HomeMy WebLinkAboutSpecial Health Board Jul 18 2023Whatcom County
Council as the Health Board (Special)
COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360)778-5010
Minutes - Final
Tuesday, July 18, 2023
1PM
Civic Center Building Conference Room / Hybrid Meeting
SPECIAL JOINT HEALTH BOARD/PUBLIC HEALTH ADVISORY BOARD
MEETING - HYBRID MEETING (PARTICIPATE IN -PERSON, SEE REMOTE JOIN
INSTRUCTIONS AT www.whatcomcounty.us/joinvirtualcouncil, OR CALL
360.778.5010)
COUNCILMEMBERS
Barry Buchanan
Tyler Byrd
Todd Donovan
Ben Elenbaas
Carol Frazey
Kaylee Galloway
Kathy Kershner
CLERK OF THE COUNCIL
Dana Brown -Davis, C.M.C.
Council as the Health Board (Special) Minutes - Final July 18, 2023
Call To Order
Health Board Chair Barry Buchanan called the meeting to order at 1:01 p.m.
in a hybrid meeting.
Roll Call
Present: 6 - Barry Buchanan, Tyler Byrd, Todd Donovan, Ben Elenbaas, Carol Frazey, and
Kaylee Galloway
Absent: 1 - Kathy Kershner
Also Present
Announcements
Public Comment
The following members of the Public Health Advisory Board stated they
were present (and were audible on the recording):
• Steve Bennett
• Teri Bryant
• Sterling Chick
• Chris Kobdish
• Emily O'Connor
• Greg Thompson
• Rnhin Phillinc-Marlcnn
• Madison Emry
• Adrienne Renz
Clerk's note: There were other people present who spoke at the meeting
but were unnamed and not part of the roll calls.
The following person spoke:
• Natalie Chavez
Hearing no one else, Buchanan closed the public comment.
Health Officer/Health Director Updates
Greg Thompson, Co -Health Officer, stated his update would be his
presentation for the next agenda item.
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Opioids in Whatcom County
Data Update
Update on Settlement Funds
MAC Group Structure
All Hands Re -cap and Next Steps
System challenges and opportunities
Short Term Plan Recommendations and Resources
The following people presented:
• Greg Thompson, Co -Health Officer
• Erika Lautenbach, Health and Community Services Director
• Joe Fuller, Health and Community Services
• Emily O'Connor, Public Health Advisory Board
Lautenbach introduced the presentation.
Data Update
Thompson gave an update on the opioid crisis and presented on the
Whatcom overdose prevention website, overdose data and trends in
Washington state and Whatcom County, and Naloxone distribution
activities. He and Lautenbach answered how long the overdose prevention
website has been up, how much traffic it is getting-- particularly for
requests for Naloxone, and how to make the request form easier to find.
Lautenbach stated they have just sent the regional Chambers one hundred
kits that they can distribute to businesses that have specifically asked for
Naloxone. It is a combination of individual requests and larger requests
from organizations that are willing to be distribution sites. She stated they
will make sure they have the request form in multiple places and more
obvious.
Update on Settlement Funds
Joe Fuller, Health and Community Services, updated the Councilmembers
on the opioid settlements (on file in the agenda packet). They are looking at
over $1.1 billion in settlement funds coming into the state and he spoke
about the $518 million distributors settlement, which is the first settlement
of what they call "the big three," and the $434 million Pharmacies and
Manufacturers settlement. The distribution amounts for the $518 million
will be over the course of 18 years and the payouts for the $434 million
will be staggered in different time periods. Fifty percent will be a State
share and fifty percent will be a local share. He then presented on opioid
abatement strategies. Just under 100 services can be provided through these
settlement funds and they are divided into three strategies: treatment,
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prevention and other. He spoke about the settlement distribution amounts
on a local level for the first two settlements referenced above. They expect
it to be over $10 million and then there are four additional settlements that
are pending.
Frazey asked who is choosing where the money will go for the opioid
abatement strategies, whether they could start with addressing needs of
pregnant/parenting women and their families (under treatment strategies)
and preventing over -prescribing and ensuring appropriate prescribing and
dispensing of opioids (under prevention strategies), and whether there is a
place you can call if you think someone is over -prescribing.
Fuller spoke about the anticipated process for determining priorities and
money and stated there will be a regional opioid development council for
our five -county region, and local decision -making will be with the local
governments. They should collaborate though with the other counties and
the State.
The group discussed where someone can file complaints against providers
(for over -prescribing), the timeline of distribution and what the ongoing
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can do with this money since the distributions will not be as large as they
seem as they trickle down to counties and cities over a several -year period,
whether the funds are limited to prescribed opioids or whether they can also
be used for opioids in general and the Fentanyl issue that is in front of them
now, and whether it is still true that alcohol and marijuana are entry drugs.
Lautenbach stated, to answer an earlier question, she heard back from
communications staff that they have received 23 requests for Naloxone
from both groups and individuals since the website went live.
Fuller shared a slide that showed that people who are addicted to alcohol,
marijuana, cocaine, or prescription opioid painkillers are progressively
more likely to be addicted to heroin. The primary drug of admission for
youth is marijuana and for adults it is still alcohol.
Thompson stated we have had about 107,000 to 110,000 opioid deaths in
the last couple of years, and the estimate is that alcohol contributes to about
140,000 deaths per year. They are tightly interrelated and it is all impactful.
Multi -Agency Coordination (MAC) Group Structure
Lautenbach spoke about letters (on file in the agenda packet) between the
County Executive, City of Bellingham Mayor, and Health and Community
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Services regarding a request to convene a multi -agency coordination
(MAC) group. The group would have the following goals:
• Goal 1 - Prevent opioid and other drug misuse
• Goal 2 - Identify and treat opioid misuse and stimulant use disorder
• Goal 3 - Ensure and improve the health and wellness of people who
use opioids and other drugs
• Goal 4 - Use data and information to detect opioid misuse, monitor
drug user health effects, analyze population health, and evaluate
interventions
• Goal 5 - Support individuals in recovery
She stated there are a lot of good systems they can work with. They are
thinking of engaging with partners on what prevention activities might look
like. They will be coming back with some requests and more information
about funding for schools to do behavioral health and other supportive work.
She spoke about thinking about how our providers and systems work
together (or do not work together) to either create barriers for transitions
and the continuum of care for people who have opioid misuse disorder, or
contribute to the warm handoffs that help their success. They also want to
think about transitions between systems (Emergency Department, jail, etc.)
since that is the point they see the highest risk of overdose. They are first
convening the MAC group next month and will meet monthly and they
would love to have a Health Board member as a participant of that group and
as a representative of this legislative body.
All Hands Summit Re -cap and Next Steps
Emily O'Connor, read from a summary of the summit (on file in the agenda
packet).
The group discussed use of drugs among teens and helping them survive if
they make a mistake, getting resources and Naloxone to parents and
schools, feedback on attending the summit and leaving inspired and
motivated to take action, and the fact that Whatcom County accounted for a
quarter of the attendees of the summit across the state.
Amy Harley, Co -Health Officer, spoke about the need (coming from the
perspective of a health provider and a systems member) for coordination of
our systems of care. She stated it rings true in her clinical work as well. She
gave examples of working with five of twelve newborns this weekend that
had poly substance exposure. She stated individual providers and agencies
are not prepared to care for the complexity of medical, psychosocial, and
behavioral problems that are existing or coming their way without more
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coordination, wrap -around services, cross -agency work, and
multi -disciplinary teams.
System Challenges and Opportunities
Lautenbach stated they have already been talking about system challenges so
she went to the next topic.
Short Term Plan Recommendations and Resources
Lautenbach reported on the following:
• They are participating in an adult community survey to get broad
community participation and get a better understanding of what
people's needs and challenges are in our community. They will send
that survey out to Councilmembers as well.
• They are starting to think about their legislative agenda for next year
and would like to make sure they are all partnering and thinking about
how we can leverage State dollars to do some of this work.
• They have been receiving additional funding from Foundational
Public Health Services for the last few years, and this year (which
started July 1) included funding for a specific opioid misuse and
prevention position.
• It would be great to have a conversation about the MAC
representation.
• At the August 1 regular Health Board meeting they will talk about the
Behavioral Health Fund reserves and present some options for the
Health Board to consider with regard to both our justice related
priorities from the implementation plan, but also a focus on
prevention activities and behavioral health workforce support.
Discussion about what seems most important for the group to think about
and pursue
Donovan suggested they find out how the MAC group is working in
Snohomish County and asked how they would be involved in decisions about
using the settlement funds.
Frazey spoke about coordinated care for people coming out of the jail and
stated that would be a place (when people are in that transitional space) they
could intervene and she would love to hear what is currently happening.
Lacey McCarley, Health and Community Services, spoke but was not in
range to be audible.
Malora Christensen, Health and Community Services, stated re-entry
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support is a big priority and the Health Department contracts with Lifeline
Connections for both behavioral health services in the jail and re-entry
services. They have expanded that contract for an additional three staff and
there is also a planning group that meets every two weeks and works on the
re-entry system. They prioritize people that they know are going to be
discharged within 30 days but they do not have a lot of information from the
court until it happens, so they often scramble quickly to give the person
resources.
Frazey asked whether they are coordinating anything even for someone just
spending a night in jail for DUI and Christensen stated the re-entry team
prioritizes people who are most vulnerable and have behavioral health
challenges, but she will check in to see what is being done for all people
leaving the jail.
Lautenbach stated the Council approved funding for them to hire a
behavioral health aide which is someone that will be able to drive people
from the jail to places like the triage center, to services, a family member's
home, or a pharmacy.
Buchanan asked and the group discussed how robust that position will be
and whether it is just a one-time thing for a person that is getting out of jail
or whether it continues if that person needs other transportation.
O'Connor spoke about the community health dashboard and data overlays
and asked whether there is data to show who is exiting which institutions
and what the correlations of risk factors are that they have. It is one thing to
have re-entry case management staff, but if they do not actually have
services to offer them, such as housing, then it makes that much less
effective and impactful. We have to identify what the deficits are so we can
prioritize them.
Christensen spoke about data work that is currently happening.
Thompson thanked them for bringing up the issues of transitions and jail
re-entry and stated current and future data is challenging, but our past data
really shows how important that is. Putting that treatment piece and the
re-entry services in incarceration situations can reduce the drug overdose
death rate by 85 percent.
Lautenbach stated Mike Hilley, Emergency Medical Services (EMS)
Manager, is also trying to think about these systems when EMS is
responding to an overdose episode.
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Other Business
Adjournment
Bennett stated one thing to think about is trying to understand these funds
and how much they are actually going to be. He wants to make sure they do
not jump ahead of the State and put local money where the State will be
putting funding for the same thing. It means we have to wait on some of the
larger system things, but we can still identity some things in Whatcom
County that a lot of this State funding will likely not be directly impacting,
such as transitions. We should try to think about short-term interventions
that we could do over the next few months while we are waiting for the State
to clarify their plan for how they intend to use the money.
Galloway spoke about the importance of developing a coordinated State
legislative agenda.
Lautenbach stated that the Administration has requested that they add the
legislative agenda to the Public Health Advisory Board (PHAB) agenda in
September and Frazey asked if it should be added to the Health Board
meeting in August.
The group discussed getting Council direction to the PHAB, when they need
tv lake aitivih vi'h appointing a CoiiihV ii repro cIlLaLiva LV the hvjAC, and who
is determining the composition of that group.
Lautenbach gave final thoughts.
There was no other business.
The meeting adjourned at 2:20 p.m.
The County Council approved these minutes on August 8, 2023.
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Kristi Felbinger, Minutes Transcription
WHATCOM COUNTY COUNCIL
WHATCOM COUWY. WAS
Health Board Chair
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