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JEFFERSON COUNTY BOARD OF HEALTH
MINUTES
Thursday, February 15, 2007
Board Members:
Phil Johnson-- County Commissioner District #1
David Sullivan - County Commissioner Distrid #2
John Austin, Vice Chairman - County CommisJioner District #3
Jill Buhler - Hospital Commissioner District #2
GeoffAlasci - Port Townsend City Council
Sheila Westerman - Citizen at Large (City)
Roberta FriSJ'ell, Chair- Citizen at Lalge (County)
St~ffMembers:
Thomas Locke, MD, Health Ojjicer
Jean Baldwin, Public Health Services Director
Julia Danskin, Nursing Programs Director
Mike McNickle, Environmental Health &
Water Quality Director
Meeting was called to order at 2:30 pm on February 15,2007 by Vice Chair Austin in the
conference room of Jefferson County Public Health. All Board members were present with the
exception of Members Phil Johnson and Roberta Frissell. A quorum was present.
APPROVAL OF AGENDA
Member Masci made a motion to approve the Agenda as presented. Board Member Buhler
seconded the motion, which passed by unanimous vote.
APPROVAL OF MINUTES
Board Member Masci moved to approve the minutes of January 18, 2007, as written.
Board Member Sullivan seconded the motion, which carried by a unanimous vote.
PUBLIC COMMENTS
None
OLD BUSINESS
Seasonal Influenza Update
Dr. Locke reported that influenza has arrived in the Pacific Northwest. A variety of surveillance
indicators for influenza detection are used. School absenteeism rates above 10%, the number of
x-rays being taken, and hospitalization rates have all been used as markers for seasonal
influenza. There is a network of sentinel physicians who report the numbers of their patients who
meet a set of criteria (known as influenza-like illness). School absenteeism rates are up in W A
state and the Olympic Peninsula, sentinel physicians in Kitsap County are reporting influenza-
like illness, and King County virus culture tests are running about 30% positive for influenza. It
is likely that there will be a rise in the levels of influenza over the next 3-4 weeks. It is possible
to see multiple peaks in the season. The two strains of influenza A and one strain of influenza B
being seen in Washington State are covered in this year's trivalent influenza vaccine.
Immunization Update for Physican's Offices
Lisa McKenzie, Communicable Disease Program Coordinator, spoke to the Board about the
meeting she and Jane Kurata, Immunization Program Coordinator, held with clinic nurses and
doctors in January. The discussion centered on new vaccinations coming from the State Supplied
Vaccine Program and vaccine recommendations. Lisa also spoke about CHILD Profile, a State
Immunization Registry, where a child's immunization record can be viewed from a secure
website, allowing for easier access and availability to these records by multiple providers. In the
near future, all local clinics will be online. In addition to allowing prompt access to
immunization records by health care providers, this system will allow JCPH to generate reports
on immunization rates for the range of childhood vaccines given.
Jean Baldwin added that these new vaccines have new target populations and spoke about the
Federal Vaccine for Children Program and costs for various vaccines.
Member Westerman suggested that a letter be written to the Department of Health in
support of added funding to expand the coverage of the HPV vaccine for underinsured
women 19 years and above.
Member Buhler asked if Dr. Locke would speak to the Clallam County Board of Health asking
for their documented support in expanding the coverage for the HPV vaccine.
2006 BOH Action Items Thumbnail- Final COpy
Jean presented the Board with the final copy of the Action Items and Thumbnail from the 2006
Board of Health meetings. The Thumbnail will be posted on the JCPH website.
NEW BUSINESS
HB 1825/ SB 5729 (Public Health Fundinl!) Introduced
Member Sullivan testified in Olympia on HB 1825 and reported that he spoke briefly to the
committee, pointing out that Jefferson County invests at one of the higher rates per capita for
local public health services. Much of this local support comes from the County General Fund
but it is still not enough to cover increasing costs.
Jean Baldwin spoke about Public Health Funding and Accountability Legislation. She reviewed
with the Board some of the initial communicable disease prevention outcomes to be achieved
with increased financing. Jean pointed out that the increased revenue is 'new' money dedicated
to communicable disease investigation and tracking and other unmet public health needs.
Other Lel!islative Issues
Dr. Locke reviewed HB 1821 and HB 2012. HB 1821 proposes exemption from state registration
for manufacturers of biological remediation technologies for use in on-site sewage disposal
systems. HB 2012 creates an exemption from the registration process for proprietary
denitrification devices used in on-site sewage systems. Dr. Locke pointed out public health
concerns about devices that claim to fix failing systems. If the septic system is failing it is
discharging infectious waste onto the ground surface or into surface or ground water. Septic
systems additives have no proven benefit in preventing system failure or repairing failing
systems. New technologies that claim to accomplish this goal need to be carefully evaluated.
The two bills being discussed seek to have these two types on on-site sewage devices to be
treated like septic system additives, seeking exemption from Department of Health evaluation
and registration. Representative Van De Wege is a co-sponsor on HB 2012. Dr. Locke will call
to express the Board's concerns.
Mike McNickle expressed his concern stating that passage ofthese bills would make it a county-
by-county decision whether or not to approve.
Member Masci moved to generate a letter to legislators that states that the Board of Health
is adamantly opposed to HB 2012 and HB 1821, enclosing a copy ofthe response letter
dated January 2006 from similar legislation, stating that the Board of Health feels that this
is not appropriate at this time and would reconsider in 3-5 years when appropriate science
has been accumulated to demonstrate the efficacy of this product and procedures. Absent
the science, we cannot support it. The motion was seconded by Member Sullivan.
Member Westerman recommended omitting '3 -5 years'.
Dr. Locke asked the Board to consider whether or not the Board feels on-site sewage system
devices should be regulated or unregulated.
Member Masci amended his motion to read "until such time as adequate science
demonstrates efficacy", and added, "as County Board of Health, we adamantly oppose
unregulated products, if anything needs to happen it should be regulated based on
scientific methodologies".
Member Sullivan seconded the amended motion, which passed by unanimous vote.
Mike talked to the Board about HB 1650. This bill requires an inventory of all septic systems in
the county.
Member Masci moved that Mike generate a letter of BOH pointing out that HB1650 is
flawed and that it provides an unfunded mandate and is duplicative to previous
legislations, ie; Marine Recovery Area legislature and as such should not be supported or
passed this session.
Member Buhler seconded the motion.
During discussion Member Westerman stated that she was not in complete support of the letter
as proposed. Member Westerman expressed that she would like the letter to include a funding
pIece.
After in depth discussion it was agreed to rephrase the letter to include, 'the idea behind
the proposal is good, as long as adequate funding is provided'.
The amended motion was seconded and approved by unanimous vote.
Jean Baldwin spoke briefly about law enforcement officials, led by Seattle Police Chief Gil
Kerlikowske, who spoke at the capital to ask lawmakers to invest more state dollars in the Nurse
Family Partnership program.
Member Westerman motioned that the Board of Health send a thank you letter to Seattle
Police Chief GiI Kerlikowske for his stand on this issue. Police Chief Connor Daily will
receive a copy. Member Masci seconded the motion, which carried by unanimous vote.
Dr. Locke spoke about the 2006 Annual Report published by the State Board of Health, which
summarizes the prior year's efforts and the Washington State Health Report. The purpose ofthe
Washington State Health Report is to propose priorities for the legislature and state agencies to
use in making health policy and appropriation decisions. The State Board publishes the report
every two years and tries to make it relevant to the people who are making decisions on how
state resources should be spent. Member Westerman remarked that she would like the
legislature to have direct involvement in the report as opposed to being just an audience.
A motion was made and seconded to have Dr. Locke invite a representative from the State
Board of Health to speak at a future Jefferson County Board of Health meeting. The vote
passed unanimously.
Leadership Development at JCPH
Jean Baldwin informed the Board that she is joining the Jefferson County Community Network
Board, assisting in writing a prevention plan. Issues ahead will include setting priorities and
finding ways to get private and public agencies involved.
Jean also spoke briefly about the Collaborative Leadership Skills training series presented to
various program leaders at JCPH. Jean said she has gotten positive feedback from staff.
Member Masci suggested that Board members become more involved at JCPH, meeting with
each division leader, in an effort to become better acquainted with programs thereby becoming
an educated advocate for services.
On-Site Sewal!e Operation and Maintenance Privatization Discussion
Mike McNickle provided the Board with results from discussions with the PUD regarding the
on-site sewage (OSS) Operation & Maintenance (O&M) program. A rough draft was shared with
PUD at the meeting in January. There was discussion about the possible transfer of the O&M
program to JCPH. Discussion also centered around PUD continuing to perform O&M on all
large and community OSS systems in the county, a certification process for the private sector to
become O&M Specialists to perform O&M work, the opportunity for homeowners to perform
O&M on their own OSS, O&M reporting requirements, and enforcement strategies. Mike stated
that PUD would consider this proposal and send a letter of intent to the Board of Health in
March.
Activity Update
The Smile Mobile, sponsored by the Washington Dental Foundation, will be available March
12'h - 16th at JCPH. The Smile Mobile provides screening and potential treatment for children 15
years and younger from low-income families.
Al!enda Planninl!
Follow up on On-site Sewage Operation and Maintenance
Meeting adjourned at 4:40 pm.
Next Board of Health meeting is March 15, 2007.
JEFFERSON COUNTY BOARD OF HEALTH
Excused
Roberta Frissell, Chair
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David Sullivan, Member
Excused
Phil Johnson, Member
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Sheila Westerman, Member
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Jill Buhler, Member
"
JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street. Port Townsend. Washington. 98368
www.jeffersoncountypublichealth.org
January 5, 2007
The Honorable Lynn Kessler
PO Box 40600
Olympia, WA 98504-0600
Dear Representative Kessler,
After reviewing the findings of the Washington State Legislature's Joint Select Committee on
Public Health Funding on December 14, 2006, the Jefferson County Board of Health
unanimously passed the enclosed resolution. This resolution "urges Jefferson County's
legislative delegation to support legislation in the 2007 session, implementing the JSC
recommendations for stable, dedicated public health funding" and recommends that the Joint
Select Committees funding proposal of $50 million per year be doubled to $100 million per
year.
As Health Officer for Jefferson County, I must alert you to the urgency of the public health
funding crisis facing local health jurisdictions. Demand for local public health services has
never been greater - emergency preparedness, communicable disease control, threats to
safe food and drinking water, and the growing ranks of community members without access
to basic health services. In the face of these unprecedented demands, resources have not
only failed to keep pace, they are actually shrinking. Our ability to maintain essential public
health services is becoming more precarious with each passing year.
The Joint Select Committee has done an admirable job of identifying the critical gaps in our
public health systems. Each of these gaps represents a lost opportunity to prevent disease
and improve community health. Failure to address these critical deficiencies will not save
money - it will only serve to accelerate the runaway costs elsewhere in the health care
system. What is needed is an immediate and substantial investment in our long-neglected
public health system.
On behalf of the Jefferson County Board of Health, I ask for your support in addressing the
crisis in public health funding and averting the even greater crisis that will result from
continued inaction.
Sincerely,
~~~W-D
Thomas Locke, MD, MPH
Jefferson County Health Officer
COMMUNITY HEALTH
OEVELOPMENTAL DISABILITIES
MAl N: 360-385-9400
FAX: 360-385-9401
PUBLIC HEALTH
ALWAYS WORKING FOR A SAFER AND
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTH
NATURAL RESOURCES
MAl N: 360-385-9444
FAX: 360-385-940 1
.
JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street. Port Townsend' Washington' 98368
www.jeffersoncountypublichealth.org
January 5, 2007
The Honorable Kevin Van DeWege
PO Box 40600
Olympia, WA 98504-0600
Dear Representative Van DeWege,
After reviewing the findings of the Washington State Legislature's Joint Select Committee on
Public Health Funding on December 14, 2006, the Jefferson County Board of Health
unanimously passed the enclosed resolution. This resolution "urges Jefferson County's
legislative delegation to support legislation in the 2007 session, implementing the JSC
recommendations for stable, dedicated public health funding" and recommends that the Joint
Select Committees funding proposal of $50 million per year be doubled to $100 million per
year.
As Health Officer for Jefferson County, I must alert you to the urgency of the public health
funding crisis facing local health jurisdictions. Demand for local public health services has
never been greater - emergency preparedness, communicable disease control, threats to
safe food and drinking water, and the growing ranks of community members without access
to basic health services. In the face of these unprecedented demands, resources have not
only failed to keep pace, they are actually shrinking. Our ability to maintain essential public
health services is becoming more precarious with each passing year.
The Joint Select Committee has done an admirable job of identifying the critical gaps in our
public health systems. Each of these gaps represents a lost opportunity to prevent disease
and improve community health. Failure to address these critical deficiencies will not save
money - it will only serve to accelerate the runaway costs elsewhere in the health care
system. What is needed is an immediate and substantial investment in our long-neglected
public health system.
On behalf of the Jefferson County Board of Health, I ask for your support in addressing the
crisis in public health funding and averting the even greater crisis that will result from
continued inaction.
Sincerely,
~~~~~
Thomas Locke, MD, MPH
Jefferson County Health Officer
COMMUNITY HEALTH
DEVELOPMENTAL DISABILITIES
MAIN: 360-385-9400
FAX: 360-385-9401
PUBLIC HEALTH
AlWAYS WORKING FOR A SAFER AND
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTH
NATURAL RESOURCES
MAIN: 360-385-9444
FAX: 380-385-9401
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JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street. Port Townsend. Washington. 98368
www.jeffersoncountypublichealth.org
January 5, 2007
The Honorable Jim Hargrove
PO Box 40424
Olympia, WA 98504
Dear Senator Hargrove,
After reviewing the findings of the Washington State Legislature's Joint Select Committee on
Public Health Funding on December 14,2006, the Jefferson County Board of Health
unanimously passed the enclosed resolution. This resolution "urges Jefferson County's
legislative delegation to support legislation in the 2007 session, implementing the JSC
recommendations for stable, dedicated public health funding" and recommends that the Joint
Select Committees funding proposal of $50 million per year be doubled to $100 million per
year.
As Health Officer for Jefferson County, I must alert you to the urgency of the public health
funding crisis facing local health jurisdictions. Demand for local public health services has
never been greater - emergency preparedness, communicable disease control, threats to
safe food and drinking water, and the growing ranks of community members without access
to basic health services. In the face of these unprecedented demands, resources have not
only failed to keep pace, they are actually shrinking. Our ability to maintain essential public
health services is becoming more precarious with each passing year.
The Joint Select Committee has done an admirable job of identifying the critical gaps in our
public health systems. Each of these gaps represents a lost opportunity to prevent disease
and improve community health. Failure to address these critical deficiencies will not save
money - it will only serve to accelerate the runaway costs elsewhere in the health care
system. What is needed is an immediate and substantial investment in our long-neglected
public health system.
On behalf of the Jefferson County Board of Health, I ask for your support in addressing the
crisis in public health funding and averting the even greater crisis that will result from
continued inaction.
Sincerely,
~~ \f2J--~!:>
Thomas Locke, MD, MPH
Jefferson County Health Officer
COMMUNITY HEALTH
DEVELOPMENTAL DISABILITIES
MAl N: 360-385-9400
FAX: 360-385-9401
PUBLIC HEALTH
ALWAYS WORKING FOR A SAFER AND
HEALTHIER COMMUNITY
ENVIRONMENTAL HEALTH
NATURAL RESOURCES
MAl N: 360-385-9444
FAX: 360-385-9401
State of
washington
House of
Representatives
January 12,2007
Thomas Lock, MD, MPH
Jefferson County Public Health
615 Sheridan St
Port Townsend, W A 98368
RECEIVED
, 8 -'/1W
;. l,':l.;l(
iaoofSOr. COI.ii1t\
Public Health
Dear Dr. Locke,
_ Thank you for sending me the resolution supporting the findings, conclusions, and
recommendations of the Joint Select Committee on Public Health Financing. As a
frrefighter/paramedic, I see every day the results of our under funding of public health. It
is regrettably common for me to go on calls to people whose health problems have been
exacerbated by a lack of access to basic health services.
I have not yet had time to look closely at the recommendations of the committee, so I
cannot commit to supporting them quite yet. I will say however that a ~eri(j'u.s response to
the healthcare crisis in Washington State is extremely important to me and I will take all
necessary steps to get us there.
Please keep in contact with my office with any further guidance or information on public
health issues.
~~
~in Van De Wege
State Representative, 24th Legislative District
PO Box 40600
Olympia, W A 98504
(360) 786-7916
VanDe W ege.Kevin@leg.wa.gov
STATE REF'RESENTATIVE
241h DISTRICT
LYNN KESSLER
MAJORITY LEADER
Thomas Locke, MD, MPH
Jefferson County Health Officer
Jefferson County Public Health
615 Sheridan Street
Port Townsend, W A 98368
Dear Dr. Locke:
State of
Washington
House of
Representatives
January 17,2007
Thank you for your letter dated January 5, 2007 regarding public health funding. I
understand the need and will support an increase, but with the overwhelming needs
for education, health care, etc. it's unlikely we will be able to double the amount as
requested but we will do our best.
Thank you for your dedication and service to our community.
Sincerely,
/J1uIiJL
LEGISLATIVE OFFICE: 3:rd FLOOR LEG., PO BOX 40600, OLYMPIA, WA 98504-0600 - 360-78&7904
TOLL-FREE LEGISLATIVE HOTLINE: 1-B00-562-6<XX> -TbD: 1-800-635-9993
RESIDENCE: 62 KESSLER LANE, HOQUlAM, WA 98550 . 360-533-1944
E-MAIL: kesslecly@leg.wa.gov
PRINTED ON RECYCLED PAPER
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APPROPRIATIONS
RULES
EXECUTIVE RULES
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:=FIGHT pRJ~1=
Invest In Kids
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America must cut the pipeline that funnels young people into lives of crime and
violence. We take a hard-nosed look at research on what keeps kids from becoming
criminals and put that information in the hands of policy-makers and the public.
IN WASHINGTON
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EARLY EDUCArIOI\l
CHILD ABUSE & r.EGlECT
Bn\UnlL1i~.LaDd Youth Viglence Pr<lY.llnngRl'lan
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WASHINGTON NEWS RELEASE
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Law Enforcement Leaders Call on Lawmakers to Increase Funds for Home
Visiting to Improve School Readiness and Cut Crime
New Report Says One Year of Child Abuse and Neglect Leads to 270 Future Violent
Criminals in Washington
CONTACT: Laura Wells. 206 664.7110
FOR RELEASE: Thursday. January 25. 2007
Olympia. Jan. 25-Seattle Police Chief GiI Kerlikowske led a delegation of law enforcement officials to the
capital today to ask lawmakers to invest more state dollars in home visiting programs for at-risk families to
prevent child abuse and neglect, improve school readiness and cut crime.
Ke~ikowske, Snohomish County Sheriff Rick Bart and Sumner Police Chief Colleen Wilson released a
WQtl by Fight Crime: Invest in Kids Washington showing that one year of abuse and neglect leads to 270
future violent criminals in the state.
The law enforcement leaders testified before the House Early Learning and Children's Services Committee
in support of a home visiting bill introduced by Rep. Ruth Kagi (D-32). Kagi and Rep. Maureen Walsh (R-
16) later joined Ke~ikowske, Bart and Wilson at a news conference.
Home visiting programs strengthen families by helping at-risk parents raise healthy children who will
succeed in school and in life. They are voluntary. Trained personnel help parents understand the health and
nutrition needs of Infants, learn to identify signs of problems with their child. make their home safe and find
resources in their neighborhoods such as doctors and child care help.
"Research shows that child abuse and neglect can be prevented by programs that also prepare children to
succeed in school," Kerlikowske said. "It.s just common sense for Washington's lawmakers to increase the
state's investment in intensive home visiting programs:
Ke~ikowske said an additional state appropriation of $14 million over the next two years would mean that
3,500 more at-risk families would have access to the support they need to reduce child abuse and neglect
and ensure that children enter school ready to learn.
"If today is like most other days, 18 children in WaShington will be bruised, burned, sexually molested. or
left alone, hungry, without needed medical treatment or love." Bart said. "The home visiting bill will help
prevent those tragedies."
Some 6,700 children a year in Washington are victims of abuse and neglect. Sixty-one kids were killed in
http://www.fightcrime.org/releases.php?id=264 .
. 1/29/2007
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the last four years. The U.S. Justice Department estimates the cost to the state and its residents at $2
billion a year.
Atthough Washington has a number of programs to help at-risk families raise healthy children, they are so
under-funded they serve only a fraction of the eligible families who would accept help if it were available.
Bart pointed out that the only program targeted at low-income, pregnant women under 19-a high-risk
population-has enough funding to serve just 600 of the 3,800 such women in the state.
Wilson cited research on one such program, the Nurse-Family Partnership. The research showed that
children of mothers who received home visits were half as likely to be abused or neglected as children of
similar at-risk mothers not in the program. Also. as they grew up. the children in the programs had nearly 60
percent fewer arrests than the children of mothers who did not receive visits.
A study by the Washington Institute for Public Policy found that the Nurse-Family Partnership reduced
crime so effectively that it saved over $27,000 per family served.
"We know that home visiting cuts crime," Wilson said. 'By helping parents become better parents, we
ensure that Washington's most vulnerable children won't become Washington's most wanted adults."
Not only is child abuse a crime, but it may launch a cycle of violence that extends into the next generation,
Kertikowske said. One study showed that poor mothers who had been abused and neglected as a child
were 13 times more likely to abuse or neglect their children Ihan similar mothers who were not abused and
neglected.
Citing the Fight Crime: Invest in Kids' finding that one year of abuse and neglect leads to 270 future violent
criminals. Kerlikowske called it a conservative estimate. but still a significant toll of future crime that will tax
Seattle's Police Department and all of Washington's law enforcement agencies for years to come.
Kerlikowske. Bart and Wilson are members of Fight Crime: Invest in Kids Washington. The bipartisan.
nonprofit, anti-crime organization is comprised of 125 police chiefs. sheriff. prosecuting attorneys and
victims of violence. Kerlikowske is chairman of the board of the national Fight Crime: Invest in Kids
organization.
To view report. click here.
Fight Crime: Invest in Kids Washington * 3706 NE 42nd St.. Suite 200 * Seattle. WA 98105 * (206)664-7110
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http://www. fightcrime. org/releases. php ?id=264
1/29/2007