OUR COMMITMENT to the COMMUNITY at the Snohomish Health District, We Believe the Community Is Our Client

OUR COMMITMENT TO THE COMMUNITY At the Snohomish Health District, we believe the community is our client. We also believe that our clients deserve healthy places to live, learn, work and play. This requires a continued focus on promoting healthy habits, preventing illness due to communicable diseases, and protecting our food, water and environment from health threats. But we can’t do this alone.

We are fortunate to have a dedicated Board of Health and community partners stepping up to assist us on the Public Health Advisory Council and other workgroups. To everyone who helped us in 2014, we appreciate your time, energy, and commitment to making our community a safer and healthier place. HEALTHY 2014 BOARD OF HEALTH Stephanie Wright, Snohomish County Council, Chair Karen Guzak, City of Snohomish Mayor Ken Klein, Snohomish County Council John Joplin, Brier City Council Terry Ryan, Snohomish County Council Sam Low, Lake Stevens City Council Dave Somers, Snohomish County Council Scott Murphy, Everett City Council Brian Sullivan, Snohomish County Council Seaun Richards, Mountlake Terrace City Council Suzie Ashworth, Granite Falls City Council Sid Roberts, Lynnwood City Council Adrienne Fraley-Monillas, Edmonds City Council Donna Wright, Marysville City Council Linda Grafer, Mukilteo City Council

2014 PUBLIC HEALTH ADVISORY COUNCIL Terry Clark, ChildStrive, Chair Jiho Bryson, MD, MPH, The Everett Clinic Oliver Collins, Kamiak High School (student) D.W. Donovan, Providence Regional Medical Center Everett Bob Farrell, Community Health Center of Snohomish County (partial-year) Mickie Gunderson, Pilchuck Audubon HEALTHY Brent Hackney, Brent Hackney Designs Dennis Haddock, EdD, Lakewood School District (partial-year) Bridget Healy, United Way Mark Richardson, Snohomish County Sheriff’s Office Gabe Snedeker, Snohomish County Planning & Development (partial-year) Jim Steinruck, Senior Services of Snohomish County Brant Wood, Snohomish County PUD Fred Worthen, Community Transit Amy Beth Cook, EdD, Lake Stevens School District (partial-year)

Our Commitment to the Community 2014 Annual Report

Snohomish Health District 3020 Rucker Avenue, Suite 306 Everett, WA 98201-3900, 425.339.5210 www.snohd.org HEALTH OFFICER’S REPORT How The Money Comes In Total General Fund Revenue

2% LicenseLicenses & Permits & Permits $3,077,096 $ 3,077,096 16% 19% THE FUTURE OF PUBLIC HEALTH HOLDS GREAT FederalFederal $2,926,907 $ 2,926,907 OPPORTUNITIES. TO MAKE THE MOST OF EVERY StateState $4,272,156 $ 4,272,156 $16,323,262 OPPORTUNITY, SUSTAINABLE FUNDING AND NEW WAYS 19% 18% CountyCounty $3,168,200 $ 3,168,200 ChargesCharges for Servicesfor Services $2,608,498 $ 2,608,498

OF PROVIDING SERVICE ARE ESSENTIAL. 26% MiscellaneousMiscellaneous $270,405 $ 270,405

The last year was about preparing for an uncertain future Last year alone, 13,000 people moved into our county, while responding to both the ordinary and extraordinary every one deserving assurance that public health is There is also a lack of dedicated reduction, early intervention for FEDERAL FUNDING needs of Snohomish County. We embarked on a out there making sure that the water and food are safe, sources of revenue for public infants, dental care, and regulating These grants support programs thoughtful update to our strategic plan which yielded communicable diseases are controlled, and risk factors health at the local, state and drinking water and onsite sewage. for immunization outreach, STD eight initiatives aimed at moving our agency forward. You for chronic diseases are getting appropriate attention. federal levels. Unlike many other control, maternal/infant services, will see highlights of that work in the coming pages. At the same time, the health care system is being government agencies and special COUNTY FUNDING pregnant and parenting teens, transformed. Public health has a unique role to play, purpose districts, the Snohomish We rely on Snohomish County to safe drinking water, emergency Unfortunately, 2014 also brought local tragedies and supporting community partners that are best positioned Health District has no local taxing provide annual funding to support readiness and response and more. disease outbreaks that tested our community and to serve individuals while we focus on serving the authority. for communicable disease work the Health District. The SR 530 slide near Oso was a community as a whole. and the First Steps program for at- CHARGES FOR SERVICE sobering reminder of the impact Mother Nature can have Each year brings new challenges risk mothers and their babies. Each of the divisions charges on the county. Our staff and volunteers with the Medical At the same time, local, state, and federal funding in balancing our budget, requiring fees to recoup costs for providing Reserve Corps responded to ensure that the health of continues to fall short. Without additional financial reduced services and staff. LICENSES & PERMIT FEES services, such as immunizations, responders and community members was safeguarded resources, and a commitment to maintaining them, the This is not a sustainable way to The fees collected from food vital records and inspections. in the months following the slide. gains made in the health of Snohomish County residents operate, which is why we continue vendors, public and semi-public will be lost. advocating for dedicated public pools, onsite septic, small public MISCELLANEOUS Along with natural disasters, we also confronted many health funding. water systems, and solid waste Interest from investments and communicable disease challenges. In some cases, like The transition will not be easy, and it will not happen disposal facilities cover the costs rental income from leased office hepatitis C and gonorrhea, we saw a surge in active overnight. As we move into 2015, you will see the STATE FUNDING of permit review and inspections. space. cases that required monitoring and treatment. For Snohomish Health District and our Board of Health State grants support programs However, these fees do not cover emerging diseases, like Ebola and enterovirus D68, the united in advocating for sustained funding, ensuring that like disease prevention through responses to complaints and focus was more on separating fact from fiction so that we the most vulnerable are served, and communicating immunizations, youth tobacco system failures. could ease public fears. the important work that public health does. We do this because it is the right thing to do, and it is what Based on newly released County Health Rankings Snohomish County deserves. and Roadmaps data, Snohomish County is the 7th healthiest county in Washington. We are among the How The Money Goes Out top in the state for access to healthy foods and reducing The funding and revenue is allocated across three broad areas. Each one includes a number of programs, services the percentage of low birth weights. However, the reports and functions. To learn more, visit us online at www.snohd.org. also show where improvements are needed and reaffirm that local priorities (suicide, youth abuse and obesity) Gary Goldbaum, MD, MPH remain on point. Health Officer & Director

The Health District’s mission is simple: improve the health of individuals, families and communities through disease prevention, health promotion and protection from Bold steps are needed to ensure we can continue to carry out our environmental threats. In order to support this work, the public health framework defines mission at the highest level of service and to the greatest number of some functions as foundational capabilities. Here are some of the accomplishments made Snohomish County residents. We updated our strategic plan last year, during 2014 in each of these areas: focusing on eight initiatives that will allow us to evolve our programs and services in the best way possible.

ADMINISTRATION Executive leadership spearheaded the strategic plan update process MOVE CLIENTS INTO MEDICAL HOMES in order to prepare the Health District for the future. Dr. Goldbaum and Deputy Director Pete Mayer also participated in a number of regional Remove the disconnect that happens when people seek independent and statewide efforts, such as the Washington State Innovation Model, services. Instead, develop new partners to provide direct clinical services and the Snohomish County Health Leadership Coalition, and the North integrated health care. Sound Accountable Communities of Health. Moving forward into 2015, the team will be working closely with the Board of Health to strengthen IMPROVE ENVIRONMENTAL HEALTH BUSINESS governance and funding for the District. PRACTICES BUSINESS OFFICE AND INFORMATION SYSTEMS Staff in 2014, Leverage new technologies and streamline procedures in order to improve In 2014, the two groups merged into one group for increased down from 228 efficiency and overall customer service experience. efficiencies and cost-savings. Working together the team completed an positions in 2008 information technology assessment that will be used to help move the 148 District into a more robust and tech-savvy organization. OPTIMIZE DELIVERY OF EARLY CHILDHOOD DEVELOPMENT PROGRAMS COMMUNICATIONS Analyze and plan for the best ways to deploy human and financial resources The Communications team also went through a similar restructuring, Unique public to serve the needs of vulnerable children and families. with two positions merged into a new Communications and Public records requests Affairs Officer. Other highlights from the year include launching a processed revamped website and an increased presence in social media. The goal 693 for 2015 will be to expand partnerships opportunities and engagement MOBILIZE COMMUNITY HEALTH ACTION TEAMS with the community. Capitalize on opportunities to make it easier for people to lead healthier lives Birth right where they live. HUMAN RESOURCES certificates Under new leadership, the Human Resources team did an assessment issued of District policies and unfunded liabilities, which will be addressed in 18,444 REDUCE ADMINISTRATIVE OVERHEAD COSTS the coming year. Contract negotiations were also started at the end Death Thoroughly examine overhead expenses and implement cost-savings and/or of 2014 with the four bargaining units, with final contracts just recently certificates cost-efficiency measures. approved. 19,545 issued INSTITUTE WORKFORCE DEVELOPMENT AND SUCCESSION PLANNING Proactively work to ensure the Health District has a skilled and motivated workforce, now and into the future. Snohomish County residents IMPROVE HEALTH DISTRICT FUNDING AND 759K GOVERNANCE Examine our current form of public health governance and finance, and Average spent on deliver recommendations for possible changes. public health per $21 county resident INTEGRATE QUALITY IMPROVEMENT PRINCIPLES Design and implement a formal quality improvement program throughout the

Strategic Plan Update Health District. National average spent on public $40 health per resident AJ’s Burgers in Marysville, Wash. OVERVIEW 2014 2014 Food Safety Excellence Award Winner

► Response and cleanup efforts ► The Medical Reserve Corps ► Presented five area for the SR 530 slide near Oso. had 78 people totaling 1,778 organizations with Healthy We had 44 staff members involved hours in support of the SR Community Awards. The award in the hours, days and weeks 530 slide. Made up of doctors, recognizes groups like ECEAP following the devastating slide. nurses, veterinarians, mental & Head Start, Everett Housing health professionals, and non- Authority, Premera and the medical volunteers, the teams were City of Arlington that are health deployed to provide medical care champions. For instance, the for the Sauk-Suiattle Tribe, who Edmonds School District’s new had been cut off because of road wellness policy is a model for closures. getting kids eating healthier and being more active. Better ► One of the first in the state health leads to better educational to complete vaccine inventory outcomes, and that’s a win-win management trainings for situation. all providers in the county. In 2014, Vaccine Preventable Disease Outreach managed quality assurance for 87 Vaccine for Children clinics and $12M worth of vaccines. Our team also collaborated with regional providers and school nurses on policy issues, In addition to managing the pilot programs, and preparing medical volunteers, our primary annual updates to the immunization responsibility was safeguarding schedule pocket guides distributed food and water for the response statewide. teams. The Health District ensured proper safety protocols were followed for all volunteers, since they are not covered under the formal Incident Command ► Assisted 166 refugees and Structure. asylees relocating to Snohomish County with required health We also assisted the Medical screenings. In addition to Examiner in coordination with comprehensive health reviews, families, and environmental health our staff perform testing, evaluate SERVING UP FOOD THE RIGHT WAY staff inspected homes and debris immunization records, and give When Aaron Kemp gets a visit one of the 2014 Food Safety resonates with our public health for potential hazardous materials, referrals for other health conditions. from food safety inspector Excellence Awards. These philosophy. mold issues and septic system We assist in the paperwork needed Cheyenne Ray at AJ’s Burgers awards, nominated by our Health damage. for adjustment in status and in Marysville, he sees it as just District inspectors, recognizes “It’s all about prevention. completing form I-693 required by another day at work. That’s food establishments that make Whether you work in a school the Uniited States Immigration and because his dad taught him to safe dining experiences their top cafeteria, a food truck, or a Citizenship Services. always do things right the first priority. restaurant like mine, imagine the time. impact we can have if we all do Aaron says he is more than happy what we should. “I want to make sure that each to pay for his permits and fees, person eating in my restaurant, because he knows that money is “We can keep people out of or every bag walking out that an investment in his brand. hospitals and walk-in clinics door, has safe food to eat that because they don’t have food won’t make them sick,” explains “Posting that award on Facebook, poisoning. The healthcare “You help us get most of the healthier “Thank you so much. I do not have Aaron. “As a business owner, and the news article that featured savings alone, not to mention foods we need that we may not any money for such things. All I can there is no better ‘thumbs up’ for us, did more for our business what I save on my business’s always be able to afford.” do is pay rent.” me than a great health inspection in one week than any amount of insurance policy, that’s huge.” — quote from WIC client — quote from refugee client report.” paid advertising I’ve ever done.” We couldn’t agree more! That work ethic shows, which He also has a perspective on is why AJ’s Burgers received his role in the food industry that HEALTHY ENVIRONMENT From issuing permits to following up on complaints and inspections, our priority is ensuring that your food, water and environment are safe from health threats like foodborne illness, ► Collaborated with local ► “They helped me with my ► Partnered with the state’s pollution, pests, and other hazards. partners to develop and begin first child and made me feel Disinfection Workgroup on implementing the Community like I could succeed!” From new bleach guidelines for Health Improvement Plan. As a our Mother’s Day Tea to our childcares. Given the increased follow on to the community health breastfeeding classes, the staff potency of bleach developed over Breaking it down assessment process started in our WIC and First Steps clinics the years, we were concerned in 2012, the team set out key helped more than 3,000 moms and previous guidelines could produce ENVIRONMENTAL HEALTH INFORMATION LIVING ENVIRONMENT objectives to make a collective nearly 10,000 babies and young chlorine amounts with 3-4 times the MANAGEMENT PROGRAM impact on youth physical abuse, children get the healthy starts they recommended levels. Now rolled pools, spas and camps permitted In late 2013, our staff embarked on an effort to 500 obesity and suicide. deserve. The Early Intervention out statewide, the bleach solution implement a new software system that allows for 1,100 inspections and Children with Special Health mixing guide helps childcares keep convenient access for our customers, added security Care Needs programs provided our kids safe while keeping toys to protect sensitive personal information and financial WATER & WASTEWATER home visits, referrals and case and surfaces sanitized. transactions, and enhanced capabilities for staff in conferences for more than 400 the office and out in the field. While we won’t go live 256 failing septic systems corrected children in Snohomish County. ► District staff declared “I’m IN” with a new system until later this year, the intensive 427 complaint investigations with the Seattle Seahawks. We process analysis and improvement phase yielded some joined in with our Blue Friday pride significant improvements that we have already begun to 1,705 drinking water tests processed to support our Seahawks in their adopt. applications and/or march to another Superbowl. 3,500 plan reviews SOLID WASTE months18 invested processes220+ identified processes121 137 permit and plan reviews in overall process in our system selected to be improvements mapped out 335 local source control site visits inspections at solid waste sites or 543 facilities 1,123 complaint investigations ► Made RNA testing for item found1 to be food75 permit processes,5 like HIV screening of high-risk the main cause renewals returned food renewal FOOD SAFETY individuals the new standard. for returns for missing permits, analyzed Together with Public Health – 301 food complaint investigations information for inefficiencies Seattle & King County, staff worked 359 applications and plan reviews to offer a more specific diagnostic test that can detect exposure within 5,767 food safety inspections 10 days of the collection date. Prior ► Teamed with United Way of permit 7renewals RFP2015 released to food permits and food to this, the antibody test was used Snohomish County and 83 other returned after acquire a new 33,169 worker cards issued modifications software system and and only detected exposure within programs for Project Homeless vendor selected the last 90+ days. Using this more Connect. With sites at Evergreen effective test allows individuals to High School and Cascade High begin a treatment regimen sooner, School, the event provides direct SAFELY DISPOSING OF UNWANTED MEDICINES ultimately helping to reduce the care and support services to more Unused medications pose a risk to our families, communities and the environment. As a member of the spread of HIV. than 1,200 homeless individuals. Snohomish County Partnership for Secure Medicine Disposal, we facilitate the collection of medications Our staff gave immunizations, as dropped off at our local police departments and some pharmacies. 7,824 well as testing for STDs, HIV/AIDS, 7,098 lbs hepatitis, and tuberculosis. Why do we do this? lbs 5,367 ► Unintentional poisonings are the #1 cause of injury deaths 4,552 lbs in Snohomish County. lbs ► Many teens think prescription medicines are safer to 3,096 abuse than street drugs, and 3 out of 5 teens say they lbs get them from their parents’ or grandparents’ medicine “This clinic changes the lives of many cabinets. moms and improves our Overview ► Wastewater treatment plants and septic systems are living standards.” not designed to remove or treat pharmaceuticals, — quote from First Steps client so medicines flushed down the drain end up in our 2010 2011 2012 2013 2014 waterways. Unused Medications Collected Annually 2014 HEALTHY PEOPLE KEEPING KIDS HEALTHY Making it easier for people to make healthy choices and turn those into lifelong habits is We want to make sure our kids are Environmental health specialist child home or what immunizations essential. The Health District is here to help you get the healthy starts needed in order to happy, healthy and ready to learn. Micha Horn and public health nurse to require for children and staff, all enjoy the life that you deserve. Not only is it important to keep Alba Suarez make up our Child done free of charge. them active and eating nutritious Care Outreach team, reaching foods, but we also want to help out to nearly 500 preschools, Another popular feature is Taking prevent the spread of illnesses. daycare centers and in-home Illness Prevention to Preschool, a facilities across the county. They program aimed at teaching younger Whether it’s whooping cough or influenza, and everything The impact we made That’s why our teams work so hard share materials and monthly kids about the importance of in between, we are monitoring emerging threats to help to promote immunizations, monitor distance learning modules on washing hands. When a preschool keep you and your families safe and healthy. disease outbreaks, and inform topics like illness prevention, signs up for the program, Alba 64% caregivers and schools on proper proper sanitization procedures, and or Micha make a series of visits, EBOLA WIC families served that are living in poverty precautions to take. We connect medication management. including a curriculum kit and use No active cases of Ebola occurred in the county, but our with preschools and childcare of our lending library of books and team monitored a number of low-risk individuals for signs providers to share best practices for Alba and Micha also help providers games. Kids love meeting Sniffles of infection. A considerable amount of time was spent helping the kids and staff members develop or update their health the Germ and practicing their hand educating healthcare providers, emergency response, law 36,313 keep the germs at bay. policies, such as when to send a washing! enforcement, and the general public on symptoms and risk of exposure. nutrition education sessions provided Our Child Care Outreach team works with preschools and daycares to stop the spread of illnesses. TUBERCULOSIS While we had 16 adult and 3 pediatric new active cases last year, our rate dropped 28 percent from 2013. This was 68% also below state and national rates. Overall, we treated 36 clients served in our WIC program that are active cases, 82 latent infections, evaluated 57 suspects, working families and screened 404 individuals.

HEPATITIS There were 825 Hepatitis C cases reported in 2014, and 65,000 staff tested more than 200 clients. We also administered referrals for preventative health services given 213 vaccines for Hepatitis A and B prevention, and tracked 136 infants born to mothers with chronic Hepatitis B.

SEXUALLY TRANSMITTED DISEASES 40 Referred 30 clients to local clinics with our vouchers for free testing and treatment. Of those, 36 percent tested hygiene kits given to refugee families filled with soap, positive for an STD. washcloths, toothbrushes, shampoo, hair brushes, razors, first aid, and more.

EARLY WINS FOR HEALTHY COMMUNITIES INITIATIVES In 2014, the Community Health Improvement Plan completed laid out objectives for three top priorities: reducing youth physical abuse, suicide and obesity. There is much work to be done in order to achieve these goals, but our recently adopted 5210 campaign from LetsGo.org has been gaining traction with our partners as a way to turn the tide on rising obesity rates. Look for signage and information like this coming to your neighborhood soon.

EVERYBODY.EVERYBODY. EVERYEVERY DAY.DAY.

oror mmoreore frufruititss hourshours oror llesesss houhourr oror moremore susugargaryy && vegevegetabltableses recrerecreatiationonalal ofof physicalphysical dridrinknkss 55 22 scscrreeneen timtimee 11acactivittivityy 00 HEALTHY PEOPLE KEEPING KIDS HEALTHY Making it easier for people to make healthy choices and turn those into lifelong habits is We want to make sure our kids are Environmental health specialist child home or what immunizations essential. The Health District is here to help you get the healthy starts needed in order to happy, healthy and ready to learn. Micha Horn and public health nurse to require for children and staff, all enjoy the life that you deserve. Not only is it important to keep Alba Suarez make up our Child done free of charge. them active and eating nutritious Care Outreach team, reaching foods, but we also want to help out to nearly 500 preschools, Another popular feature is Taking prevent the spread of illnesses. daycare centers and in-home Illness Prevention to Preschool, a facilities across the county. They program aimed at teaching younger Whether it’s whooping cough or influenza, and everything The impact we made That’s why our teams work so hard share materials and monthly kids about the importance of in between, we are monitoring emerging threats to help to promote immunizations, monitor distance learning modules on washing hands. When a preschool keep you and your families safe and healthy. disease outbreaks, and inform topics like illness prevention, signs up for the program, Alba 64% caregivers and schools on proper proper sanitization procedures, and or Micha make a series of visits, EBOLA WIC families served that are living in poverty precautions to take. We connect medication management. including a curriculum kit and use No active cases of Ebola occurred in the county, but our with preschools and childcare of our lending library of books and team monitored a number of low-risk individuals for signs providers to share best practices for Alba and Micha also help providers games. Kids love meeting Sniffles of infection. A considerable amount of time was spent helping the kids and staff members develop or update their health the Germ and practicing their hand educating healthcare providers, emergency response, law 36,313 keep the germs at bay. policies, such as when to send a washing! enforcement, and the general public on symptoms and risk of exposure. nutrition education sessions provided Our Child Care Outreach team works with preschools and daycares to stop the spread of illnesses. TUBERCULOSIS While we had 16 adult and 3 pediatric new active cases last year, our rate dropped 28 percent from 2013. This was 68% also below state and national rates. Overall, we treated 36 clients served in our WIC program that are active cases, 82 latent infections, evaluated 57 suspects, working families and screened 404 individuals.

EVERYBODY.EVERYBODY. EVERYEVERY DAY.DAY.

oror mmoreore frufruititss hourshours oror llesesss houhourr oror moremore susugargaryy && vegevegetabltableses recrerecreatiationonalal ofof physicalphysical dridrinknkss 55 22 scscrreeneen timtimee 11acactivittivityy 00 HEALTHY ENVIRONMENT From issuing permits to following up on complaints and inspections, our priority is ensuring that your food, water and environment are safe from health threats like foodborne illness, ► Collaborated with local ► “They helped me with my ► Partnered with the state’s pollution, pests, and other hazards. partners to develop and begin first child and made me feel Disinfection Workgroup on implementing the Community like I could succeed!” From new bleach guidelines for Health Improvement Plan. As a our Mother’s Day Tea to our childcares. Given the increased follow on to the community health breastfeeding classes, the staff potency of bleach developed over Breaking it down assessment process started in our WIC and First Steps clinics the years, we were concerned in 2012, the team set out key helped more than 3,000 moms and previous guidelines could produce ENVIRONMENTAL HEALTH INFORMATION LIVING ENVIRONMENT objectives to make a collective nearly 10,000 babies and young chlorine amounts with 3-4 times the MANAGEMENT PROGRAM impact on youth physical abuse, children get the healthy starts they recommended levels. Now rolled pools, spas and camps permitted In late 2013, our staff embarked on an effort to 500 obesity and suicide. deserve. The Early Intervention out statewide, the bleach solution implement a new software system that allows for 1,100 inspections and Children with Special Health mixing guide helps childcares keep convenient access for our customers, added security Care Needs programs provided our kids safe while keeping toys to protect sensitive personal information and financial WATER & WASTEWATER home visits, referrals and case and surfaces sanitized. transactions, and enhanced capabilities for staff in conferences for more than 400 the office and out in the field. While we won’t go live 256 failing septic systems corrected children in Snohomish County. ► District staff declared “I’m IN” with a new system until later this year, the intensive 427 complaint investigations with the Seattle Seahawks. We process analysis and improvement phase yielded some joined in with our Blue Friday pride significant improvements that we have already begun to 1,705 drinking water tests processed to support our Seahawks in their adopt. applications and/or march to another Superbowl. 3,500 plan reviews SOLID WASTE months18 invested processes220+ identified processes121 137 permit and plan reviews in overall process in our system selected to be improvements mapped out 335 local source control site visits inspections at solid waste sites or 543 facilities 1,123 complaint investigations ► Made RNA testing for item found1 to be food75 permit processes,5 like HIV screening of high-risk the main cause renewals returned food renewal FOOD SAFETY individuals the new standard. for returns for missing permits, analyzed Together with Public Health – 301 food complaint investigations information for inefficiencies Seattle & King County, staff worked 359 applications and plan reviews to offer a more specific diagnostic test that can detect exposure within 5,767 food safety inspections 10 days of the collection date. Prior ► Teamed with United Way of permit 7renewals RFP2015 released to food permits and food to this, the antibody test was used Snohomish County and 83 other returned after acquire a new 33,169 worker cards issued modifications software system and and only detected exposure within programs for Project Homeless vendor selected the last 90+ days. Using this more Connect. With sites at Evergreen effective test allows individuals to High School and Cascade High begin a treatment regimen sooner, School, the event provides direct SAFELY DISPOSING OF UNWANTED MEDICINES ultimately helping to reduce the care and support services to more Unused medications pose a risk to our families, communities and the environment. As a member of the spread of HIV. than 1,200 homeless individuals. Snohomish County Partnership for Secure Medicine Disposal, we facilitate the collection of medications Our staff gave immunizations, as dropped off at our local police departments and some pharmacies. 7,824 well as testing for STDs, HIV/AIDS, 7,098 lbs hepatitis, and tuberculosis. Why do we do this? lbs 5,367 ► Unintentional poisonings are the #1 cause of injury deaths 4,552 lbs in Snohomish County. lbs ► Many teens think prescription medicines are safer to 3,096 abuse than street drugs, and 3 out of 5 teens say they lbs get them from their parents’ or grandparents’ medicine “This clinic changes the lives of many cabinets. moms and improves our Overview ► Wastewater treatment plants and septic systems are living standards.” not designed to remove or treat pharmaceuticals, — quote from First Steps client so medicines flushed down the drain end up in our 2010 2011 2012 2013 2014 waterways. Unused Medications Collected Annually 2014 AJ’s Burgers in Marysville, Wash. OVERVIEW 2014 2014 Food Safety Excellence Award Winner

Strategic Plan Update Health District. National average spent on public $40 health per resident HEALTH OFFICER’S REPORT How The Money Comes In Total General Fund Revenue

OF PROVIDING SERVICE ARE ESSENTIAL. 26% MiscellaneousMiscellaneous $270,405 $ 270,405

According to U.S. Census data, we represent the fastest growing county in the Puget Sound region. The job and housing markets are rebounding. And the county is second in the state for gross regional product (at $36.2 billion). The economic prospects for our community are promising. HEALTHY HEALTHY FOUNDATIONAL PEOPLE These factors come together to point out two things—we ENVIRONMENT CAPABILITIES must work differently and we need additional sustainable $8.6M (52%) $4.2M (25%) $3.7M (23%) funding. OUR COMMITMENT TO THE COMMUNITY At the Snohomish Health District, we believe the community is our client. We also believe that our clients deserve healthy places to live, learn, work and play. This requires a continued focus on promoting healthy habits, preventing illness due to communicable diseases, and protecting our food, water and environment from health threats. But we can’t do this alone.

Our Commitment to the Community 2014 Annual Report

Snohomish Health District 3020 Rucker Avenue, Suite 306 Everett, WA 98201-3900, 425.339.5210 www.snohd.org