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HomeMy WebLinkAboutPacket Health Board Jan 29 2024Whatcom County Council as the Health Board COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360) 778-5010 Meeting Agenda Monday, January 29, 2024 10 AM Civic Center Building Conference Room / Hybrid Meeting 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 Kaylee Galloway Jon Scanlon Mark Stremler CLERK OF THE COUNCIL Dana Brown -Davis, C.M.C. Council as the Health Board Meeting Agenda January 29, 2024 Call To Order Roll Call Roll call of PHAB members Announcements Individuals who require special assistance to participate in the Council's meetings are asked to contact the Council Office at 360.778.5010 at least 96 hours in advance. This committee meeting is also noticed as a meeting of the Whatcom County Council, with the agenda limited to committee business. Meeting Materials AB2024-008 Meeting Materials for Health Board January 29, 2024 Public comment Health Officer/Health Director update Public Health Framework and Local Practice Alignment PHAB Role, Subgroups, Plan for Year Work Plan and HB/PHAB Coordination for 2024 Other Business Adiournment Whatcom County Page 2 Printed on 411812025 • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-008 File ID: AB2024-008 Version: 1 Status: Received File Created: 12/12/2023 Entered by: KFelbing@co.whatcom.wa.us Department: Council Office File Type: Receipt of Document(s) Assigned to: Council as the Health Board Final Action: 01/29/2024 Agenda Date: 01/29/2024 Enactment #: Primary Contact Email: kfelbing@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Meeting Materials for Health Board January 29, 2024 SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: None HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 01/29/2024 Council as the Health Board RECEIVED Attachments: Agenda and Packet for 1.29.2023 Meeting Whatcom County Page 1 Printed on 411812025 WHATCOM COUNTY COUNCIL COUNCIL MEETING AS THE HEALTH BOARD JOINT MEETING WITH THE PUBLIC HEALTH ADVISORY BOARD 10:00 a.m. Monday, January 29, 2024 Garden Level Conference Room, Civic Building, 322 N. Commercial Street (if virtual: www.whatcomcounty.us/joinvirtualcouncil) AGENDA 1. Roll call of Health Board members. Roll call of PHAB members. No paper 10:00-10:05 2. Public comment No paper 10:05-10:15 3. Health Officer/Health Director update (pages 2-8) 10:15-10:25 4. Public Health Framework and Local Practice Alignment (pages 9-18) 10:25-10:45 5. PHAB Role, Subgroups, Plan for Year (pages 19-end) 10:45 —11:05 6. Work Plan and HB/PHAB Coordination for 2024 No paper 11:05-12:00 Pt WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer Bi-Monthly Report January, 2024 Whatcom County Health and Community Services — Equity — Collaboration — Compassion — Transparency — Innovation - Service Leadership, provided by Health Director Erika Lautenbach and Health Officers Dr. Amy Harley and Dr. Greg Thompson: Health Director The department continues to be focused on our strategic plan priorities: community partnerships and engagement, organizational infrastructure, workforce development, and quality management. There are examples of these priorities in action in the following pages, but I'll share two timely updates. Within the workforce development priority: HCS received two $200,000 grants for training, skill development, workforce stabilization, and other activities. We look forward to using these dollars for learning management software, training and conference opportunities for staff, and training development for both staff and community partners. I convened a Funder's Roundtable group last year, which includes public and private philanthropy as well as government funders. Collectively, we want to address workforce shortages in housing, behavioral health, and human services fields, and are developing plans to support existing staff while also bolstering recruitment, strengthening relationships with K-12 and higher ed, and supporting non-profit leaders. Within the organizational infrastructure priority: After several years of regular recruitments for new positions, we are nearly fully staffed. There are few new positions including an Environmental Health Supervisor, a Policy Analyst, and a Healthy Children's Fund specialist yet to recruit in the first quarter of the year. Work continues with the Executive's office to ensure that the organization is prepared for additional growth associated with housing and homelessness, opioids and fentanyl, and behavioral health programs, facilities and staffing associated with the public health and safety ballot measure. Health Officers One of our main roles continues to be providing consultation around exposures or outbreaks of infectious conditions of public health significance and we are always happy to be a resource to WCHCS staff and community providers in this regard. This time of year, a lot of energy goes into maintaining situational awareness of respiratory illnesses in our community. In the fall of 2023, we joined other organizations in our region in an approach of closely monitoring percentages of Emergency Department visits due to COVID-19, Influenza or RSV and defining thresholds indicating high transmission. To ensure easy access to this indicator of disease transmission for our community, the Health Information Assessment and the Communications teams revamped the Respiratory Virus Data Dashboard. Excitingly, this year brought new tools to fight RSV in the form of a vaccine for older adults and pregnant women and a preventive antibody for newborns, so it's hopeful that there will be less burden of disease due to RSV in coming years. Another major body of work for us is contributing to the opioid crisis response by participating in the county MAC Group and through collaborations with community partners, healthcare providers, tribal partners, schools, other health officers, and the Washington State Department of Health. The data on the impact of opioids in our county are tough and provide ample motivation for our continued efforts to work alongside WHATCOM COUNTY HEALTH AND 509 Girard Street • �� COMMUNITY Main Line: (360) 778-6000 Bellingham, WA 98225-4005 SERVICES www.whatcomcounty.us/health Page 2 of 26 our internal and external colleagues in eliminating obstacles and applying solutions to all aspects of this complex issue. Our county's focus on increasing supports for families with young children and focus on youth mental health are important parts of upstream prevention and we're also particularly excited to hear the unique perspective of our county's youth at the All Hands Next Gen Summit in June. Administration: The department's Financial Services Manager Kathleen Roy's last day with the department was November 27, 2023. A recruitment for a replacement is underway and after a multi -step process, we hope to have a new manager by mid to late February. Communicable Disease and Epidemiology (CDE), provided by CDE Manager Shamika Brooks In 2023, the CD&E division completed nearly 300 scheduled clinical visits tallied across multiple programs at the Girard location. To maintain our current clinical service offerings, the CDE team will utilize the Division Street location (half of the old triage facility next to the work center) for an additional clinic site. The additional space will allow us to accommodate larger families, increase storage capacity, give us access to additional exam rooms, and increase the availability of space for outreach events. Immunization program The team completed the Immunizations Community Health Assessment in the summer of 2023. The health assessment identified that the most common barrier to accessing immunizations is provider office availability. The Immunizations program has been instrumental in partnering with local school districts over the summer to reduce barriers to access to vaccinations for students by hosting clinics at school locations. In 2023, 134 vaccine outreach events were held serving over 500 clients and more than 1,000 vaccines were administered. Tuberculosis (TB)The Public Health Nurses in the TB program have provided services for approximately 138 clients in 2023 which includes clients with Latent TB. This team was essential in collaborating with the Washington State Department of Health to ensure that refugees (largely the Ukrainian population) received adequate assessment and follow-up for TB surveillance. The Public Health Nurses provided case management and treatment for 5 active cases of TB, including a case of Multidrug-Resistant Tuberculosis (MDR TB) which required extensive monitoring. Syringe Services/Harm Reduction program Staff and volunteers provided over 5,000 kits of Narcan to the community in 2023. In addition, we have provided approximately 125 SSP/harm reduction clinics and training for community partners. In 2024, we are piloting a program with the Response Systems Division (RSD) in which SSP/harm reduction nurses will accompany the ARNP from RSD and her team weekly to round and offer harm reduction services. Due to the unique challenges of the clients we serve, the SSP/harm reduction nurses are being trained in wound care to assist clients with wound care needs. We find that our clients have high barriers to accessing care and are often lost to follow up with community partners. In addition, we are adding drug checking services for clients to allow individuals to learn the composition of their substances to reduce the risk of unintended overdoses. Communicable Disease (0) The team continues to work on response time and case completeness. As COVID-19 work stands down, the CD team can focus more on other projects and tasks. The Infection Prevention team continues to work with healthcare congregate settings with communicable disease Page 3 of 26 surveillance and infection control. The current focus is utilizing SHARP/Strike grant funding to support respiratory protection programs with fit testing services. Sexual Health While Chlamydia and Gonorrhea trended down for 2023, there has been an increase in syphilis cases, and more than any previous year on par with national rates. Public Health Nurses continue to test clients and offer treatment to clients with barriers to access to treatment in the community. In 2023, the WCHCS staff conducted 62 Hepatitis C, 131 HIV, and 88 Syphilis point of care tests. In addition, they conducted 19 Syphilis confirmatory tests and 100 Chlamydia/Gonorrhea tests. Many of our clients are unhoused, suffer from substance abuse, and are uninsured or underinsured. Public Health Nurses work with local and state partners to reach unhoused clients and those lost to care. Community and Organizational Development (COD), provided by COD Manager Dr. Lynnette Bennett: The Community and Organizational Development division facilitates collaboration across the divisions and provides accurate, meaningful, and timely information, data, and assessment to the community and our partners. We provide centralized services for informatics and data applications, assessment, epidemiology, performance management, evaluation, graphic design, communications strategy, media relations, website management, equity work, hiring and onboarding, and professional development. Health Information & Assessment Staff, along with CDE, developed the new Respiratory Virus Data Dashboards to provide accurate and relevant data for COVID-19, Influenza, and RSV rates in one location. These dashboards are publicly available and include transmission monitoring, emergency department visits, testing, and long-term care outbreaks for the North Sound region (Whatcom, Skagit, Snohomish, Island, and San Juan counties). Workforce Development Staff have redesigned the onboarding process for new hires. We are also revising and updating our annual HIPAA training, in addition to a new WCHCS HIPAA Guidebook in February. Partnerships & Strategy The team is growing to expand foundational capabilities and services with the addition of a new Equity Specialist, a second Emergency Preparedness and Resiliency position, and a new Policy Analyst. Existing staff in Communications and Emergency Preparedness have been providing support and expertise to the Multi -Agency Coordination group for Opioid Response as well as the Severe Winter Shelter. Community Health & Human Services (CH&HS), Provided by CH&HS Manager Ann Beck: Homeless Housing Program Whatcom County's severe weather shelter opened in late December and provided back up when Road2Home's seasonal shelter lost power on Christmas Eve. The severe weather shelter was also open for nine continuous nights and five days in mid -January, averaging 55 people per night. In addition to the severe weather shelter, HCS staff provided staffing and support to the City's drop -in center operations. Thanks to the preparation for the severe weather shelter, we currently have a total of 48 trained individuals ready to support operations. There are 14 full time county staff, 11 temporary staff and 23 volunteers ready to jump in for the January openings. We anticipate another 6 individuals finishing their training by the end of the month. Page 4 of 26 Community Health Programs Food and health care access both contribute to stronger communities, and there are projects in the works focused on access in East Whatcom County. Thanks to County Council approval of ARPA funding in late 2023, we're able to remodel the kitchen at the East Whatcom Regional Resource Center. With the planned updates there is potential for this kitchen to provide more food access and options to east county residents. HCS staff are helping to facilitate the planning and preparation for a school -based health center at the Mt. Baker School District. With a grant from WA State DOH securing initial project funding and a provider willing to offer services, this project could be operational in some form by the end of the year. Special Projects Our Small Capital Projects (RFP) closes on January 9th. Using ARPA funds and funds from both HB 1590 and 1406, HCS has $2.6M in available funds to support acquisition, rehabilitation, and construction of affordable housing. In the future, we plan to release a similar RFP each October. HCS staff continues to work with the Executive's Office and Facilities to plan a new 23-hour Crisis facility using funds allocated by the state legislature. Developmental Disabilities The first round of RFPs closed in mid -January, which is designed to solicit projects that would increase inclusion opportunities in the community for those with developmental disabilities. The applications will be reviewed in the coming weeks. The Single -Entry Access to Services (SEAS) program has expanded through support of both DID and Community Health staff, to include services such as perinatal mental health services and home visiting. Children and Families Staff are in the process of writing requests for proposals (RFPs) from the community to advance the Healthy Children's Fund goals of supporting early learning and care, and supporting vulnerable children and their families. We anticipate the first RFP to focus on preventing homelessness will be posted in early February. Prevention Programs In 2023, we added staff, using state funding, to our Youth Cannabis and Tobacco Prevention program, and have expanded to a regional level. Our staff have also been actively involved in the Opioid response in helping to coordinate many of the collaborative conversations happening in the community, including the All Hands Event in 2023. We contracted with all seven school districts with BH funds to support student mental health and wellbeing and will be releasing an RFP soon for telehealth services to further expand those services. Veterans Our team of (as of 2023) two veteran specialists helped indigent veterans receive about $100,000 in financial assistance in 2023, which kept many veterans current on rent and utilities, and able to meet the needs of their families. We have also built a partnership with Lummi Nation by signing an MOU to make sure clear paths of access are available for Lummi veterans to meet with staff. Our two veteran specialists also filed just over 1000 claims to the VA on behalf of Whatcom County veterans. Nurse Family Partnership (NFP) In 2023, NFP served 89 families and welcomed the birth of 25 babies. The team completed 750 home visits and 250 telehealth visits, providing support to these first-time parents during this major life change. The NFP team is also looking forward to another year of successful partnership with Lydia Place and the Bellingham Public Library to offer season family activities to build community connection amongst families. Page 5 of 26 Environmental Health (EH), provided by EH Manager Sue Sullivan: Environmental Health (EH) is conducting a Climate Vulnerability Assessment focusing on the public health impacts of wildfire smoke and extreme heat on vulnerable populations. The assessment report and Story Map will be finalized by then end of June. Drinking Water We continue to receive notifications regarding State DOH's monitoring of lead in drinking water in our County's schools. Thus far, only the Bellingham School District has been tested. While there are some sources that are testing above action or remediation levels, most sources are below these levels. The school district is provided guidance on proper communication to communities, action plan requirements and sources of remediation funding. In 2023, our drinking water specialist supported access to drinking water through approximately 88 well inspections, 74 well seals observed, and completion of 13 sanitary surveys of public water systems serving 742 water connections. These activities support at least 830 individual water connections and subsequent community members. The team also provided technical assistance to the Whatcom County Parks and Recreation for their Plantation Rifle Range project. Looking ahead to 2024, we will continue to provide technical expertise to Parks and Recreation for their Plantation Rifle Range project and support DOH in sanitary surveys and well seals. It is also anticipated that our team will receive training related to the upcoming Department of Ecology's adjudication process, forecasting misdirected phone calls to our drinking water team. Onsite Sewage In 2023, the onsite sewage program increased access to sewage disposal for over 300 properties and supported continued access to adequate sewage disposal by tracking over 29,000 onsite sewage systems. In addition, homeowners of 874 residences received training to maintain their onsite sewage system and to contribute to a thriving Whatcom County. Beyond access to sewage sanitation, the Onsite Sewage Team responded to over 300 new community concerns related to improper sewage disposal. The team created and formalized an onboarding process for newly licensed operations and maintenance specialists, installers, and pumpers in Whatcom County; they developed a new online homeowner training program; and they created an internal continuing education tracking tool for licensed operators. This team has also supported the Pollution Identification and Control team in addressing surface water quality concerns. Looking ahead to 2024, we aim to complete program evaluation impacts for newly implemented processes. Currently, 180 licenses have been issued for operation and maintenance specialists, installers, and pumpers to continue supporting onsite sewage and sanitation work in Whatcom County. Our team is also looking forward to Washington state sewage code changes and aim to prepare internally for these changes prior to state adoption. To support transparency of our program, we are solidifying and developing our sewage spill notification process across the county and aim to define our role with partner agencies. Planning and Development Our EH planning and development specialist has interfaced with Whatcom County Planning and Development to ensure health measures are met for diverse projects. Our EH Page 6 of 26 planning and development specialist increased access to safe housing through the review of permits and land development issues. Looking ahead to 2024, complex projects continue to be pursued that will impact a variety of sectors including available housing, child care, hospitality, restaurants, community hubs, tourism, and industry such as recycling. Food and Living Environment The Living Environment program has applied for an additional $50,000 grant from the WA Dept of Ecology. The intention is to continue data collection and begin developing a Cyanobacteria management Plan. Our Wiser Lake data collection work continues and is expected to wrap up in April. We received state grants to assess the harmful algal blooms on the lake to determine what steps could be taken to address. Rabies exposure assessment work has been busier than usual — an average of two assessments per week in November and December 2023 compared to 0-1 per month in previous years. We aren't clear on why this has been the case but will continue to monitor to identify trends. Our food Safety team collaborated with a local organization called Northwest Fruit Rescue to support production of 280 pounds of applesauce for donation to local food banks. Solid Waste In 2023, the Solid Waste group responded to over 80 solid waste and/or illegal drug contamination complaints, and successfully permitted two new solid waste handling facilities. We hired a Public Health Educator to support solid waste reduction and recycling education and outreach; completed a landfill mapping project to ensure accuracy when determining water availability, and completed of the Comprehensive Solid and Hazardous Waste Management Plan. Looking ahead to 2024, we aim to increase our waste reduction and recycling education and outreach efforts, amend County Code to allow for single -stream curbside recycling, permitting two new solid waste handling facilities, and installing a new scale house to replace the old and deteriorating one at the Point Roberts transfer station. School Health and Safety In 2023, the School Health and Safety program, which is new in the department, focused on creating the foundational structure for a successful program. Staff created a school health and safety workgroup comprised of representatives from each school district; performed school health and safety assessments, focusing on the highest risk areas including playgrounds and chemistry labs; implemented a "rehab the Lab" program, allowing schools to properly dispose of old, expired and/or unused chemicals at no cost; and coordinated with the Northwest Clean Air Agency to supply Purple Air monitors at schools around the county to provide more data around air quality and allow for schools to make more informed decisions about when to cancel outdoor events due to poor air quality. Looking ahead to 2024, we aim to perform school assessments at all county K-12 schools, focusing on Career and Technical Education areas, strengthen our relationships with our school partners, and further solidify our program structure. Response Systems (RS), provided by RS Manager Malora Christensen: In 2023, Response Systems division continued to build direct service programs designed to meet critical, unmet needs in our ecosystem of care in Whatcom County. Page 7 of 26 Alternative Response Team (ART) On January 5, 2024, the Alternative Response Team (ART) celebrated the 1 Year Anniversary of responding to 911 calls instead of local law enforcement. The pilot year of ART was a dynamic, community -based engagement process of developing a new program that would work for our system. Currently ART responds to calls Monday -Friday 8 am to 5:30 pm with a full team of five Behavioral Health Specialists. One of the most significant developments of ART was the Community Connector position at WhatComm dispatch. The Community Connector position took 1,008 calls in 2023 with 773 of those calls handled by ART. Co -Responder Program As of January 17, 2024, the Co -Responder program (in partnership with the Whatcom County Sheriff's Office) is fully staffed and operational. This dynamic partnership pairs a Behavioral Health specialist with Behavioral Health deputies to respond to calls for services in our community. We are eager to see how this new program evolves in 2024 to serve the unique needs of Whatcom County residents. Mental Health Court In 2023, Mental Health Court expanded their capacity to serve up to 50 individuals. The Mental Health Court team added a Behavioral Health specialist to make a team of three that work closely with both Bellingham Municipal Court and District Court. With this staffing expansion, Mental Health Court will also be assisting with the coordination of Mental Health Sentencing Alternative (MHSA). Ground Level Response and Coordinated Engagement (GRACE) At the beginning of 2024, GRACE welcomed two new Community Paramedics to the partnership. Steve Larsen with Bellingham Fire and Ryan Pavitt with Ferndale Fire have stepped into this dynamic role and will be partnered with GRACE Intensive Case Managers. We would like to thank both Captain Joe Frank and Tiffene Hanson for their years of service as Community Paramedics! Let Everyone Advance with Dignity/Law Enforcement Assisted Diversion (LEAD) In 2024, the Whatcom LEAD program continues to operate at capacity with over 130 individuals enrolled and 8 Behavioral Health specialists doing the work of Intensive Case Management and Outreach Coordination. Medical Team Near the end of 2023, we were able to add a Registered Nurse to our Response Systems medical team. This new position works closely with the Response Systems ARNP to serve individuals in our community that are not connected to healthcare. This team of two regularly supports: Gardenview Village, BaseCamp, Francis Place, 22 North, Dorothy Place, City Gate, local encampments, winter and severe weather shelters. In 2024, the Response Systems division will continue to focus on system improvement efforts that improve the delivery of services within our community. Our team will continue to focus on jail behavioral health and re-entry services, system coordination between emergency systems, our hospital and the Anne Deacon Center for Hope. Development work will be focused on the 23-Hour Crisis Relief Center and pursuing additional opportunities for criminal legal diversion programs. Page 8 of 26 HEALTH BOARD Discussion Form AGENDA ITEM #4 PRESENTERS BOARD ACTION: January 29, 2024 Public Health Frameworks and Health and Community Services Practice Alignment Erika Lautenbach, Director, Health and Community Services ❑ Action Item Q Discussion ❑ FYI - Only Public Health at a national level is guided by two frameworks: Foundational Public Health Services and 10 Essential Public Health Services. These models drive professional practice via the Public Health Foundation's Core Competencies for Public Health Professionals. Foundational Public Health Services is a framework most Councilmembers should be aware of as the foundational programs and capabilities are the basis for categorical funding provided by the Washington State legislature to all local health jurisdictions. The 10 Essential Public Health Services is a framework that includes Foundational Public Health Services, but is a more descriptive and broader outline of the public health discipline. This framework is closely aligned with Public Health Foundation's Core Competencies for Public Health Professionals, which is a practical set of skills and abilities for different public health positions. There are three tiers of employees outlined in the competencies: Tier 1 — front line and program support; Tier 2 — program management and supervisory; and Tier 3 — senior management and executive leadership roles. Each tier has different competencies related to each sub -category, which guide the types of responsibilities and skills expected at each tier. For example, within the Policy Development and Program Planning Skills competency, one of the sub - competencies (2.1.2) is: Tier 1: Contributes to assessment of the feasibility and implications of policies, programs and services Tier 2: Assesses the feasibility and implications of policies, programs and services Tier 3: Ensures assessment of the feasibility and implications of policies, programs and services HCS has adopted these frameworks in practical and strategic ways. 1. The department's reorganization within the last two years has more intentionally grouped the Foundational Public Health Core Capabilities into the new Community and Organizational Development Division. 2. We have grown our core capabilities by adding evaluation, equity, and workforce development positions, and plan to add a policy position in Q2 of 2024. WHATCOM COUNTY '■ HEALTH AND 1 ; - COMMUNITY SERVICES Page 9 of 26 3. We have expanded our core capabilities with additional epidemiology, emergency preparedness and resiliency, and communication positions. 4. We have added positions in core program areas including Environmental Public Health, Maternal Child Family Health, Communicable Disease Control, Access to Health Care, and Business Competencies. 5. Every job description changed or created within HCS since 2018 includes the list of core competencies expected for that specific position, in order to align competencies with individual learning plans and priority trainings. 6. The 2023-2027 Strategic Plan includes both key elements of the 10 Essential Public Health Services and both Foundational Public Health Services capabilities and programs. While the frameworks provide national standards and priorities for the field of public health, HCS also recognizes the important frameworks guiding human services, behavioral health, and the provision of healthcare, and works to incorporate those models and learnings into our programs, services and culture. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Both the frameworks and HCS practice have a strong focus on ensuring equity in programs, services and outcomes. BOARD ROLE / ACTION REQUESTED ►[.Tits ATTACHMENT(S) Foundational Public Health Services Diagram 10 Essential Services Diagram Description of Core Competencies for Public Health Professionals Population Heath Framework (Social Determinants of Health) Public Health Frameworks and HCS Practice matrix HCS Org Chart HCS Strategic Plan Summary WHATCOM COUNTY '■ HEALTH AND 1 ; - COMMUNITY SERVICES Page 10 of 26 �ertl5,�ve111ance and Epideln P Chronic Communicable Disease & Disease Injury � Control Prevention Vital o Records ' c Environmental �s16 Pubtic Health G� GP/ op4�.'I*t I AQIC �Q o� N 'a O Maternal Child Family Health fi F O� Access to c, Clinical Care b� a{ Kati se` Emergency Preparedness &Res'qo' THE 10 ESSENTIAL PUBLIC HEALTH SERVICES To protect and promote the health of all people in all communities The 10 Essential Public Health Services provide a framework for public health to protect and promote the health of all people in all communities. To achieve optimal health for all, the Essential Public Health Services actively promote policies, systems, and services that enable good health and seek to remove obstacles and systemic and structural barriers, such as poverty, racism, gender discrimination, and other forms of oppression, that have resulted in health inequities. Everyone should have a fair and just opportunity to achieve good health and well-being. 4) U C to i. N 1 i4S5Qss lheot Page 12 of 26 Crcated 20. Public Health Foundation: Core Competencies for Public Health Professionals: Domains The Core Competencies for Public Health Professionals (Core Competencies) are organized into eight domains representing skill areas within public health. Each domain contains between 4 and 13 competency statements. In addition, the Core Competencies include three tiers, which describe different types of responsibilities within public health organizations. The tiers are used to organize subcompetencies, which articulate more detailed knowledge and skills for individuals with responsibilities related to each tier. The eight domains are: Data Analytics and Assessment Skills. Data Analytics and Assessment Skills focus on identifying, collecting, and understanding data; employing and evaluating rigorous methods for assessing needs and assets to address community health needs; and using evidence for decision making to improve the health of communities. Policy Development and Program Planning Skills. Policy Development and Program Planning Skills focus on developing, implementing, and evaluating policies, programs, and services; engaging in quality improvement for organizational and community planning; and influencing policies and programs to impact health and well-being for all. Communication Skills. Communication Skills focus on employing effective communications strategies to convey information and combat misinformation and disinformation; assessing and addressing population literacy, language, and culture; soliciting and using community input; identifying opportunities to communicate data and information; communicating the roles of government, healthcare, and others; facilitating communications; and building trust with communities. Health Equity Skills. Health Equity Skills focus on recognizing and responding to diversity of the workforce and populations served; applying principles of ethics, diversity, equity, inclusion, and justice to policies and programs; committing to continuous self -reflection; re- evaluating organizational policies; and advocating to reduce systemic barriers that further health inequities. Community Partnership Skills. Community Partnership Skills focus on understanding and developing relationships within the community; advancing collaboration while ensuring community power and ownership; defending public health policies, programs, and services; and evaluating effectiveness to improve community health and resilience. Page 13 of 26 Public Health Sciences Skills. Public Health Sciences Skills focus on using and contributing to the evidence base; understanding historical systems, policies, and events impacting public health; applying public health sciences to deliver the 10 Essential Public Health Services; critiquing and developing research; using evidence when developing policies and programs; and establishing cross -sector partnerships to improve the public's health. Management and Finance Skills. Management and Finance Skills focus on securing, managing, and engaging human and financial resources; supporting professional development and contingency planning to achieve program and organizational goals using principles of diversity, equity, inclusion, and justice; developing and defending budgets; motivating personnel; evaluating and improving program and organization performance; and establishing and using performance management systems to improve organization performance. Leadership and Systems Thinking Skills. Leadership and Systems Thinking Skills focus on understanding and engaging with cross -sector partners and inter -related systems; creating opportunities for collaboration among public health, healthcare, and other organizations to improve the health of communities; building confidence and trust with staff, partners, and the public; identifying emerging needs; and developing a shared vision to engage with politicians, policymakers, and public health to advocate for the role of governmental public health. Page 14 of 26 HEALTH DETERMINANTS Doe 0010 DUCATION HOUSING COMMUNITY INCOME SOCIAL EMPLOYMENT SECURITY SAFETY& &POVERTY SUPPORT VIOLENCE a BUILT AIR & WATER TRANSPORTATION VIRONMENT QUALITY 1LCOHOL& NUTRITION & SEXUAL TOBACCO USE IMMUNIZATIONS DRUG USE PHYSICAL ACTIVITY HEALTH ad) KCESSTO QUALITY OF CARE CARE 170 _ QUALITY OF LIFE LENGTH OF LIFE 10151 Page 15 of 26 Public Health Frameworks and HCS Practice - Areas of Alignment 10 Essential Public Health Foundational Public Health Core CompetenciesWCHCS Strategic Plan for Public Health WCHCS Organizational Structure Services Services Professionals Priorities and Purpose 1. Assess and monitor Community and Organizational population health status, Purpose: Provide Development Division: Health factors that influence health, Core Capabilities: Assessment Data Analytics and accurate and reliable Information and Assessment (Surveillance and Epidemiology) Assessment Skills health communication, Team; Community Health and and community needs and information and data Human Services: Community assets Health Team Core Programs: Communicable 2. Investigate, diagnose, and Disease Control, Environmental Purpose: Prevent address health problems and Public Health, Chronic Disease Data Analytics and disease and injury; Environmental Health, all teams; hazards affecting the and Injury Prevention; Core Assessment Skills Purpose: Prepare for Communicable Disease and Capabilities: Emergency and respond to Epidemiology, all teams population Preparedness and Response (all emergencies hazards) Purpose: Provide 3. Communicate effectively accurate and reliable Community and Organizational to inform and educate Communication health communication, Development Division: people about health, factors Core Capabilities: Skills; Leadership and information and data; Communication Team; Communications Systems Thinking Community Health and Human that influence it, and how to Skills Priority: Community Services: Prevention Team; improve it Partnerships and Health Officers Engagement Response Systems Division, all 4. Strengthen, support, and Community teams; Communicable Disease mobilize communities and Core Capabilities: Community Partnership Skills; Priority: Community and Epidemiology, all teams; partnerships to improve Partnership Development Leadership and Partnerships and Community Health and Human Systems Thinking Engagement Services, all teams; Environmental health Skills Health, all teams; Health Director; Health Officers Community and Organizational 5. Create, champion, and Policy Development Purpose: Promote Development Division: Strategic implement policies, plans, Core Capabilities: Policy and Program health through policy Partnerships Team; Community and laws that impact health Development and Support Planning Skills and systems Health and Human Services, improvement Community Health Team; Health Director; Health Officers 6. Utilize legal and regulatory Purpose: Preserve a Health Officers; Environmental actions designed to improve healthy environment Health, all teams; Communicable and protect the public's where everyone can Disease and Epidemiology, Sexual health thrive Health and TB teams 7. Assure an effective system that enables equitable access Core Programs: Access to Clinical Priority: Community Care; Maternal Child Family Health Equity Skills Partnerships and All Divisions, all teams to the individual services and Health Engagement care needed to be healthy 8. Build and support a All Leadership; Community and diverse and skilled public Core Capabilities: Business Priority: Workforce Organizational Development Competencies Development Division, workforce development health workforce team 9. Improve and innovate public health functions Community and Organizational through ongoing evaluation, Core Capabilities: Business Public Health Priority: Quality Development Division: Health Competencies Sciences Skills Management Information and Assessment research, and continuous Team; quality improvement 10. Build and maintain a Management an strong organizational Core Capabilities: Business Finance Skills; Priority: Organizational All Leadership; Administration infrastructure for public Competencies Leadership and Infrastructure Division Systems Thinking health Page 16 of 26 Financial and Administrative Services Manager Business Office Supervisor and Team Administrative Supervisor and Team Community and Organizational Development Manager HIA Supervisor and ■ Partnerships and Team Strategy Supervisor and Team Informatics, Data, Communication, Epidemiology, Emergency Preparedne! Performance and Resilience, Policy, Management, Evaluation Equity Health Officer(s) Response Systems Manager GRACE Supervisor and Team LEAD Supervisor and Team ART/Co-Responder Supervisor and Team Behavioral health/SUD Supervisor and team Director Office Coordinator Assistant Manager Community Health and . Environmental Health Human Services Manager Communicable Disease Manager Manager On Site Sewage Prevention and Supervisor and Team Screening Supervisor and Team Community Health Improvement, Solid Waste Supervisor Healthcare Access, and Team Aging, Food Policy CD Supervisor and Team Human Services Housing Supervisor and Children and Families Food and Living Supervisor and Team Team Supervisor and Team Environment Supervisor Immunization Supervisor and Team and Team ADVANCING EQUITY L-'j PARTNERING WITH OUR COMMUNITY Community Partnerships & Engagement Partner collaboratively to find community -based solutions that advance health and health equity PROVIDE Organizational Inf rastructure Effectively manage finances, resources, and staffing to support a culture of ethical practice, decision -making and governance. Workforce Development Build and support a diverse, skilled health and human services work- force while ensuring an organizational culture and work environment that is supportive of staff. Quality Management Use program data to drive decision -making, inform ongoing improve- ments and foster a culture of transparency and accountability. Equity - Collaboration • Compassion • Transparency • Innovation • Service �Go e• COG � y 6—..c A0 '1EALTH BOARD 3r 4 Discussion Form January 29, 2024 AGENDA ITEM #5: Public Health Advisory Board Role, Subgroups, and Plan for the Year PRESENTERS: Sterling Chick, Chair, Public Health Advisory Board BOARD ACTION: ❑ Action Item Q Discussion ❑ FYI -Only The Public Health Advisory Board (PHAB) has undergone dramatic changes in the last two years in order to meet state law requirements of Community Advisory Boards. We implemented a Hub and Spoke Model, explored how to functionally create more flow and communication between Health and Community Services, PHAB, and the Health Board, and developed strategies to incorporate new members and their priorities and perspectives into the work plan. We have also increased the number of meetings and worked with the Health Board to make those meetings joint with PHAB. This discussion will focus on the Hub and Spoke Model, the flow chart between relevant bodies, the driving WAC behind these changes, and the 2024 sub -groups PHAB is forming to become compliant with state law. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The WAC, Hub and Spoke Model, and the sub -groups place a high priority on advancing equity and soliciting the views of diverse stakeholders. BOARD ROLE / ACTION REQUESTED ►reTIN ATTACHMENT(S) Hub and Spoke Model WAC regarding Community Advisory Boards Flow Chart between HCS, PHAB, and HB PHAB Sub -group descriptions WHATCOM COUNTY ' HEALTH AND J��COMMUNITY SERVICES Page 19 of 26 Whatcom Racial Equity Children and Family Healthy Whatcom Commission Wellbeing Task Force (Vesla Tonnessen, (Shu-Ling Zhao) (Dr. Christine Espina, Emily O'Connor) Sterling Chick) Business and Commerce Committee Domestic Violence (Guy Occhiogrosso) Commission \ (Adrienne Renz) County Council Representative (Jon Scanlon) PeaceHealth Representative (Vacant) Health Officer (Dr. Greg Thompson) Solid Waste Advisory Board Food System Committee Page 20 Opioid Task Force (Chris Kobdish) PHAB (At -Large Members: Kelli Carroll, Leah Wainman, Joni Hensley, Julie Terry) Veteran's Advisory Board WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer RCW 70.46.140 (Per Washington Administrative Code) Community health advisory boards —Membership —Meetings. (1) A community health advisory board shall: (a) Provide input to the local board of health in the recruitment and selection of an administrative officer, pursuant to RCW 70.05.045, and local health officer, pursuant to RCW 70.05.050; (b) Use a health equity framework to conduct, assess, and identify the community health needs of the jurisdiction, and review and recommend public health policies and priorities for the local health jurisdiction and advisory board to address community health needs; (c) Evaluate the impact of proposed public health policies and programs, and assure identified health needs and concerns are being met; (d) Promote public participation in and identification of local public health needs; (e) Provide community forums and hearings as assigned by the local board of health; (f) Establish community task forces as assigned by the local board of health; (g) Review and make recommendations to the local health jurisdiction and local board of health for an annual budget and fees; and (h) Review and advise on local health jurisdiction progress in achieving performance measures and outcomes to ensure continuous quality improvement and accountability. (2) The advisory board shall consist of nine to 21 members appointed by the local board of health. The local health officer and a member of the local board of health shall serve as ex officio members of the board. (3) The advisory board must be broadly representative of the character of the community. Membership preference shall be given to tribal, racial, ethnic, and other minorities. The advisory board must consist of a balance of members with expertise, career experience, and consumer experience in areas impacting public health and with populations served by the health department. The board's composition shall include: (a) Members with expertise in and experience with: (i) Health care access and quality; (ii) Physical environment, including built and natural environments; (iii) Social and economic sectors, including housing, basic needs, education, and employment; (iv) Business and philanthropy; (v) Communities that experience health inequities; (vi) Government; and (vii) Tribal communities and tribal government; (b) Consumers of public health services; 509 Girard Street Bellingham, WA 98225-4005 WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Main Line: (360) 778-6000 www.whatcomcounty.us/health Page 21 of 26 WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer (c) Community members with lived experience in any of the areas listed in (a) of this subsection; and (d) Community stakeholders, including nonprofit organizations, the business community, and those regulated by public health. (4) The local health jurisdiction and local board of health must actively recruit advisory board members in a manner that solicits broad diversity to assure representation from marginalized communities including tribal, racial, ethnic, and other minorities. (5) Advisory board members shall serve for staggered three-year terms. This does not preclude any member from being reappointed. (6) The advisory board shall, at the first meeting of each year, select a chair and vice chair. The chair shall preside over all advisory board meetings and work with the local health jurisdiction administrator, or their designee, to establish board meeting agendas. (7) Staffing for the advisory board shall be provided by the local health jurisdiction. (8) The advisory board shall hold meetings monthly, or as otherwise determined by the advisory board at a place and time to be decided by the advisory board. Special meetings may be held on call of the local board of health or the chairperson of the advisory board. (9) Meetings of the advisory board are subject to the open public meetings act, chapter 42.30 RCW, and meeting minutes must be submitted to the local board of health. [ 2021 c 205 § 7.] NOTES: Finding-2021 c 205: See note following RCW 43.70.675. 509 Girard Street Bellingham, WA 98225-4005 WHATCOM COUNTY HEALTH AND ��COMMUNITY SERVICES Main Line: (360) 778-6000 www.whatcomcounty.us/health Page 22 of 26 WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer FPR DISCUSSI-ON -ON PHAB RPLES AND RESP-ONSIBILITIES AND RCW 70.4E.140 From the highlighted section, each "shall" can be rearranged and grouped into three workflow categories: 1) Assigned from the Health Board to PHAB, often on an ad hoc basis: (a) Provide input to the local board of health in the recruitment and selection of an administrative officer, pursuant to RCW 70.05.045, and local health officer, pursuant to RCW 70.05.050; e) Provide community forums and hearings as assigned by the local board of health: (f) Establish community task forces as assigned by the local board of health; 2) Assigned to PHAB from Health and Community Services: (c) Evaluate the impact of proposed public health policies and programs, and assure identified health needs and concerns are being met; (g) Review and make recommendations to the local health jurisdiction and local board of health for an annual budget and fees. (h) Review and advise on local health jurisdiction progress in achieving performance measures and outcomes to ensure continuous quality improvement and accountability. 3) Assigned to PHAB by state code: (b) Use a health equity framework to conduct, assess, and identify the community health needs of the jurisdiction, and review and recommend public health policies and priorities for the local health jurisdiction and advisory board to address community health needs; (d) Promote public participation in and identification of local public health needs; 509 Girard Street Bellingham, WA 98225-4005 WHATCOM COUNTY tHEALTH AND COMMUNITY SERVICES Main Line: (360) 778-6000 www.whatcomcounty.us/health Page 23 of 26 HCS supports Boards and Commissions in developing policy; provides subject matter expertise on issues; coordinates and provides staff support for meetings Boards and Commissions: • Veteran's Advisory Board • Developmental Disabilities Advisory Board • Housing Advisory Board • Behavioral Health Advisory Board • Solid Waste Advisory Board • Children and Family Wellbeing Task Force • Food System Committee Health and Community Services (HCS) HCS originates policy; forwards to PHAB for review and recommendation; coordinates and provides staff support for meetings Boards and Commissions and PHAB collaborate to make changes to policy; support consideration at joint meetings and passage by Health Board/County Council - Pursuant to RCW 70.46.140 (1. B, C,D,H) Boards and Commissions originate policy; forward to PHAB for review and recommendation Public Health Advisory Board HCS Supports Health Board in developing policy; provides subject matter expertise on issues; coordinates and provides staff support for meetings Health Board originates policy; forwards to PHAB for review and recommendation or changes - Pursuant to RCW 70.46.140 (1. B, C, D, H) PHAB reviews policy; makes recommendations to Health Board/County Council - Pursuant to RCW 70.46.140 (1.B,C,D,H) Health Board/ County Council RCW 70.46.140 Community health advisory boards —Membership —Meetings. (1) A community health advisory board shall: (b) Use a health equity framework to conduct, assess, and identify the community health needs of the jurisdiction, and review and recommend public health policies and priorities for the local health jurisdiction and advisory board to address community health needs; (c) Evaluate the impact of proposed public health policies and programs, and assure identified health needs and concerns are being met; (d) Promote public participation in and identification of local public health needs; (h) Review and advise on local health jurisdiction progress in achieving performance measures and outcomes to ensure continuous quality improvement and accountability. Page 24 of 26 WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer PUBLIC HEALTH ADVISQRY BQARD SUB-GRQUP PPTIPNS Equity Goal/Purpose: One of the overarching areas for department and community strategic action is to decrease health disparities and inequities. Health and Community Services (HCS) will welcome a dedicated Equity position in early January, who can provide support to PHAB members in identifying an equity framework (per WAC — use a health equity framework to conduct, assess, and identify the community health needs of the jurisdiction...) and developing recommendations for implementation of the `Racism as a Public Health Crisis' resolution. This group will also work collaboratively with the Whatcom Racial Equity Commission to ensure work aligns and supports their goals. Membership: 3-4 members Frequency: monthly or every other month for the year Nominations Goal/Purpose: As PHAB implements its Hub and Spoke model, this committee would be responsible for contacting boards, commissions, and key partners that lack a member. This group would also review applicants and make recommendations to the full PHAB and County Council on who to appoint. Membership: 3 members Frequency: As needed/as vacancies occur Communications Goal/Purpose: PHAB does not currently have formalized or effective methods to communicate with partners, the public, the county council, and other boards and commissions. Per WAC, PHAB is responsible for `providing community forums and hearings' and `promoting public participation in and identification of local public health needs'. This group would develop options, make recommendations and support staff in producing and disseminating information about PHAB priorities and activities. Membership: 3-4 members Frequency: Monthly for the year 509 Girard Street Bellingham, WA 98225-4005 WHATCOM COUNTY HEALTH AND ��COMMUNITY SERVICES Main Line: (360) 778-6000 www.whatcomcounty.us/health Page 25 of 26 WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer Code Changes Goal/Purpose: The current code does not support joint decision -making between boards/commissions and the County Council regarding applicant recommendations and does not allow for time to review. In addition, advisory boards currently require a quorum of membership (as opposed to current membership), which may mean that some bodies do not have a quorum for most meetings if they struggle with member recruitment. This group would work with staff to develop code change recommendations for Council approval to support better engagement and decision -making. Membership: 2-3 members Frequency: One meeting to review and finalize draft Operational izing the Hub and Spoke Model Goal/Purpose: Because the County Council did not change their Health Board membership, state law required PHAB to expand and have more representation. In order to accomplish this, a Hub and Spoke Model was created in order to bring diverse perspectives and representation by other relevant advisory bodies to the PHAB. There remain significant questions about how to operationalize the model and coordinate with the County Council when they appoint new members. This group will be charged with supporting HCS, the Health Board, and PHAB leadership in developing a working organizational structure around the model. Membership: 5-6 members Frequency: Monthly for the year Board/Commission Assessment Implementation Goal/Purpose: This group will support staff in selecting priority items and implementing the recommendations made in the 2023 Board and Commission Assessment. This group will also provide recommendations and support for other HCS boards and commissions to implement the assessment. Membership: 4-5 members Frequency: Monthly or every other month for the year WHATCOM COUNTY HEALTH AND 509 Girard Street Pt COMMUNITY Main Line: (360) 778-6000 Bellingham, WA 98225-4005 SERVICES www.whatcomcounty.us/health Page 26 of 26