HomeMy WebLinkAboutBoard of Health Ocotober 7 20141
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Whatcom County Council
Board of Health
October 7, 2014
CALL TO ORDER
Council Vice -Chair Ken Mann called the meeting to order at 10:30 a.m. in the County
Council Chambers, 311 Grand Avenue, Bellingham, Washington.
ROLL CALL
Present: Barbara Brenner, Sam Crawford, Barry Buchanan, Ken Mann, Pete
Kremen, and Rud Browne
Absent: Carl Weimer
MEETING TOPICS
1. PUBLIC SESSION
No one spoke.
2. DIRECTOR'S REPORT
Regina Delahunt, Health Department Director, stated the accrediting board would
like more progress on performance measuring for strategic planning and the Community
Health Improvement Plan. Once that's done, the Department will receive its accreditation.
The North Sound Accountable Communities of Health organization is about health
care reform and the State's Health Care Innovation Plan. Five regional counties are coming
together to reach consensus on one or two initial regional projects that will further health
care innovation efforts in the state. Two efforts they will work on regionally may include
intensive case management for frequent users of the medical system and asthma control in
children, including making homes healthier for children.
Mann asked if there will be a five - county affordable care organization. Delahunt
stated that is part of this initial group. This is to support the State's health innovation plan.
Whatcom Alliance for Health Advancement (WAHA) is bringing these counties together.
Each regional contributor supports WAHA's work in this effort. They need to jointly develop
a plan to submit to the State by December. If the projects are good enough, the State will
choose to fund two pilot projects in the state. Four regions in the state are working toward
developing one of those two pilot projects.
The Health Department will sponsor a substance abuse forum in November to talk
about heroin addiction in the community. Multiple partners will participate. They hope to
develop a multi- sector plan to address this problem.
Brenner asked if there will be a mental health or mental illness forum. Because most
people who have substance abuse problems also have mental health issues, they should
address the cause. Government shouldn't hide mental illness issues. Delahunt stated it's
something to talk about with the Advisory Board.
Board of Health, 10/7/2014, Page 1
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They are participating in the Samish Way effort to clean up the motels in that area.
They are working from an environmental health perspective to test the rooms and from a
human services perspective to arrange for alternative housing for folks who are living in
these substandard conditions.
They are interviewing people for the position of coordinator for mental health court.
They are initiating other task forces regarding infection control and sexual health education.
They have moved to an electronic death record system.
Crawford referenced the hotel problems on Samish Way. He asked if there is a
screening process. Don't help people find housing if they are just going to create a problem
elsewhere. Delahunt stated there is a screening process. They aren't moving the problem
elsewhere. They are working with the community and housing group to help people
properly.
Crawford stated a small element of people have come here because of the available
services. Don't support people who have moved here for services. He asked how far they
are toward their goal of eliminating homelessness. Delahunt stated they have come a long
way toward achieving that goal. There is a huge waiting list for housing, so there isn't
enough housing.
Crawford stated the downtown business owners are complaining that the problem is
worse today than it has ever been.
Browne asked how they make sure they don't relocate people to somewhere else
where they will continue to contaminate areas that will have to be cleaned up. Delahunt
stated they aren't relocating someone who is engaged in illegal activities. They are trying to
help people who aren't engaged in illegal activities. They are also trying to help people with
substance abuse issues by trying to get them into treatment, but they aren't relocating
someone who will continue to contaminate rooms. Staff can schedule a presentation from
the Homeless Service Center about their screening process. They want people to relocate
successfully.
Browne stated he agrees with Councilmember Crawford that this community
shouldn't become a magnet for people from other communities. Delahunt stated the data
doesn't support that assumption. Staff can present that data.
Brenner stated application paperwork can ask how long they've been in the
community.
Mann stated he agrees with Councilmember Crawford also. He's been told that
there's no real data that supports homeless immigration, but he's heard anecdotal
information from police officers that it is happening. They need to look at the issue
specifically with data.
Kremen stated Bellingham and Whatcom County have always had more than their
share of transients and drug users, partially because this is the last stop along the
Interstate 5 corridor before the international border. These people get turned back at the
border for various reasons.
Board of Health, 10/7/2014, Page 2
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Brenner asked for data that says the assumption about the homeless immigrating to
Whatcom County is incorrect. Delahunt stated the data indicates otherwise, but may not be
strong enough to guarantee that immigration isn't happening.
Browne stated there should be evidence presented by someone to prove how long
they've been in the community. Also, come up with objective data that the community can
support, so the community will support programs.
3. PUBLIC HEALTH ADVISORY BOARD (PHAB) UPDATE
Doug Benjamin, Public Health Advisory Board Chair, referenced the recent question
of whether herbicide use on roadsides impacts human health. Department staff are looking
into the issue. The PHAB will discuss the issue at its next meeting.
Brenner stated information received recently from the State Department of Health
was helpful. The biggest problem is from people who use it on their lawns.
Benjamin referenced the Health Department strategic plan and stated the PHAB
discussed it recently in terms of creating a cultural shift. Their discussion is well
documented, and the Advisory Board will forward meeting minutes to the Board of Health.
This will be his last meeting as chair. His interest as chair was aligning the work of
the PHAB and the Board of Health. The PHAB will try to align its agenda with the strategic
plan as well.
4. EMERGING DISEASE UPDATE
Dr. Greg Stern, Health Department, gave a brief overview on communicable disease
response, particularly regarding enterovirus D68 and ebola, which have both been in the
news recently.
He described enterovirus and its symptoms, its relation to polio, the history of the
D68 strain, its current distribution, its severity, local efforts to test for and survey the
illness, and treatment and prevention. There's no evidence it's particularly threatening.
He described the ebola virus, historic areas of outbreaks, its spread across borders,
conditions that allow an outbreak to occur, and global effects of an outbreak.
Brenner stated people traveling from those areas shouldn't come into this country
without some kind of quarantine first. Stern stated the issue locally is how they will address
it. He described how the virus is transmitted and contained, the likelihood of a widespread
outbreak in Western nations, and local preparations in case someone is suspected of having
or is diagnosed with ebola.
Kremen stated he's concerned about people who may mistake traditional flu
symptoms for ebola during the upcoming flu season. He asked if they've considered the
increase in the number of individuals who will flood the system by thinking they have ebola.
Stern stated they will work with clinicians on clear assessment protocols. If there has been
no recent travel to West Africa or proximity to someone who just returned from West Africa
and who is sick, then it's not likely people will have ebola. They can reassure the individual
that there are no risk factors and that they most likely have flu because it's flu season.
Doctors deal all the time with people who are worried about something.
Board of Health, 10/7/2014, Page 3
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Kremen stated the federal administration has announced screening for people who
are coming to the U.S. from that part of the world. There will be a lot of false positives
during screening if people have the flu, for example. He asked how they will deal with that.
Stern stated they will be quarantined. Public health will monitor the quarantine.
Kremen stated the upcoming nexus of the ebola outbreak, flu season, and screening
process may overwhelm the health care system, regardless of whether the virus is actually
present. Stern stated some centers are geared up for testing. Hospitals must always follow
infection control protocol and should be implementing those guidelines all the time. It's a
collaborative effort. Public messaging will help reduce some anxiety from the public. The
biggest challenge is quarantine and determining how effective it is. Those indentified as
having a high risk for potentially having ebola will be monitored closely and treated sooner
and successfully.
Brenner stated ebola mutates every time it's transmitted from one person to
another. They don't know the future of ebola. She would like the Health Department
representatives to say that people arriving from that area shouldn't come here at this time
until they've been quarantined. Whether or not it becomes a big deal, it will damage the
healthcare system.
Browne stated anyone who is a citizen has a legal right of entry. He's concerned
about the quarantine methods that happened in Dallas. People were quarantined with the
contaminated waste and were not allowed to remove the waste. He asked if those mistakes
have been considered. Stern stated those are lessons learned. Recent pandemic planning
efforts discussed how to support people in implementing isolation and quarantine. It's
important to not treat people as if they are being punished by being quarantined. They
work with people to stop active tuberculosis cases. If he issues quarantine orders, which
isn't done lightly, the person's needs still have to be addressed. The more they can prepare
ahead of time, the better the situation will be. They must make sure they have the
resources to safely isolate and quarantine people.
Mann stated analyze the quarantine mistakes of others and make sure that doesn't
happen here.
5. HEALTH DEPARTMENT STRATEGIC PLAN
Regina Delahunt, Health Department, stated they summarized the strategic plan into
two pages (on file). She asked for the Board's reaction to the plan, and if they understand
it the way it was meant to be. She would also like to know if they are moving in the right
direction. The strategic plan is a very high overview that talks about infrastructure and the
way they approach the work they do in the community. It's not about the actual work they
do.
Brenner stated the summary doesn't say enough. She prefers to have more
specificity. Delahunt stated they are working on a companion document that is the work
plan, which is more specific.
Brenner stated the work plan is the information she wants to see. Nothing in this
summary is a problem for her.
Mann referenced bullet three under the Sustain section regarding compassion. He
stated compassion is a great value, but data should drive their decisions. Replace
'compassion' with language that references their long -term strategic plan.
Board of Health, 10/7/2014, Page 4
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Browne stated he likes the term 'compassion.'
Buchanan stated he also likes the term 'compassion,' because it's a good contrast.
Delahunt stated the Public Health Advisory Board (PHAB) discussed what may happen if
compassion is lacking from any decisions made based only on data.
Browne stated they want a good balance of both.
Mann referenced the last bullet item under the Desired Results section and stated
the statement is too vague. He doesn't know what that means or what they are supposed
to do. The potential scope of that statement is too big. The rest of the bullet points are
relevant and specific. He questions how much it is the Health Department's concern to
ensure that everyone's basic needs are met.
Browne stated he agrees with Councilmember Mann about ensuring basic needs.
Everyone should have healthcare access, but it's not the County's place to be responsible
for everyone's basic needs.
Brenner stated that item just needs to be more specific.
Delahunt asked if the three overall strategic sections, which are providing critical
infrastructure, engaging the community, and driving policy changes, are correct. It reflects
the shift in direction they've been talking about for a few years.
Mann stated the three bullet points in the Transform section don't seem to reflect a
transformation of policy changes. The three bullet points are their goals, but it should be
worded better.
Brenner stated that the Sustain section should say they operate at the policy level,
and providing critical infrastructure should be a bullet point.
Crawford stated he likes all of it. He referenced the first item in the Desired Results
section and stated not everyone is always going to be physically healthy. It's a matter of
scale. They can exceed state or national averages, which would be a more realistic result.
In that list, the fifth bullet point is most important, and the fourth is his second priority.
Government should provide an environment in which people make choices. Regarding the
graphics on the first page, they probably shouldn't include a photo of apple pie, which isn't
healthy.
Browne stated the summary is good overall. Rename the Desired Results section to
Aspirations. Reword the last bullet point to say that everyone should have healthcare
access to meet basic needs. In the Our Values section, the bullet point for effectiveness
should say the value is measureable effectiveness, and also include data - driven decision
making.
Buchanan stated he likes this summary version.
Kremen stated it's hard to improve on this. They are just fine - tuning a good
document. Rename the Desired Results section as Desired Objectives or Desired Outcomes
instead of desired results or desired aspirations. Delahunt stated the PHAB had the same
conversation. They need to do a little more work on the title of this section.
Board of Health, 10/7/2014, Page 5
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Delahunt asked for approval of the strategic priorities themselves, beyond just the
wording.
Crawford moved to approve the strategic priorities, with some of the language
changes they have just discussed.
Mann stated he's concerned about the Transform section, but he supports the bullet
points underneath it.
Brenner stated she wants to see the word changes before approving it.
The motion carried by the following vote:
Ayes: Brenner, Mann, Crawford, Kremen, Browne and Buchanan (6)
Nays: None (0)
Absent: Weimer (1)
ADJOURN
The meeting adjourned at 11:59 a.m.
The Council approved these minutes on November 12, 2014.
ATTEST:
Dana Brown - Davis, Council Clerk
Jill Nixon, Minutes Transcription
WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Ken Mann, Vice - Council Chair
Board of Health, 10/7/2014, Page 6