HomeMy WebLinkAboutBoard of Health July 29 20081 WHATCOM COUNTY COUNCIL
2 Board of Health
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4 July 29, 2008
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6 Council Chair Carl Weimer called the meeting to order at 10:30 a.m. in the Council
7 Chambers, 311 Grand Avenue, Bellingham, Washington.
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10 Present: Absent:
11 Barbara Brenner None
12 Bob Kelly
13 Sam Crawford
14 Seth Fleetwood
15 Laurie Caskey- Schreiber
16 L. Ward Nelson
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19 1. PUBLIC SESSION
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21 No one spoke.
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23 2. WHATCOM ALLIANCE FOR HEALTHCARE ACCESS (WAHA) UPDATE
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25 Regina Delahunt, Health Department Director, stated they will present background
26 information on the Whatcom Alliance for Healthcare Access (WAHA). She showed a video
27 on the benefits of WAHA and read a presentation (on file) regarding the background of
28 WAHA.
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30 Sue Sharpe has been facilitating WAHA, but will transition to another position. They
31 have undergone leadership changes. Kerri Lenderman will become the WAHA Executive
32 " b rector. She introduced the board members present.
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34 WAHA is a partnership, and they must acknowledge private practices for their
35 participation. WAHA focuses a lot on getting kids into care. The County's contribution isn't
36 included in the proposed base budget for 2009/2010.
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38 Stephen Gockley, WAHA Board Member, described his background. Connection
39 Services are largely carried out by WAHA staff. They are now dealing with a
40 compartmentalized and fragmented healthcare system that is difficult to use. He read the
41 presentation, beginning with the WAHA Connection Services.
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43 Sue Sharpe, WAHA Co- Director, continued the presentation regarding Small Business
44 Health Insurance Connection. The largest number of uninsured are people employed in
45 small businesses. WAHA staff and board members sit on many committees that implement
46 legislation. The WAHA system has been presented nationally. One reason they are
47 successful is because they don't rely heavily on federal funding. They keep the scale to a
48 community level. A Washington State Department of Social and Health Services (DSHS)
49 worker is stationed in their office to increase turn - around time.
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51 Brenner asked if there is an effort to create a countywide small business insurance
52 policy group. Sharpe stated they considered it. They haven't decided to do it. The State
53 has a new program beginning in January to subsidize low income employees if employers
Board of Health, 7/29/2008, Page 1
are willing to provide coverage. They want to see how that works first. Right now, they
think they can be more competitive than a group program.
Brenner asked if there is a formula for all doctors to participate. Sharpe stated that
they sign an agreement for project access. They say they will provide a certain level of
service to a certain number of patients for the year. They look for that kind of commitment,
track it, and report it. It's a formal process.
Brenner asked if the State knows about the County's rural health designation.
Sharpe stated the State helped WAHA with that designation. The State worked on data
collection.
Brenner stated make sure the State understands that this resource is important.
She asked what happens when services aren't available to Medicaid patients. Sharpe stated
that happens in most cases. They must first get people covered to get into routine care.
Coverage doesn't solve the whole problem. That's the challenge they face.
Brenner asked if they are focused on getting money back. Sharpe stated they get
money back to providers, but they also get Medicare patients to a provider who will accept
Medicare or Medicaid, which can be a challenge..
Caskey - Schreiber stated she thanks Ms. Sharpe for her service to this group. She
also thanked Councilmember Nelson for his leadership. She asked about the WAHA budget,
overhead costs, community matches, and whether they need annual support from the
County. Sharpe stated the goal is to seek funding from a broad variety of funding sources,
including the hospital.
(Clerk's. Note: End of tape one, side A.)
Sharpe continued to state it contributes $135,000 to. $180,000 per year. The St.
Luke's Foundation consistently gives the Alliance $50,000 per year. The County funds of
$50,000 are used to leverage many other funds. She described the funding sources. This
Alliance works because everyone contributes. They must broaden the funding base further.
They will consider how to do that in the next year. They are looking for ongoing support so
they know everyone is participating, which makes the Alliance a lot healthier. They also
recognize that they must have different approaches.
Weimer asked if the County's match of $50,000 is not included in the proposed
budget. Delahunt stated that's correct. Also, there is $25,000 from the Small Business
Development Center (SBDC). They contract directly with SBDC rather than go through
WAHA for the physician survey and small business support.
Nelson stated WAHA isn't the complete answer to solve health care access problems
for everyone. It is a tool for the goal. Educate the public, and the public will endorse and
support a plan. He hopes to connect efforts such as WAHA and other community
organizations to create a healthy community. Support the organizations as best they can
within the means they have. WAHA must maintain efficiency and support. He will work
with WAHA to do more work within the community to find other support mechanisms.
Larger businesses are supported by this effort. He appreciates the WAHA board and staff.
Dewey Desler, Deputy Administrator, stated the County jails are constitutionally
required to provide healthcare to inmates. These are very sick people who often aren't
connected with health insurance options. He asked if WAHA has talked with the County to
Board of Health, 7 /29/2008, Page 2
see if it can connect that population to health care. Sharpe stated they haven't talked to
anyone specifically. They attended a conference in June where it was discussed. The WAHA
board discussed it at a retreat. They are aware of that group needing help.
Gockley stated they are presented with a unique opportunity through State action.
Previously, Medicaid patients were ineligible while in jail and for a time after their release.
The State now allows for expedited reauthorization for prisoners being released.
Caskey- Schreiber asked the number of paid WAHA staff and asked the amount
necessary in the WAHA annual budget needed to continue. Sharpe stated the number of
staff is about eight, but it fluctuates. Many are part-time. They are direct service
providers. The budget this year was about $550,000. The goal is the same next year.
3. COMPREHENSIVE HEALTH PLAN UPDATE
Susan Sloan, Health Department, read from the Overview of the Comprehensive
Health Plan (CHP) Public Input Summary Document information. They have completed step
one, which included interviews with stakeholders, community focus groups, and public
forums. They have 655 individuals on the mailing list for this type of communication. The
Board packet includes a 113 -page document summarizing the public's input. Word about
what Whatcom County is doing is getting out around the State and nation. She has made
presentations to others in the State and will make a presentation in Washington D.C. this
fall.
During the process of getting public information, they began to hear about a vision
for health in the county. They heard about the barriers to and issues regarding the vision.
Therefore, they created the vision map for health in Whatcom County. She read the vision
map. They are working to determine what is going on in the community now related to
those vision topics.
Regarding the health promotion topic, a future search conference on the built
environment is scheduled in December. They are developing that conference now.
Regarding the communicable disease, it is the province of the Health Department.
Regarding the health care deliver, they hope the Whatcom Alliance for Healthcare Access
(WAHA) will take a lead on that topic. A discussion is necessary about transferring what
they've learned and how they can support WAHA in that topic area. Regarding the healthy
environment topic, it is the most complex. There isn't one organization that would naturally
address that topic. They could possibly have another future search conference for that
topic, specifically the topic of water.
The first draft of the Comprehensive Health Plan is expected in December 2009.
Fleetwood asked how and what the Board of Health would prioritize. Sloan stated
the Board would prioritize within each quadrant of the CHP Vision Map.
Brenner stated she thanks Ms. Sloan for her work. She read the entire thing. Some
of the things are repeated within the same topic, such as the use of the word "fabulous."
She doesn't know what was asked of people. For instance, they can't end homelessness
completely. The vision has to be realistic. Some of the things won't be possible and are out
of their control, which makes it discouraging. Delahunt stated this is a summary of what
people said. It's not a recommendation from the department. Some of the input was kind
of unrealistic. If they look just at the visioning map, it gives a good, broad idea. The big
document is just a list of what people in the community said. It's useful information.
Board of Health, 7/29/2008, Page 3
Brenner asked if there were any limits on the comments.
Nelson stated there were not.
Crawford stated he has the same concerns, but will trust the process for now. The
Board of Health will have a discerning eye when prioritization occurs to get to the significant
community factors that affect health. For now, take it as what it is, and see what results.
Caskey - Schreiber stated this is just feedback. Don't censor that feedback. It is
information to gauge what the community is thinking and what is important to them. Look
at their suggested solutions to see if the County can facilitate any of those solutions. The
Board and County must let the public know what's already been done or is being done. This
process was a great way to gauge the community.
Nelson stated the community has many different perspectives. It was important that
the community knows the County is listening without judgment. When they go into the
future search process, he is concerned that they don't get so myopic that they narrow the
goals. They won't reach all their goals. However, they can include all the goals to benefit
lobbying efforts and have plans in place to show community commitment. When they get to
the future search process, they will be ready to start implementing some processes.
He asked if the Public Health Advisory Board (PHAB) recommends leaving the topics
in the health promotion section for the entire future search, and not narrow the focus.
Delahunt stated the future search topic connects chronic disease with environment and is
the broad topic. The PHAB realizes that the topic contains all elements of health promotion.
Brenner stated she fears that this kind of a document will result in unrealistic
expectations. By the time the Board gets to it, the expectations are still out there. Sloan
stated that's why they are trying to communicate through the newsletters what is actually
occurring after the input process. They will take quantitative data and attach it to what
people have said to see the reality of the situation.
Delahunt stated that in the end, the responsibility is to develop reasonable goals that
they can obtain and have already obtained.
Brenner stated there are a lot of comments that go far beyond what they, at the
local level, can do. That scares and overwhelms her.
Fleetwood asked whose expectations will be dashed by having lofty goals in the
health care plan.
Brenner stated whoever made these comments in the document has these
expectations. She doesn't know who those people are. This is a public document. When
she sees something in a public document, it implies that is what the County is doing. This
public document doesn't say that this is just a wish list and has nothing to do with reality.
This list will remain on the shelf as a public document. Sloan stated this was presented as a
brainstorming process. The prioritization process was always intended to narrow it down to
define what they can actually impact, who would be willing to work on it, and where they
can find funding.
Delahunt stated the participants understood the process and that things would be
prioritized to something realistic.
Board of Health, 7/29/2008, Page 4
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2 Nelson stated this document encompasses a wide vision from the public, but it's not
3 the final plan for goals and priorities.
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5 Brenner stated she's glad they discussed it.
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7 4. DISEASE SURVEILLANCE & 2010 OLYMPICS
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9 This item was not discussed. It will be discussed at a future meeting.
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11
12 ADJOURN
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14 The meeting adjourned at 12:02 p.m.
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18 Jill Dixon, Minutes Transcription
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20 ``\`,%%Tihe1(Eo14pcil approved these minutes on September 23 , 2008.
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28 % DaN* 'rs, C(Zdncil Clerk
WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Carl Weimer, Council Chair
Board of Health, 7/29/2008, Page 5