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HomeMy WebLinkAbout04 April JEFFERSON COUNTY BOARD OF HEALTH MINUTES APRIL 14, 1998 BOARD MEMBERS Dan Haryo/e, chAtrman - county Commissiolltr Di5trid I Glen Huntill'iford, Member - county commi55ioner Dlstrid 2 RichArd woft, Member - county Commissioner Dlslrld 3 Ted shouIberg, Member - pori Townsend City council Jtll Buhltr, vice chAlrmilll - HOl}'ltill DIstrid #2 commi.55wner sheila weste1'11lJVl, Member - Citizen at LtlJ/Je (ctty) Roberta Fris5ell, Member - Citizen at Large (county) STAFF MEMBERS David syeder, Health Deyartment Director Jean Baldwin, Dlredor of Nunl'1'l services Lany Fay, Director of Environmental Health Thomas Locke, M.D.. Health officer Chairman Dan Harpole called the meeting to order. All other Board and staff members were present with the exception of Vice Chairman Jill Buhler. APPROVAL OF MINUTES Member Shoulberg moved to approve the minutes of March 19, 1998 as presented (a spelling error was noted and corrected). Member Westerman seconded the motion which carried by a unanimous vote. PUBLIC COMMENT PERIOD No public comments. NEW BUSINESS NEEDLE/SYRINGE EXCHANGE PROGRAMS AS A PUBLIC HEALTH STRATEGY: Dr. Tom Locke proposed that this issue be discussed in three (3) different stages beginning with the broad overview and information segment. If the Board of Health wants to continue to pursue the needle/syringe exchange program, the next stage would be to hear from advocates and opponents in the community. The final stage would be to deal with all the issues it takes to implement a program. Dr. Locke stated that there has been a great deal of research conducted on needle/syringe exchange programs. This type of program was very controversial in the mid to late 80's and it died down for a while and is now starting to heat up again. Programs were initially adopted by the large municipal health departments in Spokane, Pierce, and King Counties. HEALTH BOARD MINUTES - APRIL 14, 1998 Page: 2 Dr. Locke said the first thing we should ask ourselves is, "1 s there a need for this type of program? " After a program is in place, the need is determined by the number of individuals who take advantage of the services offered. Dr. Locke explained that there are three (3) data sources to assess the need in the community. Unfortunately, none are very good. ~ Communicable disease information. This type of disease has to do primarily with blood born infections such as HIV infection, Hepatitis C and Hepatitis B. If the data shows a spread of these types of infections in the community, it can't be proven that it was caused by needle exchange. It is assumed that Hepatitis C is spread by needle sharing. ~ Criminal Justice System. This would include records of people who were arrested or convicted of intravenous drug use related offenses. This is a random look at the population of users. ~ Drug Treatment Programs. This information usually comes from public funded programs. Only a small percentage of intravenous drug users seek treatment for their addictions. Dr. Locke briefly discussed the information provided in the Boards packet (see attached). Chairman Harpole asked if there are any specific data sources that can provide information on drug use in Jefferson County? Dr. Locke replied that there are a couple of organizations such as Jefferson Aids Services (JAS) and the Boiler Room who deal with HIV/AIDS issues and who have brought up the idea of a needle exchange program several times. They have concerns about the spread of HI VIA IDS and would like to have more programs, education and services available to them. Member Prissell asked Dr. Locke what his knowledge is of Hepatitis C in the community? Dr. Locke explained that Hepatitis C is typically chronic and is not reportable which makes the data limited. Jefferson County has been tabulating the data for the last year from providers who voluntarily report chronic Hepatitis C. The number of cases seem to have increased. The reporting of acute Hepatitis C is required. Chairman Harpole asked if any other smaller counties have taken on this issue? Dr. Locke stated that he is not aware of any in Washington State but there are several located in the nation. He suggested that a regional approach might be a good idea. This would be where three (3) Counties join together to implement a program. Chairman Harpole stated that he realizes implementation is a long way off, but appreciates the fact that there are other avenues and options available. Member Westerman asked for clarification of exactly how many HIV cases there are locally. Dr. Locke replied that one third of the mv cases are associated with needle sharing nationwide. It is reported that 7% of the AIDS cases in Washington State are people who are intravenous drug users. Another 4% are intravenous drug users and have sexual behaviors that may also be attributed, but it is not sure which one is responsible for the AIDS virus. Chairman Harpole asked how many AIDS cases there are in Jefferson County? Dr. Locke answered that in the last ten (l0) years there have been approximately 27 cases of full blown AIDS. Chairman Harpole then asked how many cases of mv there have been? Dr. Locke said that since mv is a non reportable disease there is no way of knowing. Member Shoulberg asked if there is a way to track mv without physicians reporting it? Member Shoulberg suggested checking the types of drugs pharmacies sell to people with HIV. Jean Baldwin HEALTH BOARD MINUTES - APRIL 14, 1998 Page: 3 stated that most of the mv cases in Jefferson County don't use local pharmacies. Dr. Locke said that some of those drugs are used for other illnesses and he is not aware of anyone proposing this type of method for tracking mv cases. Although this is a controversial subject it is agreed by both sides that some type of system needs to be established. Commissioner Huntingford asked iflaw enforcement usually stays away from areas that have a needle exchange program? Member Westerman answered that in Spokane County law enforcement officers agreed to stay away because they believed the program was a long term solution to a problem that wasn't being resolved. After further discussion Member Shoulberg moved to direct staff to gather more information on the needle/syringe exchange program and report back to the Board of Health. Commissioner Huntingford seconded the motion which carried by a unanimous vote. NEW BUSINESS REPORT ON ASSISTANT SECRETARY OF HEALTH MAXINE HAYES' PRESENTATION re: Action Plan on Unintended Pregnancy: Jean Baldwin reported that Assistant State Secretary of Health, Dr. Hayes was in Port Townsend earlier this month. Dr. Hayes gave a presentation on the action plan on unintended pregnancy. She explained that the information is gathered from birth certificates and then a profile is done on the mothers and their pregnancy. It was found that the risk of unintended pregnancy is greater than previously thought. There was an article in the Leader regarding this presentation (see enclosed). Commissioner Huntingford asked if there is a difference between unintended and unwanted pregnancies? Jean replied that there is a difference. "Unintended," could mean that they didn't want to be pregnant but came to accept the fact by the time the baby was born. "Unwanted," means just that. A handout of the Morbidity and Mortality Weekly Report (MMWR) was given to each Board member and discussed briefly (see enclosed). This is an overview of what the public perceives are health issues and, who is responsible to pay for them. LEGISLATIVE UPDATE: Dr. Locke reported that the legislative session is officially over. Included in information presented to the Board is a "Washington Health" newsletter that is specific to health issues in Washington State. This edition of the newsletter is an overview of the legislative session. The State Department of Health has not yet sent out their summary issue. Dr. Locke stated that there were no mandates that constituted a major change from a public health standpoint. The Board concurred to subscribe to the "Washington Health" newsletter. PRIVATIZATION OF DRUG AND ALCOHOL PROGRAMS: David Specter informed the Board that three (3) proposals were received for the privatization of the Drug and Alcohol programs. A review panel consisting of: two (2) members from the Drug and Alcohol Advisory Board; one (1) person who has completed the drug and alcohol program; Dennis Kelly, DSHS stakeholder; two (2) Drug and Alcohol Coordinators from Island and Thurston Counties; Laurie Strong, Jefferson County Mental Health; Ted Shoulberg, representing the City Council and Jefferson County Board of Health; David Goldsmith, Deputy Director of Public Services; David Specter, Director of Health and Human Services; and Judith McClure, Acting Drug and Alcohol Director. This committee has already met to discuss the selection process and will interview the applicants on Monday, April 20, 1998. The review panel will HEALTH BOARD MINUTES - APRIL 14, 1998 Page: 4 make a recommendation to the Board of County Commissioners for their approvaL David Specter stated that there was an article in the newspaper about concerns that the privatization process has been done behind closed doors. He feels this is not the case. The meetings have all been open to the public. Chairman Harpole said that he has heard concerns about the reduction in hours of the counselors. It was his understanding that this was the best way for counselors to continue working with their clients without disrupting their progress. David Specter clarified that the primary motive for privatizing was not to save money but to better serve the community. Chairman Harpole asked what the effective date is for the privatization? David Specter responded that July 1, 1998 is the target date. OTHER PROGRAM UPDATES: Larry Fay reported that the Environmental Health Department has received a $30,000 grant from the State Department of Health to be administered with the consolidated contract process. Statewide, the grant will be used to monitor and evaluate innovative and alternative onsite sewage systems. The project will focus on the effectiveness of nitrogen removal from several alternative and proprietary treatment systems in order to refine the nitrogen reduction BMP's identified in the critical areas ordinance. A potential site to be used is the H. 1. Carroll Park. Larry Fay suggested an upgrade of the proposed system beyond the minimum required regulation,. The upgrade would accommodate a nitrogen reduction performance system to be monitored by the Health Department. Larry Fay also reported that the State Department of Health Drinking Water Program is making an effort to comply with federal drinking water regulations. The State is conducting sanitary surveys of non- community group "A" water supplies. If the Board of Health is interested in entering into an agreement to help with the surveys, Larry Fay said he will talk with the State Department of Health and draft ajoint plan to be discussed at a future meeting. AGENDA CALENDAR: David Specter informed the Board that the State Secretary of Health, Bruce Myahara has submitted his letter of resignation to Governor Locke, although he is still planning on coming to Port Townsend in May. The Board reviewed the following tentative agenda schedules: May Meeting Secretary of Health Visit Draft On-Site Sewage Ordinance and Schedule Fee Principles June Meeting On-site Sewage Board of Health Tour (June 4, 1998) Board of Health Retreat (June 18,1998,12-5 p.m.) a Health Access a Partnership a Program Priorities a Emerging Public Health Issues a Report on Needle Exchange Investigation HEALTH BOARD MINUTES - APRIL 14, 1998 July Meeting HIV Named Reporting Fee Schedules CD Program Reorganization Meeting adjourned. The next meeting will be held on Thursday, May 21, 1998 at 2:30 p.m. Page: 5 (Excused Absence) Jill Buhler, Vice Chairman ~J\tc~4vv~ Sheila Westerman, Member /~dA / -4;up#.efL/ Roberta Frissell, Member . ard E. Wojt, Me er 'ft~ \ . CDC ~"""-00Nf1'Q. ~~ February 6, 19981 Vol. 471 No.4 MORBIDITY AND MORTALITY WEEKLY REPORT 69 Public Opinion About Public Health - California and the United States, 1996 73 State-Specific Prevalence of Lapses in Health.Care-lnsurance Coverage - United States, 1995 77 Adult Blood Lead Epidemiol09Y and SUlveillance - United States, Third Quarter, 1997 Public Opinion About Public Health - California and the United States. 1996 Despite widespread belief that public support is critical to the success of public health programs and agencies. systematic efforts to measure public opinion about public health have been limited. This report summarizes surveys conducted by two or- ganizations-one a public policy center in California, the other a national opinion poll- ing firm-to measure support for public health activities. The findings indicate wide- spread support for community-oriented disease-prevention and health-promotion activities. California Survey From September 30 through November 5, 1996, the Field Institute of San Francisco (with consultation by Louis Harris and Associates, Inc.) conducted a random-digit- dialed telephone survey of California residents aged :::18 years; the survey was com- missioned by the nonprofit California Center for Health Improvement and was funded by The California Wellness Foundation ( 1). A representative sample of 4803 persons was interviewed. The standard error associated with the results of this survey was :1:2% at the 95% confidence level. The percentage of respondents who reported that selected public health services were "top priority" ranged from 29% (for collecting community health data) to 84% (for ensuring safe drinking water). The percentage who reported delivery of these services as "very effective" ranged from 18% (for providing community education and counseling services about improving health) to 37% (for minimizing the spread of dis- ease carried by insects or animals) (Table 1). Selected local and state fees or tax in- creases were supported by substantial proportions of respondents if funds were needed to pay for what the survey instrument termed as "adequate programs" (Table 2). Most respondents preferred that funds for public health services be raised at the state level instead of at the local level (Table 2). The sources of revenue for those services that were most supported by respondents were increases in state taxes on alcoholic beverages and tobacco. Most respondents opposed state surtaxes on health insurance premiums (72%), local residential property taxes (64%), and local sales taxes (57%). Respondents supported the existing state requirements that nonprofit health-care providers fund community health programs (84%) and that nonprofit health-care providers that convert to for-profit status be required to dedicate funds to U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES . } 70 MMWR February 6, 1998 Public Opinion About Public Health - Continued TABLE 1. Percentage of survey respondents who reported that selected public health services were "top priority," and percentage who reported delivery of these services as "very effective" - California, 1996* Public health service Top priority o/a Respondents Very effective Ensurin9 safe drinking water 84 34 Ensuring that foods are free from contamination (e.g., through restaurant and produce inspections) 77 33 Protecting the public from exposure to toxic chemicals and other hazardous materials (e.g., monitoring the disposal of industrial and medical wastes and after oil spills) 75 29 Protecting the public from the spread of communicable diseases (e.9., AIDS, hepatitis. and tuberculosis) 74 22 Helping treat disease and injury after natural disasters (e.9., earthquakes, wildfires, and floods I 65 30 Providing community education and counseling services about improvin9 health (e.g., through nutrition education programs, alcohol- and drug-abuse programs, and tobacco prevention programs) 53 18 Minimizin9 the spread of disease carried by insects or animais (e.g., rabies) 49 37 Collecting community health data (e.g., registering births, determining causes of deaths, and monitoring health trends I 29 19 'Results of a random-digit-{jialed telephone survey of California residents aged ,,18 years (n=4803 respondents) ( 1). The survey was conducted by the Field Institute of San Francisco, with consultation by Louis Harris and Associates, Inc.; the survey was commissioned by the nonprofit California Center for Health Improvement and was funded by The California Wellness Foundation. The standard error was :1:2% at the 95% confidence level. promote health (82%). In addition, most respondents indicated support for a statewide initiative for a 63\i per pack increase in cigarette tax (i.e., 72% strongly or somewhat favored the increase). National Survey During December 12-16, 1996, Louis Harris and Associates, Inc., conducted a na- tional random-digit-dialed telephone survey of 1004 U.S. residents aged ,,18 years (2). This survey was conducted for the Harris Poll column, which is syndicated to the media but is not commissioned by anyone client. The standard error associated with the survey was :1:3% at the 95% confidence level. The response rate was 62%. Respondents were asked to rank the importance of eight services "to improve the health of the public" on a five-point scale (i.e., very important, somewhat impor- tant, not very important, not at all important, or did not know). The percentage of respondents who rated specific public health services as very important ranged from . Vol. 47 ! No.4 MMWR 71 Public Opinion About Public Health - Continued TABLE 2. Preferred sources of revenue for improving community health promotion and disease and injury prevention programs and environmental health services, by percentage of survey respondents - California, 1996* % Respondents Did not Favor Oppose know 81 18 1 78 21 1 72 24 4 68 29 2 Source of revenue Increasing state taxes on tobacco products Increasing state taxes on beer, wine, and other alcoholic beverages Expanding tax deductions for contributions to charities and other nonprofit organizations Increasing state income taxes for persons earning >$200,000 per year Increasing city developer fees on builders of new homes 59 53 41 33 38 43 57 64 3 4 2 3 Increasing local taxes on business property Increasing local sales taxes Increasing local taxes on residential property Charging a surtax on health insurance premiums paid by businesses and persons 24 72 4 'Results of a random-digit-dialed telephone survey of California residents aged ;;,18 years (n=4803 respondents) ( 1). The survey was conducted by the Field Institute of San Francisco, with consultation by Louis Harris and Associates, Inc.; the survey was commissioned by the nonprofit California Center for Health Improvement and was funded by The California Wellness Fou ndation. The standard error was :t2% at the 95% confidence level. 56% (for helping persons cope with stress) to 93% (for preventing the spread of infec- tious diseases) (Table 3). Respondents also were asked "Who do you think should be mainly responsible for the performance of prevention rather than the treatment of disease." Most (57%) re- spondents indicated that government should be responsible for this service; and 40%, that "someone else" should be responsible. Of those persons who responded that government should provide this service, 53% stated that the federal government should do so; 32%, the state government; and 13%, city and local governments. When asked the open-ended question, "What do the words 'public health' mean to you?," <4% of respondents gave answers corresponding to what the Harris Poll considered "generally...regarded as referring to public health" (i.e., health education! healthier lifestyles, prevention of infectious diseases, immunization, and medical research) (2). Eighty-three percent of respondents identified one or more of the fol- lowing: general physical health, mental health, and well-being of the public; the health-care system; welfare programs; universal health care; health assurance; health insurance; and Medicaid and Medicare. Reported by: K Bodenhorn MPH, California Center for Health Improvement Woodland Hills, California. H Taylo/; Louis Harris and Associates, Inc., New York. Office of the Directo/; Public Health Practice Program Office, CDC. Editorial Note: Opinion polling is used extensively as an adjunct to or in assessing contemporary public policy. Polling can help to clarify the perceived importance of 72 MMWR February 6. 1998 Public Opinion About Public Health - Continued TABLE 3. Percentage of survey respondents who reported that selected public health services were "very important" or "somewhat important" - United States. 1996* % Respondents Very Somewhat important important Public health service Preventing the spread of infectious diseases (e.g., tuberculosis, measles, influenza, and AIDS) 93 7 Vaccinating to prevent diseases 90 9 Deliverin9 medical care to ill patients by doctors and hospitals 85 13 Improving the quality of education and employment 83 14 Ensuring persons are not exposed to unsafe water supply, dangerous air pollution, or toxic waste 82 15 Conducting medical research on the causes and prevention of disease 82 15 Encouraging persons to live healthier lifestyles (e.g., eat well, exercise, and not to smoke) 72 24 Helping persons cope with stress from the problems of daily living and work 56 34 *Results of a random-digit-dialed telephone survey of U.S. residents aged " 18 years (n=1004 respondents) (2) conducted by Louis Harris and Associates, Inc., for the Harris Poll column, which is syndicated to the media but is not commissioned by anyone client. The standard error was :t3% at the 95% confidence level. issues and the impact of advocacy campaigns and other factors on public support for, or opposition to, policies. The survey conducted in California identified 1) substantial support for public health services and 2) substantial support for taxes, if necessary, to achieve more effective public health programs and services. Although findings from the national survey were consistent with findings from the California survey about support for public health services, the national survey did not address financial con- cerns. The findings in this report are subject to several limitations. First, the results of the two surveys were not directly comparable because the samples were drawn from dif- ferent populations, the questions differed, and the results were reported in different formats. Second, each survey gauged public opinion at a specific point in time; there- fore. the reported opinions could not be linked to contextual, secular events. Other limitations associated with survey methodology (e.g., refusals to be interviewed, wording and order of questions, and interviewer bias) also apply to the results of these two surveys. Interest in marketing public health has been stimulated by perceived low public support for public health activities. limited financial resources, and the impact of extensive restructuring in the health-care sector. The findings in this report indicate substantial public support for public health services and suggest the need to deter- mine the extent to which this support is consistent across jurisdictions and whether it can be translated into policy. Finally, these findings suggest the need for strength- ened methods to improve the polling of opinion about public health, including clarifi- cations ofthe distinction between clinical care and community- or population-oriented Vol. 47 I No.4 MMWR 73 Public Opinion About Public Health - Continued disease and injury prevention, and the practical meanings of "public health," "com- munity health," and other key terms. References 1. California Center for Health Improvement. Spending for health: Californians speak out about priorities for health spending. Sacramento: California Center for Health Improvement, 1997. 2. Louis Harris and Associates, Inc. 'Public health': two words few people understand even though almost everyone thinks public health functions are very important. New York: Louis Harris and Associates, Inc., 1997. Jefferson Count Health and Human Services NEWS 1998 . -------------------------------------------------------- These issues and more are brought to you every month as a collection of news stories regarding the Jefferson County Health and Human Services and its programs for the public: l. "Jeffco woman does amazing feats with feet" -- Peninsula Daily News, March 16, 1998 2. "Health inspector gives food service ratings" -- Port Townsend LEADER, March 18, 1998 3. "Eating establishments recognized with food awards" -- Port Townsend LEADER, April 1, 1998 4. "Age distribution in county heavy on older persons" -- Port Townsend LEADER, April 1, 1998 5. "U ointended pregnancy issues raised by state health doctor" -- Port Townsend LEADER, April 1, 1998 6. "Privatization angers Jeffco staff" n Peninsula Daily News, April 8, 1998 7. "Woman's treasure is county's trash"-- Port Townsend LEADER, April 8, 1998 ...-, ;,': VA:-'-E:;:;_-" :'ItCGH.\DY p,::<]:;~U,\ :)\][-, .,':'.\~ ~yrtJe Core fixes up the feet of seniors who are unable to do it any- nore~ J effco woman does amazing feats with feet BY VANESSA McGRADY PE:-.'INSULA D.AJLY NEWS QUlLCENE - N, mist dropped around Quilcene like a cold wet blanket, Myrtle Corey was at it again, saving soles. Once a month the registered nurse from the Jefferson County Health Department comes to the Communitv Cente; to fIx feet for elderly and disabled people who can't do it themselves. ;'1 used to, of course, trim my toenails all my life," said 76.year-old Maury Anderson. "The big thing is getting old and rickety, a guy can't bend over anymore." Trimming toenails is only part of the package. For $10, or whatever they can afford, clients get their feet soaked and the dead skin sloughed off. ..o\n electric Dremel tool with fil- ing attachments pares down rough skin, calluses and nails. Corey finishes each foot ..vith a slathering of lotion. For many of the seniors, it's like a social hour. Talk this day ran from weight lifting to the search for Amelia Earhart to peacocks in the road. And for all of them, it's a necessity. "It's been a life-saver for us," Anna Hanson, 73, said as she soaked her feet. She comes in regularly with her husband, Hugh. She has diabetes, and he is on heart medication; both are under doctor's orders not to trim their own toenails for fear of a cut. Corey received special training from a podiatrist and can look at the feet as a road map to a person's life. "Everybody's feet are so different. You can certainly tell someone who has worn sensible shoes their whole life as opposed to someone who wore high heels on cement floors," she said. The treatment goes beyond beauty. Corey said swollen feet often indicate ailments such as congestive heart fail- ure or diabetes, and she refers questionable cases to higher medical care. :.lost of the time, they listen. One didn't - a man in \vhom she detected serious circulation problems. He refused to see a doctor, and after a few months, Corey told him she could no longer help unless he sought treat. FEET COKTII\"UED FROM Al ment for his problem. "He stopped coming," she :5aid. ';A couple of years later he lost :'1is leg and later, his life." ivlost of her clients, however, have become her friends. "I like it. I get to meet so many nice people all over the counn.," she said. Corey, who's been filing feet since 1984. also works out of the rpbN 3!G -'if ~O<:'___ : ;c .... ... ... ...., _ ^ . .1~atBt~ c. ,. .. _..~~.~Uiki[;:"" Brinnon, Tri-Area and Port Townsend community centers. To make a foot-care appoint- ment, call the nearest commu~ nity center. 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CJ c:l ::: ....., ...., C tll';::: :: S E .... l- 0 ...c..::: rr. ::: - 5 ;z ~ ?f';: ~ "'C. ... ...-- " --d '>:;: :s: .~ ,-; -> t ~ ~___ct{f)SO~~o-_oo~~"""~~~tll~~~~~~Ecv>-~'a:.tll~-'8:;' le\l .:;'....,""0 ~ ill<VZ "'z.... >'z ;> b.C '-' cEO:: c..... ~''''''''O.....,.- u U'--C; u.,. I: C cr. I-< E ""0 "'? c:=. 5 E-i .:= W 2 _ ro 0 :;: ..c :3 --7 ~ >. CJ I: -~ tll OJ::> 2 ~ tll i: f"...' _;:l"'" ro..c <ll a.: _ t::: _.... .-. ~ _ tr. . If; _ _ o..cE---..5 ~ ~ ~ t:. ;:l a:: c:::. ;!; :>-. I- Q P;:: ~ ....-t 8 b ~ ~ ~ -:5 .~ 5 S ] .g g ~ c ~:2 2 ] 8.8 ~ 8 t 8 :J ~ Age distribution in county heavy on older persons By Fred Obee leader Staff Writer The distribution of age groups in .Jefferson County is an oddity in \Va!';hington state. Among county residents, big growth is coming at the upper end of the age scale \'\"hile younger people are disappearing. People 55 to 64 comprise 30.5 percent uftbe county population, while statev,'ide the average is 19.1 percent. People ages 65 to 74 com- prise 19.9 percent of the popula. tion and people 75 to 84 make up 8.2 percent of the county popula- tion. The statewide averages in tllDse categories are 11.6 percent and 5.1 percent, respectively. At a recent citizens' meeting in the Tri.Area on health issues. Health Department Director Da\'id Specter said he was struck by a comment made by one of the presenters. "He said that Jefferson County looks like what demographers say the \vhole country will look like 25 years from now," Specter said. According to Assessing County Change, a 1994 report that evalu- ated census data in Olympic Pen~ insula counties, Jefferson County's lopsided ,age distribution is the direct result of in- and out-migra- tion. Older people are coming here in droves, the report concluded, but young adults are leaving just as ql1ickly.Jt is a pattern that de- veloped even before 1980. "In-migration has affected ev- ery age group between 50 and 75," said Annabel Kirschner Cook, the study's author. "Be- tween 1980 and 1990, there was substantial growth in the num~ ber of persons in the age groups from 60 to 75." By 1990, Cook concluded. Jefferson County - with San Juan and Garfield counties - possessed the highest median ages in the state by a substan- tial margin. "Thus at the ages where we wouln m:ually see a slight decline .in the number of persons in each older age group [as happens for the state as a whole] we see growth in Jefferson County age groups. The rapid growth in tilE' number of older adults, particu- larly at the oldest ages. means that services used by those per- sons need to be expanded." Not surprisingly, Cook noted, the high percentage senior popu- 50 Persons 65 and Over Living Alone: 1990 40 . Percent of Men 30 and Women Washington Clallam I!!lMen Grays Harbor Jefferson Mason State/County .Women Pacific Women are far more likely to end up living alone after age 65, according to U.S. Census data depicted in the graph above. That fact, along with others, suggests that Jefferson County will need to develop additional programs to help people coping with old age. lation also is driving up the num- bers of seniors in other categories. For example, the number of older people living alone appears to be on the increase, and the number of older people living in group homes, assisted care facili- ties and other "non~family" households was also heading up. The rise of individuals living in non-family households between 1980 and 1990 was greatest on the Olympic Peninsula in Jeffer- son ~ounty. ':These changes point to the possible need for counties to en- hance programs that help older adults maintain an independent lifestvle," Cook said. C~ok also noted that on the Olympic Peninsula, women older than 64 are twice as likely to live alone than is the case with men. This is because women frequently marrv men a few vears older than them~elves and five up to seven years longer on average. In many cases, women over age 65 may be living on their own for the first time in their lives, and while manv manage nicely, a si!,'11ificant pe;- centage probably will require more assistance with things like home maintenance, financial planning and advice on income tax prepa- ration, Cook said. Although statistics 8ho".' women are more likely to find themselves living alone, the num- ber of both men and \vomel1living by themselves in Jem'rson County is trending upward, Cook found. Older people also show up in the county's poverty statistics. The number of older people living in poverty increased during the 1980s on the Olympic Peninsula. In poverty rates, there is a clear distinction by gender. In 1989, of the Jefferson County residents over age 65 living in poverty, 71.8 percent were women. One consortium of agencies that formed recently to grapple with a whole array of public health problems is the Jefferson County Community Health Partnership. The group is compiling and evaluating stati!'tics to deter- mine what actions should be takpn to meet Jeffcr::::on County health needs. The partnership is comprised of Community Counseling, Olympic Area Agenc.y on Aging, Jefferson General Hospital, Department of Social and Health Sen'ices. Communitv Action Council. the county He~lth Department and Kuh Tai Care Center. Specter said he would like to see senior i!'.sues become a much more integral part of the public health picture than is the case today. ''I'd like to see it much more on the agenda," Specter said. "There's a lot to address here."' Currently, Jefferson County Health Department docs run a foutcare program that. is widely appreciated and supported, Spec- ter said, and the Olympic Area Agency on Aging provides many services to seniors. At Jefferson General Hospital, a wellness program focuses on helping people who aren't sick stay well. A national report issued in 1990 set some basic goals for the nation. The No. 1 goal is reducing heart disease, No.2 is urging Americans to become more ac- tive, and No.3, getting people who are overweight to adopt sound diet and exercise regimes. Also offered are seminars on diabetes, asthma and cardiac re- habilitation, and nurnerou~ sup- port grou ps. All of that and more will be necessary if current trends for Jefferson County continue, health officials sa\'. Although st;tistics show people generally \",'ill work longer in the next 20 years than was the case historically, they also will have longer retirements as life expectancy increases. 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Q.) ~ >-..t;--:.;:; ... rr:.":::"::< c:: Q .... C': - rn If. ~Q.)~..c~cc,- r::~Q.)""':l~~2Q.)~ c~ ~w~.....~'"Oc uv.:.:O:::..~r::u"::~ -~ J b-J-/1 "CJ::3 Q tip'? Privatization angers Jeffco staff Program: County to drop alcohol drug center; jobs could be lost. BY cHRiS'i'iNA'KELLY>"- " PENlNSULA DA1IJ' NEWS PORT TOWNSEND - Jefferson County officials are looking to ~t out of the alcohol/drug abuse treatment business, but that may cut jobs of employees who have worked for the county for years. The treatment program is operated by the Jefferson County Community .-\.lcohol and Drug Abuse Center. It has been in operation since the early 19708, treating clients who have insurance to pay for the treatment, and those who cannot afford to pay. But the number of clients has been declin- ing over the years, with the competition of private contractors, said David Goldamith, Jefferson County personnel director, who has been working on the issue for months for the county commissioners. -- "Originally we gofmto t!iISl>w,mess because there were no private providers available in the county," Goldsmith said. "But, over the years, we have thought that . I TuRN TO CENTER /A2 CENTER CONTINUED FROM A1 perhaps we shouldn't be in the treatment business." One of the biggest factors was cost. County authorities are convinced that a private contractor can do the job cheaper. . But center counselors say clients will be hurt and services cut. George Logg, an alcohol/drug treatment counselor, said he believes the clients, especially low-income people. will be hurt. "The county said it will save money and still be able to offer the same programs. My ques- tion back to them is how do you plan to do tbat?" The center has an annual budget.of around $300,000. In February; the county commis- sioners put out a requ-est for bids by private contractors. The contractors had to specify how tbey would operate on a budget of about $130,000. Chester Prudhomme, another center counselor, said the county haa the right to switch services to save money. However, he said he does not agree that the same level of ser~ vices can be provided for one. third the cost. "My concern is that the peo- ple in the county who need these services will not be get- ting them," Prudhomme said. "It is a standard statistic that for every $1 you spend on recovery, you get back $8 in return. That includes court and jail money that won't have to be spent." Prudhomme has been with the center for 18 years. He and the other three counselors could lose their jobs if privati- zation takes place. Counselor John Franke also said the staff believe the county commissioners took a less than public approach to eliminating the agency. "We have the same feeling that this wasn't handled pub- licly to keep things quiet:' Franke said. Phyllis Solomon, who serves on an alcohol advisory commit- tee for the county, said she wrote a letter to the editor ask~ ing the commissioners to have an open forum on the matter. The letter was published three weeks ago, and she has not heard a word from anyone. "I don't know what will hap- pen if the treatment programs are priv~ti;~edJ_ but 1'd like it di:;cgs...!i !I\ the open, ~ . Solomon said., . . Goldsmith said the county commissioners adopted a reso- lution in January, stating their intentions. A request for bids went out, and three agencies responded. In October of 1997, Gold- smith said a meeting was held with all the stakeholders in alcohol/drug treatment pro~ grams. The meeting included the courts, the state Depart~ ment of Social and Health Ser- vices, Child Protective Services and law enforcement. The rep- resentatives were asked if their needs were being met by the center. The response was no, Goldsmith said. "I know there are people who have an affinity for the center," Goldsmith said. "I real- ize from a human standpoint, there are jobs which will be lost. "It makes financial sense to allow a private contractor do the job. We would rather focus on prevention and interven- tion." The center has been the sub~ ject of public scrutiny because of a sexual harassment case focusing on Prudhomme..The victim is suing the county. Prudhomme was once the direc- tor. Some of his supporters believe the county is cutting the program to get rid of Prud- homme. While Goldsmith admitted the timing was bad, he said the two situations are not con- nected. When Prudhomme was demoted to a counselor, the county hired Jude McClure as transition manager. McClure said it ~as appropriate for the county to try to save money. "I don't think anyone looks at privatization as a panacea," McClure said. "I also don't think anyone naively thinks this will solve all the problems. "1 do understand there is a painful part of this, and that is the loss of jobs." -pt,J t.f~ g - 'if ..... - -- - - -... .. -- - .... ~. ~ Linda Sexton stands outside her Chimacum home. She belieyes everything has a use and thai someday people will want the materials they are throwing away today. Her penchant for collecting used items :lod ita ring lhem in sometimes unsightly piles has drawn a lawsuit from Jefferson County. - Photo by Fred Cbee Woman's treasure is county's trash County files lawsuit to clean up land By Fred Obee leaderStaHWriter A Chimacum woman's con vic- :ion that nothing shQuld be N<1sted is on a cullision course with ,Jefferson Countv The county this ~onth filed suit against 'the woman, Linda Sexton, claiming her unceasing efforts to coHee! second-hand ~tems quallfies her as operating a solid waste facilitv. and she "hould become per~itted if she wants to continue. To Sexton. the suit, and aU that has preceded it. is one mis- step after another "1 am not a .~olid "vaste facil. it,,:' Sexton~aid last '.'..-eek. "1 feel r<'e been framed by the govern+ ment and pigeonholed in a hole where I don't belong." Sexton's penchant for collett ing used goods has caused her trouble for years. About 10 years ago, neighbors complained her second-hand store near the Center Valley/ SR 19 intersec- tlon was an eyesore. In recent years, the county also has in- vestigated piles of rubbish on 22 acres Sexton owns on Beaver Valley Road. Sexton doesn't deny that she collects and piles up used goods, but she said the countv's insis- tence that she comply ~with the rules and regulations required of landfills and recycling cen- ters is unfair. ~obOdy comes on my prop- erty. It's not a public faciIity,~ Sexton said. She doesn't charge for pickup, and, she added, the items she collects have value, Thev aren't rubbish. ~Most people are concerned these items don't end up in the landfill," Sexton said. ''I am sav+ ing stuff from not being wasted." ,Jefferson County Environ+ mental Health Director Larrv Fay, however, 3aid Sexton's a~- tivities go beyond all reason- able bounds. Her closed second- hand store is crammed, a ware- house on her Beaver Vallev land is stacked to the ceiling, and there are piles ()f"tC<Hnmuditie~ outside the warehouse. ~She';; handling other people's discards,~ Fay 3aid, ""\Vhen you are actively soliciting it you are doing it as a business whether YOU take money for it or not. ~ . Fay admitted other people col+ lect leftovers from garage sales and sell them and aren't required to be permitted as solid waste fa- cilities. but in Sexton';; case, he said he thinks the label is justified. "It's not different than what others are doing, but others are managing it better:' Fay said. Back to the land Sexton, a Seattle native. came to Jefferson Count.,. in 1972 after becoming attra"cteci to the ~back to the land move- 01 ,,-,n1. " She had earned a master's degree in education from the University of Wash- in,gton and taught overseas for several vears, but she left her teaching career behind and bou::rht ~7 acres off Beaver Val- le,' Road. 'There, she said. she and her husband planned a homestead ::md she started on a journey to- ward self-sufficiency for philo- sophical and spiritual reasons. "The \'ision was eventuaU,' a cOr.".munity of people \vho wo~lci See SEXTON, Page A 8 a: ~ w " <( . .... w ~ > s c , 0 0 c 0 . ~ .. .. ~ Q;) " c & c ~ . 0 ... <; "- Q;) . ~ ... ~ fIl ~ ~ roc . .... ...-4 0 fIl fIl ~ ~ ~ ~ ~ ~ ~ :;:j 0 0 .. = ~ 0 ~ ~ oj ~ g, <( " . " . Q) . c " . ~ rn ~ " >..... G.l t>.l: ..c-. '... I:lD 0."'0 .' 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'" u C Q..' 1lI_ '" O-::l C u "" ~.- III .~ ~ ~ .E ~ ~ o ... -= .... ... ~' :g,.?':, ~ r.c] ..,"'1::-;;; ~ -= t: c::s C oCQ; ~cc :::.g ~ :5~ ~ Q.; . ~, III "tIi11-= t"'Cr:.n ~ C.S ~ ;. ~ 1: ...~ III V. !l' Cl..= .! g c.. --ci ~'~'';:: 0.... E g c"'C 0 e -;; c tlr Cl >, C ... U"'C III Q) ... o l..= <l:~, Cl.c.... t)\f}5~E::-g ~~~~i=~]t: .&'~~C:~!:~Q; .:::'5 ~:3.5 ~i.z .~~ L~5~.S~ Z ~8.S i~ Please Publish: One (1) time, Wednesday, April 8, 1998 Bill: Jefferson County Commissioners P.O. Box 1220 Port Townsend, WA 98368 NOTICE CHANGE IN HEALTH BOARD MEETING DATE The Jefferson County Board of Health will be meeting on Tuesday, April 14, 1998 at 2:30 p.m. at the Jefferson County Health Department, Castle Hill Center, 615 Sheridan Avenue, Port Townsend, W A 98368. Next month the regular schedule for this meeting will be resumed, which is the third Thursday of each month at 2:30 p.m. ~tingfOrd, i an Jefferson County Board of Health