HomeMy WebLinkAbout2022/01/25 - BOH Packet MASON COUNTY
• COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
MASON COUNTY BOARD OF HEALTH
71' January 25, 2022
" PUBLIC , 3:00 PM
Commission Chambers
® 411 North 51h Street
Shelton, WA 98584
Zoom Information
Meeting ID: 832 2821 7230
Passcode: 859531
DRAFT AGENDA
1. Welcome and Introductions Peggy Van Buskirk, Chair
2. Approval of Agenda—ACTION Board Members
3. Resolution to Set Meeting Dates—ACTION Board Members
January 25
March 22
May 24
July 26
September 27
November 29 (November 22 is Thanksgiving week)
4. Elect Officer Positions—ACTION Board Members
5. Approval of Minutes for November, 2021 —ACTION Board Members
6. Health Officer Report Dr. Keri Gardner
7. Administration Report Dave Windom
a. Regionalization
b. Fiscal
8. Environmental Health Report Alex Paysse
a. Updates to Chapter 6.32 Platting Standards—ACTION
9. Community Health Report Lydia Buchheit
a. COVID Report
b. Presentation by Abe Gardner
Mason County Public Health
415 N 61h Street, Bldg.8,Shelton WA 98584,
(360)427-9670 ext.400
Fax(360)427-7787
c. Presentation by Melissa Casey
10. Other Business and Board Discussion Board Members
a. Presentation by Cmmr. Trask on House Bill 1152
11. Public Comments
12. Adjourn
If special accommodations are needed,please contact McKenzie Smith at(360)427-9670 ext.589.
Mason County Public Health
415 N 6ch Street, Bldg.8,Shelton WA 98584,
(360)427-9670 ext.400
Fax(360)427-7787
RESOLUTION NO. 22-01
A Resolution setting the 2022 meeting dates for the Mason County Board of Health
WHEREAS,the Department of Community Services supports the administrative requirements of the
Mason County Board of Health and provides public notice;and,
WHEREAS,the Board of Health meets regularly to address the public health needs of Mason County;
and,
NOW,THEREFORE,BE IT RESOLVED,by the Mason County Board of Health that the meetings
for 2022 will be held at 3:00 p.m. on the following dates:
January 25,2022
March 22,2022
May 24,2022
July 26,2022
September 27,2022
November 29,2022
DATED this 25th day of January,2022.
ATTEST MASON COUNTY,WASHINGTON
BOARD OF HEALTH
MASON COUNTY,WASHINGTON
McKenzie Smith,Clerk of the Board
Darrin Moody,Hospital District#1
Kathy McDowell,City Commissioner
Kevin Shutty,Commissioner
Randy Neatherlin,Commissioner
Sharon Trask,Commissioner
Peggy Van Buskirk,Hospital District#2
Gary Plews,Fire Commissioner
Keri Davidson,Shelton School Board
MASON COUNTY BOARD OF HEALTH PROCEEDINGS
411 North 5`h Street,Shelton,WA
November 16,2021
Virtual Attendance:Randy Neatherlin,County Commissioner; Sharon Trask,County Commissioner;Peggy Van
Buskirk,Hospital District#2;Dave Windom,Mason County Community Services Director;Lydia Buchheit,Mason
County Community Health Manager;Alex Paysse,Environmental Health Manager;Darrin Moody,Hospital District
# 1;Keri Davidson,Shelton School Board;Kathy McDowell,City of Shelton Council Member Seat#2;Dr.Keri
Gardner,Health Officer;Gary Plews,Fire Fighters Association;McKenzie Smith,Clerk of the Board.
1. Chair Peggy Van Buskirk called the meeting to order at 3:00 p.m.
2. Approval of Agenda—Kathy/Cmmr.Trask moved and seconded to approve the agenda as presented.
Motion carried.
3. Approval of Minutes—Cmmr.Neatherlin/Cmmr.Trask moved and seconded to approve the September
minutes as presented. Motion carried.
4. Health Officer Report—Dr.Keri Gardner
Dr.Gardner shared that since becoming the Health Officer,she has spent a significant amount of time with
the school superintendents. It has been a high priority to help get the message out,work with the
superintendents struggling with the usual workload of starting a new school year and the added layer of
testing,quarantining,and contact tracing. Dr.Gardner began her career in Public Health and has done a lot
of work in both rural and urban environments and communities. Overall COVID cases,hospitalizations,
and deaths are declining. The deaths we are seeing now are a result of the Delta variant. Staff may have
recognized discrepancy with the numbers pulled from the Washington State registry. Since September 1,
there have been 38 COVID-related deaths. Vaccinations are slowly picking up. Pediatric doses for
COVID have arrived. The message is the same—vaccines work.
5. Administration Report—David Windom
Dave shared a presentation of what is presented to Area Command regarding COVID hot spots. As of
November 15,across the state about 79%of the population has received one dose and 73%is fully
vaccinated. The bottom line up front(BLUF)is that cases have decreased recently but are still high. The
Department of Health stopped updating all metrics on the testing tab of their website. Mason County
dropped out of being a hot spot. Mason General is in good shape with hospitalizations going down. School
rates are also declining. 46%of deaths are from long-term care facilities. Early November more guidance
will be received. Washington State will modify the guidance most likely. There are three contingencies—
vaccine,test,or modify.
6. Environmental Health Report—Alex Paysse
Alex highlighted program updates such as billing and fee updates with the Clean Water District Committee,
getting the food safety program back on track,recent staff changes. Sewage standards such as design and
construction standards related to on-site sewage regulations. The code was updated earlier this year and
will be effective January 1,2022.
Keri/Kathy moved and seconded to approve changes. Motion carried.
7. Community Health Report—Lydia Buchheit
Lydia shared her staff has gone back to their regular work and a new COVID team was introduced. The
first draft of the Community Health Assessment went out and should be finished by the end of the year. In
January they will move on to the Community Health Improvement Plan with the health coalition. The
Substance Abuse Program came to an end in October and her team has been invited to present at the
BOARD OF HEALTH PROCEEDINGS
November 23,2021—Page 2
national conference. The data report should be coming out soon. There are 1,800 pediatric COVID doses
available and she estimates 2,000 to 2,500 people may want and qualify for that vaccination. 712 doses
have been given so far.
8. Other Business and Board Discussion
Continue with meetings on the 41 Tuesday of every other month. The next meeting will be January 25,
2022 at 3:00 p.m.
9. Public Comments
10. Meeting adjourned at 3:35 p.m.
ATTEST MASON COUNTY,WASHINGTON
BOARD OF HEALTH
MASON COUNTY,WASHINGTON
McKenzie Smith,Clerk of the Board
Scott Hilburn,Hospital District#1
Kathy McDowell,City Commissioner
Kevin Shutty,Commissioner
Randy Neatherlin,Commissioner
Sharon Trask,Commissioner
Peggy Van Buskirk,Hospital District#2
Gary Plews,Fire Commissioner
Keri Davidson,Shelton School Board
From the Director's Desk
January 2022 -�
Welcome to 2022
This past two months have been incredibly busy with the continuing response to COVID and
other public health related issues.
Mason County partnered with Mason Health and the YMCA for two very successful vaccine
clinics. These clinics provided pediatric, regular, and booster doses as well as flu shots. Working
with partners is by far the most efficient and really a very enjoyable means of providing
vaccination coverage and we really do appreciate Mason Health the YMCA.
The Omicron variant is skyrocketing in Mason County.This is causing staffing shortages in all
sectors. We've had fifteen outbreaks as of this writing.The hospitalization rate is lower but due
to sheer numbers, is taxing the hospital system.
Cases have increased recently and are extremely high:
The total reported for the past week was the highest of
the pandemic.
New reported cases throughout the pandemic
100 case_:
�n 7-day
average
Apr.2020 Aug E-c Apr.2021 = G
From the Director's Desk
7-day
average
Data from South Africa from early
December 2021 to January 14, 2022
- 1
When we look at the history of this variant, we see sharp climbs, very little time at the peak and
then it drops sharply as opposed to the Delta variant which maintained a higher plateau.
The Board will need to evaluate our position as it relates to HB 1152. 1 am sending some
homework in the packet for review before Commissioner Trask and I present this topic at our
meeting. I think that we meet most of the criteria as laid out in the legislation, but we will need
to make some changes and have those through the process by July 1st. It is my understanding
that the legislature will open 1152 for some much-needed fixes and clarification but not until
next year's legislative session.
Lydia Buchheit announced that she will be retiring in the first half of 2022 and we've begun the
process of updating the job description in preparation for filling the Community Health
Manager position. My hope is to have at least a one month overlap if possible, to ensure a
smooth transition. I certainly congratulate Lydia on her retirement and look forward to
continuing to work with her on Mason Matters.
Regionalization of public health services continues to be a concern. I have previously sent the
latest updates from DOH. Even though the part of HB 1152 that set up regionalized public
health offices was removed, there was a budget proviso that directed DOH to begin that
process. We'll discuss in more detail at the meeting.
2022 has been a wild ride so far with much to talk about on the 25tn
David Windom, MSHS
Director
1 Tracking Coronavirus in South Africa: Latest Case Count-The New York Times (nytimes.com)
Title 2-ADMINISTRATION AND PERSONNEL
Chapter 2.14 HEALTH DEPARTMENT*
Chapter 2.14 HEALTH DEPARTMENT*
2.14.010 Established.
Effective January 1, 1979,there is constituted a Mason County health department,the jurisdiction of which is
coextensive with the boundaries of Mason County including all cities and towns,incorporated or nonincorporated,
therein.
(Res.946§ 1, 1978).
2.14.020 Board of health—Designated.
The composition of the Mason County Board of Health shall consist of[twelve] members as follows:
(1) Three elected members of the Mason County Commission
(2) One elected member of the City of Shelton Commission
(3) One elected member of Mason County Hospital District 1
(4) One elected member of Mason County Hospital District 2
(5) One elected member of the Mason County Fire Commissioners Association
(6) One representative of the Squaxin Island Tribe
(7) One representative of the Skokomish Tribe
(8) Two representatives from Mason County School Board Districts;one from the south end and one from
the north end of Mason County.
(9) One active medical provider(MD, DO,ARNP, or PA)practicing in Mason County.
(Res.946§2, 1978;Ord. No.21-02,2-16-2021)
2.14.030 Board of health—Chairman.
At the first meeting of the board of health,the members shall elect a chairman for the period of one year,
who may be any one of the three county commissioners.
(Res.946§3, 1978).
2.14.035 [Board of health—Voting.]
All members of the board of health shall have the ability to vote on all issues pertaining to public health
policy and priorities. However,any board of health supported issue requiring additional funding from the county
will be forwarded as a recommendation to the board of county commissioners for final action.
A quorum shall consist of at least one county commissioner and at least three other members.
(Ord. No.21-02,2-16-2021)
Mason County,Washington,Code of Ordinances Created: 2021-12-29 14:27:07 [EST]
(Supp. No.57,11-21)
Page 1 of 3
Editor's note(s)—Ord. No.21-02,adopted February 16,2021,added provisions to the Code, but did not specify
manner of inclusion.Therefore,at the discretion of the editor,said provisions have been designated as§
2.14.035,as set out herein.
2.14.040 Board of health—Powers and duties.
The powers and duties of the board of health shall be as enumerated in RCW 70.05.060.
(Res.946§4, 1978).
2.14.045 [Terms and compensation.]
The members of the Mason County Board of Health shall serve terms consistent with the terms of the entity
they represent.
Members will serve without compensation, but may be reimbursed for travel expenses approved by the
Mason County Board of Health.
(Ord. No.21-02,2-16-2021)
Editor's note(s)—Ord. No.21-02,adopted February 16, 2021,added provisions to the Code, but did not specify
manner of inclusion.Therefore,at the discretion of the editor,said provisions have been designated as§
2.14.045, as set out herein.
2.14.050 Health officer—Appointment.
The board of health shall appoint a county health officer who shall be an experienced physician licensed to
practice medicine and surgery or osteopathy and surgery in this state and who is qualified or provisionally qualified
as prescribed in RCW 75.05.050.
(Res.946§5, 1978).
2.14.060 Health officer—Terms.
The health officer shall serve pursuant to the terms of RCW 70.05.050.
(Res.946§6, 1978).
2.14.070 Health officer—Powers and duties.
The powers and duties of the health officer shall be as enumerated in RCW 70.05.070.
(Res.946§7, 1978).
2.14.080 Rules and regulations.
Until and unless subsequently amended by the board of health,the rules and regulations of the Thurston-
Mason health district which were effective as of December 31, 1978,are incorporated herein by reference and
constitute the Mason County rules and regulations required by RCW 70.05.060(3),with the understanding that
"Thurston-Mason"shall be read as"Mason County"and "health district"shall be read as"health department."
(Res.946§8, 1978).
Created: 2021-12-29 14:27:07 [EST]
(Supp. No.57,11-21)
Page 2 of 3
Created: 2021-12-29 14:27:07 [EST]
(Supp. No.57,11-21)
Page 3 of 3
Excerpt for HB 1152
(1)Except as provided in subsection(2)of this section,for
8 counties without a home rule charter,the board of county
9 commissioners and the members selected under(a)and(e)of this
10 subsection,shall constitute the local board of healthy unless the Commented[DWI]:3 county Commissioners
11 county is part of a health district pursuant to chapter 70.46 RCW.
12 The jurisdiction of the local board of health shall be coextensive
13 with the boundaries of the county.
14(a)The remaining board members must be persons who are not
15 elected officials and must be selected from the following categories
16 consistent with the requirements of this section and the rules
17 adopted by the state board of health under section 8 of this act:
18(i)Public health,health care facilities,and providers.This _ Commented[DW2]:This is covered by the two hospital
districts and line 31 below.3 board members total
19 category consists of persons practicing or employed in the county who
20 are:
21(A)Medical ethicists;
22(B)Epidemiologists;
23(C)Experienced in environmental public health,such as a
24 registered sanitarian;
25(D)Community health workers;
26(E)Holders of master's degrees or higher in public health or the
27 equivalent;
28(F)Employees of a hospital located in the county;or
29(G)Any of the following providers holding an active or retired
30 license in good standing under Title 18 RCW:
31(I)Physicians or osteo path it';physicians Commented[DW3]:Covered above and in ordinance 01-
21
32(ll)Advanced registered nurse practitioners;
33(III)Physician assistants or osteopathic physician assistants;
34(IV)Registered nurses;
35(V)Dentists;
36(VI)Naturopaths;or
37(VII)Pharmacists;
38(iil)Consumers of public health.,This category consists of county :— Commented[DW4]:Not covered undercurrent
ordinance
39 residents who have self-identified as having faced significant health
40 inequities or as having lived experiences with public health-related
1 4 E2SHB 1152P4, -- Commented[DWS]:Would require 3 me
programs such mbers to equal
other sections
as:The special supplemental nutrition program for
2 women,infants,and children;the supplemental nutrition program;
3 home visiting;or treatment services.It is strongly encouraged that
4 individuals from historically marginalized and underrepresented
5 communities are given preference.These individuals may not be
6 elected officials and may not have any fiduciary obligation to a
7 health facility or other health agency,and may not have a material
8 financial interest in the rendering of health services;and
9(iii)Other community stakeholders.This category consists of Commented[Dw6]:Covered by school districts and fire
commission.3 board members
10 persons representing the following types of organizations located in
11 the county:
12(A)Community-based organizations or nonprofits that work with
13 populations experiencing health inequities in the county;
14(B)Active,reserve,or retired armed services members;
15(C)The business community;or
16(D)The environmental public health regulated community.
17(b)The board members selected under(a)of this subsection must
18 be approved by a majority vote of the board of county commissioners.
19(c)If the number of board members selected under(a)of this
20 subsection is evenly divisible by three,there must be an equal
21 number of members selected from each of the three categories.If
22 there are one or two members over the nearest multiple of three,
23 those members may be selected from any of the three categories.
24 However,if the board of health demonstrates that it attempted to
25 recruit members from all three categories and was unable to do so,
26 the board may select members only from the other two categories.
27(d)There may be no more than one member selected under(a)of
28 this subsection from one type of background or position.
29',(e)If a federally recognized Indian tribe holds reservation, _.- Commented[DW7]:covered in current ordinance.
Remains unfilled
30 trust lands,or has usual and accustomed areas within the county,or
31 if a 501(c)(3)organization registered in Washington that serves
32 American Indian and Alaska Native people and provides services within
33 the county,the board of health must include a tribal representative
34 selected by the American Indian health commission.
35(f)The board of county commissioners may,at its discretion,
36 adopt an ordinance expanding the size and composition of the board of
37 health to include elected officials from cities and towns and persons — Commented[DW8]:Shelton fills this position
38 other than elected officials as members so long as the city and
39 county elected officials do not constitute a majority of the total
40 membership of the board.
p.---- ----- Commented[DW9]:Pertains to health districts not
departments
WPe
3 r r r
and OF Mb at expenses.
T
7 shall be appointed by the 941G al.deSigRate d 6 R deF the PF9ViS1GRS9f
UE)we Vea 8le t 5 t�3 S66t PHE SECY50'Ot MYd t'3aS-tt
'HO!j3@S S!qj I-(t)H8113aSqAS jE)Sj8aWa!!Ab8!ge
aql laaba lsnw uewi!5edwe3 qlleaq te p�eeq teael al sagueqE)a�njRf S?
AHV'Sple8q AjeSmApe q!lLaq Ajjunwwe3 jet Ige s!qj le t ue!13as�e
u!paqs!jqejsa sjuawaAwnbaj aql iaaw isAbu pieeg�e aEffilbUW03 AIGS!P,pe-F-f-
qj,eaq 3!jqp�aqj'?E()e'T AAenuef Aq-Tef3e'T Menuef ue paqs!lqei5a Ee
sme!Aq Hme 5i qi m pieeq 18 aajj!wwe3 AIBS!Ape qjleaq E)!Iqnd tf
e peq ue.13!ps+jnf qj,eaq eE)el aqj j!u8mj�5adweq s!qj u4ejaj Aew()�
s,e!E)!jje paigap je Alaps pos!jdweg qIleaq je p�eeq leae,v(e)6t
-p�eeq aqj uE)slepqta papala Ajunea pue A163 aq!Aq paupbwajap 9T
aq Albie Aeea saal ue,ie3!,dde pue'Ou!suaa!j'I!wjad IE)uE)!jeqq!p(3w tt
iE)BLiffiBS aq!8i palel8l qlWi3q je pieeq aqj Aq aeasagap Au,v(1)qt
,ieaA aue le pe,iad e iet afdas ej i!eqg e i9a,E)l,eqs sjaqwaw sT
aqj qt!28q 18 pleeq jE)OAj5wp e te oumtaaw lsjil aq!!'V'()I)tt
,qlleeq P3 pieeq aqj ue Et
sle!3d#e palE)aja Ajunaq pHe AI!3 jE)jBqLbAbi aqj ILAba 15Rw uampasqns ef
s4qj te(a)pue(e)lapun paigalas sjaqwabu fe jaqwnu aq±ff)TT
'900,50T)t M-M 0!paq!A3sap OT
se'�aq!jje aA,jejjs,u,b8pe we juiedde Aew jelAeqa Alunea aqj le 6
Environmental Health Report
For Board of Health January 25t'', 2022
EHManager Updates:
Environmental Health staff continues to serve Mason County residents with its various programs throughout COVID-
19. Billings for our licensed professionals and facilities were mailed out in late December. This equates to about 400
licenses including;Onsite Sewage System(OSS)Installers,OSS Pumpers, OSS O/M Specialists,Food Establishments
(fixed and mobile),Water Recreation Facilities(public pools and spas),and Solid Waste Facilities(permitted and
exempt).
End of the year staff and management are busy collecting data and information for various grant and DOH reporting.
Environmental Health received 1,618 permits in 2021,an increase of 2.3%from 2020. This does not include"EH
Review"of DCD permitting,such as building permits and plats(over 500 additional permits prompting EH review in
2021). 1,918+inspections were completed by Environmental Health staff in 2021 across licensing,code enforcement,
and permitting services.
Environmental Health Permits
1800
1600
1562 1618
1400 1277
1200
962
1000 885
800
600
400
200
0
2017 2018 2019 2020 2021
Food Safety Program: (Travis Casey,Rosalie Howarth)
COVID-19 restrictions continue to impact the county food service industry and therefore our food safety program.
While some community events were held,temporary inspections continue to be lower than normal. The number of
food establishments licensed were down over 2020. This is due to the timing of the pandemic and when our agency
collects its annual fees. Our food safety program saw some staffing changes in September when Kayla Hamme
resigned. Travis Casey stepped into the program and then Rosalie Howarth was added in December through
foundational public health funding.
Task/Permit Description 2020 2021
Food Establishment Permits 365 292
Food Worker Cards issued 2301 3026
Routine Inspections 241 253
Re-Inspections 14 13
Temporary Food Establishment Inspections 1 26
Foodborne Illness Complaints 5 12
Sewage Program: (Jeff Wilmoth, Rhonda Thompson,Luke Cencula,Erik Doran)
Onsite Sewage System(OSS)permits saw a 3%increase,mostly related to new construction. Due to impacts from
COVID-19 and staff availability,letters to homeowners were not completed. Staff were able to send out its routine
mailer in June that reaches over 25,000 residents. Chapter 6.76 and the sewage standards were updated in fall of 2021.
Task/Permit Description 2020 2021
New Construction/Upgrade OSS Permits 486 515
Repair/Replacement OSS Permits 180 173
Total OSS Permits 669 690
Property Evaluations(ahead of permitting) 7 5
OSS Installation approvals(finals) 279 361
Letters to homeowners in response to unsatisfactory maintenance reports 869 0
Reminder letters sent to homeowners for OSS maintenance 0 0
WSU Homeowner Classes 1 1
Drinking Water Program: (Jeff Wilmoth, Wendy Mathews,Luke Cencula,Ian Tracy)
Well construction saw an 8%increase and water adequacy saw an 24%increase over 2020.
Task/Permit Description 2020 2021
Well Construction Permits(Construction and Decommission) 209 226
Sanitary Surveys for Group A Water Systems 31 30
Group B Water System Permits(New or upgrades) 4 4
Water Adequacy Review 393 490
Water Quality Program: (Ian Tracy,Travis Casey)
In May of 2021,the BOCC approved an ordinance combining all existing shellfish protection districts into a single
clean water district. In addition,they approved a$5 per parcel fee that will go towards a more proactive water quality
program. In August an advisory committee was formed to oversee implementation of the program and provide a
conduit for public and partner coordination. The first committee meeting was held in December of 2021. Fee
collection and work will begin later in the 2022 year.
Task/Permit Description 2020 2021
Samples Collected 210 245
Parcel Surveys 70 179
Miles of Shoreline Sampled 11 13
Solid Waste Program: (Wendy Mathews,Erik Doran)
Vouchers continue to be very helpful in bringing sites back into compliance and helping residents with disposal costs.
30,446 educational postcards were mailed out in June related to recycling contamination,funded by Dept.of Ecology.
Task/Permit Description 2020 2021
Solid Waste Facilities 6 22
Facility Inspections 6 16
New Complaints/Enforcement Cases 77 96
Disposal Vouchers Used 278 155
Waste disposed by use of vouchers 70.7 tons+ 160.9 tons
16 cu yds
Vector Program: (Ian Tracy)
Task/Permit Description 2020 2021
Vector calls(mostly rabies related) 47 18
Rabies specimens(tested) 7 3
Rabies Positive specimens 0 0
Water Recreation Program: (Erik Doran)
Many public pools were impacted by COVID-19 restrictions,some choosing to remain closed for their part time
season. Inspections only occurred on those who chose to open with required mitigation measures. The YMCA pool
was opened this past year. Staff worked with the state DOH staff on review of construction plans and initial
inspections.
Task/Permit Description 2020 2021
Pools Permitted 15 10
Spas Permitted 4 4
Total Inspections 6 11
Additional Items or Actions for BOH Review:
• Updates to Chapter 6.32 Platting Standards (see attached staff report)
To: Mason County Board of Health
From: Alex Paysse, Environmental Health Manager
Date: January 25th, 2022
Item: Updates to Mason County Code Chapter 6.32 Preliminary Platting Standards
See attached draft changes.
Background
RCW 70.05.060 directs the local board of health to enact local rules and regulations as are
necessary in order to preserve, promote, and improve public health and provide for the
enforcement thereof. Chapter 6.32 addresses health requirements related to plats and
subdivisions of property. The chapter ensures new lots are properly sized and divided to allow
for proper sewage disposal and safe drinking water. This chapter was last amended in 1980
(40+ years). Staff has found a lack of information and alignment with current codes,
regulations, and current policies. Proposed draft eliminates code conflicts and provides clarity
to applicants on what will be required for health approval.
Summary of changes
6.32.010 Purpose.
• Small language updates and added references to related county and state codes
6.32.020 Definitions.
• Adopts definitions in county and state code sections.
• Removes definitions that are already defined in other adopted code sections to avoid
conflicts.
6.32.030 Information required.
• Relabel as "general requirements"
• Adopts state code requirements related to onsite sewage systems WAC246-272A-0320
• Clarifies administrative requirements such as forms and fees
• Adds supporting language for additional information when plats or subdivision involve an
existing onsite sewage system, aligning with current practice and related codes.
• Reformats some of the existing requirements
6.32.040 Filing fee schedule
• Retires section, references to current EH fee schedule were added to section 030.
6.32.050 Minimum Lot Size for Subdivision
• Removes most of the language and references back to state code minimum lot sizes
WAC 246-272A-0320(2).
6.32.060 Public Water Supply
0 Adds reference to appropriate state code requirements related to Public Water Systems.
6.32.070 Individual lot wells
• Clarifies section heading and purpose
• Adds section b) which highlights WAC 246-272A-320(2)(b)(i)
6.32.080 Waiver of Regulations
• Small format changes.
• Adds reference to review fees for waiver submittals
6.32.090 Appeals.
• Adds section to support appeals, aligning with other Title 6 chapters.
Recommendations
Review and discussion of proposed amendments to Chapter 6.32. Staff recommends approval
by BOH, pending a public hearing and adoption by BOCC.
Briefing with BOCC Dec. 13t1, 2021, DONE
Review& approval by BOH Jan. 251h, 2022
Review/Approval by BOCC to set Public Hearing February, 2022
Public Hearing and Adoption February, 2022
Effective Date Aril 1st, 2022
Title 6-SANITARY CODE
Chapter 6.32 PRELIMINARY PLATTING STANDARDS
Chapter 6.32 PRELIMINARY n1 nninir_ PLAT AND SUBDIVISION HEALTH
STANDARDS
6.32.010 Purpose.
The purpose of this chapter is to:
(a) Complement the Mason County platting ordinance and Title 16—Plats and Subdivisions;
(b) Provide standards by which the county health officer can evaluate preliminary plats,final plats,Short
Plats, Large Lot Subdivisions and any other subdivision applications and sheFt plats;
(c) Comply with`"'^'� 'rti�8 96246-272A WAC,246-290 WAC, 246-291 WAC,and applicable Title 6 chapters
related to drinking water and sewage disposal;and
(d) Protect the public health.
(Res. 1162(part), 1980:Art.VIII (part)of Res.dated July, 1970 and amended November 5, 1970).
6.32.020 Definitions.
The definitions outlined in 246-272A WAC,246-290 WAC,246-291 WAC,Chapter 6.76—On-Site Sewage
Regulations,and Chapter 16.08—Plats and Subdivisions are hereby adopted and incorporated by reference. In
addition,the following definitions shall also apply.
(a) 'Board"shall mean the Mason County Board of Health"On site sewage d: ^ _^I system" __ _aRy system
mot,,m i of^ aed to a ,HI„-seweF Stl,..,
(b) "Department"shall mean the Mason County Community Services, Public Health division.
(c) "Director"shall mean the Mason County Community Services Director.
(d) "Health Officer'shall mean the Mason County Health Officer or a member of the department authorized by
and under the direct supervision of the Mason County Health Officer.
n
FePF sentative.
Mason County,Washington,Code of Ordinances Created: 2021-10-20 09:04:40 [EST]
(Supp. No.57,11-21,Update 1)
Page 1 of 6
iineludiRg ,
(Res. 1162(part), 1980:Art.VIII § 1 of Res. dated July, 1970 and amended November 5, 1970).
6.32.030 General Requirements.
(a) WAC 246-272A-0320"Developments,subdivisions,and minimum land area requirements"are adopted and
incorporated by reference to subdivision applications proposing the use of an Onsite Sewage System.
(b) An application for Environmental Health review of Land Use shall be submitted upon application using the
form prescribed by the health officer.
(c) Permit or review fees shall be charged according to the Mason County Environmental Health Fee Schedule.
(da) Preliminary Plat,Short Plats, Large Lot Subdivisions,or other division of land-
(1) A topographical map shall be ineeFpeFated inte the pFeliminaFy plat drawiRg showing contours as
specified by the health officer but shall be at least five-foot contours to be extended at least one
hundred feet beyond the boundaries of the proposed subdivision unless specifically waived by the
health officer' or director.
(2) A minimum of one representative soil log and percolation test per acre or tract larger than one acre
shall be submitted. If a sufficient amount of information is not available on water table conditions,the
health officer can require a winter observation be completed during the months of suspected high
water table conditions. All test holes shall be made available for the health officer's inspection and
constructed according to the Mason County On-Site Standards.
(3) All surface water and wells-drinking water wells and springs located in or within one hundred feet of
the subdivision shall be shown.
(4) Where existing On-Site Sewage Systems exist within project boundaries:
(A) All On-Site Sewage System components shall be located according to respective record drawings
and county records.
(B) When no record drawings exist, proof of component locations may be required by the health
officer or director.
(C) Proof of adequate reserve area(s)as required in 246-272A WAC
(D) Proof of satisfactory maintenance requirements as outlined in 246-272A WAC and Chapter 6.76—
On-Site Sewage Regulations.
(E) An easement or covenant may be required if existing sewage components are severed or
separated by any proposed lot lines to ensure future operation and maintenance of said
components according to 246-272A WAC.
(5) When a Community Drainfield,as defined in Chapter 6.76—Onsite Sewage Regulations,is proposed:
the system shall be completed prior to recording of the subdivision or a performance bond or moneys
on deposit shall be required in the same manner as required for water systems in subsections(d)and
(e)of Section 6.32.060 except the estimates shall be submitted by a licensed professional engineer,
licensed designer,or registered sanitarian.
(6) When service by a Public Sewer System is proposed,a completed sewer adequacy form signed by the
system manager shall be provided,prior to plat approval and filing, as evidence that sewer disposal is
available to each lot proposed.
Created: 2021-10-20 09:04:40 [EST]
(Supp.No.57,11-21,Update 1)
Page 2 of 6
(eb) Final Plat.
(1) Evidence shall be submitted that all requirements of preliminary plat approval have been met.
TES rt Plats-.
than a aere sha" be Submitted
nitarian Fefessienal engiReeF eF appFeved designer
that Percolation te-Sts and soil logs be eendueted dWFiRg the meRths Gf sUSpeGted high wateF table
cnn d 4i 0 A,;(f) All see!tests shall be cenducted in aCCE)FdanEe with the DepaFtment of SeEial and Wealth Se-PAce'Intepim Soil
Evalwateen
"exEept that all sail shall be te a P9*Rt thFee feet bel%s,the-hette-m.ef pFepesed
..n t. the 'abs nt•
(g) All sail leg heles shall -he madde availabble fer the health 04*EeF'S inSPP_G_tiA_.A.The health e4ieeF Shall hP RAtified
when the holes have been PFePaFed and shall make the inspeetien within ene yieek ef 5---e-h Retifieatien.The-
heles shall be Elesed within 9Ae week following the inspeetiGF�.
(h) When a sewage system utilized by tWG eF FRGFe lets is pFepesed,the see!testiRg FeelwiFements shall he as
li...RSed .. efessienal engineeF, Ii.-.rased designs. a iste Fed nita Fian
(Res. 1162(part), 1980:Art.VIII of Res. dated July, 1970 and amended November 5, 1970).
6.32.040 Filing fee «hearr eRetired.
(a) A plat with individual lat sewage systems eF individual let wells,eF,with beth in5tallations en eaeh At Shall
submit a filing fee ef ene dellaF peF 10t feF eaeh plat eF subdivision of a plat sulamitted at the time ef
feF any ene plat,additieRal diyisieR ef a plat OF Felplat with individual lot
(b) A plat te)be SeRied- -hy a publie sewage WeFl(5 and publiE wateF supply shall submit a minimum filing fee e
/ 1 t fen f fi4y dell-,..• hall be. do TETA Sk10rt�vrrcc�rTrrcy-cvncrrT�rrtm-cc-rcgc i r c
(Des 1162 (paFt) 1980i A.+ VIII f.3 of Res dated 1 I.. 1970 and amended Ne yemlaeF 5 1970)
6.32.050 Minimum Llot S&ize few subdivisions
Minimum lot size requirements shall conform to 246-272A-0320 WAC utilizing method one or method two as
outlined in state code. GRe of the fellewffiRg metheds sh-all be used fer deteFmining let sizes when on site Sewage
disposal is USed..
(a) Methed
Created: 2021-10-20 09:04:40 [EST]
(Supp. No.57,11-21,Update 1)
Page 3 of 6
TablI
WateF&WPP4V
4 - 4 g
ii iifFdHc� �*aEFe 1 aGFe aef2 aEFe et EaGh -
Let
Soi-IType
Sail Type 8rai Rage GeneFal Soo!
r46s4k,t;o„
04 E9bb�es
-2 Good 1--4 to /ORGh S,3Rd„Soil e I,,am
&&Wle�
4 PAAF 19 19 ut s/ineh
re ' ,
et- feF seil type 1 eam -hp-Pp-d-i-w-p-d- by the health G4*EeF of eRgiReeFiRg justifeeati8R EaR be pFevided that
shows signifleant adveF5e e4eets OR gFOLIRdwateF quality will net eeew; heweyeF,in ne ease--;hall the Fedweed size
be less thaR that f9F sea!type 2.
**
pepeent e,
(b) Method(2).OR site sewage dispesal syste.m.-S sh.all be installed en lets, paFeelS,eF tFaets that have a
suffk*eRt affleUM Of aFea with PFE)peF seils to adequately Fet-a-in a.m.d_tr%.at Sewage en sate,takiRg
(1)Sew type and depth;
(2) Area drainage, let drainage;
(3) Prateetien of surface-R,dgFOURd-watefs;
(4) Setbaeks kem pFepeFty lines,wateF supplies etE.;
(5) S e u F ee 9f derwestiE Dater
(6�) Tepegraphy,geelegy and gFOvndEEN:cF
Created: 2021-10-20 09:04:40 [EST]
(Supp. No.57,11-21,Update 1)
Page 4 of 6
(8) Ava°�;ability of publie seW-FSj
(9) Ae ivity OF landuse, pFesent and anrt+eipate4,
(10) !_Fewth patt.,Fns;
1111 Individual a.,d ar-eu....,,I-.+..d.....Ss.,FF., +s......,a+.,...uaCr...
(13) Anticipated sewage of
(e) Methed(3). if the let 9F Ats are within the juFisdietien ef an appFeved seweF Utility Which Will PFOVide
sizes shall be established jointly between the sewer utility,the local health, planning,establi
(Res. 1162 (part), 1980:Art.VIII§4 of Res.dated July, 1970 and amended November 5, 1970).
6.32.060 Public water supply.
This section applies to proposed plats or short plats that require public water supplies as determined in
Seeteen c 32 050246-272A-0320 WAC.
(a) All public water supply systems shall comply with 1"'^�.,,C'^�4246-290 WAC and 246-291 WAC.
(b) All potable water sources shall be developed,tested for quality and quantity,and available to the plat
or short plat prior to the approval and filing of the plat or short plat.
(c) All public water supply systems shall be installed or bonded for completion prior to the approval and
filing of the plat or short plat.
(d) A performance bond shall be provided in favor of the county health department as an alternate to
complete installation of a public water supply prior to approval and filing of the final plat or issue of the
site approval for short plat.Any such bond shall guarantee that construction will be completed within
one year of final plat approval.The bond shall be from a reputable bonding company,on a satisfactory
form and in an amount based on an estimate prepared by a licensed professional engineer for class 1,
2, and 3 water systems and by the installer for class 4 water systems plus thirty-five percent.All of the
above shall be to the satisfaction of the department of Social and Health Services,the health officer
and legal counsel for the health department.As a condition precedent to acceptance of a bond,the
water source shall be provided, proven and approved;the water source shall also be tested
bacteriologically and chemically.
(e) Preliminary to bonding an itemized list of materials shall be submitted with the water system plans to
the Department of Social and Health Services or local health department,as appropriate.
(f) Moneys on deposit for completion of the water system may be provided in lieu of a bond if confirmed
in writing by a reputable financing firm to the satisfaction of the health officer and legal counsel for the
health department.
(g) Completion of the water system(including availability of water to each lot)shall be provided within
one year after final recording of the plat.
(Res. 1162(part), 1980:Art.VIII §5 of Res. dated July, 1970 and amended November 5, 1980).
Created: 2021-10-20 09:04:40 [EST]
(Supp. No.57,11-21,Update 1)
Page 5 of 6
6.32.070 Individual let wellssources.
This section applies to proposed plats or short plats that allow an individual water source or well as
determined by 246-272A-0320 WAC.
gl To meek the standaFd ef the chapteF the subdivideF of a si-hdivisien with !aFgeF letS With R MOP"fGF
Eeach individual lot must designate on the final recorded document the general location of each
water source or well and septie tank systema one hundred-foot radius water supply protection
zone.-
a}b)Configuration of each lot shall allow a one hundred-foot radius water supply protection zone to fit
within the lot lines;or establishment of a one hundred-foot protection zone around each existing
and proposed well site per 246-272A-320 WAC.
(Res. 1162 (part), 1980:Art.VIII §6 of Res.dated July, 1980 and amended November 5, 1980).
6.32.080 Waivers of Matt^
(a) Review for subdivisions served by existing sewage systems and water systems may be waived by the health
officer.
(b) Whenever a strict interpretation of these regulations would result in extreme hardship,the health officer
may waive such regulation or portion thereof; provided,that the waiver is consistent with the intent of these
regulations and that no public health hazard will result.These Rfegulations adopted in compliance with WAE
248 96 246-272A WAC will also require the concurrence of the SeeFetaryWashington State Department of
Health.
(c) A review fee shall be required according to the Mason County Environmental Health Fee Schedule.
(Res. 1162(part), 1980:Art.VIII §7 of Res.dated July, 1970 and amended November 5, 1970).
6.32.090 Appeals.
(a) Decisions of the director may be appealed to the health officer. Appeals must be made in writing to the
director within ten working days of the decision which is being disputed. A hearing date shall be schedule
with the health officer to be held within thirty days of said decision being appealed.
(b) Determinations of the health officer may be appealed to the hearings examiner. Appeals must be made in
writing to the director within ten working days of the decision which is being disputed. A hearing date shall
be schedule with the health officer to be held within thirty days of said decision being appealed.
(c) Departmental orders and determinations shall be staved for the period the appeal is pending, provided no
public health hazard results from said stay.
Created: 2021-10-20 09:04:40 [EST]
(Supp.No.57,11-21,Update 1)
Page 6 of 6
November-December 2021
Communicable Disease & Notifiable Conditions (3 programs-CD,TB, STD) Staff:Audrey O'Connor,
Back-up: Elizabeth Custis& Lydia Buchheit
November-December our communicable disease(CD)program nurse received 50 reports requiring data entry into
the State database,and/or investigation and follow-up. * Chronic Hepatitis C cases are being directly entered into
new WDRS database by DOH. This does not include their work in COVID-19 case investigations.We are no longer
keeping COVID line list. Current case numbers provided by WA DOH.
Disease November- Total to date
December
COVID-19/2021 * 4,642
12/31/2021
Campylobacteriosis 2 17
Cryptosporidiosis 0 1
Giardiasis 0 0
higa Toxin 2 1 2
higellosis 0 1
Mumps 0 0
Haemaphilus Influenza 0 0
Hepatitis B-Acute 0 0
Hepatitis B-Chronic 0 0
Hepatitis C-Chronic
Hepatitis C-Acute 0 0
Hepatitis D 0 0
Lyme 0 1
Pertussis 0 0
almonellosis 1 2
1
ersinia 0 0
Coccidioidomycosis 0 0
Carbapenemase-resistant 1 2
enterobacteria(CRE)
Hepatitis A—Ruled out 0 0
Meningitis-Ruled out 0 0
ibrio-Ruled out 0 0
Listeriosis-Ruled out 0 0
Legionella 0 1
Suspected rabies/sample sent 0 5
Malaria 0 1
Tuberculosis-Ruled out 0 1
Tuberculosis-Latent 0 0
Tuberculosis-Active/open cases 1/WCC 1
ibriosis(non-cholera) 0 1
Listeria 0 0
Congenital Syphilis 0 2
Chlamydia 30 198
Gonorrhea 10 72
Syphilis 0 9
Herpes 4 14
HIV 0 0
Totals 50 331
Hepatitis C Screening Staff: Christina Muller-Shinn
There has not been very much activity with this program during this reporting period. Staff continues to
participate in several of the state-wide HCV Free WA workgroups.
Maternal Child Health Staff: Elizabeth Custis
Elizabeth provides COVID guidance as part of this grant. Elizabeth works with childcare and
Headstart/ECEAP agencies regarding COVID cases, response guidance,and testing. She continues
assisting with other COVID calls and outbreaks,such as long-term care and support of our county
employees.
Elizabeth participates in the SMART(School Medical Autism Review Team) in Mason County which helps
to evaluate and potentially diagnose children with Autism.Team members are Dr Rayos and Dr
2
Tuladhar,Speech/Occupational Therapy/Physical Therapy from school districts and Mason General
Hospital Pediatric Rehabilitation Team, Special Education teachers, and Birth to Three Early Intervention
Providers. Without this team, many children wait 12 -18 months to see a specialist for diagnosis,which
can delay needed services. Our local pediatricians and other providers on this team have been specially
trained to evaluate children. Elizabeth's role is to assist families to get the support and resources needed
after their child is diagnosed with Autism. We are lucky to have this team in our county to fill the gap.
Many counties do not have this in place.
Maternal Child Health Parenting Program-Incredible Years
No Incredible Years parenting classes were offered due to COVID. Future work will be with DCYF for
Child Protection Services.
Breastfeeding Coalition of Mason County
Breastfeeding Coalition meetings and support group are on hold during COVID. Elizabeth has continued
to share breastfeeding COVID immunity and vaccination information with MGH OB Department and
Mason Clinic Pediatricians.
Early Learning Coalition of Mason County
Elizabeth participates in the monthly meetings. The coalition completed a mapping project in December
to see what resources are available in the county. Now the goal is to evaluate what is missing and what
we might work toward to better support early learning.This team works together to support early
learning, identify gaps, and assist with promoting opportunities for early learning for children in Mason
County.
Immunization Improvement Grant
Elizabeth continues to encourage parents and newly vaccinated adults to apply for online access to their
child's and their own Immunization Information System records.This is for COVID records and other
vaccines. She is also able to provide immunization records for those without internet access or those
having difficulty with the state system.
Children with Special Health Care Needs
Due to COVID response, Elizabeth provides only a portion of hertime in this program for consultation
and care coordination to families with children that have special health care needs in the Mason County
area. Referrals continue to be submitted to RN. RN participates in monthly Pediatric Care Coordination
Meetings that include Mason Health Pediatricians, Birth to Three Early Intervention, School and Mason
Health Speech, Physical, and Occupational Therapy, and Developmental Preschool and Special Services
staff. The goal of these coordination meetings is to better provide services to families by reducing
duplication of services and matching needs with appropriate providers.
Social Service Programs Staff: Todd Parker, Abe Gardner, Haley Foelsch
Housing($5,994,321 Annually: 12 funding sources—grants,tax, local recording fees, 12 subcontracts,
and 20 programs) Staff:Todd Parker, Haley Foelsch
Housing Needs Assessment:
As we start our housing needs assessment, I wanted to share some information that our planning and
permitting department shared. If all the construction comes through,this is equating to 614 NEW
housing units all in the Belfair area. I have seen surveyors out in the UGA of Shelton so there may be a
larger development in the works here too.
3
Under Construction:
• In 2021 there was a submittal for 268-unit apartment complex (might become condos) in Belfair
UGA(already under construction).
In the pipeline:
• There is a preliminary plat approval for a 147-unit subdivision for SFR in the Belfair UGA.We
expect to start seeing building permits come in for that in 2022 once Final Plat approval is given.
• A pre-application conference for a 99-unit subdivision. Application is expected in 2022 also in
Belfair.
• We are expecting a 100-unit apartment complex in Belfair, but have not seen the application
yet.
Additionally, 7 single family homes through Kitsap Housing (like Habitat for Humanity) are complete and
families have moved in (Shelton). They also have 12 plots in Allyn, but I am unsure of the construction
status of this area.
Eviction Rent Assistance Program ERAP 2.0: (Effective October 1,2021-June 30,2023)
The Eviction Rent Assistance Program (ERAP) 2.0 became effective in October replacing the Treasury
Rent Assistance Program (TRAP) 1.0. ERAP 2.0 is intended to prevent evictions by paying past due and
future rent and utilities while distributing funds equitably.Two organizations are ensuring that funds are
distributed to equitably. Crossroads focuses on populations age 25+and Shelton Family Center focus on
the population under the age of 25. From October to December 2021 during the first quarter under the
ERAP 2.0 grant, a total of$1,122,754.12 of financial assistance was distributed and a total of 171
evictions were prevented.
Virtual Landlord Event
On December 8,2021, a virtual landlord event was held in Mason County through Zoom. Several
community partners attended and were involved in the landlord event.These partnerships included:
Mason County Public Health, Dispute Resolution Center, Washington State Department of Commerce,
Thurston County Volunteer Legal Service, Northwest Justice Project, Crossroads Housing, Youth
Connections, and the Bremerton Housing Authority.
Point in Time Count
Mason County has been working with community partners to prepare for the annual Point in Time (PIT)
Count to get a count of people experiencing homelessness in Mason County. Due to COVID-19,there
was not an unsheltered Point in Time Count in 2021. With Covid cases rising in January 2022, Commerce
has received a waiver from HUD to postpone our Continuum of Care's PIT Count from the night of
January 27 to February 24, 2022.
Counts from 2020 showed the following: January 23, 2020 PIT Count: Households: 99 for a total of 111
individuals (Households without children: 96, Households with children: 3)
• Shelton: 106 individuals counted
• Belfair: 5 individuals counted
4
Behavioral Health
Mason County Mental Health &Substance Use Disorder(SUD) Response(7 programs) Staff: Abe
Gardner,Christina Muller-Shinn,Audrey O'Connor
Overdose Data to Action (OD2A)
Staff presented at the November Opioid Stakeholder meeting on Mason County's Overdose Trends and
Results from the 5-year Narcan research program that was discussed in the last BOH report. Overdose
fatalities continue to climb both nationally and state-wide, continuing to break records. According to the
WA Department of Health, drug overdose deaths in 2020(all substances) were 37% higher than 2019,
and preliminary data for 2021 shows that from Jan-June, deaths were already 19% higher than that
timeframe in 2020. Synthetic opioids, predominantly fentanyl, are the main drivers of that increase, but
deaths that involved psychostimulants (specifically methamphetamine) have gone up substantially as
well.
Unfortunately, local data reflects those trends.Although the number of non-fatal opioid overdoses that
went through the emergency system only increased slightly from 2020, and the number of reported
community reversals using our program's distributed naloxone remains steady,we are expecting the
fatalities to be significantly higher in 2021 once final toxicology reports have come in.
Mason County Public Health have distributed over 2500 naloxone kits to the community since 2017, but
at this point, it is essential the community pivots to continue to meet the changing needs.
Recommendations given at the presentation for moving forward include: expect overdose trends to
continue to rise and help prepare the community from its effects through honest and accurate
conversations and education regarding fentanyl and the increasingly unpredictable drug supply; if
agencies are working with people who actively use opioids and other illicit substances, consider
distributing naloxone to them (MCPH is mostly only interacting with people who are injecting drugs at
this point, due to other outreaches being paused due to COVID. Therefor,there is a large population of
people who are using drugs that we are not engaging with. We are asking the community to help with
this by distributing naloxone to their clients); and lastly, acknowledging that people with stimulant use
disorder have unique needs and respond to treatment techniques differently than opioids users—we
must consider the exigencies of poly-substance users and continue to learn about and implement up-to-
date treatment methods to address this issue.
Substance Use Mobile Outreach of Mason County
Substance Use Mobile Outreach had 54 interactions with 44 unduplicated participants during this
reporting period.The program was closed during Christmas week, as well as the following week due to
inclement weather. 18%of visits reported knowing someone who had overdosed in the past 30 days.
Fentanyl testing strips were requested at 56%of visits, illustrating the community's concern with
wanting to know what is in the drug supply. 3 participants were new and received overdose prevention
education and response training as well as getting a naloxone kit.
COAP/COSSAP (Community partnerships,Systemic change, Program coordination)
MCPH presented at the national conference and was able to share its program development as well as
data collected over the past four years. Work on the final paper has concluded with our research
5
partner and we are currently working on presentations to highlight the incredible work that has been
done in Mason County over the past several years.
The emphasis of system coordination,which the COSSAP project was highlighting,will continue to be a
priority, and moving forward will continue to fall under the purview of Public Health as the backbone
organization in Mason County.
MCLEAD (Mason County Law Enforcement Assisted Diversion)
HCA was finally able to send MCPH the new LEAD contract,that will run until June 30th, 2023, and it was
just signed by the BOCC. Currently MCPH is coordinating with Olympic Health and Recovery Services to
get a new subcontract in place. The plan is to have a fully executed contract in place by the end of
January.
The implementation and continued efforts of the LEAD program continue to be used by the Public
Defenders Association as an example to other rural communities for how to develop, implement and
coordinate an appropriate LEAD program. Referrals continue to be received through all three referral
pathways: arrest,social contact, and community referrals. The peer case-management team will soon
be increased by at least 1.0 FTE as soon as we have a new subcontract in place.
Behavioral Health Navigator Program
The Behavioral Health Navigator Program continues to run very well. With the addition of a 1.0 FTE
provided by a partnership with Olympic Health and Recovery Services, referrals have increased and the
ability to respond in a timely manner has been appreciated by our LE partners. There is a lot of potential
for this program to grow as staffing becomes stable and consistent.
Behavioral Health Transportation Support (pilot program)
Currently MCPH is developing sub-contracts to be approved by the BOCC and will then MCPH will
subsequently offer those contracts to The Patty Wagon and Gethsemane Ministries. It has been
recommended that The Patty Wagon coordinate transportation to and from services within Mason
County and that Gethsemane Ministries is best setup to transport folks to and from services outside of
Mason County. The goal is to have contracts signed and a program in place by the end of January.
RCORP(Rural Communities Opioid Response Program)
RCORP made significant strides during this reporting period. Olympic Health and Recovery Services has
1.5 FTE dedicated to RCORP, including a 0.5 FTE Peer Navigator(the Peer's other 0.5 FTE is spent
through the jail MAT/re-entry program) and a 1.0 FTE Substance Use Disorder Professional (still trying to
hire another 0.5 FTE Peer Navigator).The SUDP is predominantly working in Mason County Jail, helping
provide substance use disorder(SUD) services including basic assessments and linkages to care and
works closely with the jail Mental Health Professional and Peer.The Peer staffs the Mobile Outreach
with MCPH providing peer services, case management, and linkage to care to participants.This funding
also allows the Peer to case manage individuals in the jail who do not qualify for the MAT/re-entry
program,so anyone can get SUD services who needs them now. This is a fantastic accomplishment.
Mason Health's new Peer Navigator has been onboarded and is meeting with patients upon referral;
referrals are sent from the Behavioral Health Department and the Emergency Department. Mason
General's Emergency Department has added a new referral system,where anyone who screens positive
for SUD (each patient is screened for SUD upon intake) is automatically given a referral to meet with the
6
Peer. Mason Health continues to learn from the first year of the program and has implemented changes
as part of quality improvement.
Substance Use Prevention Staff: Ben Johnson& Melissa Casey
The newly developed Mason Substance Abuse Prevention Coalitions have continued to meet in
November and December via zoom. There has been three meetings that have includes all of Mason
County and has sector representation from Shelton, North Mason and Mary M Knight school Districts,
Public Health, Faith Based,Youth,Substance Abuse Treatment, law enforcement, parents and local
business.
This year the coalition will focus on providing prevention programming throughout the entire county.
We are happy to announce that the Mary M. Knight School District has agreed to assist with the
development of a youth prevention leadership group at the Jr. and High school levels. We are also
continuing our partnership with prevention leadership groups at the North Mason and Shelton school
districts. The North mason and Shelton School Choice programs will begin programming in Jan , 2022.
The focus will be on promoting the new Rx take back boxes in Mason County and conducting a
Community Substance Sale Assessment at store fronts.
Cedar High School students, Gay City Pride of Seattle,Shelton Youth Connections,Youth Marijuana
Prevention Education, Mason County Substance Abuse Prevention Coalition, and North Mason School
District met twice in November and December to begin organization of a Mason County LGBTQ youth
support program that will focus on substance abuse prevention and mental health issues.
Mason County Public Health and the Mason County Substance Abuse Prevention Coalition also
partnered with Family Education Support Systems to provide Guiding Good Choices parenting training in
October.The course has been completed with 8 families who participated,the next series of classes are
scheduled to begin this spring.
The coalition has received training on marijuana additives (delta-8 and 9)to some products that may be
sold in convenience stores. The coalition coordinator conducted a store survey and did not find Delta 8
products.Although did find gummies for sale in a Belfair store that has Delta-9.This was reported to the
Washington state liquor and Cannabis department. Not all county stores have been surveyed.
Community Health Education, Assessment and Data Staff: Melissa Casey
The 2021 Community Health Assessment (CHA) dashboard will be available on health masoncounty.com
in the coming weeks. Strategic planning for the 2022-2026 Community Health Improvement Plan will
begin at the end of January.The Mason County Community Health website is also being revamped as a
hub for data and resources.
We invite community members interested in joining the Mason County Health Coalition to please
contact Melissa Casey at 360-427-9670 Ext 406 or.mcasev@masoncountywa.gov.
Emergency Preparedness Staff: Lydia Buchheit,Alex Paysee,Sunni Evans,
COVID-19 Response Staff: Rebecca Shipman,Jacob Ritter,Cesar Apaez-Mendiola,Alyssa Medcalf,Toni
Monnier
In Mid-October the final members of the COVID team were hired. Since then,they have worked to build
their team and establish their roles. With the addition of the team,the staff members who have
7
managed COVID for the last 2 years were able to return to their prior duties.The COVID team still works
closely with these staff members who are always willing to share their experience.
For the months of November and December the COVID team has:
• Assisted with various outbreaks throughout the county
• Supported the schools with changing guidance, monitored school case numbers
• Worked in partnership with Mason Health at vaccination clinics
• Provided testing and monitored positive cases for the county employees
• Supported facilities in outbreak status with testing supplies and PPE
• Supported business with COVID guidelines
• Informed public of vaccination clinics,vaccination locations, and testing locations
• Facebook Give Thanks campaign to recognize our partnerships during COVID
• In the last two weeks of December,we started into the Omicron spike.We have assisted
numerous facilities, schools, etc. with guidance
• Reviewed and reported COVID related deaths and daily case numbers
• Monitored and reviewed current and anticipated guidance changes
The Omicron variant is on a rapid rise affecting staffing of many community businesses. The variant
often does not show up positive on testing when symptoms first begin causing people to go out
or to work thinking it is not covid only to have it turn positive in another day or so. We
encourage the community to stay home when you have symptoms and not hesitate to test more
than once.
You can check the Covid 19 data dashboard for the most up-to-date data.
https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard#dashboard
8
DRAFT 1/19/22
MASON COUNTY
COMMUNITY SERVICES
Mason County
Community Health
Assessment
2021
Mason County Public Health
A Safe and Healthy Mason County
http://healthVmasoncounty.com/
www.masoncountVwa.gov
Purpose .
The Community Health Assessment (CHA) is a review of various health data used to illustrate
the current health status of a community and monitor its progress over time. It is a critical step
in defining the vision for health in Mason County so that we can choose targeted health
improvement efforts that affect policies, dismantle health disparities, and promote health in
our community. The findings of this assessment will be used to identify the health priorities of
focus for the 2022-2026 Mason County Community Health Improvement Plan.
Background
Annually, the County Health Rankings &
Roadmaps program of the University of Health Outcomes
� `(sox)
Wisconsin Population Health Institute Quall of Life«►
publishes the County Health Rankings. Tobacco Use
The local data reported in this section is
Health Behaviors Diet&Exercise
organized by the Health Rankings Model (30%) Alcohol&Drug use
(1). The Health Rankings Model
emphasizes the many factors in sexual Activity
population health that, if improved, can Clinical Care Access to Care
help make communities healthier places (20%) Quality of Care J
to live, learn, work, and play. In the I Health Factors I Education
Health Rankings Model, the current
health status of a community is social& Employment
described as health outcomes which are Economic Factors Income
(ao%)
W
ranked by rates of mortality (premature Farr &Soc support
death) and morbidity (chronic diseases). Community Safety
These health outcomes are influenced by Physical Air&Water Quality
health factors in a community, ranked b Environment
y (10%) Housing&Transit
a calculation of various health behaviors, �c_x �R__ <2D,.u�l
clinical care, social and economic, and
physical environment measures. Health
Factors represent what will influence the future health of a community, while health outcomes
represent how healthy a community is today (1). There are evidence-based policies and
programs that a community can implement to improve health factors and, ultimately, improve
its health outcomes. These standard measures facilitate comparisons and benchmarking with
similar communities and changes over time. Mason County is compared to two neighboring
rural counties—Grays Harbor and Lewis—with similar populations, health factors, and health
outcomes.
Due to the COVID-19 pandemic beginning in January 2020, the data reflected in this assessment
are from 2019 and earlier; 2020 data is used for few measures where available. Data will be
revised in the subsequent CHA after detailed 2020 data are released.The impacts of the
1
pandemic are unknown; therefore, we can only make assumptions about the anticipated
outcomes as a result of the pandemic. COVID-19 will likely have a greater impact on
unemployment, children in poverty, income inequality, premature age-adjusted mortality, food
insecurity, and severe housing cost burden than is currently reflected in this assessment (1).
Least Healthy Healthiest
0% 25% 50% 75% 100%
According to the Health Rankings Model, Mason County's health outcomes
is ranked in the lower middle range (25%-50%) of counties in Washington.
Our community's health factors are ranked among the least healthy counties
(lowest 0%-25%) in the state.
The 2021 estimated population of Mason County is 65,750 residents (2). Although Mason
County is a predominantly white population (83%), 25% identify as Hispanic origin of any race
(3). Nine percent (9%) of Mason County residents are biracial or multiracial, 5% are American
Indian or Alaska Native, and 1%are Black/African American or Asian (3).
Race(3) Ethnicity(3)
0 100%
a 75%
0
a
0
° 50%
c
v
U
25% ■■White
■Two or More Races 0%
■American Indian or Alaska Native Non-Hispanic Hispanic
2
More than half(53%) of Mason : � Male Total Percent of
County residents are adults ages 0-4 1,529 1,599 3,127 Population 5%
20-64 years (3).Twenty-six 5-19 5,216 5,561 10,776 16%
percent (26%) of the community 20-64 16,341 18,419 34,759 53%
are seniors over age 65 and 21% 65+ 8,794 8,293 17,087 26%
are under the age of 20 (3). 0'
Health Outcomes
Health Outcomes represent how healthy a county is right now, reflecting the physical and
mental wellness of residents within in a community through measures representing both the
length and quality of life (1). The County Health Rankings measures life expectancy, premature
death, birth risk factors, and ratings of physical and mental health as key factors that influence
a community's health outcomes.
Mortality
The life expectancy for a child born in Mason County between
2015 and 2019 is 79.7, meaning a person born in Mason County
between 2015 and 2019 can be expected to live 79.7 years on 79.7 years
average (4). In comparison, the life expectancy for the state of
Washington for that same period is 80.4 years (4). Mason Life expectancy in
County's life expectancy rate has increased steadily over the last Mason County
25 years; between 1994 and 2019, life expectancy increased by
4.3 years (4).
Leading Causes of Death, 2015-2019(4) ■Mason
Washington
QJ
a 200
a; c 167
c ° 160 148 136 136
s �
a a 120
°1 0
� a
0 80 49 43 43 44
v o 36 35 30 35
0 40 mom 20 16 19 21 15 12 10 11
o
_0 O O T 7 -"T�_.__. �_..._
Q 1
QJ
to `ec aye .Jsa QO Z' .Ee \ae �e5 Se �a
Q
°t P�tir O �\,es Q�e
,ae ce ••� a
Casa`°The top 3 leading causes of death for both males and females in Mason County are cancer,
heart disease, and unintentional injury; the cancer type that results in the most deaths in
Mason County is lung cancer(4). Mason County has higher mortality rates due to cancer,
3
cardiovascular disease, unintentional injury, chronic obstructive pulmonary disorder(CC)PD),
suicide, and chronic liver disease (4). Local mortality rates associated with Alzheimer's, stroke,
and diabetes are lower compared to the state's rates (4).
Premature Death (1)
0
0
0
0
0
9000
a`)
Ln a o 8000 -
Y
m 0 7000
Q
o 6000 -- -
m 5000
a
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
r
—0--Mason tGrays Harbor --*—Lewis Washington
Years of Potential Life Lost (YPLL) measures the rate and distribution of premature death, or
deaths that could have been prevented (1). While statistics that include all mortality are
dominated by deaths of the elderly, YPLL emphasizes deaths of younger people (1).The YPLL in
Mason County has remained largely consistent over time; however, between 2015 and 2017,
YPLL has begun to decline. While Mason County's YPLL remains higher than the state's, rates of
premature death have declined over time and continue to remain lower than neighboring Grays
Harbor County.
Morbidity
Morbidity measures the burden of disease on a population and can reveal how healthy a
community is as well as indicators for future health (1). Many of the leading causes of death
and chronic health conditions are caused or exacerbated by unhealthy lifestyle behaviors. Diet
and exercise influence one's risk for various chronic diseases including diabetes and heart
disease. Many of these behaviors are
established in childhood (1).
Prevalence of Select Adult Health Risk
Factors, 2015-2019(6)
0 50%
3,889 hospitalizations 40%
z3
VP 0 30%
Heart disease was the leading
o zo%
cause of hospitalizations in Mason —
10%
% .
County between 2016 and 2019 (s) _
Obesity Diabetes High blood High
pressure cholesterol
■Mason r Washington
4
Prevalence of Selected Unhealthy Habits Washington
Among Students, 2018(7) ■Mason
Less than 5 servings of fruits/vegetables daily
3+hours of screen time daily
Do not meet physical activity recommendations
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
There is a plethora of factors that influence a person's overall health. The Health Rankings
Model focuses on four main health factors that influence the health of the county: Health
Behaviors, Clinical Care, Social and Economic Factors, and Physical Environment (1).The
remainder of this report will discuss the health indicators that make up the four Health Factors.
Health Behaviors
The Health Rankings Model estimates that approximately 30%of our health is influenced by an
individual's health behaviors (1). These include actions that improve health such as eating well
and physical activity, as well as those that increase the risk of disease such as substance use and
risky sexual behavior.
Comparison
Health Behaviors Mason Washington
Adult Smoking(2015-2019) 23% 14%
Adult Obesity(2015-2019) 41% 28%
Physical Inactivity(2017) 22% 16%
Excessive Drinking(2015-2019) 15% 16% —_
Alcohol-Impaired Driving Deaths(2015-2019) 29% 33%
Sexually Transmitted Infections(rate per 100,000)(2018) 381.4 465.2
Teen Births(rate per 1,000 females ages 15-19) (2013-2019) 30 16
Smoking
The smoking rates of both adults and youth in Mason County have historically been higher than
the state's rates. Between 2012 and 2016, 21%of Mason County residents were current
smokers compared to 16%of Washington state residents (6). Since 2012, smoking rates among
5
adults in Mason County have remained around 1 in 5 residents while youth smoking rates have
decreased over the last decade. Adult cigarette smoking trends in Mason County have varied
over time and compared to similar counties. Due to changes in data collection methods for
adult e-cigarette use, data between 2015 and 2019 are not comparable.
Adult Cigarette Smoking(6)
30%
c
25%
0 20%
a
c
u 10%
v
a
5% - --- --- -_
2012 2013 2014 2015 2016 2017 2018 2019
--go—Mason —M--Grays Harbor --so—Lewis Washington
In 2008, 22%of loth graders reported they were
current cigarette smokers, compared to 9% in 2018 While youth smoking
rates have decreased
(7). Electronic cigarette use, or "vaping," has become
more popular in recent years. In 2012, only 4% of
over the last decade,
Mason Count 12th graders reported va in durin youth vaping in Mason
the last 30 days compared to 37% in 20p8.This g County 12th graders has
increased by 37/ -
staggering increase in vaping reflects national trends between 2012 and 2018
for which the Surgeon General declared youth vaping
at epidemic levels in December of 2018 (8).
Youth Cigarette Smoking, 2015-2019 Youth Electronic Cigarette Use, 2015-
(7) 2019 (7)
o 14% o 30%
0 12% 0 25% I
a 10% a 20%
a_ 8% 0- 15%
6% —
c 4% 0 10%
2% 5%
v 0% 0%
8th Grade 10th Grade 12th Grade 8th Grade loth Grade 12th Grade
■Mason �,=Washington ■Mason 0 Washington
6
Obesity
Obesity increases the risk for chronic health conditions such as Adult obesity rates in
heart disease, type 2 diabetes, cancer, hypertension, and
stroke (1). Although Mason County and Washington State Mason County have
exceeded those of
report similar rates for adult diabetes (10%and 9% neighboring counties
respectively), a larger portion of the Mason County adult
and the state over the
population is diagnosed as obese (6). In addition to
consistently exceeding statewide rates, Mason County's adult last four years
obesity rates have remained higher than Grays Harbor and
Lewis counties over the last four years (6). Between 2015 and
2019, the five-year obesity rate for Mason County adults (41%) was 13% higher than the state's
rate (28%) (6). Being obese prior to getting pregnant can result in negative health outcomes for
both mother and baby (9). Between 2015 and 2019, over a quarter of mothers (27%) in Mason
County had a BMI of 30 or greater prior to pregnancy (10).
Adult Obesity(6)
50%
c
0
.y
40%
0_
0
a
0 30%
Y ..
20% Voor
a
10%
2012 2013 2014 2015 2016 2017 2018 2019
f—Mason +!`Grays Harbor —41w-Lewis =x=1_ Washington
Mason County's youth also experience higher
Youth Obesity Rates, 2015-2019(7)
rates of obesity compared to the state.
Eighteen percent (18%) of Mason County 81i,
graders are obese, compared to the state o 20%
average of 12% (7). Youth obesity rates have ° 15%
remained relatively consistent over time in o
Mason County, with the sharpest increase - 10%
occurring in 8th graders between 2016 and v 5%
2018 by 50% (7). a 0%
..
8th Grade loth Grade 12th Grade
■Mason ■Washington
7
Physical Activity
Leisure time physical activity is defined as "physical activity or exercises such as running,
calisthenics, golf, gardening, or walking for exercise" (6).The percent of adults not meeting
leisure time physical activity recommendations has varied over time. In 2019, 38% of adults did
not meet physical activity recommendations compared to 15% in the previous year (6).
Percent of Adults Not Meeting Leisure Time Physical
Activity(6)
c 40%
0
35%
Z3
0- 30%
0
a 25%
0
20%
U 15% r V
v
a
10%
2015 2016 2017 2018 2019
--*—Mason Washington
In 2018, 79% of 12th graders in Mason County did not meet the recommendations for 60
minutes of physical activity 7 days a week, compared to the state's 74% (7).The percent of
Mason County 81h, 101h, and 12th graders meeting the physical activity recommendations has
increased over the last decade while the rate of 6th graders meeting recommendations has
decreased over time (7).
Youth Not Meeting Physical Activity
Recommendations, 2018(7)
0 80% �IHI�
2 78%
0 76% The percent of adults not meeting
0 74% physical activity recommendations
72% more than doubled between 2018
70% and 2019, and only a quarter (25%)
68% - of youth meet physical activity
6th Grade 8th Grade 10th 12th recommendations
Grade Grade
■Mason uWashington
Food Insecurity
The County Health Rankings measures a county's Food Environment Index based on 1)
estimated percentage of low-income population who live more than 10 miles from a full-service
8
grocery store and 2) food insecurity—the percentage of a population that did not have access
to a reliable source of food during the past year (1). The Food Environment Index is ranked from
0 (worst) to 10 (best). Mason County's Food Environment Index in 2018 was 7.7 compared to
the state's score of 8.2 (1). Mason County is largely rural; compared to similar counties,
Mason's food environment index is scored higher than Grays Harbor (6.8) and Lewis County
(7.2).
Food Insecurity, 2017-2019 (11) Food Insecurity measures prior to COVID-19
pandemic revealed that 13% of Mason County
25% i were food insecure (11). The impact of the
o pandemic is projected to increase food
20% insecurity to 15.8% (11).
a15%
o 10% ! Households that experience income
s% insufficiency usually supplement their budgets
by participating in various programs such as
°%
2017 2018 2019 free and reduced meal programs and SNAP
(12,13).
■Mason Washington
Participation Rate in Food Supplement Programs(12,13)
2015 2016 2017 2018 2019
Mason County Free and Reduced Meal Programs 62% 62% 59% 60% 61%
Mason County SNAP—Basic Food 25% 25% 24% - -
WA Free and Reduced Meal Programs 45% 44% 43% 42% 43%
WA SNAP—Basic Food 20% 19% 17% - -
Substance Use
Substance use and abuse is a health behavior that is harmful to the health and well-being of
individuals as well as their families, friends, and communities (1). In Mason County, adult
marijuana usage rates have increased rapidly since 2012, whereas heavy alcohol usage rates
have fluctuated but decreased between 2018 and 2019 (6).
Binge drinking is defined as having five or more drinks in a
Mason County adults row in the past 2 weeks (6). Mason County youth have similar
have higher usage rates binge drinking rates compared to the state, which have
of marijuana and similar decreased steadily over the last decade (7). In 2008, 27%of
heavy alcohol usage 10th graders reported binge drinking compared to only 10% in
compared to the state 2018 (7). Youth marijuana usage rates have historically been
higher than the state's. In 2019, youth marijuana use
increased in 8th and 12th graders compared to the previous
year. Between 2016 and 2018, marijuana use in 12th graders increased by 10% (7).
9
Alcohol-or drug-related deaths have remained consistent over the past decade (14). Mason
County's death rate between 2015 and 2019 (13.9 per 100 deaths) has remained similar to both
the previous five years (13.8 per 100 deaths) and alcohol- or drug-related deaths statewide
(14).
Binge Drinking Rates, 2015-2019 (6,7) Marijuana Usage Rates, 2015-2019
(6,7)
0 20% 0 35%
.2 30%
Q 15% a 25%
C �° 20%
0 10% p 15%
c c 10%
u 5% u 5% ,
L L c
a 0% 0%
Adults 8th Grade loth 12th Adults 8th Grade 10th 12th
Grade Grade Grade Grade
■Mason ■Mason Washington
Drug Overdose Deaths
Drug-specific overdose deaths have Opioid Overdose Age-Adjusted Death
increased in Mason County over the last Rate (4)
decade. Prior to 2010, death rates due to 0 30
any drug overdose were as low as 8.2 per
100,000 population (4). In 2016, Mason o 20
a
County Community Services—Public Health o
implemented new programs to reduce drug o 10
overdose deaths throughout the county. In CD
the subsequent years, opioid death rates a °
dropped dramatically. In 2017, the age- 2015 2016 2017 2018 2019
adjusted death rate due to opioid overdose —0—Mason --*—Grays Harbor
decreased by 65%, and the age-adjusted
death rate due to any drug overdose Drug Overdose Age-Adjusted Death
decreased by 18%compared to the previous C: Rate (4)
year (4). In 2019, deaths due to any drug .2 40
overdose, including opioids, increased OF 30
dramatically from the previous year while a
rates statewide increased only slightly. The o 20
age-adjusted death rate due to opioid 0 10
overdose increased by 14 per 100,000 a
0
compared to the previous year (4). The age- cu 2015 2016 2017 2018 2019
adjusted death rate due to any drug
overdose increased by 11.3 per 100,000 (4). — Mason (Grays Harbor
10
The increase in opioid and drug overdose death rates in 2019 may be an outlier in overall
trends; the cause of the one-year increase cannot be immediately identified, though behavioral
health professionals have inferred it may be due to the increase of fentanyl use. Between 2018
and 2019, Washington state deaths due to opioid overdose increased by 1 per 100,000 (4).
In late 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA)
released findings from the 2020 National Survey on Drug Use and Health that suggests the
COVID-19 pandemic has had a negative impact on mental health, which includes exacerbating
use of alcohol or drugs (15).
Sexually Transmitted Infections
Sexually transmitted infection (STI) indicators are typically based upon reported Chlamydia
cases, as Chlamydia is the most common bacterial sexually transmitted infection in the United
States (1). In 2020, the rate of Chlamydia infection was 326 per 100,000 in Mason County,
which was less than the state rate of 410.4 per 100,000 (16). Despite the overall rate being
lower than the states, Chlamydia infection rates are increasing in Mason County. Since 2010,
Chlamydia infection rates have increased by 44% (16). Rates of STIs are based on clinically
diagnosed STI cases reported to the Washington State Department of Health (WA DOH)
through public health surveillance.Therefore, the burden of disease may be greater than these
data indicate as not all cases of sexually transmitted infections are diagnosed and not all
diagnosed cases are laboratory confirmed (17).
Chlamydia Infection Rates (19) In Mason County, Planned
Parenthood was a highly
utilized service for young adults
400 between ages 20 and 24, teens,
a and Mason County's growing
oHispanic population. In early
C 300 2021, the state closed three
o Planned Parenthood centers in
a 200 Washington, including Mason
County's location in Shelton
100 (29). In Mason County, Planned
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Parenthood provided services
to 1,200 clients in 2020, a
growing number compared to
1,100 clients in 2019. Planned Parenthood provided a safe haven for people to receive STI
testing and contraception for family planning. Planned Parenthood also demonstrated an
impact on maternal and child health by providing an avenue for young people to receive
pregnancy testing and increasing referrals to early prenatal care.
11
Early initiation of
First Trimester Prenatal Care (10) prenatal care can
90% improve maternal
and infant health
0
outcomes. Women
o80i "' ,� who receive delayed
a prenatal care after
70% -; first 12 weeks of
v
Q pregnancy or no
aj
60% prenatal care at all
2015 2016 2017 2018 2019 2020 are at risk of
undetected
--*--Mason --*—Grays Harbor tLewis Washington
pregnancy
complications (28).
Compared to similar counties and the state, mothers have lower rates of seeking early prenatal
care in Mason County (10).
While the closure of Planned Parenthood is too recent to see any immediate outcomes, the
anticipated impact is expected to be significant on a community that relied so heavily on the
access it provided to sexual and reproductive health services. Similarly, the Shelton WIC clinic
also closed its doors in late 2021, creating a new gap in services to over 3,000 families who
accessed resources to healthy foods, breastfeeding support, and nutrition education.
Evidence suggests teen pregnancy significantly increases the likelihood of future risky sexual
behavior, STI, and other adverse health outcomes (1). Pregnant teens are more likely than older
women to receive late or no prenatal care and experience increased risk of complications in
pregnancy, preterm delivery, low birthweight, and severe neonatal conditions (1). Teen
pregnancy is also associated with poor socioeconomic, behavioral, and mental health outcomes
(1). The teen birth rate in Mason County has historically been higher than the state's (1).
Between 2013 and 2019, there were 30 births per 1,000 female population ages 15-19,
compared to 16 births per 1,000 for Washington State (1). The teen birth rate in Mason County
varies by demographic. For instance, the teen birth rate among Hispanics is 77 births per 1,000
female population ages 15-19, compared to 22 births per 1,000 among Whites (10).
Clinical Care
Clinical Care factors account for 20% of a community's health status as demonstrated in the
Health Rankings Model diagram on page 1 of this report (1). Clinical Care considers both access
to care and quality of care issues. Key indicators examined in clinical care include the
percentage of uninsured individuals, and the ratios of population to providers for medical,
dental, and mental health services.These indicators help to show ho readily accessibly these
crucial services are in the community.
12
Comparison .
Clinical Care Mason Washington
Uninsured(2018) 10% 7%
Primary Care Physicians(2018) 3,850:1 1,180:1
Dentists(2019) 2,900:1 1,200:1
Mental Health Providers 490:1 250:1
(2020)
Health Insurance Status
The quality of health care in a community is dependent on an individual's ability to access both
health insurance coverage and health care providers (1). Between 2015 and 2019, the number
of Mason County residents who are insured has remained consistent as in previous years, which
is also historically lower than the number insured statewide (18). In 2019, 95.4%of children
under the age of 19 in Mason County were also insured. That same year, 96.9% of children
under the age of 19 were insured in Washington State (18).
Access to Healthcare
Mason County's Access to health care can be challenging in Mason County due
shortage in primary care to barriers such as geographical distances and provider
physicians exceeds other shortages. In 2018, the ratio of Mason County's population to
counties and the state primary care physicians was 3,850:1, meaning there is only one
primary care provider per every 3,850 residents in Mason
County (1). In comparison, the ratio for
Mason County Washington Washington State was 1,180:1 (1). Comparing
provider rates per 100,000 population to other
counties with similar populations and
3YB50 jV180 geographical barriers as Mason County further
illustrates our community's access to healthcare
People People needs. In Mason County, there are
per 1 Primary Care per 1 Primary Care
Physician Physician approximately 26 primary care physicians per
100,000 people; there are 34 in Grays Harbor
2 �oo � �oo County, 43 in Lewis County, and a statewide rate
of 84 primary care physicians per 100,000 people
People People (1). As a result, many residents are forced to
per 1Dentist per 1Dentist leave the county to access primary care or utilize
urgent cares and emergency departments.
490 ® "� 250 In 2019 the population to dentist ratio was
People People 2,900:1, more than twice the state's ratio of
per 1 Mental Health per 1 Mental Health
Provider Provider 1,200:1 (1). Finally, the ratio of residents to
mental health care providers—psychiatrists,
social workers, counselors, marriage and family
13
therapists, and those who treat alcohol and other drug abuse—was also nearly twice the state's
ratio. In 2020, Mason County's ratio was 490:1 compared to the state's ratio of 250:1 (1).
Social and Economic Factors
The Health Rankings Model estimates that 40%of our health is influenced by the social and
economic conditions in which we live (1). Some examples of social and economic factors of
interest are education, employment, income, poverty, and crime.
Comparison of Key Indicators(1)
Social and Economic Factors Mason Washington
On-time graduation rates(2015-2020) 76% 81%
Adults w/some college education (2015-2019) 49% 71%
Unemployment rate(2019) 6.3% 4.3%
Children in poverty(2019) 21% 12%
Income inequality ratio(2015-2019) 4.3 4.4
Children in single-parent households(2015-2019) 23% 20%
Violent crime rate(per 100,000(2014-2016) 220 294
Injury deaths rate(per 100,000)(2015-2019) 96 67
Graduation Rates
In 2020, A high school degree is correlated with higher life expectancies
County
achieved its Mason and improved quality of life (1). Adults with high school diplomas
C are more likely to be employed and earn more than their less
highest time educated counterparts (1). Historically, Mason County's high
graduation rate in the school graduation rates have been lower than the state rates for
last decade both on-time and extended graduation (19). On-time graduation
rates in Mason County have remained consistent over the last five
years but have increased steadily over the last decade; our highest
rate of on-time graduation was achieved in 2020 (19).
On-Time Graduation Rates (19) Extended Graduation Rates (19)
85% 90%
c
Q1 > a' >� 85%
80% Ln
V1 .� Ln
cn ._
o � - -0 80%
0
+� °J 75% Q1
aci � v 75%
U p U -0
a U 70% a (D 70%
101� 1016 101� L01$ L019 L0�0 1015 L016 101� L01� L019 y0�0
--40--Mason —6— Washington —*Mason -y" Washington
14
Extended graduation rates include students who completed their high school diploma after
their expected year of graduation (19). Rates for students who graduated in 5 years have
remained consistent at both the local and state level with improvements seen in the last two
years (19).
High School Completion, 2015-2019 (1) High school completion
rates are similar across
s Mason, Grays Harbor,
3 `0 100%
and Lewis counties.
"' °a 90% Although slightly lower
N
v 9
than the state, all
o •� 85%
o counties are similar to
o U "' 80%
Washington high school
+ L °
75�° completion rates (1).
a`, 70%
a Mason Grays Harbor Lewis Washington
Educational Attainment
Mason County's adult educational attainment levels have been consistent over the past decade
and have historically been lower than the state's rates (20). Mason County has a higher percent
of adults with less than a high school diploma and a lower percent of adults who have completed
a college degree. Thirty-six percent of Washington State residents have a Bachelor's Degree or
higher, while only 17% of Mason County residents has attained this same education level (20).
Educational attainment levels are comparable to neighboring rural counties.
Adult Educational Attainment, 2015-2019 (20)
c 40%
0
m 30%
CL
0 20%
ai
v
0%
Less than High School High School Some college,no Associate's Degree Bachelor's Degree or
Diploma/GED degree Higher
■Mason ■Grays Harbor ■Lewis Washington
Unemployment
Historically, Mason County's unemployment rates have been consistently higher than the
state's rate. Despite a slow recovery after the 2008 economic downturn, unemployment rates
in Mason County fell by 3.7 percentage points between 2013 and 2019 (21). In March 2020, the
15
Unemployment(10) COVID-19 coronavirus pandemic profoundly
impacted the Washington labor market.
12% Widespread business closures prompted a
to°i° wave of mass unemployment that would have
8% been uncharacteristic in a pre-pandemic
6i° setting. Washington state's unemployment
o ° rate reached an all-time high of 16.3% in April
4% 2020 and declined to 5.1% by July 2021 (21).
i 2% Concurrently, the unemployment rate in
v
0% Mason County reached 17.5%at the start of
V15 p16 11,11 11315 11319 1131-11 the pandemic and declined to 5.7% by July
--*--Mason -Washington
2021 (21). Economic recovery is ongoing as the
virus continues to impact communities and the
workforce worldwide; however, the outlook
appears promising with the sharp decline in unemployment in the later months of the COVID-
19 pandemic.
Poverty and Income Inequality
The poverty rate is a ratio of the number of people
whose income is at or below the Federal Poverty Mason County's poverty rates
continue to decline from
Guidelines. In 2019, the poverty threshold for a family of
four with two children under the age of 18 was any previous years but remain
high compared to the state.
family making at or below$25,926 a year(22). In Mason poverty rates are similar to
County, 12.8%of residents met these criteria and were neighboring rural counties
living below the federal poverty level (23). Nearly a
quarter (21%) of Mason County children under the age of
18 lived in poverty (23).Though Mason County's poverty
rates historically exceed the state's, local rates have decreased slowly over the last half decade.
Poverty Rates (23) Over the past five years,
poverty rates have remained
20% similar across Mason County
0 18% and neighboring Grays Harbor
12 and Lewis counties. While
0 16% — poverty rates have decreased
a
0 14% over time in all three counties,
12% progress has been slower in
Grays Harbor, which has had
10% 2015 2016 2017 2018 2019 the highest rates of poverty
over the last two years. Rates
tMason --e—Grays Harbor --*—Lewis :Washington for all counties consistently
average 33% higher than the
state.
16
While poverty at any age
Poverty Rates for Children Under 18 (23)
contributes to increased risk
of more frequent and severe
35i°
chronic health conditions �
' 0 30%
children in poverty may 25i°
experience long-term effects o 20%
on academic achievement, 15%
0
health, and income into - 10%
adulthood (1). Child poverty 5%
rates in Mason County have a 0%
2015 2016 2017 2018 2019
been consistently higher than
in similar counties and --*—Mason—t—Grays Harbor--*—Lewis Washington
compared to the state.
The incidence of children in poverty is not evenly spread across the county, as indicated by Free
and Reduced Meal Program data (13). All but one Mason County school district reported higher
or equal rates of poverty compared to the state (13).
Percent of Students Eligible for Free/Reduced Meal Program by School District,
2015-2019 (13)
Washington
Grapeview
Hood Canal
Pioneer
Mary M.Knight
North Mason
Shelton
Southside
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Income inequality can also be an indicator of health outcomes,
Mason County's increasing risk for chronic disease and mortality (1). Income
income inequality inequality is defined as the ratio of household income at the 80th
ratio is consistent percentile to that at the 20th percentile. A higher inequality ratio
with the state's rate indicates greater division between the lowest income and highest
income earners in a community (1). Between 2015 and 2019,
Mason County's income inequality ratio was 4.3, which is
consistent with Washington state's ratio of 4.4 (1).
17
Household Structure
Adults and children in single-parent Household Structure for Families
households are at higher risk for adverse with Children Under 18 Years,2015-
health outcomes (1). In 2019, the divorce rate 2019 (24)
in Mason County was 3.6 per 1,000 persons, 0 80%
with a recorded 194 divorces (14). Divorce T 60%
rates in Mason County remained relatively the 0 40%
same prior to 2017 when the trend decreased o 20%
by 27%from the previous year; rates remain v 0%
lower than the previous 10 years (14).The v Couple Male Female
a Headed Householder, Householder,
majority of families in Mason County with Households no spouse no spouse
children under the age of 18 are headed by present present
couples (24). However, 42% of families are ■Mason Washington
single parent households (24).
Family & Social Support
Research shows that individuals with limited social and emotional The majority of
support experience poorer health outcomes (1). Three out of 4 Mason County
Mason County youth reported that they could ask their parents for youth report having
help with a personal problem (7). Nearly half also reported having consistent social
an adult in their lives they could turn to if they felt depressed (7). and emotional
For 12th grade students in particular, the percent of youth who feel
they have an adult they can turn to for help has decreased over support; however,
time. In 2012, 57%of 12th graders reported having a supportive rates havedecreased for 12tn
adult (7). By 2018, less than half(46%) reported feeling they had an graders over time
adult they could turn to when they felt depressed, 20% less than in
2012 and a 15% decrease over the last decade (7).
Youth Reporting They Could Ask Youth Reporting They Had an Adult
Parents for Help with a Personal to Turn to When Feeling Depressed,
Problem, 2018(7)
2018(7)
2 100% 2 80%
Y (0
5 80% 60/o°
Q
a O
a° 60% a 40%
o
40% Y
20% v 20%
U i
0% a 0%
6th Grade 8th Grade loth 12th 6th Grade 8th Grade 10th Grade 12th Grade
Grade Grade
■Mason € Washington ■Mason . Washington
18
Community Safety
The safety of the communities in which we live
Crime Arrest Rates for Adults, and work can also be an indicator of health
2019(14) outcomes (1). In Mason County, the arrest
0
8 rates for youth ages 10-17 are lower than the
ru state's rates for all types of crime (14). The
0 6 total arrests for youth in Mason County have
0 4 decreased significantly over the past decade.
o In 2005, there were 381 recorded arrests for
2 youth ages 10-17, compared to a mere 32
v ■ arrests in 2019 (14). For adults, Mason County
o Violent Crime Property Crime Drug Law arrest rates are lower than the state's rate for
Violation property crime and for drug law violations;
e Mason Washington arrest rates are similar to the state for violent
crime (14). Arrest rates for adults have
remained relatively the same over time (14).
Unintentional Injury Deaths
The final indicator used to access social and Unintentional Injury Death Rate by
economic health is injury death rates (1). County, 2015-2019 (4)
Between 2015 and 2019, deaths due to
70
unintentional injury or accidents were the 60
third leading cause of death for Mason County Q so
residents, occurring at an age-adjusted rate of o 40
49.2 per 100,000 (or 192 deaths) (4).This rate o 30
is higher than the state's rate for that same o 20
10
time period of 42.8 per 100,000 (4). The top 3 a o
causes of unintentional injury death in Mason �o� �0t
County between 2015 and 2019 were
poisoning, motor vehicle-traffic, and falls, in ay
�a
that order (4). Death rates due to
unintentional injury have remained consistent
over the past two decades (4).
Physical Environment
Physical Environment factors account for 10%of a community's health status as demonstrated
in the Health Rankings Model. The physical environment is where individuals live, learn, work,
and play (1).The air we breathe, the water we drink, the housing we live in, and the
transportation we have access to are examples of the physical environment that can affect our
ability to live long and healthy lives (1).
19
Housing Stock
Stable, affordable housing can provide a safe environment for families to live, learn, and grow.
A home that is safe and free from physical hazards reduces the risks for infectious diseases,
injuries, and poor childhood development. Safe housing provides families with a sense of
privacy, security, stability, and control. Research shows that these factors can make important
contributions to health. Conversely, unaffordable housing can create additional stress. Housing
is often a family's largest expense and when the majority of a paycheck goes to the rent or
mortgage, this housing cost burden can force people to choose among paying for other
essentials such as utilities, food, transportation, or medical care (1). According to the American
Community Survey, between 2015 and 2019 there were 33,503 housing units located in Mason
County (22). Of that total, 24,278 units are currently occupied with 77%of units being owner-
occupied and 23%of units being rentals (22).
Housing Cost
A measure used to identify housing problems Percent of Households that are
is housing cost burden (1). The U.S. Housing Cost Burdened, 2013-2017
Department of Housing and Urban (26)
Development (HUD) considers households that 32%
pay more than 30% of their income on rent or 0
housing costs (including utilities) as housing CL
o 30i
cost burdened (25). Nearly a third of Mason o zsio
County residents have a housing cost burden
greater than 30% of their income (26). Of v 26%
those residents that are housing cost c � �y KI
burdened, 34% of households are renters and �ay� yo �e� �
r`O
66%are owner households (26). Mason (§aS �a
County has a lower housing cost burden
compared to the State of Washington, but a
higher housing cost burden compared to neighboring Grays Harbor County (26).
Water Quality
Drinking Water Systems, 2018(27) Water contaminated with chemicals, pesticides,
or other contaminants can lead to illness,
infection, and increased risks of cancer (1).
302
Mason County residents receive drinking water
from three different types of public water
1,490 ,9 systems: Group A, Group B, and private wells
(27). Group A systems are the largest type of
system and are regulated by the State
Department of Health Office of Drinking Water
■Group A ■Group B ■Private Wells (27). Group B systems are smaller systems and
are regulated by Mason County Public Health
20
(27). Homeowners with private wells are responsible for monitoring their own drinking water
systems for quality. Between 2015 and 2019, the United States Environmental Protection
Agency reported no drinking water violations in Mason County (1).
Open shellfish harvesting areas are an indicator of good water quality (28). Washington State
monitors marine water quality to assure safe shellfish for the consumer (28). In addition to
shellfish harvesting, stringent water quality requirements exist to ensure the public's health is
protected for other water recreation uses. At the beginning of 2018, 350 acres in Mason County
were restored to harvestable shellfish acreage.This increase in harvestable shellfish acres
indicates the correction of pollution sources (28).
Air Quality
Poor air quality can be detrimental to a population's health outcomes such as greater incidence
of asthma, chronic bronchitis, decreased lung function, and other adverse pulmonary effects
(1). This is especially true for more vulnerable populations such as the elderly, the very young,
and those with existing chronic health conditions (1). Particulate matter is a measure of
outdoor quality; in Mason County, the main source of particulate matter is wood burning fire
emissions. Forest fires are also a source of particulate matter. A key method for evaluating the
quality of the air is to measure the average daily density of fine particulate matter in the air
that are less than 2.5 micrometers in diameter (PM2.5) (1). Levels of particulate matter may
vary geographically; more urban areas may have additional contributing factors such as vehicle
or industrial emissions while heavily forested areas may have higher risk of wildfires (28). For
most areas in Washington, PM2.5 levels are not considered a contribution to elevated risk of
adverse health outcomes (28). The prevalence of asthma in Mason County has fluctuated over
the last decade but has ultimately decreased in 2018 compared to the previous year. Rates are
similar in Mason County compared to the rest of the state, suggesting that there are no major
environmental conditions contributing to adverse health outcomes in the county.
Percent of Population with Asthma, 2015-2019(6,7)
Levels of fine
zs% particulate
o Z matter have
20%
generally
0 15% declined in Mason
a
0 10% County and statewide
5% since 2000
v
0%
Adults 6th Grade 8th Grade loth Grade 12th Grade
■Mason P,Washington
21
Conclusions
Strengths
Mason County residents are expected to live longer lives, an improvement in life expectancy
that can be linked with positive changes in other health factors:
• Mason County residents are living longer; life expectancy has improved by over 4 years
and premature death has begun to decline in recent years
• Graduation rates have increased steadily over the last decade and reached its highest
rate in 2020
• Adult crime rates are lower than the state's rate for property crime and drug law
violations
• Arrest rates for youth have decreased significantly over the last decade
• Water and air quality continue to improve and suggest that there are no major physical
environment factors that contribute to health outcomes in the county
• Binge drinking rates for both adults and youth have decreased over time
Weaknesses
Ultimately, Mason County is ranked among the least healthy counties in Washington. In
addition to demonstrating our strengths, this report has highlighted some areas where Mason
County can improve its health factors and health outcomes:
• Access to healthcare continues to be a major barrier in Mason County; local provider to
population ratios are very large as many residents seek primary care or utilize urgent
cares and emergency departments in larger neighboring counties
• Adult obesity rates in Mason County have exceeded those of neighboring counties and
the state over the last four years, increasing the risk of chronic health conditions
• The percent of adults not meeting physical activity recommendations more than
doubled between 2018 and 2019, and only a quarter of youth meet physical activity
recommendations
• Chlamydia infection rates have nearly doubled over the last decade
• Teen birth rates remain higher than teen births statewide
• The rate of drug overdose and opioid overdose deaths have increased significantly in
Mason County, inconsistent with the state; in 2019, Mason County reached its highest
rate of opioid overdose deaths in the last ten years
• While poverty rates are declining compared to previous years, they remain much higher
than the state's
• Cigarette smoking rates remain higher than the state for both adults and youth
• Electronic cigarette use or "vaping" in youth has increased by 22% across all grade levels
• Mason County adults have higher marijuana usage rates compared to the state
• Nearly a third of Mason County residents are housing cost burdened
22
References
(1) County Health Rankings & Roadmaps. University of Wisconsin Population Health
Institute. www.countyhealthrankings.org
(2) Office of Financial Management. (30 November 2021).April 1 official population
estimates. https://ofm.wa.gov/washington-data-research/population-
demographics/population-estimates/april-l-official-population-estimates
(3) Office of Financial Management. (11 January 2022). Estimates of April 1 population by
ag, sex, race and Hispanic origin. https://ofm.wa.gov/washington-data-
research/population-demographics/population-estimates/estimates-april-l-population-
age-sex-race-and-hispanic-origin
(4) Washington State Department of Health, Center for Health Statistics, Death Certificate
Data, 1990-2019, Community Health Assessment Tool (CHAT),January 2021.
(5) WA Hospital Discharge Data, Comprehensive Hospitalization Abstract Reporting System
(CHARS) 1987-2019. Washington State Department of Health, Center for Health
Statistics, Community Health Assessment Tool (CHAT), Aug 2021.
(6) Behavioral Risk Factor Surveillance System (BRFSS) 2012-2019. Washington State
Department of Health, Center for Health Statistics, Community Health Assessment Tool
(CHAT), December 2020.
(7) Washington State Department of Health. (2019). Healthy Youth Survey.
https://www.askhys.net/
(8) Stein, R. (2018, December 18). Surgeon General Warns Youth Vaping is Now an
Epidemic. NPR. https://www.npr.org/sections/health-
shots/2018/12/18/677755266/surgeon-general-warns-youth-vaping-is-now-an-
epidemic
(9) Vinturache, A., Moledina, N., McDonald, S., Slater, D., &Tough, S. (2014). Pre-pregnancy
Body Mass Index (BMI) and delivery outcomes in a Canadian population. BMC
Pregnancy and Childbirth, 14, 422. httpj/doi.org/10.1186/sl2884-014-0422-y
(10)Washington State Department of Health, Center for Health Statistics (CHS), Birth
Certificate Data, 1990-2019, Community Health Assessment Tool (CHAT), October 2020.
(11) Feeding America. (2021). Food Insecurity in Mason County Before COVID-19.
https://feedinga mericaaction.org/resources/state-by-state-resou rce-the-impact-of-
coronavirus-on-food-insecurity/
23
(12)Client Count and Direct Services Expenditures: Washington State Department of Social
and Health Services, Research and Data Analysis, Client Services Database.
http://clientdata.rda.dshs.wa.gov/Home/ShowReport?reportMode=2
(13)Washington Office of Superintendent of Public Instruction Data Portal. (2015-2019).
School Meals Participation Report. https://www.kl2.wa.us/policy-funding/child-
nutrition/child-nutrition-program-reports
(14)Washington State Department of Social & Health Services, Research and Data Analysis
Division. (2021). Risk and Protection Profile for Substance Abuse Prevention in Mason
County. https://www.dshs.wa.gov/data/research/research-4.47-mason.pdf
(15)Substance Use and Mental Health Services Administration. (26 October 2021). SAMHSA
releases 2020 National Survey on Drug Use and Health.
https://www.sa m hsa.gov/newsroom/press-
announcements/202110260320?utm campaign=386b60df3a-
SAMHSA Announcement 2021 10 26 1600418&utm medium=email&utm source=S
AMHSA&utm term=0 ee1c4b138c-386b60df3a-168173297
(16)Washington State Department of Health. (1 June 2021).Sexually Transmitted Infection
Cases and Rates by County.
https://www.doh.wa.pov/YouandYourFamily/illnessandDisease/SexuallyTransmittedDis
ease
(17)Washington State Department of Health, Infectious Disease, STD Services Section,
PHIMS-STD, 1992-2019, Community Health Assessment Tool (CHAT), Oct 2021.
(18) U.S. Census Bureau. (2019). 2008-2019 Small Area Health Insurance Estimates(SAHIE)
using the American Community Survey(ACS).
https://www.census.gov/data/datasets/ti me-series/demo/sahie/estimates-acs.html
(19)Washington Office of Superintendent of Public Instruction Data Portal. (2020). Report
Card Graduation 2014-15 to Most Recent Year. https://www.kl2.wa.us/data-
reporting/data-portal
(20) U.S. Census Bureau. (2019). Educational Attainment for the Population 25 Years and
Over, 2015-2019 American Community Survey 5-Year Estimates.
https://data.census.gov/cedsci/
(21) U.S. Bureau of Labor Statistics, U.S. Department of Labor (2021). Local Area
Unemployment Statistics Map. https://data.bls.gov/map/MapToolServiet?survey=la
(22) U.S. Census Bureau (2021). Poverty Thresholds by Size of Family and Number of
Children.https://www.census.gov/data/tables/time-series/demo/income-
poverty/historical-poverty-thresholds.html
24
(23) U.S. Census Bureau. (2019). Poverty Status in the Past 12 Months, 2015-2019 American
Community Survey 5-Year Estimates. https://data.census.gov/cedsci/
(24) U.S. Census Bureau. (2019). Children Characteristics, 2015-2019 American Community
Survey 5-Year Estimates. https://data.census.gov/cedsci/
(25) U.S. Department of Housing and Urban Development. (2020). Comprehensive Housing
Affordability Strategy(CHAS)2013-2017.
https://www.huduser.gov/portal/datasets/`cp.html
(26) U.S. Census Bureau. (2019). Selected Housing Characteristics, 2015-2019 American
Community Survey 5-Year Estimates. https://data.census.gov/cedsci/
(27)Washington State Department of Health. (2018 December). Water System Data.
https://www.doh.wa.gov/DataandStatisticalReports/EnvironmentalHealth/DrinkingWa
terSystemData/Data Download
(28)Washington State Department of Health. (2018 March). 2018 Washington State Health
Assessment.
https://www.doh.wa.gov/Portals/1/Documents/1000/2018SHA FullReport.pdf
(29)Santos, Melissa. (2021, March 15). Planned Parenthood shutters 3 clinics, including the
only one in Mason County. Kitsap Sun.
https://www.kitsa psun.com/story/news/2021/03/15/planned-parenthood-shutters-3-
c l i n i cs-i n c l u d i ng-o m y-o n e-m a so n-c o u n ty/4707972001/
25
Questions about this report may be directed to:
Melissa Casey, MPH
Public Health Educator
Mason County Community Services—Public Health
mcasey@masoncountywa.gov
360-427-9670 Ext. 406
Acknowledgment:
Jacob Ritter, MPH
Community Health Specialist
Mason County Community Services—Public Health
26
MASON COUNTY
COMMUNITY SERVICES
Mason County Public Health
A Safe and Healthy Mason County
http://healthymasoncounty.com/
www.masoncountVwa.gov
27