved because of the suspension or denial of a certificate by the Health Officer may, within fifteen (15) days of the suspension or denial, appeal to the Board of Health as set forth in JCC 8.15.170. (4) Administrative - Property Owners (a) Notice to Title. If the Health Officer finds than an owner has failed to comply with the requirements of this regulation, AND all administrative remedies have been exhausted, AND the case has been forwarded to the Jefferson County Prosecuting Attorney for further action, the Health Officer may record a Notice of Potential Uncorrected Violation finding on the title of the property with the Jefferson County Auditor. (b) Removal of Notice. The owner shall make written request to the Health Officer for recision of the Notice to Title. The request shall specify corrective actions that have been completed. -19- (c) The Health Officer, upon determining that noticed violation has been corrected, shall record a Recision of Notice with the Jefferson County Auditor. (d) The owner shall pay fees as required to complete inspection(s) to verify correction and to record the Recision prepared by the Health Division. 8.15,190 SEVERABILITY Provisions of these rules and regulations are hereby declared to be separable, and if any section, subsection, sentence, clause, phrase, or portion of these rules and regulations is for any reason held to be invalid or unconstitutional by the decision of any court of competent jurisdiction, such decision shall not affect the validity of the remaining portions of these rules and regulations. 8.15.200 FEES (1) Fees shall be as per Jefferson County Health and Human Services Department Fee Schedule, (2) Refunds shall not be granted if field investigation, plan review, site visit or design review has been completed by the Health Division. (3) A refund of the application fee minus an administrative fee of forty-five dollars ($45.00) shall be granted upon written request of the applicant/owner, EXCEPT as noted in (2) above. (4) All Sewage System Installer's, Septic Tank Pumper's, Sewage System Designer's and Operation and Monitoring Specialist Certificates are renewable annually on March 1. Should any renewal fee remain unpaid by March 31, a penalty fee according to the Fee Schedule shall be charged. Previously issued certificates shall become void if not renewed prior to April 1. 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VJ c::I'P CI) ~ ~ ~ cd (/) o......~ I=l Z'~~~2 8t~bD~ ~ ~ M tn t> UEl.'3~"'" ~ lI.l'~ ::1 ll) B3t)~or; z ~ 8 .13 ] :;c::I~~~ ....1 '" 0 ~ ~ ...::] 80.g ~ ~ [;J b U 08"'Z& ~llJ~~d P:: t; .s :>- .~ o ~ "Z '" p..,>.Elot: ~ "';::: U * 0:: ....: ....: * * '" '" ..<:: ~ .;;; I'i .S '5 ~ t; Q '" ;S ~ .... o '" -::; "0 '" .0 ~ '" :s .... '" p.. i:i '" .... .... " U P- '" .>< '" '" '" .0 " '" '" > " ..<:: '" '" .g U '" p.. .S ~ >. -a o "0 '" .... .; cr< '" .... '" '" .... " '" '" '" .... p.., .... <8 '" '" ~ '" "t:l '::; CJ '" ';;j en '" {3 '" .~ U '" p.. .s '" '" '" """ o S f,:: Human Services October 2, 2000 David Alvarez Deputy Prosecutor P.O. Box 1220 Port Townsend, Washington 98368 Re: Linda Sexton Dear David, In follow up to our conversation last week I am sending this letter in order to clear up the misunderstanding that has apparently occurred between our departments with respect to the un permitted solid waste operation conducted by Linda Sexton. I have attached for your consideration a summary ofthe enforcement activities that have taken place over the years. You should have more detailed information in your files. As you can see, Ms. Sexton has been advised numerous times that she is in violation of state and local solid waste regulations. Ms. Sexton advertises that she will provide free collection of garage sale left overs, spring-cleaning discards and scrap lumber. These materials are transported to her property off Beaver Valley Road. Ms. Sexton has said that these "goods" have value and she collects them for future use/recycling. In fact the materials are accumulated outdoors, exposed to the weather and are slowly rotting away. This office determined that irrespective of whether Ms. Sexton recycles or disposes of the waste on her properties, she is subject to solid waste permitting requirements. She was notified in 1997 and she subsequently appealed the department's action to the Board of Health. An appeal hearing was held on 5/28/97. The Board found in favor ofthe Department; ordering Ms. Sexton to comply with the solid waste regulations. She was given the option of discontinuing her practice and commencing to cleaning up the property or applying for a permit and operating in compliance with the solid waste regulations. In either event she was ordered to stop collecting solid waste until she prepared a compliance plan. To date Ms. Sexton continues her practice of collecting garage sale and other leftovers as evidenced by her weekly advertisement in the Port Townsend Leader. She has taken no steps to either obtain a permit or to begin remedial action on either of her properties. HEALTH DEPARTMENT 360/385-9400 ENVIRONMENTAL HEALTH 360/385-9444 DEVELOPMENTAL DISABILITIES 360/385-9400 ALCOHOL/DRUG ABUSE 360/385-9400 FAX 360/385-9401 The Board of Health has expressed frustration at the disregard of their order and the apparent inability to enforce it. I know that we have had some discussions about possible actions that could be used to enforce solid waste regulations including issuing civil infractions. This may have caused confusion regarding what action we wanted to see with respect to Linda Sexton. I would suggest that the time for tickets is past. Ms. Sexton has been notified. She has requested and received a hearing. She has failed to respond to the Board's order. The Board would like their order enforced. RCW 43.70.190 provides the following: RCW 43.70.190 Violations -- Injunctions and legal proceedings authorized. The secretary of health or local health officer may bring an action to enjoin a violation or the threatened violation of any of the provisions of the public health laws of this state or any rules or regulation made by the state board of health or the department of health pursuant to said laws, or may bring any legal proceeding authorized by law, including but not limited to the special proceedings authorized in Title 7 RCW, in the superior court in the county in which such violation occurs or is about to occur, or in the superior court of Thurston county. Upon the filing of any action, the court may, upon a showing of an immediate and serious danger to residents constituting an emergency, issue a temporary injunctive order ex parte. 43.70.190 would appear to be the tool necessary to seek injunctive relief. I believe this is the direction the Board wishes to go. I look forward to further discussing this matter with you and please do not hesitate to let us know what assistance we may need to provide. ~in rely ()..... ,--.. CS a rence D~ Fay Jr. ~1 Environmental Health Director cc. Juelie Dalzell, Prosecutor Jefferson County Board of Health TLird times a charm here it all is in one spot.... TEN _\ND ONE HALF YEARS OF EFFORT BY THIS DEPARTMENT 10/15/86 Jeanne Chao, Sanitarian, made a site visit to the property near the intersection of Center Valley Rd and Beaver Valley Road. Linda Sexton was present for the site inspection and Jeanne recommended that Ms. Sexton make regular and frequent trips to the Jefferson County Landfill. Linda Sexton said she would clean up the property within two weeks. 08/05/87 Rick Miklich, Environmental Health Director, notified Linda Sexton by letter that the clutter and trash surrounding the premises could b.e creating habitat for rodent infestation. Linda Sexton was asked to contact the health department to set up a schedule to correct the problem. 09/13/89 Linda Atkins, Sanitarian, notified Ms. Sexton that due to her lack of cooperation, the case was being turned over to the Prosecuting Attorney for further legal action. 03/02/90 Linda Atkins, Sanitarian, mailed certified letter to Linda Sexton, notifying her that WAC 248-50-120 states waste shall not be disposed of upon the surface of the ground where it may become a nuisance or menace to health through breeding. of flies, harboring of rodents or pollution of the water. Ms. Sexton was asked to contact the health department to set a schedule to correct the problem. 3/11/96 Ms Sexton was notified by the Jefferson County Building Department to contact Randal Marx of the Health Department regarding garbage and refuse. 11/5/96 A letter was sent to Ms Sexton from the Health Department informing her that the property remains in violation of WAC 173-304, Solid Waste Handling Regulations, and that the matter has been referred to the Prosecutors Office. 1/22/97 A letter was sent to Ms Sexton from Randal Marx of the Health Department, stating that she is in violation of WAC 173-304-100. Ms Sexton was notified that because she collects discarded commodities throughout the county and stores them in piles, s'.1e is subject to WAC 173-304. Ms Sexton was notified that since she has not recycled at least fifty percent of her inventory in the last three years, her business is not considered a recycling facility (WAC 173-304-300,3,c,i). 2/11/97 A letter was sent to Ms Sexton from Randal Marx of the Health Department giving her 30 days to either begin the solid waste facility permitting process or submit a closure plan for Health Department review. 2/28/97 Written appeal to the Health DepartmentDs decision was received from Ms Sexton. The appeal was placed on the Board of Health agenda for, May 28, 1997, at the request ofMs Sexton. 5/28/97 Board of Health meeting a hearing was held on whether Ms.Sexton (1) would be required to make application for a. solid waste facility permit or , (2) initiate a plan for cleanup of her properties that are in violation of solid waste regulations. The appeal of Ms Sexton was denied. The Board of Health directed the Health Officer to work with Ms Sexton and her Attorney on a compliance schedule and required that Ms Sexton stop collecting new materials until an agreement could be reached. Larry Fay From: Sent: To: Subject: Juelie Dalzell Monday, October 02,200010:58 AM Larry Fay; David Alvarez RE: Linda Sexton I would really prefer we go gross misdemeanor with this. an injunction will only lead to criminal court anyway. Let's get there first. Larry, go to the site, obviously not on her property and write a report about what you see. List the ordinance and RCW's she has violated and take photos. I noticed that there was a neighbor putting a roof on his house. One of the roofers or preferably the owner could take pictures from there into Sexton's yard. I will prosecute in district court if you give me a report with probable cause. Thanks Juelie -----Original Message----- From: Larry Fay Sent: Monday, October 02, 20009:39 AM To: David Alvarez; Juelie Dalzell Subject: Linda Sexton Juelie and David, On behalf of the Board of Health I am sending this letter and attachment regarding Linda Sexton. A hard copy will follow. We can get new photos of Linda's Chimacum property. I don't know about the Beaver Valley site. I doubt that she will let us on. We could easily get pictures from the air if anyone know a friendly pilot. We have pulled recent ads from the Leader. Let us know what else you need or hat we can do to help. Thanks, Larry << File: Linda Sexton.doc>> <<File: 10YEAR HISTORY.doc >> Larry 1 Larry Fay From: Sent: To: Cc: Subject: Juelie Dalzell Monday, October 02,200012:19 PM Larry Fay David Alvarez RE: Linda Sexton Larry, it is possible to do it civilly with an injunction but she will not obey the injunction. Then the next step is contempt of court, she doesn't do jail if she says she will clean up. She will say she will clean up and won't then we are back at contempt again as a criminal sanction with a maximum seven day penalty. She could do seven days in the county jail standing on her head. And the place is still not cleaned up. I can understand how you want the authority of the health officer supported but will injunctive relief really help? Juelie -----Original Message-m- From: Larry Fay Sent: Monday, October 02, 2000 12:02 PM To: Juelie Dalzell Subject: RE: Linda Sexton Juelie, Thanks for your quick reply. We can prepare an updated report to you and start down this pathway. It is however, fundamentally different than the direction we were headed (operating a facilty without a permit) and would seem to minmimize the authority of the BOH and Health Officer to order corrective action. Is there a way that this can be presented as a continuation of the ongoing enforcement efforts rather than a new action? Politically, I would like to see the gross misdemeanor connected to the failure to comply with the legitatmate order of the Health Officer and the Board. I don't know that the statutes support this. They do support injunctive relief. I don't mean to seem argumentative, but it is a little sensitive. And by the way, we can charge prosecutorial time to the solid waste enforcement grant so it may be worthwhile to track the hours and costs spent on this, Larry 1 JEFFERSON COUNTY BOARD OF HEALTH For October 19, 2000 Board of Health Agenda 1. Description: Washington Restaurant Association Food Worker Card Program 2. Issue: Through an agreement with local Health Jurisdictions, qualified individuals are authorized to conduct food worker safety classes and proctor food worker card exams. Food trainers under this program are certified by the Washington Restaurant Association under protocols agreed upon with the local jurisdiction. At a minimum, these include two years experience, completion of the "Servsafe" training program and possession of a valid food worker card. 3. Opportunity Analysis: Until 2000, food worker cards were handled on a drop-in basis in Jefferson County. Applicants for food worker cards were encouraged to read the food safety manual prepared by DOH, however, obtaining a passing score on the food worker card exam was the only prerequisite for receiving a card. Beginning in January 2000, new state food safety regulations require participation in a food safety class before sitting for the exam. As a result, Jefferson County now conducts classes a minimum of 5 times per month. Most classes are held at the Health & Human Services office, and other classes are held regularly in the county and occasionally at specific establishments or institutions. The primary benefits of the classes have been the opportunity for question and answer exchanges before the exam and a personal exposure and familiarity with food staff and new permit holders. Pass rates have generally been higher than with the old system. It is too early to tell if required classes have resulted in improved performance in the establishments. There are two main downsides. Staff time involved in administering the exam (scheduling, tracking, etc.), as well as the actual time spent preparing and scheduling the exams, has placed additional demands on an already stretched system. We have estimated that the cost associated with food handler cards is approximately $10 to $11 per card. Fees for cards are statutorily limited to $8. In addition to workload issues, the availability of class space may be limiting access to some workers. The Washington Restaurant Association, anticipating that some departments would have difficulty conducting classes, has developed a program to certify qualified restauranteurs to conduct training classes and proctor exams. The exams are forwarded to the association for scoring. The association prepares food worker cards for those passing the exam and sends them to the trainer for distribution. The association regularly sends updated lists of new card holders to the Health Department. Program quality control is addressed through appropriate agreements between the association and the department. At this time there is probably little direct benefit to the Department in entering into an agreement, as it is unlikely that certified trainers will reach a large enough portion of the prospective food workers to significantly reduce departmental workload. However, in principle, providing access to additional training opportunities should benefit the workers and will certainly benefit establishments conducting training in-house as a matter of convenience. The primary concern is assuring that all training classes are equivalent. 4. Specific Departmental Recommendations: Staff recommends the Board authorize the Department to pursue an agreement with the Washington Restaurant Association. Staff also recommends that specific issues around qualifications, requirements and limitations to the third-party food worker training program be addressed in a separate policy statement submitted for Board approval. 5. Attachments: Washington Restaurant Association hand out. AI _l}~~~.;.:."':".~,,,,,.. -~~1r~~;.:;"." . HEALTH DEPARTMENT / WRA PARTNERSHIP FOOD WORKER CARD PROGRAM I j : contact persons at WRA: Kit Hawkins,kithawkins@aol.com (206) 632-1221 fax (206) 632-1233 Clo Foote for operational details clo@wrahome.com 800-225-7166 5/3/00 1 :,::;~~" ;'i.~:<:i:;;u~~t~~ ~-~~,ZIr~~~~';~,~......:.;,~::.'_,.... ~.~.'.. _~C-:"'. The Opportunity · Create "win-win" partnership with health districts, because · We have the same objective...public confidence in food safety, but · Limited resources challenge food worker card administration in many counties 5/3/00 2 ;,"2t>:,~7;~~;1~-_.__myt . '.~,:,.l;~~'?:~i~ l\!1!"~6~_~'_, .:..~~X~ .u::2~~:;a;~~'],_;,:; .:;:. ~~~&..~~s:.,.., . Health District Requirements , j 'I .~ J c 5/3/00 ....."..;;,);._~ · H D controls process · HD cost drivers eliminated, and · HD staff freed · HD can rely on WRA track record 3 ; ..... .... .'~/':~~W~L -- F ~j,;J~~~;~~~..:_~..~.. la.lK.l?jI,t~:;;I~i;:~': ~:-- '.~ What WRA Does We do all of the "heavy lifting" for... Food worker card training (video) Certify trainers 'j j l ':! The exam Issue FW cards Update HD database 5/3/00 4 ;:j~'~~ ,~~~"'i;tr.;;.;,' ", :' "':~'I~':r;:\r~r: ~~w-~:r:';~~~;,:~~~-.'T~~~-~:'.~-':':: . 1~~i!~i5{::'..:;'; ~.~ :~, The video Content developed by DOH, WRA j ~ Available in Spanish, Vietnamese, Cantonese, Mandarin, Russian, Korean Produced by Studio 207 5/3/00 5 ,.,..~.~.'.;;'}kl~!h~~)~9!o{'\~ ........;i";r~1.~ .", - _u_.~,...,~~c;:~.:'":': --~ref~~V:~~~~'::":~ Certify the Trainers WRA certifies trainers by... Servsafe Two years experience Current food worker card 5/3/00 6 .(, .:,."t,\:;l,,"i,;';~i~->-'~- :':',.'V';,:i&.~_f~ ~~ -~,~!f:',;"[,~",...".' .-:'.''-'__- .....n - --rt'J9J;S'l~.; WHAT THE TRAINER DOES: Shows video + custom instruction and Q and A Administers test I 1 : ! ; Collects $8.00 Completes processing form Mails answer sheet, form and money to WRA office 5/3/00 Distributes cards upon receipt from WRA and keeps copies for inspector 9 ',";;Gi~;..ii~~-'~- ......ik;4\:~~~ ,-... "''i.~;';i.>,Z,_.__. ,. _ ~~:~y:..::..-,.:.. The Exam Given at the qualified restaurant or entity, using Video Custom training ! ~ Notes tied to video Q and A .~ j Trainer is test proctor . Trainer sends answer sheets to WRA for grading 5/3/00 7 ~,:~tiiim ~ .,": ~:-~. " ,\:;i;€IrJ1.~1 -~:~~~~:~~~~~.~'._. .. _~~~.'t'l!:~:<:-:i Issue the FW Card WRA office: Grades exam and certifies pass or fail \ i ; I , , . .< ! Notifies trainer of test results Mails FW cards back to trainer Remits 50 cents to HD at end of month 5/3/00 8 ..:.";:t~i~-- ,:.::,:,,,~~ ~_ -~;l~~:~~k::~.:'~~.'~~" .....~:... - ~~~!.7.~f'::;"":':,~: Uploading to HD Database i _ l WRA updates HD Access 2000 database with cards issued, at the end of the month , i J \ I ; WRA issues check to H D at the end of the month Includes expiration flag for trainers . 5/3/00 12 :.~.~, ~;~:~,'i';,,:~(,:;~i~L~;~~~r;?,~'--' .. ;-;,;~.:~~~~ ~~S;n"":~~~."",,",,_,~,~ . t'~.."~~~:::";.::~. What Health Department Does: Retains control Signs contract with WRA j , 1 Establishes Access 2000 01 j database Notifies WRA if H D disqualifies trainer 5/3/00 10 o:;::~~~1i~if~'- ':l~:.->>:0:i:z~~~~~itrm ~ti~r:2fZb':;~.:~~.~'~.~_~,.. .. d'~~ ~~~r~:'~,~.:':.". Why this a good deal ($$) Staff no longer involved in time/travel for testing, card . Issuance I ! ! . I . i , Phase out facilities devoted to testing and card administration 5/3/00 13 :'..:\'.~,:,::,',)~~~~ .;~i}'i~~;~:jx~t~ ri -~~'~4i7':~:F:':)~:~,,""'.-,..,. "'-'t1fIt:ff!!~7'7':tf..:7"""" Why this is a good deal for workers Easy to re-test if necessary , j " I Languages 5/3/00 14 ..:;:.Z::~~~~ ; -;~-;'t~{;;~~ --:.-,:w.<;Jl'!:'r~:~__:':_.~',..~l._...~~~.' ~_'..~;_... 00. . .---:.~~~~~s~.~,!~ '7?' ,",; References for WRA performance and conduct State Health Dept: Janet Anderberg (425) 745-5028 King County Health Dept: Morgan Barry (206) 296- 4328 Washington State Liquor Control Board (history with alcohol server training permits): Deb Glidden (360) 664-1727 5/3/00 15 t,O:;<~-~~~"!];1~~:'~~~~~~~ .,h"Z::~i~ Washington State Department of Health Proposalsfor 2001 Agency Request Legislation The Department of Health has submitted nine proposals to the Office of Financial Management (OFM) for approval as agency request bills. The agency's Senior Management Team reviewed the proposals, which they had tentatively approved in June, and agreed to submit them to OFM. If approved by OFM, the proposals will be introduced as agency request legislation in the 2001 legislative session, which begins in January. The nine proposed bills are: Continuing Competency for Health Care Professionals: Disciplinary authorities for some health professions want to require self-assessments and learning plans as part of a continuing competency program. The current requirement that the Department disclose such information raises the concern that the self-assessment will be used to create liability for the health professional. This proposal would exempt those continuing competency documents from public disclosure and discovery to allow full and candid completion of the documents. Department of Health Funding Authority: This proposal would give the Department the authority actively to seek financial support for its activities from foundations, businesses and other private entities. Under current law, the Department may accept money from private entities, but may not take steps to solicit such funding or pursue "public/private partnership" strategies in important areas like women's health and immunizations. Drinking Water Program Financing and Scope of Regulation: This proposal would reshape regulation of water systems with five or fewer connections. It would require approval of those systems when constructed, but would reduce ongoing oversight of operations by the Department and local health departments. This proposed legislation would also dedicate 15 percent of the public utility excise tax paid by water distribution businesses to the funding of the drinking water program. Drinking Water Program State Revolving Fund Interest: The proposed legislation would create an account for the federally funded Drinking Water State Revolving Fund which would retain the interest generated by the funds, as required by federal law. Health Professions Account Interest: This proposal would allocate the interest generated by the Health Professions account back into that account. The additional funds would be used instead of fee increases for licenses and other credentials for the ongoing regulation of health care professionals. Immunizations - Access and Funding: This proposal would codify Washington's program of universal access and distribution of childhood vaccines. It will include a budget request to support universal access to a new federally approved vaccine, pediatric pneumococcal vaccine. July 2000 Pro Tem Members of Boards and Commissions: The proposal would amend the Uniform Disciplinary Act for health care professionals to increase the number of pro tem, or temporary, members that a licensing board or commission can appoint to participate in board or commission disciplinary proceedings. {"-' Regulating Drugs Used to Make Methamphetamine: This proposed legislation would amend the current drug laws to tighten the regulation of and access to ephedrine, pseudoephedrine, and polypropanolamine. Those three substances are used to manufacture methamphetamine, an illegal drug that has become a major law enforcement, environmental and substance abuse problem. Water Recreation and Bathing Beaches: The proposed bill would authorize the creation of local bathing beach programs to monitor and protect water quality and other aspects of public beaches. The Department of Health would provide technical assistance and develop a model program for local adoption. It would also repeal statutory language that provides for Department review and permitting of swimming pools, spas and other water recreation facilities statewide. {' ~t- ..., 2 July 2000 OPTIONS FOR 20/0 BUDGET REDUCTIONS IN 2001-2003 BIENNIUM September 2000 BACKGROUND State agencies have been directed to propose a two-percent reduction in state general fund budgets for the next biennium, which begins July 1, 2001. For the Department of Health, this equals $2,660,000. The department has identified program areas to consider for reduction, which are described below. Some options would reduce a program area. In these cases a percent reduction is shown. Percentage reduction is not shown in cases where a program area would be eliminated. - Please keep in mind that these are options for consideration in developing the Governor's budget. The Governor and the Office of Financial Management may include some of them and not include others in the executive budget proposal for the next biennium. This is the first step in a long process that will last through the next legislative session. TOTAL ADMINISTRATIVE REDUCTIONS: ($896,000) Agency & Division Administrative Reductions Related to Programs: ($288,000) This option represents the administrative reductions related to each program reduction. It is based on how the department calculates overhead charges. Community and Family Health Efficiency Reduction: ($250,000) This reduction will be accomplished by changing practices for purchasing supplies and software, and staging the purchase of health education materials and equipment, and putting other E!fficiency measures in place. CDC Consulting Medical Epidemiologist Contract: ($150,000) This option would eliminate the department's current contract with the federal Centers for Disease Control and Prevention for the consulting services of a Medical Epidemiologist. When this contract was developed, Maternal and Child Health (MCH) had inadequate assessment capacity and epidemiology support. MCH now has assessment and epidemiology staff to meet program needs. Environmental Health Policy: ($72,000) This option would eliminate funding for a part-time policy position in the Environmental Health Programs Division. 1 .... Sunrise Review Publiccltions: ($16,000) DOH produces several documents related to the health professions and mandated benefits sunrise reviews. By increasing use of the web site and recently purchased, in- house copiers that are more efficient, reductions can be made to publication expenditures. r 11 \:. State Board of Health: ($20,000) This reduction will be accomplished by putting efficiency measures in place for mailings, publications, office space, and purchasing supplies and equipment. Teen Pregnancy Prevention: ($100,000) The department funds ten projects that focus on reducing pregnancy among teens. The department sets aside additional funds to assist the projects with such items as public education materials, new project activities, and other non-permanent needs. This reduction would reduce funding available for contracts and for the -purchasing and printing of teen pregnancy prevention materials. It represents a reduction of less than 4 percent of the state funds for the program. TOTAL INTERNAL PROGRAM REDUCTION OPTIONS: ($567,OOO) Drinking Water Laboratory Testing: ($255,000) DOH currently operates a program that certifies drinking water testing laboratories. DOH is required to maintain its own drinking water laboratory capability to support the certification program. This option would merge the DOH certification program with an environmental laboratory certification program operated by the Department of Ecology. Ecology would also assume responsibility for the necessary drinking water laboratory testing capability, which DOH would no longer need to maintain. This option would eliminate DOH capability to perform drinking water testing. Testing in support of local health agencies or DOH programs would need to be obtained through private sector laboratories. r- \. Rural Health Data Book: ($32,000) DOH produces a Rural Health Data Book every two years, which contains data on health status and systems. This option would eliminate the data book. Shellfish Database: ($60,000) The DOH Shellfish Program is developing an integrated database for water quality and other program elements, including biotoxins and licensing of commercial shellfish growers. The water quality portion of the database has been completed. This option, which represents a 50% reduction in state funds, would extend development of the remaining portions of the database over a longer period than originally planned. 2 Toxicologist Support: ($66,000) DOH provides toxicology, health education and epidemiology technical assistance to local health jurisdictions and other federal, state and local agencies regarding potential human health effects associated with people's exposure to environmental contaminants. This proposal would reduce the level of technical assistance, and represents a 32% reduction in state funds for this program. Trauma Registry Data Collection: ($138,000) DOH requires trauma registry data to be collected by pre-hospital providers. DOH provides technical assistance to providers in the collection of this data. This option would remove the data collection requirement, and thereby eliminate the need for technical assistance provided by the department. CASA HIV Home Care Program: ($16,000) HIV Client Services administers a small Medicaid waiver program that provides home care services to persons with AIDS who would otherwise be in the hospital. No clients are currently receiving services from the program because programs administered by DSHS now adequately meet AIDS home care needs. This reduction would eliminate this program. TOTAL EXTERNAL PASS THROUGH AND CONTRACT REDUCTION OPTIONS: ($1,197,000) Acute Care And Rehabilitation Personnel Training: ($160,000) Funding is now provided to 8 regional EMS and Trauma Care Councils for training for acute care and rehabilitation personnel in hospital facilities. This training assists providers to meet certain regulatory requirements. This proposal would eliminate the training funds for this program. Children's Hospital and Regional Medical Center Contract : ($120,000) DOH has a contract with Children's Hospital and Regional Medical Center under which ChJldren's provides assessment, quality assurance, inclusion of families in decision- making, and other services for families and providers related to Children with Special Health Care Needs (CSHCN) and chronic health conditions. This proposal represents a reduction of 8% of the contract. Family Planning Funding: ($250,000) The family planning program contracts with agencies to provide reproductive health services to women and men. Services include breast and cervical cancer screening, STD diagnosis, treatment and education, contraceptive services, supplies and education. This proposal represents reduction of 2.6% of the state funds for the program. (DOH anticipates that a federal Medicaid waiver will offset the effects of this proposal.) 3 HIV/AIDS Omnibus Funding: ($325,000) The department provides funding to the six regional agencies (Spokane, Yakima, ( Snohomish, King, Piercl9 and Southwest) known as AIDSNETS for the planning, .. " prevention, case management, and care coordination for those who have HIV or AIDS. This proposal would reduce funding to the AIDSNETS and represents a reduction of 2% of the state funds for thel program. Locum Tenens Program: ($30,000) The Locum Tenens pro~Jram provides health care professionals to rural communities when the local provider iis unavailable due to sickness, vacation or training. This proposal would reduce the capacity to meet these needs in rural areas, and represents a 30% reduction in state funds for this program. Medical Program Director, EMS: ($312,000) The medical program director assists DOH in regulating certified pre-hospital EMS personnel by helping to set consistent standards of practice and to alert the department to potential problems. State law requires a medical program director function. This proposal would transfer funding for the medical program director from State General Fund to the to the Trauma Care Fund. 4 ("'-. :-:' ~ 'C BUDGET ENHANCEMENT PROPOSALS FOR 2001-03 BIENNIUM September 2000 BACKGROUND This summary describes recommendations that the Department of Health (DOH) is submitting to Governor Locke for additions to our budget in the next biennium, which begins July 1, 2001. Unless otherwise noted, enhancements are for state general funds. The Governor and the Office of Financial Management may include some increases and not include others in the executive budget proposal- for the 2001-03 biennium. This is the first step in a long process that will last through the next legislative session. PROGRAM RELATED ENHANCEMENTS AIDS Prescription Drug Program: $1,885,000 The AIDS Prescription Drug Program (APDP) helps low and moderate income persons with HIV infection gain steady access to prescription medications, medical monitoring, dental care and other services necessary to improve their health. APDP caseload is expected to increase from 1,825 to 2,660 by the end of the 2001-03 biennium. This request would provide funding to meet the demands of this caseload increase and increased client care costs. Birth Certificate Software: $98,000 DOH received $98,000 in the 2000 supplemental budget to develop software to comply with new federal requirements of the U.S. Standard Birth Certificate. The new federal standard has been delayed, and this request will carry this funding forward to the 01-03 biennium. Child Health Enhancement: $14,766,000 Essential to the functioning of a state immunization program is the provision of recommended vaccines; assessment of individual, community, and statewide vaccination rates to help protect the public from vaccine-preventable disease; and health education/health promotion activities. Under Washington State's current universal vaccine access and distribution policy, federally recommended childhood vaccines have been available to all children in the state at no charge since 1990. In June 2000 the key national advisory body recommended a new vaccine for all children ages 0 - 23 months, and for specific high-risk populations ages 24 - 59 months. The Pneumococcal 1 Conjugate vaccine will prevent Pneumoccocal infections, including middle ear, blood stream, sinus and meningitis. Thus in order to maintain our universal access and distribution status and provide this vaccine to all children in Washington State, additional state funding is needed to complement federal funding. Immunization assessment includes the identification of individual, clinic, community and statewide immunization coverage, disease surveillance, reporting and outbreak control" quality assurance monitoring and vaccine management and accountability. An information system will facilitate these essential assessment functions by making accurate immunization information quickly and easily accessible. Child Profile health promotion is the state's primary mechanism for reminding parents of children 0 '. 6 years of the need for well-child checkups and immunizations. Currently, health education/health promotion materials are being provided to children statewide from age 0 to age 3. Additional state funding is needed to continue the statewide implementation, adding children age 3 in SFY02 and children age 4 in SFY03. Health Professions-Use of Investment Earnings: (from $1,200,000 Health Professions Account) 1-695 has curtailed the ability of DOH to raise fees to cover increasing costs incurred in regulating health practitioners. Currently, interest generated by the health professions Iicemsing fee fund balance is allocated to the general fund. This request would allocate the interest income to the health professions account for investigations and actions against unlicensed health practitioners. It would also expand our ability to encourage public inquiry about practitioners and license renewals, and provide for an external evaluation of the disciplinary process. Hepatitis C Surveillance: $222,000 Hepatitis C is now recognized as a major emerging chronic infection that causes death and disability. There are an estimated 100,000 Washington residents infected with Hepatitis C virus. Often decades pass before individuals experience the full effed of Hepatitis C. DOH lacks basic capacity to use reported information about this disease to advise policy makers on courses of action. This request would provide funding to incorporate Hepatitis C Virus (HCV) reporting into the department's existing disease surveillance system. Methamphetamine Laboratories, Technical Assistance: $125,000 The problems associated with Methamphetamine (Meth) abuse and manufacture have reached epidemic proportions. DOH provides technical assistance and training to the Washington State Patrol, Local Health Jurisdictions and other state and local agencies regarding the public health and safety hazards associated 2 with Meth. This request will provide funding for DOH to meet the increased demand for technical assistance and training. New Technology for Newborn Screening: $660,000 Newborn screening currently uses radioactive tests. Radioactive tests pose safety and liability issues, and are increasingly regulated regarding use, storage and disposal of radioactive materials. As a result, the recent new facility for newborn screening was not designed for radioactive tests. Before 1-695, we had planned to cover this cost through fees. The request will allow the DOH Laboratory to transition to modern non-radioactive tests. Recreational Water Quality: $270,000 Recreational waters, such as rivers and lakes, pose significant public health problems. The recent outbreak of E.coli at Battleground Lake in Clark County emphasizes the need for standard criteria to evaluate the safety of these areas. public information and education is also needed to advise people as to the safety of these waters for recreation. This request would provide funding for development of a model program for use by local health jurisdictions and technical assistance regarding water recreational facilities from DOH. Safe Drinking Water: $5,844,000 (from Safe Drinking Water Account) There are significant public health issues associated with safe drinking water. DOH has issued over 45 boil water advisories to water systems over the past twelve months. In addition, there has been a huge increase in federal requirements under the Safe Drinking Water Act which DOH has responsibility for implementing. The effects of 1-695 have also caused some local health jurisdictions to return responsibilities for small systems to DOH or reduce staffing. This request is part of a set of recommendations by the DOH Water Supply Advisory Committee to assure safe drinking water. It would provide funding to local governments, local health jurisdictions and DOH to assure safe drinking water through public health activities, including inspections, compliance with water quality standards, and technical assistance. This request proposes appropriating an amount equivalent to 15% of the Public Utility Water Distribution tax as a mechanism to provide state funding. Shellfish Testing: $100,000 Washington State has sporadic Vibrio parahaemolyuticus illnesses associated with eating unsafe shellfish. Federal guideJines governing interstate shipment of shellfish now require monitoring for Vibrio. This request will provide funding for this testing and assure that shellfish are safe to eat. Transfer of Funding from the Department of Social and Health Services:$340,000 DOH currently receives funds from DSHS through an interagency agreement for activities that increase screening for substance use during pregnancies. This 3 request will transfer funding to DOH, thereby eliminating the need for the interagency agreement. CAPITAL RELATED ENHANCMENTS Capital Plan for Public Health Laboratory: Approx. $6,700,000 (from State Bldg. Construction Account) The DOH laboratory requires periodic additions, improvements and repairs in order to respond to public health needs. This capital budget request would provide funding to design and build additional Biohazard Safety Level 3 facilities, remodel of microbiology space and various safety improvements. Drinking Water Facilities: $24,000,000 (from Federal State Revolving Fund) This request is for spEmding authority for federal funding to provide loans to local government and public water systems for projects and activities to protect drinking water facilities and resources. INFRASTRUCTURE AND OTHER ENHANCEMENTS Building Lease Increases: $ 553,000 General Fund-State $252,000 Other Funds $ 805,000 Total With the exception of the state laboratory, the department leases its office buildings. This request is to cover lease increases that have occurred since last biennium and the increases expected in the next biennium. Consolidation of Offices: $1,375,000 This request would consolidate DOH operations in Thurston County into a single building. Current fragmentation in 21 buildings impairs the department's ability to provide quality customE~r service, results in costly maintenance of multiple operating systems, such as computer networks, and makes effective and efficient management of the agency more difficult. Approval in the 2001 legislative session would allow DOH to occupy the building in 2004. Costs associated with the project in the 2001-03 biennium include functional planning, specifications, request for proposal, and project management. Death Records Document Management: $538,000 There is a significant need to preserve deteriorating paper death records dating back to 1907 to an electronic format for storage and retrieval. Digital Government: $1,339,000 There is increasing demand from the public and DOH customers to use the internet for business transactions and to obtain public health information. This 4 request would provide the resources to more fully use the internet to better meet customer and public health needs by developing a universal web design with enhanced navigation, enhanced data privacy and an interface for rule-making. Regulating Methamphetamine Precursor Drugs: $13,000 The illegal manufacturing and abuse of methamphetamine (Meth) has become epidemic in Washington. The methods currently used to manufacture Meth use pharmaceutical products containing ephedrine, pseudoephedrine phenylpropanolamine. The Department would develop regulations to control the sales of large quantities of these products. Utility Increase for Public Health Laboratory: $168,000 This request would pay for the increased utility cost for heating the public health laboratory building and operating laboratory equipment. The rate for this utility cost has not been adjusted in the last ten years. Women, Infants and Children, Rebate Spending Authority Increase: $7,200,000 (from formula manufacturers) In 1989, the Special Supplemental Nutrition Program for Women, Infants & Children established rebates with three infant formula manufacturers as a voluntary cost-containment initiative. The program currently has authority to receive rebate revenues of $44,200,000 for the 1999-01 biennium. This request is to increase the program's spending authority by $7,200,000 to allow projected rebate revenue collections of $51 ,400,000 in the 2001-03 biennium. An increase in the rebate spending authority will ensure the program is able to fully utilize all allowed rebates in order to offset infant fonnula costs. 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"tl !2. ;:;- '< ("':l = - tlI IrQ = ""l '< ~ Cl2 tlI ""l <l! ;:;- t'll - - tlI a - = - tlI ""l <l! tlI = - ;- = - = ::;" = '" - ""l = n - = ""l tlI 00 tlI ""l <l! ;:;- tlI .., '< "Cl r ~ = 0- - (CI ~ ~ ""l Q "'0 Q Cl2 (CI Q. ~ -. = = - ~ (CI = = ~ - (CI = Cl2 = = Q. rJ:J. (CI ""l -< -. ~ (CI ~ ~ "0 (CI -. ~ Q = - -. = = (CI Q. '-' -. ::e (CI -< -. Cl2 (CI Q. -...J - N 0'\ - o o '-' Jefferson County Health and Human Services SEPTEMBER ~ OCTOBER 2000 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. "Sick W. Marin diners blame county" - article in the Marin Independent Journal, 9 pages, 9/27/00. 2. "Health Board hears concerns" - Peninsula Daily News, 9/14/00. 3. "State hears complaints about Jefferson General" - P.T. LEADER, 9/20/00 4. "Videos on developmental disabilities now available" - P.T. LEADER, 9/20/00 5. "Health program offers free exam" - P.T. LEADER, 9/20/00 6. "County girds for flu shot shortages" - Peninsula Daily News, 9/24/00 7. "Kah Tai park soils to be checked" - P.T. LEADER, 9/27/00 8. "Abortion pill hailed, panned" - Peninsula Daily News, 10/3/00 9. "No local shortage for flu vaccine" - P.T. LEADER, 10/4/00 10. "New parent resource center birthed" - P.T. LEADER, 10/4/00 11. "State begins tobacco-paid health ads" - Peninsula Daily News, 10/11/00 Marin IJ - Sick W. Marin diners blame county webvan.com Ma.iill Mews Page 1 of9 @ .3 ! .....-': \ ,.....-::-..;~.~.~\ \~.:;'..~ '.~ \~. Sick W. Marin diners blame county By Richard Halstead A $1 million claim against the county of Marin asserts that Environmental Health Department negligence resulted in at least 19 people becoming ill at Rancho Nicasio restaurant in February. FIRED: Dave Mesagno, who was fired from Marin's Environmental Health Department, says the claim over well water has merit. The claim, which attributes the illnesses to contaminated well water, was filed in preparation for a possible class action lawsuit, said Steven Schoonover, a San Rafael lawyer. The claim, filed by a Point Reyes Station woman, alleges that West Marin Supervisor Steve Kinsey played a role by blocking enforcement of regulations designed to protect the public health, Kinsey denies the allegation. "They can file their claim but it will be defended and rejected," said Marin County Counsel Patrick Faulkner. But David Mesagno, a supervising Environmental Health specialist until he was fired by the county in January, said the claim has merit. Mesagno said he urged installation of a new septic system at Rancho Nicasio, as well as a thorough evaluation of the restaurant's water system, but that Kinsey interfered. " Mesagno says his refusal to knuckle under to pressure led to his firing. The county denies this, but officials say they are prevented by law from commenting on why Mesagno was terminated, Mesagno said he wanted the work done before the previous restaurant owner, Ken Marshall, was allowed to sell the restaurant to Bob Brown in 1998 for more than $1 million, Kinsey said he let Mesagno know he didn't think a new septic system was required, but put no pressure on him. As for telling Mesagno not to evaluate the water system, "I have no recollection of that whatsoever," Kinsey said. http://www.marinij.com/news/archive/Sunday/stories/news 1 000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 2 of9 A copy of an e-mail sent by Kinsey to Mesagno, obtained by the Marin Independent Journal, confirms that Kinsey lobbied Mesagno. Public documents - including copies of e-mail, internal memos and water system inspection reports - reflect a history of lax enforcement of regulations related to Rancho Nicasio's water system, and a less than rigorous procedure for testing the water there for bacteriological contamination. Furthermore, health officers discovered connections to two unpermitted, unauthorized wells when they inspected the water system after the illnesses were reported. Since then, however, Brown has severed his connections to the unauthorized wells and dug a new well that meets all state water quality requirements. The water there is safe to drink. "Bob Brown has really done a good job," said Bruce McCarthy, the Environmental Health Department's acting chief. Kinsey e-mail In 1998, however, Mesagno considered it vital that a new septic system be installed at Rancho Nicasio because the existing sewage leach fields were 2.3 feet below the groundwater table. Leach lines are required to be separated from the water table by a minimum of 3 feet. Mesagno notified Marshall of the situation in a letter dated Aug. 28, 1998. Mesagno said that soon after that, he began to receive pressure from Kinsey. "Kinsey wanted the restaurant permit issued, he wanted the sale to go through and he didn't want us to do anything to require a septic upgrade," Mesagno said, In an e-mail sent Sept. 21, 1998 to both Mesagno and his boss, Mark Riesenfeld, then head of Community Development, Kinsey wrote: "I would like the County to send a letter to Mr. Marshall stating that no improvements to the system will be required as a condition of the change of ownership." It wasn't the first time Kinsey had confronted him about Rancho Nicasio, Mesagno said. "He met me at my desk that morning, he was waiting at my desk. He wanted to know what was going on out there and how come we wouldn't release the permit," Mesagno said. Kinsey said the e-mail was merely a suggestion. "I wasn't ordering, telling," the supervisor contended. "The tone of this thing is one of advocacy or encouragement but no more than that. I would do this for constituents. This is what I'm paid to do." http://www.marinij.com/news/archive/Sunday/stories/news 1 000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 3 of9 Employee Mesagno interpreted it differently. "I definitely felt threatened. I considered it a threat when he met with me in my office. "This is a board member reaching down to a staff person using the full power and authority of his office to influence a department. It is totally inappropriate." Riesenfeld, who later was promoted to county administrator, never mentioned the e-mail to him, Mesagno said, "I don't have any particular recollection of this e-mail and what I may or may not have done with it," Riesenfeld said. Riesenfeld said he is unaware of any written policy preventing an elected supervisor from offering a county staff member his opinion. "He as an individual supervisor was offering an opinion," Riesenfeld said. Is it possible a county staffer might feel intimidated receiving such a message from a Marin County supervisor? "That's why we have the merit system - they're not subject to being fired because Steve Kinsey doesn't like what they're doing," Riesenfeld said. Department shakeup Both Mesagno and Ed Stewart, the longtime head of Marin's Environmental Health Department, were fired on Jan. 28 this year, after they filed the county's first-ever "whistleblower" complaints. The complaints were filed after Mesagno was abruptly stripped of his responsibility for issuing permits for septic systems on all new residential and commercial construction in unincorporated Marin. On May 10, 1999, newly appointed Community Development Director Alex Hinds ordered Mesagno to switch jobs with McCarthy. Stewart, who was Mesagno's supervisor at the time, objected to Mesagno's reassignment. During the subsequent whistleblower hearing before the Board of Supervisors, Stewart said the move was "tantamount to asking two doctors, one a brain surgeon and the other an orthopedic specialist, to switch roles." Stewart told supervisors the employee flip-flop came under orders from at least two county supervisors unhappy with his department's strict enforcement of sewage regulations. Stewart named Kinsey as one of the supervisors. Kinsey denies it. Supervisors voted 5-0 to reject Stewart's contention that the job reshuffling involved improper political meddling and jeopardized public health. The county says Stewart was fired because he was guilty of racial and sexual discrimination, http://www.marinij.com/news/archive/Sunday/stories/news 1 000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 4 of9 Stewart - who is appealing his firing to the Marin Personnel Commission - declined an IJ interview request. At last report, the county was attempting to negotiate a settlement with Stewart. Kinsey represents West Marin, where many homeowners face the expensive prospect of upgrading septic systems if they seek new building permits. In March, Kinsey admitted that he had built a studio and upgraded the septic system on his Forest Knolls property without obtaining county permits. Although he has filed necessary applications, Kinsey still has not brought his property into compliance with the law. In an Aug. 31 letter to senior zoning enforcement officer Debbi Poiani, Kinsey explained that he faces "extremely limited options" in designing a new septic system and may have to obtain easements on adjacent properties to meet required setbacks. People get sick Point Reyes Station resident Jerelyn Jacobson, who is making the $1 million claim against the county, said she became sick on Feb. 18, two days after drinking two big glasses of water at Rancho Nicasio restaurant on Feb. 16. It was the week after Valentine's Day and the area had been drenched by heavy rains. "I mean it was miserable, horrible," said Jacobson, 58. "I had a very high fever for two or three days." Three other people in her party, who drank alcoholic drinks instead of water, did not get sick, Jacobson said. Kinsey said Herb Goldberg, Jacobson's companion, listed on the complaint as one of her witnesses, is a longtime political foe of his. "It appears to me he's trying to take a case of the runs, turn it into a retirement fund and do some political muckraking along the way," Kinsey said. "There is nothing political about it," Goldberg said. "She became violently ill. She couldn't stop throwing up. For him to call that political is despicable." . Inverness resident Jennifer Livingston said she became sick on Feb, 16 after visiting Rancho Nicasio that same week and "drinking mostly water. " "I was throwing up for about 30 hours," Livingston said. It took nearly two weeks to completely shake the intestinal illness, she said. Restaurant owner Brown said he and his wife also became sick that same week. Water testing spotty Environmental health records show that no bacteriological water http://www.marinij.com/news/ archi ve/Sunday/ stories/news 1 000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 5 of9 samples from the restaurant had been submitted to the county during 1999, Normally, water system operators are required to send test results to the county on a quarterly basis. If a well is susceptible to surface water, however, test results are supposed to be submitted monthly. "There is a lot going on down there," Brown said, referring to the restaurant. "If they weren't sent, it wasn't for any particular reason." Records also show that a water sample collected from Rancho Nicasio on Feb. 11, 2000 tested positive for coliform bacteria on Feb. 15 - the day before Jacobson said she ate there,"Coliforms are a broad classification of bacteria that are found in the soil," said acting chief McCarthy. Some coliforms are found in the intestinal tracts of humans and animals; a rare strain of E. coli, one type of coliform, can be deadly. Scott Laboratories in Petaluma mailed the positive results to Norcal Pump Works, a water pump maintenance business also based in Petaluma, which had submitted the sample to the private lab for the restaurant. Operators of water systems, such as at Rancho Nicasio, are allowed to gather their own water samples and send them to a lab. The results are sent back to the water system operator, who then forwards them to the county. On Feb. 17, Environmental Health received a complaint that several people became ill after eating at Rancho Nicasio on Feb. 14. At this point, health officials still had not been notified of the positive test result by Rancho Nicasio or Norcal Pump Works - even though, according to county documents, Norcal had notified Rancho Nicasio of the positive test result the morning of Feb. 17. "They didn't tell us," McCarthy said, "There was a communication problem there which we have taken care of." Brown said he has no clear recollection of when he told the county about the positive test result. "I can't remember from seven to eight months ago," he said. County inspectors immediately took five water samples from the restaurant. All five came back positive for some type of coliform; three of the five were positive for fecal coliform. The fecal coliforms could have come from human or animal sewage, McCarthy said. "It could have been from a cow; it could be from a duck," he said. When the test results from the samples taken by the county came back on Feb. 18 - the day after people reported becoming ill after eating at Rancho Nicasio - the restaurant was closed while storage tanks and distribution pipes were drained and disinfected, It was also on Feb. 18 that the county finally was notified of the sample submitted by Norcal, which had come back positive three days earlier. The restaurant reopened the evening of Feb. 18 at 7 http://www.marinij.comlnews/archive/Sunday/stories/news 1 000685 .shtml 09/2712000 Marin IJ - Sick W. Marin diners blame county Page 6 of9 p.m. and for several months after that trucked in water. Troubled water system When health officials inspected the water system, they found several problems, Environmental Health specialist Jock Smith discovered that the surface water may have been getting into the main well supplying the restaurant - a well situated about a mile away in a cow pasture. The well's seal was suspect and the roof of the tank where the water was stored had holes in it. If a well is susceptible to surface water, the law requires that the water must be chlorinated, McCarthy said. The pasture well was not chlorinated, Health inspectors also found what appeared to be connections to two unpermitted and unauthorized wells. It was difficult to determine all the sources of the restaurant's water, said senior Environmental Health specialist Phil Smith. "It's basically a labyrinth of pipes, They all disappear very quickly into the ground and reappear at the points of treatment and use," Phil Smith said. In addition to the restaurant, a meeting hall for a local chapter of Druids and several Nicasio Valley residents get their water from the pasture well. Health officials now believe that this well was the source of the contamination, but doubts remain. It is unlikely that the septic system played any role since a new, mound system was installed and certified on Dec. 29, 1999. Although fecal coliform was found at two locations in the restaurant and in one of the holding tanks, none was found at the faucet of the pasture wellhead. Brown said this was the only well that was being used for the restaurant. Nevertheless, connections existed to two other wells. Health officials discovered a pipe leading to an unpermitted well on an adjacent lot at 4750 Nicasio Valley Road. Brown said water from that well was being used solely for irrigation. Environmental Health specialist Jock Smith, however, said the pipe was connected to a holding tank that was fully integrated with the rest of the system. In addition, Scott Callow, Marin's acting supervisor for consumer protection, found a water hook-up to the restaurant labeled "field," which appeared to connect to a well on an adjacent playing field. Callow instructed owner Bob Brown to sever this connection. Brown said that connection was not being used. Neither of these wells were tested for coliform bacteria because health officials said they accepted Brown's assurance that he wasn't using water from them in the restaurant. "The main thing I was interested in was that they disconnect that well from using it as a source and they've done that," Jock Smith said, http://www.marinij.com/news/ archive/Sunday/ stories/news 1000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 7 of9 regarding the well at 4750 Nicasio Valley Road. In May, Brown drilled a new main well, 10 feet from the well in the pasture. The county has given him until Oct. 31 to destroy the old well so it won't contaminate the new one. History of problems Past inspection reports indicate a long history of problems with the restaurant's water system, dating back to when Ken Marshall owned the restaurant. After an inspection in June 1993, Callow warned Marshall that "the well from the playing field has not been approved for the restaurant. Water quality and rights to the water must be demonstrated. Disconnecting from the supply will be required if the above can not be demonstrated. " During the same inspection, Callow instructed Marshall to re-install a chlorinator to the pasture well, which was attached when the system was permitted in 1982. "A review of bacteriological tests show that results have been inconsistent," Callow wrote in this report. Mesagno said that in the past coliform bacteria was found in Rancho Nicasio's water "with some regularity." Mesagno's assertion is supported by test results submitted to the county on July 25, 1994, At that time, water from two wells - the one in the pasture and the ballfield - tested positive for coliform bacteria. "We never had a repeat water sample fail. Our policy was to allow them to do a repeat sample. If it tested negative, we took no further action," Mesagno said. An inspection report dated March 1996 mentions that nitrate levels at the well had gone unmeasured since 1988. In his March 1, 2000 report, Jock Smith also noted that nitrate samples were not received for 1999. Such samples are supposed to be submitted to the county yearly. Nitrates, which are one of the component parts of solid and liquid excrement, can pose serious health problems for infants and children. The lack of chlorination is mentioned again on two 1998 reports by senior Environmental Health specialist Phil Smith; one of those reports was filed in connection with the sale to Brown. Rights to three wells Former owner Marshall says ownership of Rancho Nicasio includes water rights to three wells - the pasture well, the ballfield well and the well at 4750 Nicasio Valley Road. All three were connected to the restaurant through underground pipes, Marshall said. He said he used the ballfield well in the past during drought years. Water-well drill reports show that Marshall http://www.marinij.com/news/ archive/Sunday/ stories/news 1000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 8 of9 drilled two wells on his property in 1989 that were immediately filled, indicating they were unproductive."There isn't much water in Nicasio," said John Fiori, secretary for the Druid's Hall, which also gets its water from the pasture well. "The ballfield is hooked up to a little well by the creek there, but they're already out of water so therefore their field is drying up. There just is no water out there," Fiori said. Mesagno said he wanted to do a complete survey and evaluation of the Rancho Nicasio water system but "I was stopped from completing that by Supervisor Kinsey." He said the order came in the form of a phone call from Kinsey to him after a special legal agreement was signed Oct. 29, 1998 between the county and Brown - giving Brown until Sept. 15, 1999, about 11 months, to install a new septic system while continuing to operate the restaurant. Under state law, for the county to issue a new use permit to a restaurant all plumbing must be maintained to prevent contamination. Mesagno said he had never seen a similar such agreement during his 16 years with the county, "This was big stuff. For county counsel to get involved in a private individual case was really quite precedent- setting," he said. Just three weeks before the agreement was signed, Marin Deputy Counsel Nancy Stuart Grisham had notified Brown's attorney that a new septic system had to be installed before a restaurant permit could be issued. "A leach line that contaminates the water table, such as the situation we have here, constitutes an improper discharge of effluent," Grisham wrote in her letter. Grisham did not return phone calls and County Counsel Faulkner could cast no light on the abrupt change in policy. "I don't know because I wasn't party to it. I didn't directly oversee it," Faulkner said. "There had been numerous complaints over the years that that system was failing, actually surfacing sewage during the winter time," Mesagno said. Hundreds like it Supervisor Kinsey said: "Keep in mind that there are hundreds if not thousands of existing septic systems in West Marin that don't comply with this groundwater separation requirement. "There was never any question on the part of the restaurant owner that he was prepared to install a new system," Kinsey said. Mesagno disagrees. "They did everything they could to go around us and go straight to Supervisor Kinsey to get a special accommodation," he said. http://www.marinij.com/news/ archive/Sunday/stories/news 1000685 .shtml 09/27/2000 Marin IJ - Sick W. Marin diners blame county Page 9 of9 "That's a bunch of bull," Marshall said. When he and Brown contacted Kinsey, they were merely questioning whether the county had the authority to withhold the restaurant permit until a new system was installed, Marshall said. "If Brown didn't have to do it, he wasn't going to do it," Marshall said, regarding installing a new septic system. Under the law, Marshall could have continued to operate the restaurant without making any changes to the septic system. The upgrade became mandatory only if the restaurant changed hands. Kinsey said it's his job to solve problems. "I do know there are water supply situations in West Marin that are less than desirable - a number of circumstances that a better monitoring program would identify," Kinsey said. "To me it is so much easier to get people to improve the situation if you can actually have programs where you help them identify their problems and solve the problems, rather than simply come in like the truth police and insist on these black and white enforcement activities." But Mesagno, who has found a new job as a health inspector for Sonoma County, insists Kinsey pushed him beyond mere accommodation. "When you get hired to be a public health specialist, you have to swear to a loyalty oath and every time I was compelled and coerced to break the law I was actually being asked to violate my loyalty oath - which is what I refused to do," he said. Use of this site signifies your agreement to the IE!nn$Qt$$rvicE~. http://www.marinij.com/news/archive/Sunday/stories/news 1 000685 .shtml 09/2712000 \Health board hears concerns By PHILIP L. WATNESS PENINSULA DAlLY NEWS PORT TOWNSEND - Fewer physicians acce~t state and federal health insurance programs on the OlympIC Peninsula, middle-income wage-earners are finding it more difficult to alToI'd coverage and health consumers worry that a stay at JelTerson General Hospital could prove unhealthy. The Washington State Board of Health listened to those and other worries during its monthly meet- ing Wednesday, held this month at Fort Worden State Park and Con- ference Center. Residents asked the board to represent Jefferson County con- cerns when recommending policies and funding to Gov. Gary Locke and the state Legislature. Jan Hollingsworth of Nordland criticized the state Health Depart- ment for failing to monitor the hos- @ pital's performance more regularly. She also criticized the county Hos- pital Commission and hospital administration for dismissing the state charges as not being serious. The state Health Department last month charged that the hospi- tal had failed to have a working quality improvement process, did- n't have adequate record-keeping procedures and prepared food in unsanitary kitchen conditions. TURN TO HEALTH /A2 Health: Hospital, care concerns CONTINUED FROM Al Hollingsworth encouraged the health board to look into manda- tory hospital accreditation for pub- lic health hospitals as one method to make sure Jefferson General and other Ol~""'pic Peninsula hospitals maintain a high standard of care, Grace and Jerry Chawes of Port Townsend also addressed the hos- pital's recent problems. Jerry Chawes advocated a policy that all hospitals' food service facilities should be subject to local health department regulations, "Without an independent agency acting as a watchdog, how does the public know that their hospital, paid for with their taxes, is handling food in a proper and safe manner?" he said. The issue shouldn't be taken lightly, Jerry Chawes said, citing a food-poisoning incident late last year that involved dozens of local fIrefIghters, "I'd hate to think that on a par- ticular day, food poisoning could knock out the staff at the hospital," he said. Care concern Maia Penfold of Port Townsend also told the health board that she worned about the hospital's ability to provide appropriate care. She said she was nearly given a pain- reliever she is allergic to when she was in the hospital in July. Dr. Tom Locke, the health offi- cer for both Clallam and Jefferson counties and a member of the health board, addressed the issues of health care access, both in terms of insurance coverage and access to physicians. He said recruitment and retention of physicians contin- ues to be a problem in both coun- ties. "We are seeing rising demands in the face of very limited and sometimes precarious funding," he said. He said inadequate funding for mental r -lth facilities and oral health plograms also contributes to a health care crisis on the Penin- sula. "The OIYIl}pic Peninsula is in th~ same rural health care crisis as the rest of the rural areas of the state," he said. "The population that is most affected is the low- income population." The health board also received a briefIng from Jefferson County Community Health Director Jean Baldwin concerning local efforts to . provide care for newborn babies during their fIrst several years. She said local efforts and national stud- ies both point to the elTectiveness of early care in preventing long- term health and social problems, Retired Dr, Eugene Turner of Port Angeles told the board that many lower-income consumers cannot get care because physicians accept only a certain percentage of federal or state insurance clients. "There is something wrong with a system that will accept only a small percentage of people in these programs," the pediatrician said. Turner said one result is that people decide to use emergency PDN rooms at hospitals for primary care. "They seek emergency room care and increase the costs to the state and taxpayers by three to fourfold. The reason is because emergency room doctors don't know the patients, they tend to do unnecessary tests," The Port Townsend meeting of the health board continued a long- standing tradition of holding meet- ings throughout the state to get local perspective on issues, Dr. Locke said, 9-1 t/- 0 cJ .. @) "State--hears complaints Su~~~ about Jefferson General By Janet Huck leader Staff Writer A parade of Jeffernon County residents voiced concerns about Jefferson General Hospital (JGH) at the Washington State Department of Health (DOH) board meet- ing in Port Townsend last week. Last August, the DOH brought charges against JGH for failing to fonnulate a hospital-wide quality im- provement process as required by law, to prepare food in sanitary conditions and to maintain adequate record-keeping procedures. Such charges are rare. The DOH has made legal charges in only a handful of cases in the last 10 years. JGH could 'have lost its license If it didn't draft a suitable correction plan. The settlement hasn't been signed yet. JGH administrator Vic Dirksen saia the hospital has worked out a correction plan with the state, but the lawyers are still negotiating the language of the charges. At the DOH board meeting, local residents elaborated on the charges. Dirksen said the hospital was acting to correct the problems. "We will do better at the end of the day for all these things," said Dirksen. "We are a different organization than we were two years ago." Wrong medicine? Maia Penfold, a Port Townsend resi- dent, told the DOH board no JGH nurse bothered to look at her bracelet indicat- ing allergies to pain medications during See HOSPITAL, Page A 11 Hospital: Issues Continued from Page A 1 her seven-day stay last July. "One @vening a nurse popped int6 my f?Om saying, 'Here's your Percocet,'" she said. Penfold is allergic to Percocet and told the :nurse. The nurse said she ~ad the -Wrong room. But'Penfold won- dered what would have happened if the nurse had simply said, I'Here's your pain medication." "Giving patients the wrong (lrug can be extremely hazard- 'eus," she said. "I Wll3 lucky 1 es- ,taped the consequences of the 'nurse's carelessness." " Dirksen said he would very much like to know about the in- cident in question so the hospi- 'tal can track the problem. "I'd be shocked that a nurse never 'Checked a bracelet:' he said. JGH's head of nursing and the insurance company are going to concentrate this year on medica- tion errors, because the national figures are so alanning. Accord-, 'iog to Dirksen, medication errors i nationally total 40 percent. : Jan Hollingsworth, a retired I registered nurse from Marrow- stone Island who read the DOH i ,tnvestigators' report, was con- cerned about the JGH nurses' failure to adhere to blood trans- fusion protocols, According to the DOH report, the staff failed to assess patients receiving blood transfusions in a timely manner and failed to ensure documenta- rian of the assessment in three of three patients. "Blood is one of the most dan- gerous things you can adminis- trate," said Hollingsworth. "It kills patients." , In f~ct, she charged that a pa- 11ent died three years ago as a result of a blood switch. Dirksen would not comment ?n t~e !,?ssible death. "I don't get Int,o Incidents at the hospital," he said, "I wouldn't say yes, I wouldn't say no." But he clarified the DOH in- vestigator complaints. "It wasn't ahout giving the wrong blood type," he explained. "'!be nurses are supposed to monitor on a cer- tain frequency level. We were doing it on the first unit of blood but we weren't doing it on th~ second, It's important to follow the protocol on all units," "We will do better at the end of the day for all these things." VIe Dirksen , JGH administrator ",," ComplaJnt process ': Grace Chawes, a retired reg- , lstered nurse, suggested the hos- pital install a volunteer om buds- i man pr?gram to handle patient ' ,::omplamts more efficiently. On Sept. 6 she voiced a complaint I}bout the medical imaging de- partment at Harrison Memorial Hospital in Bremerton. The next day the director of the hospital and the surgical manager called back. In contrast, she also called in a complaint about the emergency room to the JGH complaint ad- ministration Sept 6. She did get a message back that the com- plaint administrator wasn't avail- able but she would call Chawes back on Monday, Sept. 11. As of Thesday, Sept. 19, Chawes still had not received a phone call. "Is that person in charge of complaints the only one who is concerned with my problem?" she asked the DOH. Dirksen agreed that while hospital officials are good at let- ting people know they have re- ceived the complaint, they were behind the timeline in answering the complaint. "We have a timeline we want to meet, and we aren't meeting it," he said. "But we are working on it." Gag orders, accreditation Hollingsworth also com- plained that when patients sue, JGH settlement offers usually come with gag orders attached so the patients cannot later discuss the problem. Hollingsworth recommended the state Legislature ban gag or- ders on public hospital complaint settlements. "We the patients and the taxpayers have the right to Ventilation, food concerns . : know about injuries, negli~ence, " Hollingsworth said suroical etc., and how our money IS be- &' .' t" h said sites are supposed to have air Clr- tng spen, s : . .. eulation systems that exchange Dtrksen s81d the hospital tn- u. . 15 t' n hour How surance company works out the Die 81r Imes a . - ,,' 'ever, lilt" DOH report said the arrangement. We don, t make hospital's engineers turn off the ,pe~ple aware of ~Il the com- 'Ventilation to the operating plamts, all the suitS, b~caus~ Tooms during helicopter takeoffs people have' a right to pnvacy, and landings on the roof. Due to he s~id, ~e s~ressed that all <1l building design flaw, the arrival pOSSible Ii.tlgatlon .was r~ported of a helicopter meant noxious 10 exe~u~lve sessIOn With the fumes would enter the operating , commlsslone~s. . rooms. The JGH engineering When Holling~w?rth tned to staff stated the ventilation has contact the commissioners about been off for 20 to 90 minutes. the DOH charges, she sai~ they " "You don't want dead skin par_ assured her there was nothmg to ,ucIes or pathogens settling in open be ~oncerned about. wounds," said Hollingsworth, a ~ey wer~ unaware. of. ~e fonner intensive and acute care nursmg, medical and hablllty :Uurse. implications in the charges," she . Dirksen said the hospital has tol~, the DOH board. . 'Correct~d the ventilation system .,1 was there whe~ th~ msre<:- problems. Now, air is recircu- tIOn team,w~ there~ s81d hospl- ,Illted when a helicopter lands in- tal commission ch81nnan Chuck ,stead of shutting down the sys- Russell. "I. have a better ide~ of ,tern that drew from the outside. what went on than she does. j','The state was pleased with the Several of the speakers sug- ;solution," he said. gested that JGH seek accredita- r; The DOH investigators found tion to help increase the appar- numerous food safety violations, ent flagging trust in the hospital. ,including oven racks caked with "Accreditation provides'us with black residue and perishable food the necessary assurance that our ~ept at temperatures not cold health risks will be minimized," ,e,nough for safe storage. said Penfold. .' Jerry Chawes, a food chem- The hospital hasn't sought ist for 37 years, suggested the accreditation in the past because ,hospital submit to mandatory it was so expensive. "Many small i,nspections, the same as all 10- rural hospitals like ours don't do cal restaurants. it because of the costs," said "I'd hate to think that on a Russell. particular day food poisoning Accreditation wouldn't assure could knock out the staff at the the patients of quality care, added hospital," he told DOH. Dirksen. Puget Sound Hospital, ;, Jefferso,n County health of- which received the most severe ficer Dr, Tom Locke told Chawes charges by the DOH in the last the hospital had already con- 10 years, was accredited, said tracted with Jefferson County Dirksen. pepartment of Health and Hu- "It would be better to have the man Services to conduct unan- state come every year than the nounced inspections. accreditation board every three 1 years," said Dirksen. @ Wednesday, Sept. 20, 2000 . B 11 Videos on developmental disabilities now available -he Developmental Disabilities Advisory Board of Jefferson County has donated $3,000 worth of videotapes on the subject of developmental tisabilities to the Port Townsend Public Library and the Jefferson County Library. Video topics range from parenting issues to interview tips :l American Sign Language. The Aug. 31 presentation involved (from left, back row) Melanie Bozak, Marlaina Verraes, Jeanne Paddock- :oester, Beth deJarnette, Carl Hanson, Tami Lydic; (front row) Judi Erlandson, Herb Herrington, Helen Brink and Anna McEnery. Board 1embers not pictured are Sheila Westerman, Richard Wojt, Marie Smith and Jane Dwyer. "We're trying to help educate the community," said oard member Anna McEnery, "as well as give parents and those who deal with developmental disabilities some new resources." Photo by Shelly Testerman .. (iJ f Health program offers free exam -' The Breast and Cervical Health Program (BCHP) is a lim- ited health screening program [hat provides eligible women with a free yearly women's health exam, Services provided may include a clinical breast exam. education on how to do self-breast exams, a pelvic exam with Pap test, and mammogram. The program is designed for women ages 40 to 64 (those age 65 and older who are covered by Medicare do not need the program because Medicare covers the cost of yearly manunograms) who have limned or no insurance and fall withjn these income guidelines: Maximum Maximum family Monthly yearly size Income income 1 2 3 4 5 $1,392 $1,876 $2,358 $2,842 $3,326 $16.700 $22.500 $28,300 $34,100 $39,900 Mammography breast can- cer screening is the most effective method of detecting breast cancer in its earliest, most treatable stage. Most cervical cancer deaths cou Id be prevented if women got a Pap test everyone to three years. Mammograms are recom- mended every 1.2 years for women, starting at age 40. Yearly screening mammogra- phy is especially important for women age 50 and older. The risk of breast cancer increases with age. For more information or to find out if you qualify, contact Jefferson County Health & Human Services, 385-9400 or 1-800-756-5437, or stop in at the health depart- ment, 61 S Sheridan St., Port Townsend, '\. (f) County girds for flu shot shortages Officials may prioritize who gets vaccine By PmLIP L. W ATNESS PENINSULA DAlLY NEWS PORT TOWNSEND - Jeffer- son County health officials don't think they'll run out of flu shots this fall, but they're making con. tingency plans just in case. Dr. Tom Locke, health officer for both Jefferson' and Clallam counties, has told the Jefferson County Health Board that the U.S. Centers for Disease Control in Atlanta anticipates a shortage of flu vaccine, Locke's briefing familiar-ized the board members with the sub- ject. Jeanne Baldwin, nursing ser- vices director, said local physi- cians and Jefferson General Hos- pital who receive _ the vaccine ~J q... 2. tf- C) () Flu: Sho.t< though the Jefferson County . Health Department is still awa1t- ing a shipment of 1,500 ~cises ordered last April. "It's too early to say what kind of shortages will exist," Baldwin said. "In the past, we didn't know when there were shortages in supplies; we only knew there could be," Baldwin said the CDC has pro- vided early warning to health departments, providers- and offi- cials just in case. "It's not a crisis," she said. If a shortage does arise, the Health Department may have to restrict vaccination for higher- risk people, those older than 65 years, people who are ill or preg- nant women. Baldwin saiq flu shots w.ill be given throughout the county beginning in early November. Locke's memo to the health board said physicians should be strongly encouraged to vaccinate their high-risk patients as soon as they receive the vaccine, TURN TO FLU / A2 to. CONTINUED FROM ~~ However, vaccine effectiveness for people with impaired immune systems can last as little as just two months. For healthy people, protection usually lasts sl~ months. . : The potential shortage of flu vaccine is arising because one of the three components of the va9: cine has been difficult to grow an~ two of the manufacturers have experienced manufacturing prob: lems, the memo said. . . ., (j) Kah Tai park soils to be checked. By Barney Burke Leader Staff Writer The Jefferson County.Health )epartment is working with the .tate department of health to 'valuate a 1986 report on toxins n Kah Tal Lagoon Nature Park. -\ recommendation on whether further study is warranted should be ready in three months, and if needed, state funds are available to pay for additional investiga- tion as well as cleanup of the site, In August, City Manager David Timmons discovered the report which documented the presence of heavy metals in and around Kah Tai Lagoon. Apparently, neither the city nor the Port of Port Townsend - which owns the land - ever took action on the report, Timmons briefed the City Coun- cil on the report Aug, 7, and he has taken the initiative on the is- sue. In a letter to the Leader, Timmons wrote: "I believe we have a public duty to follow through with additional efforts to assure the public that greater en- vironmental risks are not present." Larry Fay, Jefferson County Environmental Health director, said Timmons requested that his department review the existing information and help the city de- termine what should be done to get a better understanding of the situ- ation and what to do about it. Fay has not yet discussed the situation with Larry Crockett, port district general manager. But he has con- tacted Trace Warner, public health adviser with the state department of health's office of environmen- tal health assessment in Olympia, "One of the problems that we're faced with right now is that there's a limited amount of data, and it's dated," Warner explained, Warner's office is preparing a "health consultation" report that will review the available 1.T LetWAZ.. 7-). 7-0-0 information and recommend what additional investigation may be needed, The report should be available to the public in about three months. Funds are available from the state department of ecology (DOE) if further study or remediation is needed, Dave Jansen, cleanup section manager for DOE in Southwest Washing- ton, explained that the funds would come from the Model Taxies Control Act, an initiative passed in the late 19805. Revenues for the rund are determined in part by the price of petroleum products, and with the high price of gas to- day, Jansen is optimistic that ample funds will be available to study orremediate the park, Once the responsible party (typically, the current property owner) and DOE agree on the appropriate scope of work, grant funds will be immediately available, he said. Is park safe? Asked about whether it's haz- ardous for people to use the park, Fay responded: "I wouldn't be alarmed about walking my dog out there, If there are metals of con- cern, they are probably contained in the soil, sediment and dust. It's not something that's going to be absorbed through the park," How- ever, he clarified that the situation would be different if the park had baseball fields, as ingesting dust would then be more likely. The bigger issue on risk expo- sure and potential mitigation is tied to land use, Fay and Warner say. "That's what drives our ex- posure estimates," Warner ex- plained, Fay concurred: "We've got a park there that people would like !O preserve as a park, Are you better off leaving things as they are? I don't know if we know enough info to make a recommen- dation right now:' Responding to recent "pave it to save it" rhetoric, Timmons says that making Kah Tai a per- manent city park is an opportu- nity to "finish what we started:' He commented, "As the city grows and fills in, that kind of open area is an asset:' Timmons doesn't see the land as prime development property and feels the council should-con- sider taking the next logical steps toward making the park perma- nent. However, a better under- standing of the magnitude of the toxic issue is key to determining the feasibility of making KahTai a permanent open space facilit.y. Another barrier to making Kah Tai a permanent park is that most of the land is owned by the port and leased to the city for $1 a year, The lease ends in 2012, and the port may consider devcl- oping the land for commercial and industrial uses. "It's the cily that made it an open public space, not the port," Crockett said. The park land in question is "manmade:' Dredgings from the port boat haven in the early 19605 were used to fill in the natural la- goon, Students involved A proposal for studying die contamination question surfaced recently from Port Townsend High School science teacher Lois Sherwood, She expressed inter- est in using local students and the resources of Battelle Northwest Marine Sciences Laboratory in Sequim to do a bio-impact study of the site, Sherwood is earning.a master's degree in biotechnology from Washington State Univer- sity and recl'ntly completed ~ internship at Battelle. Battelle will need to approve the idea, as will the school district. ~ Warner said he is interested In Sherwood's idea and says tMt any additional sampling would be a benefit. However, ~e stressed the importance of ha~- ing the work done under the su- pervision of qualified individ~- als, both for safety and for t~e accuracy of data collection. Timmons agreed that the idea could be a great opportunity fPr a learning experience if stude~s can be "kept out of harm's wa~:' .. r .. ~]' Abortion pill h~iled, panned By ADRIANA JANOVICH AND LaRA GREEN PENINSULA DAILY NEWS North Olympic Peninsula health and religious leaders are mixed over to 'the federal Food and Drug Administration's recent approval ofthe abortion pill RU- 486. . . The FDA decided last Thursday to allow Americans the use of the early abortion method already used in Britain and a dozen other' countries. The drug was intro- duced in France in 1988. While several North Olympic Peninsula physicians declined to comment on the issue, family prac- "Even staunchly pro-choice providers are nervous about disclosing their thoughts;" DR. MELANIE McGOREY Port Townsend family practitioner' tice and' obstetJ;"ics ~Dr. Melani~ McGary of Port T.ownsend, shared this reaction: "My gen.eral recom.' . mendation.. is;, if you fmdyour&elf..' unexpectedly pregnant,. talk to' your primary care provider to dis- cuss your options. . "This is an extremely contro- versial issue and due tQ fear of reprisals, even staunchly pro- choice proV'idersare nervous about disclosing their thoughts." . Known ~mifipriston~, the' pill will be available to doctors in the United States within four. to six weeks.'...... Chandra Huston, acting direc: tor' of-. Family'. Planningof.Clallam. County, saidanyphysicl8ncould p~~the smies of pills. .' "'RU4S'6' will not~be'~fe, through pharmacies. and'mu\t~'be used only unde!: ii. doctor's supervi- sion, Hustpn emphasi2;~; ., "RU-486 is effective approxi- mately 92 percent to 95 percent of the time," she said. fuRN TO PlLIJA2 Pill: Drug stirs old debate CONTINUED FROM Al "RD-486 would not be avail- able through Family Planning as we do not provide abortions or surgical interventions," the assis- tant director of the Port Angeles- based clinic said in a letter Mon- day. Surgical interven~ion may be needed if the chemical procedure failed, she added. It is also important for a woman to consult a doctor because the pills may only be used in the early stages of pregnancy, said Huston, head of the clinic which provides referrals and information, 'The taking of human life' "This is a personal health care decision," McGory. said. "The issue is pro-choice, "Every woman has the respon- sibility and the right to take the best care of herself and her family as possible. I think it's going to revolutionize the ability of women to exercise personal health care choices." PntJ /0 '3 -(30 The Rev. Raymond Heffernan, pastor of St. Mary's Star of the Sea Roman Catholic Church in Port Townsend, differed. "(RU-486) is in the same cate- gory of the other forms of abor- tion," Heffernan said. "It's the taking of human life. You can't take the life. of a child after it's born, neither can you do it before it's born. It's not morally justified. Neither is this new method of the pill." Dr. Ed Ropfner of Port Ange- les, an abortion opponent, also lamented approval of the drug. "I'm not sure it changes the nature of the problem," he said. "It seems likedt just makes it eas- ier - a non-abortion abortion." "I know there is a detailed medical protocol to follow as far . as follow-up (to the procedure)," said Julia Danskin, a Jeff~rson County public health nurse. "I'm unsure whether our family plan- ning team will provide it, but we will make sure referrals are avail- able." The pill-.induced abortion must be taken within the first seven weeks of pregnancy or within three weeks after a woman misses a menstrual period. The pill can cause bleeding and nausea. The process requires an initial doctor's visit in which a woman takes three mifipristone pills. She returns two days later for a second pill, misoprostol, and two weeks later for a check-up. $350 to $500 per office visit Women can expect to pay an estimated $350 to $500 per office visit. Although the cost of the chem- ically induced abortion is similar to that of a surgical procedure, lack of abortion providers on the North Olympic Peninsula has been a, barrier to women in the past, Huston said. If a doctor prescribed abortion pills in the early stages of preg- nancy, a woman who wanted an abortion would not have to travel to Seattle or Olympia for a surgi- cal abortions, she said, Staff writer Austin Ramzy also contributed to this report. No local shortage for flu vaccine Flu shot clinics will be delayed By Janet Huck Leader Staff Writer Though the U.S, Center for Disease Control (CDC) warned of possible shortages and delays, Jefferson County Health and Human Services expects to re- ceive its full shipment of 1,500 flu vaccinations this month, "There won't be any short- ages here," said Lisa McKenzie, the health department's immuni- zation program coordinator, But there will be a month's de- lay in the start of the health department's public flu shot clin- ICS. Usually the health department receives its shipment in August and September so that clinics can be staged in October. With the delay in shipment, the health department has postponed its clinics to November, Some local physicians, however, already have their shipments in hand, "The delay shouldn't have a big impact because the peak of the fl u season doesn't come un- til after Christmas," explained McKenzie. Sometimes there are small flu outbreaks in December, If you get a flu shot in November, you would be protected by early De- cem~r, :;~d JlUleK,ufpt~) a nurse with the immunization program. Last month Dr. Tom Locke, Jefferson County's health officer, informed the Jefferson County Health Board that the CDC an- ticipated delays in the distribution I. and a possible shortage in flu vac- cinations. Although the delays materialized, the shortages did not In the past there have been minor delays, but McKenzie said there hasn't been a CDC "There won't be any [flu vaccine} shortages here." Lisa McKenzie coordinator immunization program county health department announcement of this magnitude in the last 10 years. "It's pretty unusual," she said. The potential shortages and delays were due to manufactur- ing problems with this year's flu vaccination, Some flu vaccine manufacturers have reported that one of the three influenza virus components used to make this year's vaccine had not grown as well as the corresponding strain used last year, In addition, two of the manu- facturers licensed to distribute the vaccine have been experiencing manufacturing problems, The two manufacturers worked closely with the Food and Drug Adminis- tration to address the problems. Because of the CDC an- nouncement, some health care professionals began making con- tingency plans, The CDC recom- mended they first inoculate high- risk people: those with heart. lung or kidney disease, diabetes. anemia or asthma. Jefferson County's immunization nurses had made similar preliminary contingency plans. "People don't have to worry now," said McKenzie. "The only inconvenience has been the clin- ics will start a little later this year." The health department has now scheduled its clinics. Port Townsend Nov. 8 County Health Dept. Nov. 17 County Health Dept. Dec, 4 County Health Dept. 9:30 a.m.-12:30 p.rn. 9:30 a.m.-12:30 p,m. 1-4 p.m. Tri-Area: Nov.13 Tri-Area Community Center 9:30 a.m.-12:30 p.m. & I :30-3 p.m. Nov.27 Tri-Area CommuDity Center 9:30 a,m.-12:30 p.m, Quilcene Nov, 15 Quilcene Community Center & 1:30-3 p.m, Brimion Dec. I Brinnon Booster Club 10:30 a,m.-12:3{}p.rn. 10:30 a,m.-12:30 p,m. & 1:30-3 p.rn. Gardiner Noy, 2 I Gardiner Community Center 10:30 a.m.-12:30 p.m. CD ffLeAOe1C I 10 _4-00 @ ... 'New parent resource center birthed Jefferson County Community Network has proposed a new parent resource center to be located at Grant Street Elementary School in Port Townsend. The mission of the Family Connec- tions program would be to provide parents and other caretakers of young children (from birth to 5 years old) opportunities for education, interaction and support, and to promote positive parenting, healthy home environments and a strong connecti.on to the community. Play groups, parenting classes and parent sup- port groups would be some of the resources offered. The county agreed to act as fiscal agent for the center on Sept. 25, a position that does not carry any financial commitment. County Administrator Charles Saddler gave the center his seal of approval, saying the worthwhile program "is a natural con- tinuum in providing resources and care to children." The Community Network is currently in the process of ob- taining funding for a resource coordinator. rp-7: L(S;AO ~ !O~L(-oC) tn -c ea .c ...., - co CI) .c -c l- ea Q. I o (.) (.) CO .Q o ...., tIJ C 1- ~ (1) .Q (1) ...., ea ...., en .. 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Jefferson County Board of Health Jefferson General Hospital District Board of Commissioners Joint Meeting 3:30 PM - 5:00 PM Thursday, October 19, 2000 Draft Agenda 1) "Gap Analysis" Discussion 2) Proposed Jefferson County Health Care Access Summit meeting 3) Future Planning: Joint Board Meeting Schedule 'C7IT'It::I~'a~'UVLvJlllnIU""y ..._..,.~._-.... -..--- Jefferson Health Access Summit October 12, 2000 Draft Purpose: To discuss community-based strategies for improving local health care access Outcome: Written summary of summit and adequate information to seek major grant funding to continue work Sponsors: Joint Boards with funding from the Washington Health Foundation Facilitators: Tom Locke, Vic Dirksen, Other "outside" person familiar with health issues (e.g. Aaron Katz) Invited Guests: 50 - 75 community and state leaders 9 Jefferson General Hospital Commissioners and key staff 10 Jefferson County Board of Health and key staff 10 Health Access Summit Workgroup and staff Local physicians City Council State representative State senator Workgroup speakers Union representative Others as determine by workgroup and Joint Boards Format: 9:30 - 3 PM Weekend or Weekday Welcome - Chair, Hospital District Commissioners and Chair, Board of Health Introductions Overview of Community Issues, Joint Board and Workgroup Process Present Workgroup/Joint Boards Work Products Lunch Questions, Answers, Discussion, Next Steps Summary