HomeMy WebLinkAboutBoard of Health June 7 2007WHATCOM COUNTY COUNCIL
Board of Health
June 7, 2007
Council Chair Carl Weimer called the meeting to order at 5:43 p.m. in the Council
Chambers, 311 Grand Avenue, Bellingham, Washington.
Present:
Dan McShane
Sam Crawford
Seth Fleetwood
Laurie Caskey- Schreiber
Public Health Advisory Board Present:
Lavern Lane - Oreiro
Doug Benjamin
David Davidson
Jenny Shuler
Chris Phillips
1. PUBLIC SESSION
No one spoke.
Absent:
L, Ward Nelson
Barbara Brenner
Absent:
L. Ward Nelson
Mary Ellen Shields_
John Worlund
2. WHATCOM COUNTY COMPREHENSIVE HEALTH PLAN
Regina Delahunt, Health Department Director, stated the Board of Health charged
the Public Health Advisory Board (PHAB) to come up with a plan for how to put together a
Comprehensive Public Health Plan. The PHAB spent a lot of time working on this task.
Susan Sloan, Health Department, stated she would give the Board an overview of
the guidance document and go through the decision points. She read through sections of
the plan. They estimate that the Board of Health subcommittee would meet through
December 2010.
Fleetwood stated it's interesting that they used the Land Use Chapter of the
Comprehensive Plan as an example to model this after. Policies and goals are great things.
It's wonderful having a Comprehensive Plan to express the community's vision. However,
as they've all observed, the Comprehensive Plan, especially the Land Use Chapter, is an
enormous, ambiguous political compromise. Trying to understand what it really means is
difficult. He hopes that this plan doesn't become that plan.
McShane stated the Land Use Chapter is a good model with action plans. The
Council has been frustrated that those action items haven't been implemented. The County
Council has been holding the administration accountable for not bringing those items
forward. Make sure any action items can be implemented. Sloan stated the plan includes
an evaluation and review process to revisit the action items, to provide accountability.
Board of Health, 6/7/2007, Page 1
1 Delahunt stated they used the Comprehensive Plan outline because it's a good
2 outline, The issue is making sure they follow up on the action plans. If the community has
3 a problem following up on the actions, then the Board of Health needs to know why.
4
5 Sloan stated the health assessment piece will help them reassess the action items
6 and other data. She continued to read through the plan.
7
8 Weimer asked who would draft the plan. Sloan stated she would create a draft.
9
10 Delahunt stated it's a community plan. The Health Department is taking the lead to
11 make sure it all comes together. However, they hope other partners will also step forward
12 to take on certain pieces of it.
13
14 Sloan continued to read through the plan beginning with issue development tasks.
15
16 Caskey - Schreiber stated she applauds the staff and PHAB for taking on this
17 development process.
18
19 Phillips stated County Councilmember and Advisory Board Member Nelson was a
20 major factor in providing the leadership to put this forward.
21
22 Weimer asked if there was impetus from the State to put this plan together.
23 Delahunt stated it started in Whatcom County. There are no other models for something
24 like this. The State may be very interested that the County is doing this.
25
26 Sloan read through the discussion form for this item. She read the first .action item
27 regarding governance.
28
29 McShane moved to approve the governance item.
30
31 Weimer asked' how many councilmembers would be on the subcommittee. Sloan
32 stated that has yet to be decided.
33
34 Crawford asked what governance means in this process. Sloan stated it's about final
35 decision making, authority in terms of the final plan, assurance that each stage is completed
36 and brought before the subcommittee.
37
38 Delahunt stated there will be a lot of public input and ideas that will have to be
39 prioritized. Someone will have to do that prioritization. The same will be true with the
40 goals and an action plan. They need a body that makes the final decision for moving
41 forward.
42
43 Davidson stated the PHAB discussed another idea, which was that the PHAB would
44 lead this effort, more than what is shown. However, he advocated involving the Board of
45 Health much more. If the Board doesn't form that kind of subcommittee and stay on top of
46 incremental decisions, the plan runs the risk of not being approved. To be adopted, it needs
47 to have Board of Health approval throughout the process.
48
49 Crawford asked if the plan ultimately comes before the Board of Health for approval.
50 Sloan stated that is correct.
51
52 Caskey- Schreiber stated she agrees with Mr. Davidson. It helps to have Board of
53 Health members be involved in the process. They are setting up a healthy governance
54 process.
Board of Health, 6/7/2007, Page 2
Crawford moved to amend the motion, that there be three councilmembers and
three Advisory Board members on the subcommittee.
McShane stated he accepts the motion as a friendly amendment. It should be
set up as a standing committee of the Council, just like the Council's other four standing
committees. Every year, during Council re- structuring in January, councilmembers would
be appointed to the committee.
Davidson stated that was his vision for this committee. However, there are no other
Council subcommittees that have citizen members. It is difficult to get the PHAB to meet.
The idea of everyone meeting regularly every other Tuesday would be difficult. However,
that is what needs to happen. This amendment ought not to have three permanent PHAB
members.
Caskey- Schreiber asked if the Health Department would work out most of the details
in the PHAB.
Davidson stated that in his opinion, it would not. Most of the work would happen in
the subcommittee.
Phillips stated another view was that this gives the PHAB a real function and would
establish a positive relationship with the Board of Health. Decouple the exact governance
details from overall structure.
Crawford withdrew his friendly amendment.
Motion carried unanimously.
Caskey - Schreiber stated she envisions the PHAB and staff do a lot of the detailed
work. They are the experts. She doesn't have the background or knowledge of some of the
main health issues and concerns.
Weimer stated that in terms of the Land Use model, the Council doesn't draft those
subarea plans. They aren't the people doing the work to figure out things like the
population base.
Delahunt stated she envisions that members of the PHAB would attend community
forums when they work on different topics and scoping. Each member of the PHAB may
pick one topic in which they are most interested. Staff would do the drafting, writing, and
facilitation. The PHAB would be involved as an advisory group to the Board of Health. If
they create a subcommittee of the Board of Health, the PHAB can report back in an advisory
capacity.
McShane stated create a standing subcommittee of the Board of Health to
institutionalize this part of the Council job.
Fleetwood asked if there is enough work to justify a regular meeting of a standing
committee of councilmembers. Delahunt stated the committee would work on this plan for
three to four years. She doesn't know about the workload after that. It can be reevaluated
in the future.
McShane stated the Council may need to reevaluate the workloads of each standing
committee on an annual basis.
Board of Health, 6/7/2007, Page 3
Delahunt stated the committee doesn't necessarily have to meet every two weeks.
Sloan stated they built a five -year review process into the plan.
Weimer stated he supports Councilmember McShane's idea. Public Health is a
priority, but there is no committee to talk about it.
Delahunt stated a lot of the Board of Health meetings are difficult because the Board
of Health doesn't have a subcommittee. They don't have sufficient time to have enough
Board of Health members who are familiar enough with the issues.
Crawford stated Council needs change every few years. He moved to form a
subcommittee to work on this process, which has a beginning and an end, made up of three
Board of Health members and three PHAB members. It would not be a permanent Council
subcommittee. If it needs to transition into a permanent subcommittee, it can. If they are
serious about forming a subcommittee of the Council, look at a particular year as an end
date. A subcommittee for this task is appropriate.
Fleetwood stated he will support the motion.
Caskey- Schreiber stated she approves of a subcommittee that would meet for one
year and then be reevaluated.
McShane restated Councilmember Crawford's motion to create a standing
subcommittee of the Board of Health plus three members of the PHAB, until completion of
the plan. His only concern is how to select the three councilmembers.
Lane - Oreiro stated she's not sure it's realistic to have three members of the Board of
Health and three members of the PHAB because of time constraints. Two from each body
will be much more realistic.
Crawford accepted the suggestion as a friendly amendment. The motion is
amended to have two members from the Board of Health and two members of the PHAB on
the subcommittee.
McShane stated they need three Board of Health members. The PHAB members are
volunteers. The PHAB is going to continue to do other things. Set up the Board's own
standing committee for this project.
(Clerk's Note: End of tape one, side A.)
McShane stated act as a standing committee that comes to the full Board of Health
on a routine basis, which can happen at any Council meeting, to address issues that come
up. They are going to review plans crafted by staff, with input of the PHAB at times that
work best for them.
Crawford withdrew his motion. He moved to appoint three councilmembers as a
subcommittee of the Board of Health. That subcommittee will interact with the Advisory
Board. The committee can decide if it wants to formalize the relationship with certain
members.
Fleetwood asked if other councilmembers can attend.
Board of Health, 6/7/2007, Page 4
1 Crawford stated they can.
2
3 Davidson stated he agrees with the motion.
4
5 Phillips stated it also allows them to build a relationship between the subcommittee
6 and Advisory Board.
7
8 Crawford stated the Board of Health will need to elect those members at a future
9 Board of Health meeting.
10
11 Motion carried unanimously.
12
13 Sloan read through the discussion form on the four scope topics. She asked if any
14 other topics are needed to organize the plan, or if these four topics are comprehensive
15 enough.
16
17 Crawford asked if they are voting on the descriptions of the type of issues, listed on
18 pages two through four in its entirety, or just the definitions. Sloan stated they are only
19 voting on the four topics to organize the process. They can refine the definitions and four
20 lists of bullet points.
21
22 Crawford stated he suggests amendments.
23 • On page two, "2. Healthy Environment: Assuring environmental —and
24 building and community infrastructure designs that encourages healthy
25 lifestyles.°
26 • On page three, the top bullet point, "Recognition that the btA
27 infrastructure of
28 the communities is an essential eempenent On may contribute to the
29 creation and sustainment of healthy communities and healthy
30 environments; and"
31
32 The example on page 15 would upset many people in the community in terms of its
33 implications. Keep this at the bigger picture level now. Have an encompassing document.
34 He asked if he is voting just on the four scopes and their definitions, without the topics. As
35 this stuff is processed, they can discuss those definitions in the future. Sloan stated that is
36 the intent. A lot of definitions can go with these terms. They can definitely be refined. The
37 main question is whether these four topics are comprehensive enough for the health plan.
38
39 Crawford moved to approve all four items, with specific definitions subject to
40 continued refinement.
41
42 Fleetwood asked if there were any other topics discussed.
43
44 Phillips stated these four items captured the PHAB discussion.
45
46 Caskey- Schreiber asked about Councilmember Crawford's hesitancy about the
47 definition. The definitions are more esoteric than literal.
48
49 Crawford stated his motion is just to continue to finesse the definitions as they get
50 public input.
51
52 Weimer asked where the mental health issues fit into these four topics.
53
54 Benjamin stated it has to do with access.
Board of Health, 6/7/2007, Page 5
1
2 Phillips stated it is the second -to -last bullet the fourth topic regarding health care
3 access and delivery. It has to do with behavioral health being a part of the healthcare
4 delivery system.
5
6 Motion carried unanimously.
7
8 Sloan stated the next action item is implementation. The PHAB has two proposals.
9 She read the two proposals from the discussion form.
10
11 Weimer asked if public outreach would include prioritization. Sloan stated they will
12 ask for input and flush out the broad list of issues, and then construct a survey that is then
13 sent to households where those issues are prioritized on a larger scale.
14
15 Weimer asked if the PHAB discussed other scenarios.
16
17 Davidson stated they discussed seeing one topic through to completion to prove to
18 the community that this can be done. However, they realized the four areas are related, so
19 they decided to deal with all.
20
21 Caskey - Schreiber moved to approve implementation as proposed.
22
23 Motion carried unanimously.
24
25 Crawford stated he hears about health care access and delivery more than anything,
26 and seems to be the topic they should start with. It`s the biggest problem.
27
28 Davidson stated the PHAB thought that the existence of Whatcom Alliance for
29 Healthcare Access (WAHA) and its progress made it seem like access can happen. The
30 PHAB believes. that disease prevention is primarily staff driven. Regarding health
31 promotion, there is a belief that activities to change lifestyles are crucially important.
32 Regarding healthy environment, the Planning Department could be involved but it has a
33 staffing problem at the moment. Those are some factors the PHAB considered.
34
35 Caskey- Schreiber stated the safest and easiest route may be the best, which is
36 health care access and delivery. Health promotion is a big issue that will be daunting.
37 Many people will have many different ideas.
38
39 Delahunt stated the PHAB said it's difficult to decide. One option is to see which
40 issues rise to the top and how they are prioritized. That could better - inform what issue they
41 begin with. They may not have to decide this now.
42
43 McShane moved to defer that discussion to the subcommittee when it is formed.
44
45 Motion carried unanimously.
46
47 Davidson stated he asks the Board to keep in mind how large plans are built. It's a
48 large issue that takes a lot of staff work and effort.
49
50 Caskey - Schreiber stated the Board will rely on the PHAB to work with staff to
51 develop the bulk of the document. The time factor is huge.
52
Board of Health, 6/7/2007, Page 6
1 Delahunt stated there is a .5 full -time equivalent (FTE) employee working on this
2 item. It will take time. If all they can devote to this is .5 FTE and some facilitation, it will
3 take some time.
4
5 McShane stated having a subcommittee of the Health Board will keep the Board
6 honest. Health issues are often an after- thought. He's excited about having a standing
7 committee.
8
9 Phillips stated the metaphor of the Comprehensive Plan's Land Use Chapter has
10 brought them a long way, but they don't have to be attached to it as a limiting factor. They
11 could engage the community in creative, different ways that they wouldn't in the Land Use
12 context, which would save resources and lead to a more meaningful and community -
13 engaged plan.
14
15 Crawford stated he is concerned that this must become a living, changing, adaptable
16 document rather than shelf art. This is really important. The Comprehensive Plan is
17 required by law. This is a guidance document, and is not law. It will only be a policy
18 document. Be attentive to that.
19
20 Weimer stated that even though it is a policy document, it will allow them to
21 prioritize things so they know how to spend the limited resources.
22
23 McShane stated there is one chapter in the Comprehensive Plan that is not required.
24 Much of what is in the Comprehensive Plan was done from citizen input, through
25 subcommittees and Council, that is not required by law. This is an opportunity to expand
26 beyond what is required.
27
28 Crawford stated that if the Council makes a decision in conflict with the
29 Comprehensive Plan, it has the burden of appeal. If the council approves this document,
30 and then makes a health decision in conflict with the document, there is no burden of legal
31 appeal. He is not trying to be pessimistic.
32
33
34 ADJOURN
35
36 The meeting adjourned at 7:00 p.m.
37
38 _
39
40 ]ill Nixon, Minutes Transcription
41
42 The Council approved these minutes on June 19 , 2007.
43
44 ATTEST: WHATCOM COUNTY COUNCIL
45 WHATCOM COUNTY, WASHINGTON
46
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49
50 Dana ,awn -DW ou c h{C1Txk Carl Weimer, Council Chair
SUM
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Board of Health, 6/7/2007, Page 7