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- About Public Health
- Certificates and health records
- Child and family health
- Diseases and conditions
- Drinking water and wells
- Emergency preparedness
- Food safety
- Health care
- Healthy living
- Low and no-cost insurance
- Mosquito control
- On-site septic systems
- Pools and beaches
- Reporting a dead bird
- Smoking in public places/inhalant delivery systems law
- Waste

About Public Health

What is an advisory council?
An advisory council is a group of community members who volunteer their time to address important public health issues and concerns. Advisory councils help Public Health operate responsibly and best serve Clark County residents. Public Health has advisory councils for all of its major program and service areas.

What's the purpose of an annual report?
Each year Public Health evaluates the work accomplished in the previous year, and measures it against both statewide public health standards as well as the department’s strategic plan. By evaluating these achievements, Public Health can improve access to health care and better meet the needs of children, families and vulnerable populations.

What is in the annual report?
Public Health looks at many different statistics and outcomes to prepare its annual report. Some of these include: clients served in various program areas, food safety inspections and certifications of food handlers, septic systems permits, evaluations, and reviews, and new programs or services implemented in the community.

When and where does the Board of Health meet?
The Board meets on the fourth Wednesday of the month at 9 a.m. in the Public Service Center, sixth floor hearing room, 1300 Franklin St., Vancouver.

Can I watch the meetings online?
CVTV offers live streaming video of all Board meetings. You can also watch videos of past meetings online. (You will need Windows Media Player to view the videos.)

What is the General Fund?
The General Fund contains non-restricted funds that can be spent for a wide range of services. It is the only part of the county budget where the Board of Clark County Commissioners has discretion about spending. It pays for many of the key services that residents receive from the county such as Sheriff’s patrols, judges, prosecutors, jails, courts, elections and parks.

When and how is the budget adopted?
Each even numbered year, the commissioners adopt a biennial budget for the following two-year period by the end of the first full week in December. Public hearings begin on Monday and adoption occurs no later than Friday of that week. Before the end of the first year of the biennium, the commissioners re-adopt the budget.

How can I influence the county budget?
The Budget Office provides information throughout the year on the budget, uses public surveys and focus groups and uses meetings to involve citizens in shaping the budget. Contact us at (360) 397-6097 or e-mail to get involved.

Does Washington State also have codes and ordinances governing public health? Both state and federal laws govern public health. County code is based on these laws, but is specific to the services, needs, and programs within Clark County.

What does the Public Health director do?
The Public Health Director/Health Officer is responsible for public health operations, interventions and activities. The director manages a staff of more than 80 employees through intermediate managers and administrative officers, and reports to the county administrator and the Clark County Board of Health. A Public Health Advisory Council works with the director and staff to provide two-way communication with the Board of Health. Additionally, as the county health officer, the Public Health Director/Health Officer works to control and prevent communicable disease and plans for and responds to bioterrorism and other public health emergencies.

Why does Public Health need a strategic plan?
A strategic plan helps Public Health respond proactively to emerging health challenges and opportunities in our community, promote healthy environments, improve health care access, and support good health at every age.

Certificates and health records

How long does Public Health keep records?
If you received medical services at Public Health, you may request copies of your personal health records dating back to 1999 and immunization records back to 1996.

What is the difference between a birth certificate and a birth record?
A "birth certificate" and "birth record" are the same thing.

Are birth records certified?
Certificates issued are certified copies. They are printed on special certified paper and bear a printed and raised seal.

How do I order a birth certificate?

  • For a birth date of 1895 through 1907, contact the Clark County Auditor’s Office.
  • For a birth date of 1908 through 1921, contact Washington State Vital Records or by calling (360) 236-4300.
  • For a birth date of 1921 to the present in Washington, submit a completed application in English (PDF) or Spanish (DOC):
    • In person - Clark County Center for Community Health, Vital Records, 3rd Floor 1601 E. Fourth Plain Blvd., Vancouver
    • By mail - Clark County Public Health, P.O. Box 9825, Vancouver, WA 98666-8825
    • By FAX - Clark County Public Health, Vital Records, (360) 397-8091
    • Online - Vitalchek
  • Home birth registration is by appointment only. Call (360) 397-8092 to make an appointment.

What information do I need to order a birth certificate?

  • Full name at birth
  • Date and place of birth
  • Both parents' names, including the mother's maiden name (if applicable)
  • Your mailing address and daytime phone number

How much does a birth certificate cost?

  • Each certificate costs $20.
  • If an application is processed and no record is found, there is an $8 search fee.

How do I order a death certificate?

  • For a death prior to 1999, contact Washington State Vital Records at (360) 236-4300.
  • For death certificates from 1999 through 2008 in Clark County only, submit a completed death certificate application (PDF):
    • In person - Clark County Center for Community Health, Vital Records, 3rd Floor, 1601 E. Fourth Plain Blvd., Vancouver
    • By mail - Clark County Public Health, P.O. Box 9825, Vancouver, WA 98666-8825
    • By FAX - Clark County Public Health, Vital Records, (360) 397-8091
    • Online - Vitalchek

What information do I need to order a death certificate?

  • Name of the deceased
  • Date of death
  • Your mailing address and daytime phone number

How much does a death certificate cost?

  • Each certificate costs $20.
  • If an application is processed and no record is found, there is an $8 search fee.

Why isn't the time of my birth shown on my birth certificate?
No times were reported on birth certificates in Washington state between the years 1949 and 1967. The hospital where you were born may have retained records that indicate the time of your birth.

How can I find out where a person was buried?
The burial location is listed on the death certificate.

Do people have a right to get copies of their medical records?
Yes. Washington State Department of Health has jurisdiction over private practitioners to determine what fees providers may set for charging for copies of medical records. Fees are adjusted based on changes in the consumer price index. Providers are not required to release medical records until they are paid for the copies. Providers may charge a clerical fee for searching and handling records, and a "cents per page" charge for copying and providing the records.

If you have trouble getting a provider to release the copies, there are civil remedies available within the court system. See RCW 70.02 for the law, and the civil remedies are contained in paragraph 70.02.170. If a provider refuses to provide copies under this law, then an unprofessional conduct complaint may be in order.

How can I get immunization ("shot") records?
There are two ways you can access your immunization records.

  • To get immunization records from your medical provider, you need to contact the physician or medical center that provided the immunizations.
  • To request a copy through the Washington State Immunization Information System (IIS) click here for instructions. If you were seen at Clark County Public Health please follow these instructions to request your immunization records.

Child and family health

How can I find out more about the Washington Basic Health Plan?

Does Clark County Public Health provide birth control services?
Clark County Public Health no longer provides birth control services. A health educator is available for speaking to school and community groups. Call (360) 397-8254 to arrange a presentation. Sea Mar Community Health Center provides family planning services at the Center for Community Health (360) 852-9070. Title X family planning services are provided by Planned Parenthood of the Columbia-Willamette at (360) 694-1188.

Where can I get a pregnancy test?
Clark county Public Health no longer offers pregnancy testing. Try calling your primary care provider or health maintenance organization (HMO) (insurance provider). Most providers and HMOs provide testing and referral services. If you don't have a provider or insurance try calling a provider from the Pregnancy Test Provider list (PDF).

Where can I enroll into parenting classes?
Clark County Public Health no longer offers parenting classes, but there still are several opportunities in our community for you to join a parenting education program that are designed to give families important skills and information to help children reach their potential in safe, loving homes. Click on this link Children's Home Society to find a group in your area.

Do you have any programs for children with special needs?
Specialized staff are available to support families with children with special health care needs.

Who is considered a child with special health care needs?
Children with special health care needs are those who have or are at an increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require more health and related services than other children.

What is the Nurse-Family Partnership?
The Nurse-Family Partnership (NFP) is a nurse home visiting program for women who are having their first baby, are low income and are less than 28 weeks pregnant.

Diseases and conditions

How should I treat my child for head lice?
Sites with information about head lice and how to treat it in your child:

What is Bird Flu?
Avian flu, also called bird flu, is flu that originally occurs in birds such as chickens, ducks, waterfowl, and other species. Outbreaks of various avian flu viruses have occurred on several continents including North America in the last five years. A serious new strain of avian flu, called H5N1, has been found in birds in Africa, Asia, and Europe, with the highest concentration of the disease in Southeast Asia. It is transmitted from bird to bird. As wild birds migrate, they spread the disease to wild and domesticated birds in other countries. The ongoing outbreak of avian flu H5N1 has resulted in the killing of millions of chickens and other domestic birds to control the spread of the disease.

What are STDs?
Sexually Transmitted Diseases (STDs) are diseases that are spread through anal, oral, or vaginal intercourse. Some STDs such as HIV and Hepatitis B can also be transmitted by sharing drug injection equipment. STDs can affect males and females of all ages, sexual orientation and backgrounds., and can become a serious health issue if left untreated.

Can I get STDs if I don’t have sexual intercourse?
A person can get some STDs, like herpes or genital warts, through skin-to-skin contact with an infected area or sore. Another myth about STDs is that you can't get them if you have oral or anal sex. That's also wrong because the viruses or bacteria that cause STDs can enter the body through the mouth and anus, as well as the penis and vagina.

How do I know if I have an STD?
Most people who have an STD have no symptoms. A test from your health care provider or local health clinic may be the only way to tell for sure if you're infected. If you do become infected, symptoms may show up right away, or they may not show up for weeks or months or even years.

Where can a person be tested for a sexually transmitted disease?
Sea Mar Community Health Center provides confidential testing for sexually transmitted disease at the Center for Community Health. Contact (360) 852-9070. Clark County Public Health provides testing and counseling for HIV/AIDS. Contact (360) 397-8425.

What is emergency contraception (EC)?
Emergency contraception (EC) is a safe and effective way to prevent pregnancy after unprotected sex — a backup method for preventing pregnancy — and is not for "all the time" use. It can greatly reduce the chance of pregnancy when taken as directed up to 72 hours (3 days) after unprotected sex if your regular birth control method fails, or if you've had sex without birth control.

What is West Nile Virus?
West Nile Virus is a mosquito-borne virus first found in the United State in 1999 when it caused illness in New York City. It is commonly found in west Asia, Africa, and the Middle East. The virus can infect people, certain types of birds, mosquitoes, horses and other animals. Only certain species of mosquito carry the virus.

Drinking water and wells

What is greywater? How can I dispose of it safely?
The Washington State Department of Health has information about residential greywater (PDF).

How can I find out if there is arsenic in my drinking water?
The Washington State Department of Health has

Emergency preparedness

Who has the authority to respond to emergencies?
In Washington, the local health officer and the boards of health have broad legal authority to protect the life and health of the people within their jurisdictions. This authority is combined with other local emergency response authority and state authority to respond to public health emergencies. The authority for responding to emergencies at Clark County Public Health is delegated by the Health Officer. The local Health Officer is required to institute disease prevention and infection control measures; authorized to carry out necessary steps to prevent disease and control infection; and authorized to enforce the public health statutes of the state and all local health rules, regulations and ordinances. The Board of Health is directed to take actions to preserve life and health of people within their jurisdiction.

What does the Public Health Emergency Preparedness Unit do?
A primary responsibility of the Clark County Public Health Emergency Preparedness Unit is to make sure that Clark County Public Health is ready to respond to emergencies. The set of activities to ensuring the “Operational Readiness” of the department includes developing emergency procedures, training staff, and equipping the department. The Emergency Preparedness Unit performs these essential functions for Clark County:

  • Maintains the Clark County Public Health Incident Command post
  • Maintains the Clark County Public Health All-Hazards Emergency Response Plan and ensuring that it works with other county, regional, and state emergency response plans
  • Provides leadership and coordination of the department-wide Continuity of Operations Plan (COOP) and Clark County Continuity of Operations plan
  • Develops emergency communication standards and tools
  • Participates in exercise planning, implementation, and evaluation activities
  • Develops After-Action Report recommendations, presenting these reports to the Clark County Board of Health, and making sure that any improvements are incorporated into plans
  • Ensures response operations are in compliance with the standards set forth by the National Incident Management System (NIMS) and by the Incident Command System (ICS)
  • Develops departmental policies and procedures supporting emergency response operations

What is the Region IV Public Health Program?
The Clark County Public Health Preparedness Unit leads the public health preparedness efforts in Clark County, Cowlitz County, Skamania County, and Wahkiakum County through the Region IV Public Health Program. Clark County Public Health continuously works to improve its capacity to respond to public health emergencies by enhancing its agency response as well as its ability to work with partner agencies and elected officials. Within Clark County Public Health the Emergency Preparedness and Response Unit takes the lead in these efforts, and works closely with the Public Health Director, the Health Officer, Environmental Health Units, The Communicable Disease Unit, and other programs and organizations. Additionally, Clark County Public Health partners with Fire Departments, Law Enforcement Agencies, Emergency Management Agencies, Emergency Medical Services, Hospitals, and others to better prepare our communities for all types of emergencies.

What is the Region IV Healthcare Coalition?
The Region IV Healthcare Preparedness Coalition brings together the resources of multiple public health, healthcare, and emergency management agencies residing in multiple jurisdictions to address all hazards preparedness in Washington’s Public Health Region IV. These organizations voluntarily agree to collaborate in this effort until such time as the members of the organization determine that this coalition does not provide additional value to preparedness efforts. Washington State Department of Health (WA DOH) provides funds through the Public Health Emergency Preparedness and Response Program (PHEPR) to develop regional healthcare coalitions to enhance Washington’s ability to provide medical surge capacity and capability in response to public health emergencies.

What can I do to protect my family?
In any kind of health emergency, protecting yourself and your family will be your first priority. Because health emergencies, just like natural disasters, can happen with little or no warning, Clark County Public Health is asking you and your family to join us in planning for them in advance.

What is Pandemic Influenza?
Pandemic flu occurs when a new flu virus rapidly spreads from country to country around the world, causing a global outbreak of serious respiratory illness that spreads easily from person to person. The swift spread of a pandemic flu happens because people are not immune to the new flu virus, and an effective vaccine would take months to develop. Depending on the nature of the virus, many people could become seriously ill and many people could die. Pandemics are not seasonal. A flu pandemic can happen at any time of year. By contrast, seasonal flu is the usual flu that occurs in the late fall, winter, and early spring.

What is Bird Flu?
Avian flu, also called bird flu, is flu that originally occurs in birds such as chickens, ducks, waterfowl, and other species. Outbreaks of various avian flu viruses have occurred on several continents including North America in the last five years. A serious new strain of avian flu, called H5N1, has been found in birds in Africa, Asia, and Europe, with the highest concentration of the disease in Southeast Asia. It is transmitted from bird to bird. As wild birds migrate, they spread the disease to wild and domesticated birds in other countries. The ongoing outbreak of avian flu H5N1 has resulted in the killing of millions of chickens and other domestic birds to control the spread of the disease.

Food safety

How can I get a food handler permit?
Visit our Food Safety section for information about food worker testing and obtaining a food card. For additional questions, please call (360) 397-8435.

Do I need to make an appointment to take the test?
You don’t need an appointment. Testing is done on a "first come, first served" basis.

How much does a food workers card cost?
There is a $10 fee. The fee must be paid in cash, debit, Visa or Mastercard before you take the test.

Do I need a food handlers card?
Yes. All Washington food workers are required to have a valid food worker card. It’s important that your card or copy is with you at work and available for Public Health to check during a food inspection. For more information read the Food Worker Card Regulations, Chapter 246-217 WAC.

Are there study materials for the food worker test?
Online training is available in English and Spanish. Applicants must print and bring the training completion certificate with them to the testing site.  

What if I don't pass the test?
Keep your receipt! You may retake the test for free for up to 30 days after the date on your receipt. If you lose your receipt, you must pay $10 again. 

What if I lose my food worker card?
You must go to the testing facility that issued your original Washington State Food Handlers Card, show your photo I.D. and pay a $10 replacement fee.  

How old do I have to be to get a food workers card?
There isn’t an age requirement. Teens and younger testers, should check with Washington State Department of Labor and Industries before working. 

I am Serv-Safe certified do I still need a food workers card?
Yes, a valid Washington State Food Handlers Card is required if you have a job preparing or handling food. 

I got my food worker card in another county in Washington state. Is it still valid in Clark County?
Yes, a Washington State Food Handler Card is valid anywhere in the state.  

How long is a food workers card valid?

  • 2 years - Your first card is valid for 2 years.
  • 3 years - Renew your card before it expires and receive an additional year on your new card. You must bring in your unexpired card or a copy to qualify.
  • 5 years – Your card will be valid for 5 years if you renew your unexpired card and show proof that you have received at least 4 hours of food safety training approved by the state of Washington within the last 2 years.

How do I renew my card?
To renew your card you must bring in your unexpired card or a copy, watch the food handler training video and pass the exam.

What types of facilities are required to get inspections?
Facilities serving food to the public such as restaurants, delis, grocery stores and temporary vendors must obtain a permit and be routinely inspected. Clark County has more than 1,500 permitted food service facilities that, depending on the complexity of their menu and preparation processes, receive one or more unannounced inspections per year.

What does a red violation mean?
Red violations reflect conditions that create a high risk of food borne illnesses or injury

What does a blue violation mean?
Blue violations reflect conditions that have a low risk of transmitting food borne illness or injury, but fail to control potential contamination of foods from addition of bacteria, chemicals or physical objects

Health care

How do I obtain public assistance services?
These resources are available through the Department of Social and Health Services.

How can I check the current status of a Washington licensed, registered or certified health care provider?
Search a Washington provider's credentials through the Washington State Department of Health Professions Quality Assurance Web site.

How do I make a complaint about a Washington health professional or hospital?
Register a complaint with the State Department of Health.

Does Clark County Public Health provide birth control services?
Clark County Public Health no longer provides birth control services. A health educator is available for speaking to school and community groups. Call (360) 397-8254 to arrange a presentation. Sea Mar Community Health Center provides family planning services at the Center for Community Health (360) 852-9070. Title X family planning services are provided by Planned Parenthood of the Columbia-Willamette at (360) 694-1188.

Where can I find low or no-cost dental care or dentists who accept medical coupons?
View a list of low-cost dental care providers (PDF) who offer low fees or reduced fees based on income, or who accept medical coupons. You may also call (360) 397-8497 or e-mail

Healthy living

What are the benefits of physical activity?
Regular physical activity provides many benefits such as helping you reach and maintain a healthy weight; helping to control blood pressure; reducing stress, anxiety and depression; and improving muscle strength and flexibility.

How does sitting in front of television, computer, or video screens affect my health?
More and more time is being spent indoors watching television, playing video games or on the computer. The American Academy of Pediatrics recommends children under two have no daily screen time and children over two years of age should have no more than two hours of screen time each day

Is physical activity important for older adults?
Keeping active during senior years is especially important. Maintaining good strength and flexibility improves energy and mental alertness, reduces aches and pains and reduces risks of falling. A healthy lifestyle allows seniors to stay independent, spend more time with family and friends and be active outside of their home.

What’s the health benefit of eating locally grown foods?
Eating locally grown foods is one way that some families are trying to eat healthier. Not only is it good for health, but it’s also good for the environment. On average, food travels 1,500 miles to get to your table. Buying locally grown foods can mean your food is fresher and you know more about how it was grown. Buying locally also supports Clark County farmers and the local economy.

What’s the advantage of eating with my family?
Family meals are a very important part of healthy eating for children and adults. Not only do children have a better diet when they eat with their family but they do better in school, learn family values and traditions and communication between children and parents improves. It’s also been shown that teenagers who eat regularly with their family are less apt to use alcohol and drugs.

What does a nutrition label tell me about healthy food choices?
Reading nutrition labels can help you check for specific nutrients in food such as calories, sodium or fat. Labels can also help you compare food choices when shopping.

What is the Smoke-free Housing Project?
Public Health is a partner in the Portland-Vancouver metro area Smoke-free Housing Project. Together with the American Lung Association of Oregon and the health departments in Clackamas, Multnomah and Washington counties in Oregon, the project helps eliminate involuntary secondhand smoke exposure in multi-family housing. For more information, please call (360) 397-8000 ext. 7378.

How can secondhand smoke hurt me?
People exposed to secondhand smoke are more likely to develop a host of preventable diseases including lung cancer, coronary heart disease, and breast cancer, especially in younger, primarily pre-menopausal women. Each year in the United States, secondhand smoke is responsible for approximately 3,000 lung cancer deaths and tens of thousands of coronary heart disease deaths among people who have never smoked.

Is it hard to quit smoking?
If you have tried to quit smoking, you know how hard it can be. Don’t get discouraged if you have to try to quit a few times before you succeed. See some of the tips on this page to help you quit smoking.

Why should I quit smoking?
There are many health benefits from quitting smoking. You will live longer and live better; your risk of heart attack, stroke or cancer is lowered; your children and other people you live with will be healthier; and you will have extra money to spend on things other than cigarettes.

What’s the best way to quit smoking?
If you smoke, or know someone who does, consider calling the Quit Line for support at (800)Quit-Now. Quit coaches can provide free quit kits and nicotine patches or gum, if appropriate. They can also help develop a quit plan tailored for each person's unique needs and challenges. Quitting smoking is tough, but you can double your chances of quitting successfully by calling the Quit Line.

How can I get rid of mold in my home?
The Washington State Department of Health has a fact sheet about indoor mold.

Are insect fogging products (bug bombs) safe to use in my home?
The Washington State Department of Health has information about pesticide fogging at home.


Who do we serve with HIV prevention services?
Clark County Public Health’s prevention services are aimed at providing services for people who are at highest risk for getting HIV or already HIV positive. People who are at highest risk for getting HIV include men who have sex with men, injection drug users, their partners and individuals whose partners are HIV positive or who engage in high risk behaviors.

How is HIV passed from one person to another?
HIV is transmitted when individuals have unprotected (sex without a condom) or share needles with someone who has HIV. Unfortunately, we don’t always know someone’s status at the time we have sex or share drugs with them, so it is important to protect yourself until you know for sure.

Who is eligible for Clark County Case Management services?
You must be HIV positive and live in Washington State in one of the following counties: Clark, Skamania, Clallam, Cowlitz, Grays Harbor, Jefferson, Lewis, Mason, Pacific, Thurston or Wahkiakum.

What can the Clark County Case Management program do to help me?
Depending on your eligibility, case managers can assist clients with applying for insurance, finding an HIV healthcare provider, accessing food resources, identifying housing options, and much more. To find out more, please call our office at (360) 397-8060.

How do I become a client?
First, call the Clark County Case Management office at (360) 397-8060 and someone will ask you a few questions to find out more about you. A case manager will then call you to schedule an intake appointment. During the appointment, the case manager will complete an assessment to determine what your needs are and the best resources to connect you with.

Why is needle exchange an important public health program?
Needle exchange is the most effective strategy available to prevent HIV among injection drug users who are not in treatment. It also protects non-injecting family members and sex partners. Studies have shown that syringe exchanges are cost effective programs that reduce the spread of diseases in the community.

Who should be tested for HIV?
According to the Centers for Disease Control and Prevention, all Americans should be tested at least once in their lifetime (regardless of risks). If you participate in high risk behaviors, it is recommended that you test for HIV every 3 months. Those at highest risk for HIV are men who have sex with men, injection drug users, their partners and individuals whose partners are HIV positive.

Who can we test at public health?
Men who have sex with men, injection drug users, their partners and individuals whose partners are HIV positive or who engage in high risk behavior. Call (360) 397-8425 to schedule an appointment.

What is community planning?
Community Planning is a process that allows a partnership between health departments and the community to discuss and provide advice to Region 6 AIDSNet office on the allocation and distribution of HIV prevention and care services in the regional service area. Our two community planning groups meet throughout the year to accomplish the related tasks of community planning.

How can I get involved in the planning of HIV programs in my community?
Region 6 AIDSNet offers two community planning groups for membership. We meet monthly for prevention planning and quarterly for care services planning. We are always open to new membership. Please contact Deb Coss-Fricke at (360) 397-8465 or e-mail for more information and identify which planning group you are interested in:

  • Region 6 HIV Prevention Planning Committee and/or
  • The Region 6 HIV Care Services Committee

Low and no-cost insurance

How can I find out more about the Washington Basic Health Plan?

How does the State help provide health care for children?
Thousands of Clark County kids are eligible for state funded low-cost or FREE Health Insurance called Washington Apple Health for Kids. Many families qualify and don’t even know it. In addition to medical care, this insurance covers dental, vision and mental health or substance abuse counseling.

What is Apple Health for Kids?
Apple Health for Kids is a new Washington State initiative aimed at streamlining applications for children’s medical. Up to 75,000 Washington children are still uninsured. Many of these families are eligible – but they just don’t know it. Don’t make that mistake. Health coverage doesn’t just work when your children are sick. It also includes preventive care like immunizations or physical exams. If your children need coverage, check it out today.

What’s a drug discount card?
Clark County offers a discount card program to help consumers cope with the high price of prescription drugs. The Clark County Prescription Discount Card offers significant savings for the uninsured, underinsured, those with Health Saving Accounts, and even people who have insurance coverage can use the card to save money on medicine not covered by their health plan.

Who is eligible for the program?
The card may be used by all county residents, regardless of age, income, or existing health coverage, and are accepted at area pharmacies. A national network of more than 57,000 participating retail pharmacies also will honor the NACo prescription discount card.

What health insurance options are there for adults over age 65?
Medicare is a health insurance program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare is divided into two parts: Part A (hospital) insurance; and Part B (medical) insurance.

If you are not eligible for Medicare, you may be eligible for Basic Health—a Washington State Health Care Authority program which contracts with health plans all over Washington State to provide reduced-cost health care coverage to qualified Washington State residents. Basic Health for adults covers medical benefits, but no vision or dental. Reasonable co-pays, annual deductible, and co insurance apply to services; no co-pays for preventive visits.

What plans does the State of Washington offer to support women's health?
The State of Washington offers several plans for Women’s Health.

  • The Family Planning “Take Charge” Plan is for anyone who wants to avoid unintended pregnancy. The plan covers counseling, birth control, and medical exams, and is free to those who qualify.
  • Medicaid Maternity Medical and Basic Health Maternity Benefits are the public insurance choices for pregnant women. Eligibility requirements and the application process differs between programs.

Who is eligible for immigrant and non-citizen insurance?
If you are an immigrant or a non-US Citizen, and you have an emergency medical condition, you may be eligible for the federally funded Alien Emergency Medical Program (AEM) which will pay for emergency care. you must be low income, have an emergency medical condition, and be one of the following:

  • a child under 18
  • a person in a family with dependent children
  • 65 and over
  • blind or disabled (must be unable to work for at least one year,) or
  • pregnant
  • not eligible for regular medical coupons

What’s considered an emergency medical condition?
An emergency medical condition is characterized by sudden onset of acute symptoms of sufficient severity (including severe pain) that the patient’s health would be placed in serious jeopardy, and/or bodily functions may be seriously impaired if immediate medical attention is not provided.

Mosquito control

When are mosquitoes most active?
Active mosquito season is April 1 through October 1.

How can I help reduce the mosquito population?
Report potential mosquito breeding sites, such as places that have standing water. The mosquito crew will visit the problem area and determine treatment or monitoring needs. You may also request information to help you control mosquitoes around your home or business.

On-site septic systems

How do I get an on-site sewage system permit?
This list of steps will assist you in meeting the requirements to obtain an on-site sewage system permit.

Why has the law changed?
Washington State has challenges with ground water pollution, which contributes to the degradation of recreational and drinking water, impacting the health of the public as well as the fishing and shellfish industries. One of the sources of pollution is thought to be high concentrations of nitrogen due to poorly functioning septic systems. The State Department of Health therefore adopted more rigorous septic inspection, design and installation standards.

Where can I find the regulations themselves?
The state issued WAC 246-272A in 2005, with the intention that new septic maintenance requirements be enacted in 2007. This regulation can be found at Washington State's Web site. Local public health departments are required to enforce these regulations. Clark County Public Health proposed Clark County Code 24.17, which the Board of Health adopted on October 16, 2007.

What is Public Health's role and how are you funding it?
Public Health is charged with overseeing the implementation of this law, ensuring that owners are educated about requirements and comply with them, and certifying on-site septic system operations & maintenance (O&M) specialists, pumpers and installers.

How often do simple gravity systems with drainfields have to be inspected?
Every three years. We will send you a notice about 6 months before your inspection is due to give you time to meet this requirement.

If I have a gravity system with a pump that pushes the effluent up into the drainfield, how often does it need to be inspected?
Every 3 years. The State Department of Health has granted our waiver request to allow these systems to be inspected every three years instead of yearly.

What about other systems like sand filters, Glendons, aerobic treatment units (ATU), etc.?
The law requires that all alternative systems be inspected yearly. Note that some systems are so complex that the manufacturer recommends inspections more often for the first two years, so be sure that you are meeting the conditions of your warranty.

Why do I have to have a maintenance contract if I need yearly inspections?
The maintenance contract is simply a system to ensure yearly inspections are carried out routinely. The contract should specify the frequency of inspections, the full cost including any laboratory testing, and should be able to be terminated if you were not satisfied with the service. We strongly recommend that you get at least three quotes before proceeding.

Can resident homeowners do their own inspections?
If it's a conventional gravity system, yes! The homeowner must take a course from Public Health and pass the operations & maintenance (O&M) test ($20). The form for reporting inspection results will also be provided at that time.

Who should I call to inspect my septic system?
If you have a gravity system with or without a pump, you can hire an operations & maintenance (O&M) specialist I or II; if you have any other type of system, you will need to contract with an O & M specialist II. These are trained, bonded individuals who have passed either a Clark County Public Health exam that covers just gravity systems (for O & M specialists I) or a state exam that covers all systems (for O & M specialists II). List of certified O&M specialists (PDF).

When should I have my system pumped?
Pumping frequency is determined by the type of system, the amount of use, the type of materials put in the system, etc. When you have your system inspected, the O & M specialist will recommend pumping if it's needed based on inspection data.

How do I know the inspector isn't in cahoots with a pumping company?
All O&M specialists (inspectors), pumpers and installers are required to complete a conflict of interest statement that identifies any financial relationship with any business or product that may present a conflict of interest. You may still choose an O&M specialist who does pumping, or a designer who is also a product representative, but at least you will be able to make an informed choice. Conflict of interest list (PDF)

What is the cost of an inspection?
Inspections cost less than pumping, but the price may vary depending on the type of system you have. As private industry is providing this service, we cannot regulate their fees, but encourage you to get more than one quote before selecting an O & M specialist.

Is there any advantage to me personally?
Research shows that even though you believe your system is operating properly, more frequent operation and maintenance increases the longevity of the system and identifies problems early while they are still relatively inexpensive to fix. In the long run, proper care for a system will not only protect our groundwater, but your investment.

Pools and beaches

How can I enjoy healthy swimming in oceans, lakes and rivers?
Swimming in cool water can offer relief from hot summer temperatures. However, swimming in untreated water — such as lakes and rivers — can result in side effects ranging from swimmer’s itch to intestinal infections. To avoid illnesses from bacteria and small organisms that thrive in untreated water:

  • Do not swallow untreated water. Keep your mouth closed when playing in the water.
  • Avoid swimming in slow-moving water that is warm and murky or very green from algae.
  • Do not swim in grossly contaminated water — containing dead animals and fish, animal or human waste.
  • Towel off thoroughly and shower with soap and water after returning home. This will rid your skin of larva that penetrate the skin and cause itching.

How can pool/spa owners and operators ensure safe and proper maintenance?

  • Test pools several times each day for disinfection levels
  • Test pools and spas at least once daily for ph
  • Maintain clarity through proper disinfection and filtration
  • Keep spa temperature below 104° F
  • Clean filters as back pressure increases and flow decreases
  • Be sure that proper safety equipment, such as ring buoys and reach poles, are available to users
  • Test spa emergency shut-off switches often
  • Check main drain grates to be sure that they are intact and secure
  • Provide lifeguards at general use facilities such as city or school pools and health clubs
  • Maintain fencing and gates in good condition to prevent small children from drowning
  • Routinely vacuum and clean facilities
  • Keep physical conditions in good repair

Properly maintained pools and spas reduce the risk of recreational water illnesses such as intestinal or respiratory diseases, skin disorders, and ear, nose, throat and eye infections. Pools with proper barriers, safety equipment or on-duty lifeguards can help prevent deaths from drowning or serious injury to swimmers.

What is an RWI (recreational water illness)?
RWIs include intestinal or respiratory diseases, skin disorders, and ear, nose, throat and eye infections.

How does pool maintenance reduce risks?
Properly maintained pools and spas reduce the risk of recreational water illnesses. Pools with proper barriers, safety equipment or on-duty lifeguards can help prevent deaths from drowning or serious injury to swimmers.

Reporting a dead bird

What should I do if I find a dead bird?
To report a dead bird to Public Health:

  • Use the online report-a-concern form or call Public Health at (360) 397-8482 and leave your recorded information.
  • Do not handle dead birds with your bare hands. Use, gloves, a shovel or a plastic bag over your hand to pick up a dead bird. Double-wrap in two plastic bags. Store in a cool place, a refrigerator or freezer is ideal.
  • Only some crows, jays or raptors will be selected for West Nile Virus testing.
  • If you have found a crow, jay or raptor and the bird is fresh and undamaged, please keep the bird for possible West Nile Virus testing. A public health staff person will contact you within 24 hours to arrange testing. If you are not contacted within 24 hours, please dispose of the bird in your household garbage.
  • Do not bring dead birds to the Public Health Department unless you have been directed to do so by a public health staff person. Dead birds will not be accepted at the Public Health Department.


What is hazardous waste?
Hazardous wastes include, but are not limited to, heavy metals, toxic chemicals, oil, gasoline, paints and solvents. Hazardous waste is any waste generated from the use of a product containing a hazardous or toxic material that, if misused or improperly disposed, can release contaminants that are potentially damaging to the environment and harmful to humans and other living organisms.

How can I safely dispose of unused or outdated medications?
Improper disposal of unwanted medications can result in serious harm to humans, animals, and the environment. Find out how to safely dispose of medications.

How can I find out about residential garbage, recycling, and yard debris?

What is solid waste?
Solid waste is household garbage, yard debris (leaves, weeds, prunings, grass clippings, brush and woody materials), and demolition and construction debris (old lumber, pallets, roofing, and so on).


What is the WIC program?
The WIC program helps pregnant women, new mothers and young children eat well, learn about nutrition and stay healthy.

Fathers, grandparents, foster parents and other legal guardians are also encouraged to apply for services for eligible children under their care.

How can a pregnant woman apply for acceptance into the Nutrition and Family Wellness (WIC) program?
You may be eligible for the WIC (Women, Infants and Children) program if you are pregnant and/or have children under the age of five and meet certain income guidelines. Through WIC, you can receive coupons for nutritious food each month, as well as breast feeding information and support, and nutrition and health information for your child.

Clark County WIC services are now provided by Sea Mar Community Health Center. Find a WIC office near you.

What is the Farmers Market Nutrition Program?
The Farmers Market Nutrition Program provides locally grown fresh fruits, vegetables and herbs for eligible women, children and seniors. This program is part of the Special Supplemental Nutrition Program for the Women, Infants and Children (WIC) Program.

What is a food package?
The WIC program provides a supplemental food package to help families meet US Dietary guidelines for healthy eating. WIC foods include juice, iron-fortified cereal, eggs, cheese, milk, peanut butter, dried beans or peas, tuna, carrots and iron-fortified infant formula.

When is the best time to start breastfeeding?
Breastfeed within an hour after delivery. Babies are most alert and ready to nurse soon after delivery. Plus, the rich colostrums helps babies with their first bowel movement and provides antibodies to protect babies from infection. Colostrum is all that babies need in the first few days of life.

I'm breastfeeding. Should I also use bottles or pacifiers?
Avoid giving bottles and pacifiers the first 4 weeks. Bottle nipples and pacifiers teach the baby bad sucking habits which may cause sore nipples for mom. Formula decreases mom’s milk production or can lead to breast engorgement. Formula also may contribute to allergies. Water bottles are not needed. Mom’s milk is 70-90% water.

Where can I go for breastfeeding help?
Peer Counselors are available to help WIC mothers with questions and concerns that come up about breastfeeding. Peer Counselors are WIC moms too, and understand the breastfeeding challenges that women may face. They help with common concerns like getting baby comfortably positioned and latched, how to deal with returning to work or school, learning how to breastfeed in public, dealing with unsupportive family members, and more. Peer Counselors are available 7 days a week, and may be contacted at (360) 397-8459.


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