HomeMy WebLinkAboutBoard of Health July 30 20131
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WHATCOM COUNTY COUNCIL
Board of Health
July 30, 2013
CALL TO ORDER
Councilmember Barbara Brenner called the meeting to order at 10:30 a.m. in the
Council Chambers, 311 Grand Avenue, Bellingham, Washington.
ROLL CALL
(10 :30:41 AM)
Present: Barbara Brenner, Ken Mann, Sam Crawford, Carl Weimer and Pete
Kremen.
Absent: Bill Knutzen and Kathy Kershner.
1. PUBLIC SESSION
No one spoke.
2. PUBLIC HEALTH ADVISORY BOARD UPDATE
Regina Delahunt, Health Department Director, introduced Public Health Advisory
Board (PHAB) Chair Doug Benjamin.
Doug Benjamin, Public Health Advisory Board Chair, referenced the County Charter
regarding the PHAB responsibilities. The PHAB is intended to be a group of experts and field
representatives to advise the Council as the Board of Health. All nine positions on the PHAB
are currently filled. He described the Board membership.
For three reasons, the PHAB has focused on a different level from typical services,
including compassionate community, trauma - informed services, compassionate schools
model, adverse childhood experience, and what it means to be healthy. First, there is
compelling information on the impact of early, traumatic, and adverse childhood
experiences. Next, supporting child and family development is a priority in the emerging
Whatcom County health improvement plan. Last, people who've experienced trauma do
succeed, due to resiliency and personal responsibility.
The PHAB focus has not been on creating new services or directing funding, but on
how to influence and change the entire culture and paradigm to be sensitive to the impact
of trauma. It's about how service is provided and how people are treated. There are places
that are the most effective to shift the culture of providing health and human services.
There must be much discussion to shift this culture, including dialog with the Board of
Health. The PHAB will discuss dialoging with the Board at its next meeting.
3. THE HEALTH OF OUR YOUTH AND PREVENTION SERVICES
(10: 41:45 AM)
Board of Health, 7/30/2013, Page 1
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Ann Deacon, Health Department, introduced today's presentation and stated there
are two goals today. The first is to discuss ideas and get guidance about programs for high -
risk youth in the community. The second is to provide information on how they do their
work. The Board will see the significant work behind the development and determination of
what programs and services they want to implement. It's a robust, comprehensive science.
It's hard to prove things that are difficult to measure. It's difficult to measure the success
of human service programs.
Joe Fuller, Health Department, gave a presentation submitted in the Board packet.
He described the Healthy Youth survey.
Mann asked if they can verify instances of attempted suicide. Fuller stated data is
collected if they show up in the emergency room. Many do not go to the emergency room.
The reported number tends to be low.
Kremen asked if teen suicide is a trend that is pervasive throughout the country.
Fuller stated it is an upward trend in Washington State. There are national initiatives
working to address this very thing.
Brenner asked if they have a definition for feelings of sadness and hopelessness.
Fuller read the actual question in the survey.
Brenner asked for a copy of the survey in the future. Fuller stated he can provide
that survey. He continued the presentation on depression and substance abuse.
Brenner asked who received the survey. Fuller stated all schools in the county had
an opportunity to participate. One school chose not to participate. Each school gets their
own results. The kids individually can opt out of taking the survey. The percentage of kids
who participate are between 50 and 75 percent. He continued the presentation on the
importance of family connections.
Brenner asked if they've talked to districts about changing school times. Brain
activity is at its highest beginning mid - morning according to the research she's read. It
seems schools are more interested in convenience for staff and parents. Fuller stated
schools have discussed it. He's read that research also. He continued the presentation
regarding the science of the strategic prevention framework. He submitted handouts
regarding the Prevention Redesign Initiative and Strategic Plan (on file).
Brenner asked about the timeframe for merging the Behavioral Health Advisory
Committee and the Behavioral Health Revenue Committee and the status of the Mental
Health Court. Deacon stated the possibility of the merge is being discussed. It will come
forward soon. They have hired a temporary employee who is designing the court. Local
stakeholders have agreed to move forward with the design and research. They are also
working with the City of Bellingham municipal court.
(11:10:00 AM)
Fuller continued the presentation on how they know the prevention redesign
initiative works.
Kremen stated the future of the local Big Brothers Big Sisters agency is uncertain
due to a dramatic reduction of revenue due to the legalization of tribal gaming. They were
Board of Health, 7/30/2013, Page 2
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netting $1 million with the bingo operation. At that time, when the county population was
much smaller, they were serving about 325 children. Today, they serve about 65 children.
The future of the agency is uncertain. The results of mentoring are compelling. He asked if
the Public Health Advisory Committee or Health Department can look into using some
dedicated funding to enable the local agency to continue to exist. Deacon stated there is a
proposal to keep the mentoring services, not necessarily this agency, in the community.
It's already part of a plan to move forward. When looking at capacity, they look at whether
current community partners have projects that are ready to go. They would like to continue
to support the program. The services are critical.
Fuller continued the presentation on the Strengthening Families Program.
Brenner stated this program is expensive to operate. She wants to know the cost
per participant and more information on the program. Fuller described the program, which
is operated through Washington State University (WSU) Cooperative Extension.
Brenner asked how many families make it to all the meetings and finish the program.
Fuller stated it serves 7 to 15 families at a time. The retention rate is about 80 percent.
This program is intentionally designed for anyone. It focuses on the 10 to 14 age category.
It also creates connections between families who are struggling.
Brenner stated part of family struggle is not having time. She asked how it
correlates with the total number of families in the community. She asked if the program
gets to the top tier of families or families who are really struggling. Fuller stated the
program reaches broadly across all kinds of families. They've done at least 20 to 30 of
these programs, which always has a blend of family skill levels.
Deacon stated this is just an example program. Other programs are designed to
meet needs. These programs have been rigorously researched and have proven to be
successful. There are different programs for different issues.
Brenner asked for results of lifetime marijuana use.
(11:27:37 AM)
Deacon introduced a movie clip of Rocky that is related to the rest of their
discussion. What makes people get up after being knocked around by life is what they have
to figure out to bring people hope for success and personal responsibility. That's what
makes people with adverse experience.
Fuller continued the presentation on resilience.
Mann asked about the reluctance from the State of removing children from an awful
home life. He asked if it's because the data shows kids still do better if there is a sense of
family attachment, even if they're in a bad situation. Fuller stated he can't say attachment
and belonging will overshadow a household of abuse and neglect.
Deacon stated this speaks to positive attachment, not negative attachment. They
can't address the child welfare system. The local role is to bring the strengths that build
resilience to families that are still together and are having an negative impact on the kids.
Mann asked their personal opinion of whether the State is too reluctant or moves too
slowly to take kids out of homes with bad situations. Deacon stated she's seen both
Board of Health, 7/30/2013, Page 3
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instances. The State has policies that are meant to protect kids. Individual case workers
are humans, and work on their own best judgment. Sometimes they err on both sides. The
alternative is moving them to a new home, but then there are concerns with foster homes.
Mann asked if the State would be more proactive with removing children from a
home if they were more confident in the foster system. His impression is that the State will
not take kids from families unless it's the last resort. He wishes they move quicker.
Brenner stated she helped a woman whose baby was taken away to get her act
together. The social worker for the case placed the baby with a friend who wanted to adopt
the baby. The social worker made it difficult for the mother to get the baby back because
her friend wanted to adopt the baby. Sometimes, going through terrible times and being in
a safe place makes a young person look at things differently. Deacon stated safety is an
overarching factor. There is a significant amount of science and research behind what they
do.
Fuller continued the presentation on the foundations of healthy development.
Brenner asked the difference between alcohol abuse and alcohol dependence.
Deacon stated that refers to the diagnostic criteria. In general, they are addressing
whether drinking is problematic.
Weimer stated underlying mental health issues go hand -in -hand with substance
abuse issues. He asked if dealing with substance abuse helps with mental health. Fuller
stated substance abuse reduction programs impact other problems as well. They reduce
the risk of several issues.
Crawford stated there is a term called non - dependent alcohol abuse. One binge
drinking session is alcohol abuse, but it may not happen daily, which makes it non-
dependent.
Kremen asked if drug and alcohol and substance dependency and abuse is common
for the individual also to have a mental illness, and they use the drugs or alcohol to mask
the mental illness. Deacon stated that is correct. Teens are at higher risk when developing
a serious mental illness.
Weimer stated information showed depression issues are on the increase. He asked
if all the new programs showing success have not been in place long enough or if there are
people who don't smoke and drink who are depressed. Deacon stated it's probably both.
She submitted and referenced a handout listing Whatcom County chemical
dependency /mental health program fund (on file). Not a lot of money is put toward youth.
The advisory boards directed them to put more money into youth programs. Have that
discussion today. Also discuss if they want to focus on prevention and intervention.
Treatment programs are in place. The school districts are also getting a lot of the services
out to the children. They worked with each school district on what they need and how to
address the need. The positive results aren't widespread because they don't have enough
services. They gave each school district a base of $55,000 knowing that the schools with
larger populations have larger resources. They tried to make sure they didn't shortchange
the small communities. From there they added an additional amount according to
population.
Board of Health, 7/30/2013, Page 4
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Mann stated it sounds like there is room to scale up services, and the value of each
dollar spent is equivalent to what they've spent so far. Deacon stated it's critical to make
sure dollars are spent to make sure they get the biggest benefit for the investment. Make
sure they spend money on items with the biggest impacts. Maybe they need to target high
risk populations or high risk areas.
Mann stated that regarding action requested on policy question 1, they should
expand the services.
Weimer stated the Mt. Baker School District has $65,000, which is a staff person, not
services. There is a person in the school to identify the children, but the children are still
sent off for counseling and drugs. He asked what happens. Deacon stated that with
everything the Health Department funds, they try to enhance what is currently in place.
With Mt. Baker School District, there are some services onsite. Some are used to identify
kids who need more. They also have private mental health providers who go out there to
provide services. Now at Mt. Baker, the kids being served qualify under Medicaid.
Whatcom Counseling and Psychiatric Clinic are providing services and billing Medicaid.
They've tried to do that with all programs to make sure they can bring in other services or
partners that aren't necessarily using County dollars. They are trying to fund a continuum
of care.
Kremen stated he agrees with Councilmember Mann. Given the problem, $600,000
isn't close to being enough. Unfortunately, the State and federal government continue to
reduce their services and grants. He doesn't necessarily want to give to the school districts,
but prefers to fund programs that are geared specifically for at -risk youth, mental illness, or
other programs. The Bellingham School District put out a $160 million levy that included $5
million for a football field AstroTurf. That isn't a priority of the school district. Most of the
program money is going to the schools. He questions whether they are getting the best
benefit for the investment. The dollars will have a greater impact if focused on programs
specifically geared to specific problems. Deacon stated they agree. They oversee the
school district contracts to make sure the funds are being used as they are supposed to, for
programs and services that they've identified, within a continuum of care, and without
moving the money around to fill out other shortfalls.
Crawford stated it makes sense to target those at risk. He's encouraged the
numbers look good for Big Brothers, Big Sisters mentoring and Strengthening Families. The
DARE program was not effective. One -on -one time spent in mentoring and Strengthening
Families programs is most effective. Do anything they can in that area.
Brenner stated she agrees with Councilmember Crawford.
Deacon stated policy discussion three refers to what they were talking about in terms
of working with current community partners that have projects ready to go.
OTHER BUSINESS
Crawford stated there will be a marijuana retailing and growing presentation by the
Sheriff and Prosecutor next week. Health Department staff should attend. Also, he would
like an update on norovirus outbreaks locally.
Board of Health, 7/30/2013, Page 5
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Regina Delahunt, Health Department Director, stated there were a few sporadic
outbreaks in the county. Hopefully no more will occur.
ADJOURN
The meeting adjourned at 12:05 p.m.
The Council approved these minutes on September 10, 2013.
ATTEST:
WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Council Clerk Barbara Brenner, Council Acting Chair
- Minutes Transcription
Board of Health, 7/30/2013, Page 6