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HomeMy WebLinkAboutPacket Health Board Mar 26 2024Whatcom County Council as the Health Board COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360) 778-5010 Meeting Agenda Tuesday, March 26, 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 Call To Order Roll Call Roll call of PHAB members. Announcements Meeting Agenda March 26, 2024 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 al4enda limited to committee business. Meeting Materials AB2024-009 Meeting Materials for Health Board March 26, 2024 Public comment Health Officer/Health Director update Resolution identifying Whatcom County approaches to the fentanyl emergency (AB2024-090) 2. AB2024-090 Resolution identifying Whatcom County approaches to the fentanyl emergency Executive Declaration of Emergency Whatcom Community Health Insights Preview Healthv Children's Fund briefing and discussion Closing/Next Steps Other Business Adiournment Whatcom County Page 2 Printed on 412112025 WHATCOM COUNTY COUNCIL COUNCIL MEETING AS THE HEALTH BOARD JOINT MEETING WITH THE PUBLIC HEALTH ADVISORY BOARD 10:00 a.m. Tuesday, March 26, 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 10:0--10:05 2. Public comment No paper 10:05-10:15 3. Health Officer/Health Director update (Pages 2-20) 10:15-10:25 4. Council Resolution re: Fentanyl (AB2024-090) (Pages 21-29) 10:25-11:00 5. Action Plan — Fentanyl Response (Pages 30-31) 11:00 —11:10 6. Whatcom Community Health Insights Preview (Pages 32-33) 11:10 —11:25 7. Healthy Children's Fund briefing and discussion (Page 34-39) 11:25 —11:55 g. Closing/Next Steps No paper 11:55-12:00 WHATCOM COUNTY h HEALTH AND COMMUNITY SERVICES WHATCOM COUNTY Erika Lautenbach, MPH, Director T c;. Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH. Co -Health Officer Department Report March, 2024 Equity — Collaboration — Compassion — Transparency — Innovation - Service Leadership: Health Director work has focused on communication/outreach, legislative session, meetings with federal legislators, and key issues including Healthy Children's Fund and fentanyl/overdose Executive action. Annual Report and City Council Briefings: Whatcom County Health and Community Services published our first Annual Report in March. In conjunction with the release and to re -open communication with local elected officials, I provided presentations to every city council in March. Topics included department/division overview, budget, strategic plan, 2023 accomplishments and 2024 projects/initiatives. Legislative Advocacy: Through Washington State Association of Local Public Health Officials (WSALPHO) and National Association of City and County Health Officials (NACCHO), I met with state and federal legislators, respectively, to share local priorities, challenges, and requests for support. Two of the three WSALPHO legislative priorities passed and were signed into law by the Governor. Priority Topics: I've worked with our staff team to move our proposed RFPs for the Healthy Children's Fund through the county process, and partnered with Executive Staff and stakeholders to develop a budget and recommendations for immediate action re: fentanyl. I look forward to the Council and Executive actions and the opportunity to move forward with a variety of new activities and initiatives. Health Officer work has focused on the opioid crisis, communicable diseases, behavioral health, and collaboration with community healthcare providers. Opioids: We have continued engaging with elected officials and community partners in addressing the opioid crisis. Within the department the Health Officers are working inter - divisionally, particularly with RSD and CDE, around improving capacity, treatment options, and interfaces between people who use drugs and the jail, hospital, outpatient medical providers, Lummi Nation, and Opioid Use Disorder treatment providers. Dr. Thompson recently attended a 2-day addiction medicine conference and is working to WHATCOM COUNTY HEALTH AND rO9 Girard street COMMUNITY Main Line: (364) 778-6000 Bellingham, WA 98225-4005 L SERVICES www.%whatcomcounty.us/health Page 2 of 39 connect the Swedish Hospital addiction medicine fellowship program and Whatcom County healthcare institutions. Dr. Harley is working to improve support for pregnant people, young families, and youth with mental health concerns. The Health Officers are also convening meetings of medical leadership to increase collaboration and communication between healthcare institutions in our county. Communicable Disease: Respiratory virus guidance is evolving to better respond to the current situation of less severe outcomes from COVID-19, and harmonize COVID guidance with that around other respiratory infections. These efforts are balanced with caution around the ongoing deaths and severe disease from COVID-19 illness, particularly in those over 65 years of age. Still at the forefront is the prevention message that vaccination continues to significantly reduce health risks from COVID-19. We are alert to up -trending measles cases nationally this year, with a number of cases within Washington state among unimmunized adults. We appreciate efforts by healthcare, schools, childcare and our immunizations nurses to improve measles immunity in our county through MMR vaccination. Other work: We continue to engage regularly around communication and media requests, data presentation and interpretation, collaboration with the Medical Examiner's office, and the Whatcom Community Health Insights project. Communicable Disease and Epidemiology (CD&E): Public health nurses and staff within the CD&E division continue clinical service outreach and educational events in the community. Refugee Health: With the assistance of Dr. Amy Harley, we are working with the state Department of Health and the federal Department of Health and Human Services to contract with a local community health center in Whatcom County to start offering Refugee Health Screenings. Refugees who resettle in Whatcom County must travel to Snohomish County for Refugee Health Screenings. Offering this service locally can reduce barriers for refugees seeking health services. Reducing barriers to healthcare access for this population is vital for infectious disease surveillance in the community. Vaccine Clinics: The immunization team continues to offer monthly vaccine clinics and clinic appointments to increase access for residents with barriers. The team recently received an expression of gratitude for their partnership with Hoagland's Pharmacy to ensure the administration of COVID-19 and influenza vaccines for residents who are insured but homebound due to disability or illness. This vulnerable population often has high barriers to accessing care due to physical disability and high medical risk, which Page 3 of 39 prevents them from accessing healthcare through traditional methods. From January to February 2024, we served 54 clients and administered 134 vaccines. Candida Auris: The Infection Prevention team, in concert with the state Department of Health, is collaborating with the local hospital and long-term care facilities on surveillance and infection prevention protocols for Candida Auris. Cases were recently identified in Washington State. Candida Auris is a multi -drug -resistant fungus that can cause severe illness and spread within healthcare facilities. School/Childcare Support: Our Public Health Nurse and Liaison for School and Childcare Health is collaborating with the state Department of Health on creating a tool to help schools and childcare facilities standardize reporting of absenteeism for certain notifiable conditions and facilitate prompt notification of clusters/outbreaks to local health jurisdictions. The tool will help streamline data collection and reduce the reporting burden on the public school system. Syphilis: Syphilis cases continue to trend upward on the local and national levels. The Sexual Health Provider Education virtual presentation series, which was organized by CD&E, begins in March. Syphilis is the first of three presentations by expert faculty from the University of Washington. This virtual education series will help with healthcare providers' knowledge deficits regarding managing STDs/STIs. Tuberculosis: The Tuberculosis Team is currently managing five active TB cases. TB nurses often provide clinical care and case management to medically complex individuals. The public health nurse went above and beyond duty to contact a patient's specialty providers to prevent an adverse outcome from the client's reaction to their cardiac medication. The same client was admitted to the hospital recently. This nurse collaborated with the hospital case management team to advocate for this client to receive a home health nurse at discharge. Drug Testing: The public health nurses in the SSP/Harm Reduction Program have started rounding with the street medicine outreach team to increase participant engagement. Collaborating with the University of Washington and the Addiction, Drug, & Alcohol Institute (ADAI), they have started offering a new service, which is drug testing to help participants identify potentially harmful substances circulating in the community. In addition, both public health nurses are participating in the Community - Law Enforcement Aligning in Response to Substance Use (CLEARS) Project, a one- year project to develop regional solutions to improve interactions between law enforcement and people who use drugs. Community and Organizational Development (COD): Page 4 of 39 The Community and Organizational Development division facilitates collaboration across the divisions and provides accurate, meaningful, and timely information, data, and training. Specialty areas include data, assessment, epidemiology, informatics, performance management, evaluation, communications, media relations, emergency preparedness, equity and belonging work, and workforce development. A few key areas of focus at this time are: Equity: The newly formed HEAL (Healing -centered, Equity and Leadership) Team launched on February 29thl This team will receive professional development in trauma - informed care, healing -centered practices, antiracism and health equity to create foundational learning in preparation for actionizing health equity. In late Spring, an organizational climate and care survey will be launched to assess the strengths and needs of WCHCS. Performance Management: Quality Improvement (QI) Council launched March 7t" This is a cross -divisional collaborative team that will execute the Quality Improvement strategic priority to improve the use of data to drive decision- making, inform improvements, and foster a culture of transparency and accountability. The council will focus on alignment and standardization of our department's quality improvement efforts, bring new innovations to the departments' programs, and increase accountability to leadership and our stakeholders. Data: A new Child Wellness Survey focused on infants and children ages 6 months to 11 years is being conducted by WA DOH. Typically, the results would be available at a state -level however, through Healthy Children's Fund, Whatcom County will survey our county and get data specific to our community. This will allow more meaningful results that reflect children and their families who live in the county. The survey will ask parents of children in this age group about the health and development of their child, access to childcare, and other topics including mental health. Whatcom County will be a model for other smaller counties in Washington State that would like to have their own county - specific sample. Community Health and Human Services (CH&HS): Retreat: CH&HS held a retreat on January 25th and nearly every staff member of the now 30+ people in the division were able to attend and share their programs, commitments and priorities for 2024. This year the focus is on intentional programming and commitments in our work, to make sustainable long-term impacts. The retreat also created space for several of our program teams to connect and find ways to collaborate. Page 5 of 39 The Veterans Program and the Child and Family team met shortly after the retreat and are now working on ways to support childcare needs for veteran households. Severe Weather Shelter: The Severe Weather Shelter has officially closed for the season, as of March 15th. Over the 20 nights that it was open, over 197 unique guests were served. The shelter was staffed using a pool of 11 temporary staff and 22 permanent Health & Community Services employees. In partnership with the Response Systems Division, over 730 hours of training were completed for the individuals who worked or volunteered for the operation. It was a very large lift, and involved staff across the department, but with 947 utilizations by guests over those 20 nights and 5 days, many of our vulnerable neighbors kept warm during some life -threatening temperatures. Youth RFPs: Supporting youth is very much a focus across several of our programs right now. It is really exciting to have three different Requests for Proposals (RFP) open to the community with a youth focus. We are seeking proposals ranging from homeless prevention strategies for families with children 0-5 (closes 3/12), Outreach work focused on preventing youth from using opioids (closes 4/2) and an opportunity to support families seeking services and referrals for their children with healthcare needs (closes 4/2). Each of these is an opportunity to prevent further harm or trauma for many of the youth in the community, and it is exciting to be one step closer to getting programs to the people and places they are needed most. Healthy Children's Fund: Over the last month, the Children and Family Programs have released a Housing Stability RFP, solicited proposals from Doulas to serve Medicaid eligible pregnant parents and finalized a Basic Needs RFP that will be released in early April for families with Children 0-5. All funded through the Healthy Children's Fund. The Child and Family Well Being Task Force will be hosting its first annual retreat on March 29th, with focus on building a work plan and connection amongst the group moving into the new year. Opioids/Behavioral Health: Our Prevention staff continue to support the work of the All Hands team, and so far in 2024, there have been four successful events. The staff are also excited as they are just beginning the scoring of the proposals from a recently closed RFP seeking providers able to offer school based teletherapy in Whatcom County. This will mean added capacity for youth mental health services in our schools. Environmental Health (EH): EH programs focus on protecting groups of people from threats to their health and safety posed by their environments. EH programs include various sanitation areas such as food safety, drinking water, on -site sewage and solid waste. Page 6 of 39 New Leadership: With the recent promotion of an environmental health specialist into a supervisor position within the division, there has been a shift and reorganization of programmatic responsibilities. This expansion in leadership will allow for more support in programs including food safety, living environment, school safety and solid waste. Smoke and Heat Response: Using Foundational Public Health Services funding, EH is building a program to support frontline communities during wildfire smoke and extreme heat events. Several public education events, including at senior centers around the county, and focused conversations are scheduled in April 2024. This qualitative assessment will inform the recommendations of the Climate Vulnerability Assessment, which will be completed June 30, 2024. Coordinated Water System Plan: The division is leading the Coordinated Water System Plan update to dovetail with the County's larger Comprehensive Plan update. Changes and updates to the plan intend to address complex issues such as the impact of climate change on water systems. Financial Services: The Financial & Administrative Services division supports the department by coordinating financial services such as contract processing, payment processing, grant billing, payroll processing and other various audit functions. New Manager: The new Financial Services Manager started February 26' and this position will coordinate and oversee the daily departmental financial and accounting activities. Year End: The Business Office has wrapped up the 2023 financial year end process. This process included creating grant accountability worksheets for the 33 Federal Grants ($2.8M) and 51 State Grants ($15.7M) that were reviewed and reconciled. Contracts: Our Contracts Coordinator is successfully managing 129 active contracts and 15 Letter of Agreements (LOA's) to help support the $34.2M the department has budgeted to contractual services in 2024. Response Systems: The Response Systems Division (RSD) programs aim to address the needs of individuals lacking adequate care for behavioral health challenges and basic needs within our community. These programs seek to alleviate the reliance on emergency services such Page 7 of 39 as 911, crisis interventions, and the legal system. By implementing innovative approaches like the Alternative Response Team (ART), Ground -Level Response and Coordinated Engagement (GRACE) program, Law Enforcement Assisted Diversion/Let Everyone Advance with Dignity (LEAD) program, Co -Responder program, Mental Health Court and Street Medicine Team, we strive to provide comprehensive support to individuals in need while also enhancing the efficiency of our emergency response and care coordination systems. A few program highlights include: ART: The Alternative Response Team (ART) is fully staffed as of March 4th. ART continues to respond to 911 calls in lieu of law enforcement when appropriate. In addition to the ART response team, RSD was able to hire a Behavioral Health Aide who support ART and community providers with transportation needs. In March, RSD will report back to County and City of Bellingham councils on how the first year of ART has gone, what we have learned and where we hope to go. Co -Response: In partnership with the Whatcom County Sheriff's Office, the Co - Responder program is in full swing. With two highly trained and skilled Behavioral Health (BH) specialists, the team is able to respond with deputies to calls for service that have a BH concern. Co -Responders are able to bring services and support to community members in the moment, provide some follow-up and free up deputies to be available for other calls. Similar to ART, we are working with a 3rd party evaluator in the pilot year of Co - Response to assist our community in understanding the need for a Co -Responder program, areas of growth and data analysis. In April, staff members from the Co -Responder and GRACE programs will attend the 2nd annual Co -Responder Outreach Alliance of WA conference. This will be an opportunity to meet with co -responder programs from across WA state. Page 8 of 39 � 4 wr ° c� C1' fir'"'• � 'v „� <. . + ` K WHATCOM COUNTY HEALTH AND fi COMMUNITY SERVICES Ann I Report Page 9 of 39 A Letter Frcrn The Dlrectc.4 r We live in a different world than five years ago. While many of the most significant impacts of COVID-19 are behind us, new threats to our health and community have emerged, or become more pronounced. Fentanyl has devastated families, and in Whatcom County, there has been a nearly 50% increase in overdose deaths from 2022 to 2023. Mental illness, while a long-term priority, has now reached a crisis level for families, schools and our young people. Key drivers of homelessness - affordability and accessibility - are worse, while services for the chronically homeless are not keeping pace with the growing numbers of people living unsheltered. Access to affordable childcare, food, and other basic needs has declined due to inflation and other economic drivers. The increase in severe weather events and temperatures we're experiencing are impacting our homes and way of life. Life has changed for you in these last five years — and it's changed for us, as well. Our department, which serves every geographic corner of the county in cities and unincorporated communities alike, is a different organization in so many ways. Coming out of the COVID-19 crisis response, we have been able to utilize our growing number of staff to expand public health work in our County. Two years ago, we created the Response Systems Division, which brought our crisis outreach and intensive case management programs in-house. Last year, we launched our new five-year strategic plan and changed our name to Whatcom County Health and Community Services. Nearly half of our staff now work in human services or behavioral health, and this change honors the complexity and diversity of our work and commitment to our community. Through state and federal grants, we've expanded programs in nearly every division in our department. We're implementing the goals of the Healthy Children's Fund, passed in 2022, and beginning work on designing the behavioral health components of the Public Health, Safety, and Justice ballot measure passed in 2023. While our team, and budget, are nearly double what they were just five years ago, only 6% of our revenue comes from the county's general fund. We are proud to have built programs and services that have gained the trust and financial commitment of outside funders. Today, the public health system is more visible than it has ever been before. We recognize that for some in our community, it may be hard to trust government agencies due to both historical traumas and recent challenges. The best way that we can grow that trust is to earn it. We intend to do that every day by providing timely services with the customer service you expect, while tackling the important issues that matter to Whatcom County. If we have learned anything in the last several years, it's that nothing important can be accomplished without the support and collaboration of our partners and our community. I invite you to move forward with us into a new era for Whatcom County Health and Community Services. We look forward to working with you, and for you. In Community, Erika Lautenbach, MPH Director, Whatcom County Health and Community Services Page 10 of 39 page 2 Whatcom County Health and Community Services 2023 Annual Report . Purpc:tse, Pricritles, Values ADVANCING EQUITY = PARTNERING WITH OUR COMMUNITY • Community Partnerships & Engagement Partner col la boratively to find community -base solutions that advanc health and health equity. P �00- pRFs�, 0 0 'C W APOVIDE 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 anc 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. • ConaVorarlon • Compassion • Transparency • Innovation • Service What We Dre� The Communicable Disease and Epidemiology division works to stop the spread of disease. They work to prevent and investigate infectious diseases, provide screenings and clinical/community support referrals, and provide vaccinations and harm reduction services. They work to prevent and control the spread of communicable diseases like tuberculosis, measles, COVID-19, RSV, influenza, hepatitis C, HIV, syphilis, MRSA, and many more. Programs include: • Immunizations • Tuberculosis • Syringe Services Program • Communicable Disease • Sexual Health The Community and Organizational Development division provides services that cross -cut and connect all divisions within the department. They help the department to carry out its priorities and projects more effectively and implement WCHCS's 2023-2027 Strategic Plan. Programs include: • Health Information & Assessment • Epidemiology • Assessment & Evaluation • Data & Informatics • Partnerships & Strategy • Communications • Emergency Preparedness & Resiliency • Equity • Policy • Workforce Development The Community Health & Human Services division promotes health and well-being for everyone in our community. They aim to reduce health disparities and encourage healthy behaviors. They offer services in areas such as housing, food and nutrition, and substance use prevention, as well as support for children and families, veterans, and people with disabilities. Programs include: • Nurse -Family Partnership • Food Systems • Homeless Housing • Developmental Disabilities • Veterans • Substance use prevention • Children with Special Health Care Needs • Childcare and Early Learning • LatinX Outreach page 4 Whatcom County Health and Community Services 2023 Annual Report The Environmental Health division works to promote a healthy and safe environment. They focus on disease and injury prevention and adherence to environmental health mandates and requirements. They monitor drinking and recreational water quality; conduct restaurant inspections and monitor food recalls in order to prevent foodborne illnesses; prevent exposure to hazards like lead, asbestos, or mold in homes or school environments, and much more. Programs include: • Solid Waste • Food Safety • School Health & Safety • Living Environment • On -site Septic • Drinking Water • Climate Change Response The Financial and Administrative Services division makes sure services run smoothly. They provide customer service to community members in accessing information and resources. They manage vital records like birth and death certificates, permits, and other health -related public records. They also oversee the department budget, grants and contracts, and financial services. Programs include: • Community customer services including vital records, permitting, and complaints • Financial Services and Contracts • Internal administrative services The Response Systems division provides intensive case management services to vulnerable community members. They work closely with first responders, healthcare providers, social services, and the legal system to coordinate services for their clients and reduce utilization of emergency services and incarceration. Programs include: • Ground -Level Response and Coordinated Engagement (GRACE) • Law Enforcement Assisted Diversion (LEAD) • Alternative Response Team (ART) • Mental Health Court • Co -Responder program with Behavioral Health Sheriff Deputies • Behavioral health contracts and coordination Whatcom County Health and Community Services 2023 Annual Report page 5 YAL7 : FF Behavioral Health Funds Improve Outcomes for Our Kids All seven school districts in Whatcom County provided behavioral health services in the previous and current school years using Behavioral Health Funds administered through our department. All Whatcom County kids benefit from this, with 57% of people served outside Bellingham. The funds go towards substance use prevention professionals and programs, mental and behavioral health practitioners, coordination of community services, and outreach. Reducing risk in these areas also impacts other `life indicators,' such as improving school performance and a child's interactions with family and community. These services demonstrate: • Cost savings to the community. • Improved behavioral health outcomes. • Referrals and connections to treatment for mental health, substance use, or both. • Leveraged resources. Cost -benefit estimates show that effective school -based programs can save $18 for every $1 spent. Wiser Lake: Our year -long data collection effort will help understand & mitigate harmful algae blooms. Improving the Health of Wiser La ke For the last two years we've been studying the consistent presence of harmful algae blooms (HABs) at Wiser Lake. Through a grant from the Washington State Department of Health, we worked with local groups to collect 12 months of data - the first step in discovering the cause of HABs. An additional grant from the Department of Ecology will start in July and fund analysis of the data we are currently collecting. Then, we can develop a set of recommendations based on the results. For updates on this project, or to sign up for notifications via email or text, visit https://www.whatcomcounty.us/wiser. Whatcom County Made Historic Childcare Investments Last May, Whatcom County awarded $5.8 million in federal American Rescue Plan Act (ARPA) funding to create 277 new early learning slots and preserve 84 existing slots, including investments in Ferndale, Bellingham, and the Meridian School District. Awardees include: • Whatcom Family YMCA Barkley • Western Washington University's Child Development Center • Opportunity Council Bellis Project • Gabriel's Art Kids, Ferndale • Meridian School District The County also awarded a $750,000 grant to the Boys and Girls Clubs of Whatcom County to mitigate financial impacts from the COVID-19 pandemic after its March 2020 acquisition of Kids' World. In addition, with ARPA funding from Whatcom County and the City of Bellingham, Opportunity Council's Center for Retention and Expansion of Childcare (C-RECC) has awarded grants to over 32 local childcare providers, ranging from $10,000 to $100,000 per provider. With these grants, providers have been able to raise wages, meet urgent maintenance needs, purchase supplies, and create enriched early learning environments with high -quality curriculum and services. Further funding from Whatcom County has supported emergency childcare vouchers for families, business leadership and technical assistance, and professional development scholarships for childcare workers. Page 14 of 39 page 6 Whatcom County Health and Community Services 2023 Annual Report Innovative New Program Provides Alternative to Law Enforcement for 911 Calls Last year WCHCS launched Whatcom County's Alternative to respond to the most serious 911 calls. From July through Response Team (ART), a program that sends behavioral health December 2023, 830 calls to 911 were dispatched directly to specialists to respond to specific non-violent behavioral health ART. Less than one percent of those calls needed to be referred 911 calls in Bellingham, instead of law enforcement. to law enforcement for back-up support. ART works to de-escalate tense situations and engage someone experiencing a behavioral health crisis. Feedback from law enforcement and other community partners is that most ART calls have been resolved without additional backup from law enforcement, and thus freeing up Bellingham Police Officers Taking Action to Address the Opioid Crisis in Our Community Responding to the opioid crisis in our community continues to be a WCHCS top priority. Every division at WCHCS is working to address the opioid crisis by supporting children, youth, and families facing addiction; preventing overdose deaths by distributing Naloxone and training community members on how to use it; working on the street directly with clients with addiction issues to connect them to housing, medical care, and other essential services; operating the Syringe Services Program; providing training and education regarding fentanyl and other opioids; working to increase access to treatment and recovery options; advocating for system -wide improvements; and leading county -wide prevention coalitions. In June, the department launched the website whatcomoverdoseprevention.org, where individuals and groups can request free Naloxone kits and find information, resources, and up-to-date local data on the opioid crisis. In August, WCHCS formed the County -wide Multi -Agency Coordination (MAC) Group formed to coordinate response efforts. The MAC group is made up of 70+ organizations and agencies focused on substance use disorder prevention, treatment, intervention, and recovery; members include leaders in healthcare, social services, housing, law enforcement, courts, EMS, libraries, schools, and tribal health. 2023 By The Numbers: For more information, visit the ART webpage at https://www.whatcomcounty.us/RSD. (Left to Right) WCHCS Co -Health Officer Dr. Greg Thompson, Whatcom County EMS Specialist Steven Cohen and WCHCS Supervisor Lela Riherd providing information and training at a Sehome High School community event. Communicable Disease & Epidemiology • 734 vaccine outreach events were held - • i served over 500 clients, more than 7,000 invaccines were administered • 300 scheduled clinical visits completed Page 15 of 39 Whatcom County Health and Community Services 2023 Annual Report Provided approximately 725 syringe services program/harm reduction clinics and trainings for community partners page 7 Partnership With Ferndale Community Services Supports County Severe Weather Shelter Ferndale • • Community Services Serving North Whatcom County WCHCS manages the county's contract to provide up to $75,450 to Ferndale Community Services, funded by the federal American Rescue Plan Act. This local nonprofit operates the only Whatcom County shelter outside the city limits of Bellingham. The group's typical service area includes Ferndale, Custer, Blaine, Birch Bay, Lynden, and the surrounding unincorporated county areas. This shelter can accept up to 15 guests and provides shower and laundry facilities, along with a warm place to sleep during extremely cold weather. In addition to the severe weather shelter, Ferndale Community Services provides year-round support to community members in need through: • A Community Resource Center with clothing and household items • The Other Bank providing hygiene supplies • The Utility Fund for help with City of Ferndale water and sewer bills • Computer and phone usage • Housing and job search assistance • Transportation services • Shower and laundry referrals Learn more at https://ferndalecs.org/ 2023 By The Numbers: Environmental Health Partnership with Local Veterans Clinic Enhances, Expands Veterans Services WCHCS has supported military veterans in Whatcom County with resource referrals and financial assistance for over a decade with a single staff member. In 2023, the department added a second veterans specialist position whose office is located at the Bellingham's Vet Center. The Bellingham Vet Center is a one -stop -shop for qualifying veterans seeking mental health counseling, veteran resources, and disability benefits/claims processing. Having county staff co -located in the same building has strengthened the partnership with Bellingham -based VA employees, maintained open communication with other veteran service providers, and increased collaboration with outreach opportunities, in order to better support veterans in our community. Many Whatcom County vets served in Vietnam, and many live in rural parts of the County with limited transportation options. Having two locations where they can get services (as well as the ability to connect over email, phone, or text) has helped make services much more accessible. In 2023, WCHCS staff submitted 1,132 claims on behalf of Whatcom County veterans. The two veterans staff members at WCHCS have been able to complement each other's work and support veterans in new ways, such as presenting to elected officials to educate them on veterans' needs, providing clinics for Border Patrol staff who are military veterans, and meet people `where they're at' in their workplaces. Both staff are veterans, which allows them to better connect and understand the services and agencies they work with on bethalf of other veterans. • Tracked over29,000 onsite sewage Supported at least 830 individual water systems connections • Trained 874 homeowners to maintain Increased access to sewage disposal for their onsite sewage system over 300 properties Page 16 of 39 page 8 Whatcom County Health and Community Services 2023 Annual Report Congratulations to our Partner, Sustainable Connections, on 1 Million Pounds in the Food Recovery Program The WCHCS Solid Waste Program provides local nonprofit Sustainable Connections with $30,000 annually to support the Food Recovery Program (FRP). This program aims to reduce food insecurity, divert edible items that would otherwise go into landfills, and address climate change by redistributing surplus, nutritious food from local businesses to neighbors experiencing hunger, rather than sending that food to the landfill. The program started in 2019 and reached the one million pound mark in 2023. The FRP is also the umbrella program for the "Freedge", a refrigerated food pantry located at the RE Store in Bellingham. In their 2022-23 annual report, Sustainable Connections reported that: • 16 new businesses were recruited to the FRP • 10 new businesses were consulted in how to to divert their inedible food to compost instead of landfills • 3 local events were supported in diverting food and organics from the landfill. For more information on the Food Recovery Program, visit https:Hsustainableconnections.org/tag/foodrecoveryprogram/ Sustainable Connections (COMMUN17Y BRIDGE) ® .� ®PEN TODAY 2023 By The Numbers: Nurse Family Partnership • 89 families served • 25 babies born • 750 home visits and 250 telehealth visits We held two free drop-off tire recycling events in 2023. We collected an estimated 72,500 tires across 755 loads - several thousand more than in past years. These events were made possible by funding from the Washington State Department of Ecology. ....................... y Care*Van Caravana de Salud Care -A -Van Clinics Offer Free Vaccine Clinics to Underserved Communities Care -a -Van Mobile Health Clinics are a partnership between WCHCS and the State Department of Health to increase access to health services in rural Whatcom County. Care -A -Van also partners with tribal nations, elder care facilities, and Western Washington University to offer free vaccines to people without health insurance. In 2023 WCHCS and Care -A -Van co -hosted 13 vaccine clinics through this program, offering free vaccines for COVID-19, flu, Hepatitis A, Hepatitis B, Tdap, Mpox, and routine childhood vaccines. 2023 Naloxone Distribution 11,824 Naloxone doses distributed in Whatcom County Page 17 of 39 Whatcom County Health and Community Services 2023 Annual Report page 9 Leadership Erika Lautenbach, Department Director Dr. Amy Harley, Co -Health Officer Dr. Greg Thompson, Co -Health Officer Management Ann Beck, Community Health & Human Services Lynnette Bennett, Community & Organizational Development Malora Christensen, Response Systems Sabrina Houck, Financial Services Shamika Brooks, Communicable Disease & Epidemiology Sue Sullivan, Environmental Health Advisory Groups Public Health Advisnry Bnard Sterling Chick, Chair Emily O'Connor, Vice Chair Behavinral Health Advisnry Cnmmittee Nicholas Evans, Chair Child & Family Wellbeing Taskfnrce Christina Jackson, Co -Chair Ray Deck, Co -Chair Developmental Disabilities Advisnry Bnard Raegen Miller, Co -Chair Lindsay Foreman -Murray, Co -Chair Fnnd Systems Cnmmittee Riley Sweeney, Chair Margaret Gerard, Vice Chair Solid Waste Advisnry Cnmmittee Rodd Pemble, Chair Brandi Hutton, Co -Chair Solid Waste Executive Cnmmittee F Satpal Sidhu, Chair Veterans Advisnry Bnard Lynne Graham, Co -Chair Andrea Vance, Co -Chair Whatcnm Cnunty Hnusing Advisnry Cnmmittee Dan Dunne, Chair Ashley Thomasson, Vice Chair Healthy Whatcnm (Community Health Improvement) ► Financials • 4.5% 501 7% 8% 39% 35.5% 8% 7% 5% 4.5% 7% 'A` 35.5% Way Station Along with our partners, we look forward to opening the doors of the Way Station this fall. The Way Station, located at 1500 State Street in Bellingham, will offer respite beds for individuals exiting the hospital, hygiene services, medical and behavioral health care and connections, as well as case management and referral services. These services will be provided by PeaceHealth, Opportunity Council, and Unity Care NW. The second floor will co -locate Whatcom County EMS and WCHCS teams including syringe services, GRACE and LEAD. Concept illustration of the State Street Way Station Facility. Climate Vulnerability Assessment Our Environmental Health division is conducting a Climate Vulnerability Assessment, with plans to release a final report in Summer 2024. The Climate Vulnerability Assessment, is specifically focused on extreme heat and wildfire smoke impacts on the health of residents of Whatcom County. The assessment will include stakeholder feedback, smoke/heat data analysis, and results of focus groups with frontline communities on needs and gaps. 2023 By The Numbers: Healthy Children's Fund We expect to release a wide range of Requests for Proposals (RFPs) to identify service providers who will receive funding to support the two overarching goals of the Healthy Children's Fund, passed by voters in 2022: 1) Increase access and affordability of early learning and care and 2) Provide support for vulnerable children and families. Selected providers will make progress on these goals by increasing childcare slots, providing systems of support for families ranging from prenatal services to early intervention, as well as addressing developmental delays, housing concerns, and meeting basic needs to stabilize families. Fentanyl response In 2024, our department will dedicate significant resources to addressing the fentanyl crisis in our community, including utilization of opioid settlement funding to provide trainings and public education about fentanyl, identifying additional intervention and treatment options for people struggling with opioid use disorder, and continued coordination with partners to ensure the most effective delivery of existing and future services. Public Health Nurse Sarah Best demonstrates how to administer Narcon on Overdose Awareness Day in August 2023. Financial and Administrative Services • 8,060 Death Certificates issued ($189,88S • Answered over 9,000 phone calls from in revenue) the public in 2023. • 3,99S Birth Certificates issued ($99,87S in • Processed 326 public records requests revenue) Page 19 of 39 Whatcom County Health and Community Services 2023 Annual Report page 11 WHATCOM COUNTY HEALTH AND Alk j� COMMUNITY KIMM SERVICES 509 Girard Street Bellingham, WA 98225 Phone: 360-778-6000 Fax: 360-778-6001 www.whatcomcounty.us/Health Front Cover Photo: Randy Rydel, Whatcom County Public Works Department Rear Cover Photo: Vincent Alvarez, Whatcom County Information Technology Department - _ qg-e-2S-of3-9 +C'r,OM CO HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 AGENDA ITEM #4: Resolution Declaring the Fentanyl Crisis an Emergency in Whatcom County and Identifying Approaches to the Emergency PRESENTERS: Barry Buchanan and Ben Elenbaas; Co-sponsors of the resolution BOARD ACTION: Q Action Item ❑ Discussion ❑ FYI -Only On February 6, Councilmembers Elenbaas and Buchanan introduced a resolution that would declare the fentanyl crisis an emergency. This was an additional step following 7-0 passage by Council of resolutions requesting the President and Governor declare declarations of emergency. While the declaration was discussed in the Committee of the Whole on February 6, no action was taken, as the Council wished to talk with stakeholders including relevant county staff and elected officials and outside boards, commissions, and task forces. Councilmembers met with a variety of stakeholders and used that feedback to create a new draft. On March 7, Councilmember Buchanan joined the PHAB meeting to discuss the resolution and gather feedback from members. A number of PHAB members provided comments and suggestions at the meeting as well as in writing the following week. Council co-sponsors have indicated they would like to take a final vote as the Health Board at this meeting. PHAB members may also choose to take an advisory vote on the resolution. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Certain populations, including residents who are unsheltered and those with pre-existing behavioral health, substance use disorder, or history of trauma, are at risk of developing opioid use disorder. Supporting these populations will impact those most vulnerable to overdose death or poor health outcomes. BOARD ROLE/ACTION REQUESTED WHATCOM COUNTY HEALTH AND COMMUNITY Pit, Page 21 of 39SERVICES Take a final vote on the Resolution. ATTACHMENT(S) Resolution AB2024-xxx Page 22 of 39 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES PROPOSED BY: BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. !BENT-IFYI G r+ECLARING THE FENTANYL CRISIS AN EMERGENCY IN WHATCOM COUNTY AND IDENTIFYING APPROACHES TO THE FENT NNI EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and WHEREAS, in June 2023, a coalition of government agencies, community -based organizations, healthcare providers, and others from across Whatcom County formed a Multi - Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and Page 23 of 39 WHEREAS, according to the Federal Emergency Management Agency (FEMA), a multiagency coordination system (MAC) is used for extraordinarily large, complex incidents occurring in the city or county involving numerous agencies and/or jurisdictions; and WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide response efforts to the opioid crisis, identify and prioritize additional short-term objectives and strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety in Whatcom County; and WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and Overdose Response (SOOR) plan, which includes five priority goals 1. Prevent opioid misuse, 2. Identify and treat substance use disorder, 3. Ensure and improve the health and wellness of individuals that use drugs, 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions, 5. Support individuals in recovery; and WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, local, state, and federal agencies and bring together state agencies, local law enforcement, and internal and external partners to pursue and achieve solutions that promote public health and safety on the Lummi Reservation; and WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 041 supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in response to the fentanyl crisis; and WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid epidemic and open additional resources and authorities to address the crisis; and WHEREAS, the Whatcom County Council understands coordination between all agencies in our county as well as state and federal supports is needed to fight the fentanyl crisis; and WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and Page 24 of 39 WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by the community and categorized in five key strategy areas: I. Ensure Oversight, Accountability, and Transparency II. Increase Access to Behavioral Health Services III. Build Facilities Needed to Promote Public Health, Safety, and Justice IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration V. Make Systems Changes with Local, Regional, State, and Federal Partners; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a statewide emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis; and WHEREAS, community leaders, agency staff, and other stakeholders convened in early 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; and WHEREAS, Bellingham Mayor Kimberley Lund issued Executive Order 2024-01 on February 20, 2024 to address the fentanyl crisis in Downtown Bellingham; anJW WHEREAS, this resolution details near term approaches, which are not intended to replace the long-term approaches detailed in more comprehensive county policy documents. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends the following near -term approaches to address the fentanyl crisis: Government Coordination: 1. Advocate for the declaration of emergencies at state and federal levels, thereby opening up additional resources to address the crisis. 2. Unite national efforts by encouraging other localgetting as n9any jurisdictions -as pessible to approve a resolution -to requesting an emergency be declared at the state and federal levels. 3. Encourage Executive Sidhu to release a County Emergency Declaration or Executive Order that detailsifrg specific action items and funding options to intensif r� , one time reserve funds) to jun9p Page 25 of 39 start efforts,, in alignment wither Opioid Task Force and MAC group recommendations. 4. Develop a budget and plan to address staffing shortages, positions needed in order to implement an Emergency Declaration or Executive Order, and action steps requiring funding. S-;—may- fr5. Using whatcomoverdoseprevention.org website and Council Committee of the Whole, provide regular updates to the public on progress of action steps, outcomes of efforts, and funds expended on initiatives. Accountability and Data Collection : 6Advocate for a -legislative changes that strengthen laws regarding children's exposure to fentanyl, Ricky's law, and other related measures. fi)( feF the legal inability te issue 4 7. Enhance legal methods to address fenta nyl -related crimes, distinguish fentan ll related crimes from other drug crimes, and offer treatment and recovery options in lieu of lengthy sentences when appropriate. ehmid --.—Request that Sheriff and local police to track data on utilization of Medication Assisted Treatment (MAT) in jail and what arrests do not end inwhe us net geing te jail time because of booking restrictions. � • Y[�� \�1�1 I��l�ll��� J`��l �i� 1►1R►���1: � Ill��i1 6--.9. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services; and. -- - -- ---- - -- -- - - - - -- - - --- -- -- ---- -- - --- -- - -- - -- -- -- - - -- - -- -- - -- -- --- - - - :1•wiio-r�:��w �uuuu�w:�� �•i�:. - - - - - - - - - - - - �� - - - - - - Il�iilJ!T-7 - - - • - - r IVA FA Page 26 of 39 11 • 11 • M WE ■ I � 1/ Mill 1 Rieky's Law. y^ '} veluntaFy tFeatn9ent whole waiting for sentencing, PFeVide access to tFeatn9ent ins he Ja"' juveniles, 26. Fund hiring and lengevity ineentives (benHses) f8F eeFreetmenal deputies On eFdeF te fill staffing vacancies in the jai' facility. MAMAS W 1.00 . NaFEetie Aleehelies ., / / / eeunseling) NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends thi—_ Whatcom County Elected officials such as the Executive, Prosecutor, and Sheriff, consider items in Exhibit A for One'usmen inExeeutmv, 4Fd-... �- future action; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward the aforementioned near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. Page 27 of 39 ATTEST: Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: Deputy Prosecutor WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Barry Buchanan, Council Chair Page 28 of 39 EXHIBIT A During stakeholder meetings to refine and develop the Council's resolution, members heard the following suggestions, ideas, and requests for action. Council requests that the Executive consider these exhibit items for potential inclusion in an Executive Declaration of Emergency or Order. 1. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 2. Expand the ability to use test strips beyond Health and Community Services to law enforcement and first responders. 3. Provide additional training on common and emerging illicit drugs to police for improved response and identification of fentanyl and other drugs. 4. Identify potential modifications to booking restrictions in the jail and develop operational plans to address inmate increases. 5. Encourage using Strict Legal measures to address maior crimes and offenses related to fentanyl, for distribution. 6. Provide more opportunities for youth diversion, especially for people ages 18-25 years old. 7. Evaluate alternative court programs for higher utilization and capacity. 8. Identify options and funding sources to provide more lower cost housing and creative housing solutions. 9. Fund and launch a multi -jurisdictional, multi -language public education program, including youth public education. 10. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. 11. Provide training for healthcare providers and first responders on the benefits of and how to administer Medication -assisted treatment. 12. Increase funding for treatment programs to increase availability of detox beds,, provide voluntary treatment while waiting for sentencing, provide access to treatment in lieu of sentencing. 13. Provide additional resources for recovery court, including a secure facility other than the jail. 14. Ensure services are available for juveniles, not just adults. 15. Ensure medically assisted treatment (MAT) offerings inside the jail match community - based options. 16. Provide support and training for first responders and behavioral health staff dealing with trauma and burnout related to overdose responses. 17. Create and implement an overdose response team. 18. Support efforts by Lummi Nation to build a Secure Withdrawal Management and Stabilization (SWMS) facility. 19. Analyze options for expanding the Alternative Response Team, including providing 24- hour responses. 20. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) Page 29 of 39 AGENDA ITEM #5 PRESENTERS: BOARD ACTION: HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 Action Plan — Fentanyl Response Executive's office ❑ Action Item Q Discussion ❑ FYI - Only While Whatcom County government has taken many steps to address opioids locally, the urgency of the issue requires new strategies, both new and re -prioritized funding, and more immediate action across the prevention, intervention, treatment, and aftercare/recovery continuum. The Executive appreciates Council's leadership in bringing the urgency of the fentanyl crisis further into the public sphere, enhancing coordination amongst different branches and levels of government, and engaging in thoughtful work with stakeholders. We want to be responsive to any Health Board action and are working with Health & Community Services, the Sheriff's OfficelDEM, and EMS on assembling a set of actions that can be implemented quickly for maximum impact, consistent with recommendations from the MAC group and the Whatcom County Justice Project Implementation Plan. This is an opportunity to discuss at a high-level the types of actions the community can expect to see. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Certain populations, including residents who are unsheltered and those with pre-existing behavioral health, substance use disorder, or history of trauma, are at risk of developing opioid use disorder. Supporting these populations will impact those most vulnerable to overdose death or poor health outcomes. BOARD ROLE / ACTION REQUESTED Provide high level feedback on concept or actions. WHATCOM COUNTY HEALTH AND niiL COMMUNITY Page 30 of 39 SERVICES ATTACHMENT(S) None Page 31 of 39 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 AGENDA ITEM #6: Whatcom Community Health Insights PRESENTERS: Amy Hockenberry, Health Information and Assessment Supervisor and Dr. Chris Laugen, Epidemiologist, Whatcom County Health and Community Services BOARD ACTION: ❑ Action Item ❑ Discussion Q FYI - Only The Whatcom Community Health Insights (WCHI) is a web -based platform to share local data, trends, and comparisons with Washington State and National averages. It will include stratification by subpopulations when possible and will provide links to relevant resources and community partners working to address the issue. The purpose of the WCHI is to: • Provide meaningful & easily accessible population health data for Whatcom County; • Give community partners, elected officials, and other community groups easy access to current data on an ongoing basis; • Help inform partners' planning, decision -making, grant applications, etc.; and • Increase transparency in sharing public health data. Staff will provide an overview and a preview of the tool, which will be released in early April. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The WCHI will both stratify subpopulations by race/ethnicity, age, geography, etc., when possible, it will also highlight disparities among populations to advance equity and prompt community action. BOARD ROLE / ACTION REQUESTED None. WHATCOM COUNTY HEALTH AND njiL COMMUNITY Page 32 of 39 SERVICES ATTACHMENT(S) None Page 33 of 39 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES AGENDA ITEM #7 PRESENTERS: BOARD ACTION: HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 Healthy Children's Fund update Erika Lautenbach, Health and Community Services Director ❑ Action Item E1 Discussion ❑FYI - Only Whatcom County Health & Community Services (WCHCS) staff will present a brief update on the implementation of the Healthy Children's Fund (HCF). In the 2022 general election, voters in Whatcom County approved Proposition 5, the Healthy Children's Fund, a property tax measure estimated to raise approximately $9.98M each year for 10 years, for investments in early learning and care and vulnerable families. There are 10 strategies contained in the implementation plan, and this briefing will focus on the strategies staff are prioritizing for RFPs, cooperative agreements, and contracts. The briefing will also discuss the current funding opportunities and the forthcoming opportunities in both the early learning and care and the vulnerable children and families categories. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The priorities of the Healthy Children's Fund will advance geographic, economic, and racial equity for young children and their families. BOARD ROLE / ACTION REQUESTED None. ATTACHMENT(S) Slide Presentation WHATCOM COUNTY HEALTH AND njiL COMMUNITY Page 34 of 39 SERVICES 3/21 /2024 Investing in early childhood_ • 90% of human brain development happens befores the age of 5. • Only 50% of kinds in Whatcom County enter kindergarten fully ready to learn • Children who attend high -quality early learning & care are more likely to be on track with their reading skills by third grade and graduate high school and attend college, technical school, or training program that lead to good jobs as adults. • Whatcom County has 5000 fewer early learning & care slots than we need, especially in rural areas. ■ Over 85% of Whatcom County businesses report staffing challenges from lack of early learning and care. ■ For every dollar invested in early childhood programs, between $7 and $13 are saved through benefits like lower incarceration rates and lower healthcare costs. Page 35 of 39 3/21 /2024 Healthy Children's Fund + Affordable 14 • Accessible High Quality • Professional r"'k • Expand mental and behavioral health services • Prevent and reduce homelessness M_ Support for parents/caregivers Year 1 & 2 Fund Priorities Early Learning and Care • Small Capital Projects • Professional Development • Subsidies • Workforce Expansion & Retention ■ Hubs a Innovative Strategies Vulnerable Children a Behavioral Health • Housing • Early Parenting Supports • Resource Navigation 2 Page 36 of 39 3/21 /2024 Healthy Children's Fund: Expected Timeline* 2023 2024 2025 Infrastructure Built Initial Proj $ April -December 2023 February -March 2024 Implementation Team formed Staff hued Processes/policies deyela Development of Initial Strategies Initial July -October 2023 April Funding mechanisms and -June logistics designed Strategy prioritization timeline pub�ished Implementation Plan Approved March 2023 Initi l Funding Advertised 0clvhei 2023•January 2024 Rchok assistance available aWrear aiM communication to providers Ann al Report and Implemen tian Update March 2024 Evaluation, rununicailvn., and Community Engngcn_ pl um published Selected Bi-annual Evaluation Late 2025 cts Executed 01 Process Evaluation Annual Report i Report Implementation December 2024 Plan for Years 3 March 2025 ARPA Funding -Birth to 5 Council -directed ARPA funding • Capital Funding and Expansion • Stabilization and Emergency Childcare Vouchers • Home -based childcare businesses • Second Round of Capital Funding Page 37 of 39 3/21 /2024 Early Learning & Care Projects ( "i Strategy #1.• Small Capital Grants Cap t Strategy #2: Pathways to a Stable EL&C Workforce Strategy #3 & 4: Subsidies and Workforce Strategy #5: Create Regional Hubs Strategy #6: Innovative Projects Vulnerable Children Projects I � Strategy #7. Behavioral Health Workforce Recruitment Strategy #8: Housing/Homelessness Strategy #9: Expand and Enhance Early Parenting Supports Strategy #10: Expand and Enhance Early Parenting Support M Page 38 of 39 3/21 /2024 What's Coming Evaluation, Communications, and Community Engagement Plans • RFPs and Contracts for nearly every strategy • Planning process for next implementation plan (due March 2025) * Performance Audit Questions? Learn more and sign-up for updates at https:ffwww.whatcomcounty.us/4069/HeaLthy- ChiLdrens-Fund Page 39 of 39 5 • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-009 File ID: AB2024-009 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: 03/26/2024 Agenda Date: 03/26/2024 Enactment #: Primary Contact Email: kfelbing@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Meeting Materials for Health Board March 26, 2024 SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: None HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 03/26/2024 Council as the Health Board RECEIVED Attachments: Agenda and Packet, REVISED Agenda Packet sent from Health and Community Services on 3.21.2024 Whatcom County Page 1 Printed on 4/21/2025 WHATCOM COUNTY COUNCIL COUNCIL MEETING AS THE HEALTH BOARD JOINT MEETING WITH THE PUBLIC HEALTH ADVISORY BOARD 10:00 a.m. Tuesday, March 26, 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 10:0--10:05 2. Public comment No paper 10:05-10:15 3. Health Officer/Health Director update (Pages 2-20) 10:15-10:25 4. Resolution identifying Whatcom County approaches to the fentan I emergency AB2024-090 (Pages 21-27) 10:25-11:00 5. Executive Declaration of Emergency (Pages 28-29) 11:00 —11:10 g. Whatcom Community Health Insights Preview (Pages 30-31) 11:10 —11:25 7. Healthy Children's Fund briefing and discussion (Page 32) 11:25 —11:55 8. Closing/Next Steps No paper 11:55-12:00 WHATCOM COUNTY h HEALTH AND COMMUNITY SERVICES WHATCOM COUNTY Erika Lautenbach, MPH, Director T c;. Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH. Co -Health Officer Department Report March, 2024 Equity — Collaboration — Compassion — Transparency — Innovation - Service Leadership: Health Director work has focused on communication/outreach, legislative session, meetings with federal legislators, and key issues including Healthy Children's Fund and fentanyl/overdose Executive action. Annual Report and City Council Briefings: Whatcom County Health and Community Services published our first Annual Report in March. In conjunction with the release and to re -open communication with local elected officials, I provided presentations to every city council in March. Topics included department/division overview, budget, strategic plan, 2023 accomplishments and 2024 projects/initiatives. Legislative Advocacy: Through Washington State Association of Local Public Health Officials (WSALPHO) and National Association of City and County Health Officials (NACCHO), I met with state and federal legislators, respectively, to share local priorities, challenges, and requests for support. Two of the three WSALPHO legislative priorities passed and were signed into law by the Governor. Priority Topics: I've worked with our staff team to move our proposed RFPs for the Healthy Children's Fund through the county process, and partnered with Executive Staff and stakeholders to develop a budget and recommendations for immediate action re: fentanyl. I look forward to the Council and Executive actions and the opportunity to move forward with a variety of new activities and initiatives. Health Officer work has focused on the opioid crisis, communicable diseases, behavioral health, and collaboration with community healthcare providers. Opioids: We have continued engaging with elected officials and community partners in addressing the opioid crisis. Within the department the Health Officers are working inter - divisionally, particularly with RSD and CDE, around improving capacity, treatment options, and interfaces between people who use drugs and the jail, hospital, outpatient medical providers, Lummi Nation, and Opioid Use Disorder treatment providers. Dr. Thompson recently attended a 2-day addiction medicine conference and is working to WHATCOM COUNTY HEALTH AND rO9 Girard street COMMUNITY Main Line: (364) 778-6000 Bellingham, WA 98225-4005 L SERVICES www.%whatcomcounty.us/health 2 of 32 connect the Swedish Hospital addiction medicine fellowship program and Whatcom County healthcare institutions. Dr. Harley is working to improve support for pregnant people, young families, and youth with mental health concerns. The Health Officers are also convening meetings of medical leadership to increase collaboration and communication between healthcare institutions in our county. Communicable Disease: Respiratory virus guidance is evolving to better respond to the current situation of less severe outcomes from COVID-19, and harmonize COVID guidance with that around other respiratory infections. These efforts are balanced with caution around the ongoing deaths and severe disease from COVID-19 illness, particularly in those over 65 years of age. Still at the forefront is the prevention message that vaccination continues to significantly reduce health risks from COVID-19. We are alert to up -trending measles cases nationally this year, with a number of cases within Washington state among unimmunized adults. We appreciate efforts by healthcare, schools, childcare and our immunizations nurses to improve measles immunity in our county through MMR vaccination. Other work: We continue to engage regularly around communication and media requests, data presentation and interpretation, collaboration with the Medical Examiner's office, and the Whatcom Community Health Insights project. Communicable Disease and Epidemiology (CD&E): Public health nurses and staff within the CD&E division continue clinical service outreach and educational events in the community. Refugee Health: With the assistance of Dr. Amy Harley, we are working with the state Department of Health and the federal Department of Health and Human Services to contract with a local community health center in Whatcom County to start offering Refugee Health Screenings. Refugees who resettle in Whatcom County must travel to Snohomish County for Refugee Health Screenings. Offering this service locally can reduce barriers for refugees seeking health services. Reducing barriers to healthcare access for this population is vital for infectious disease surveillance in the community. Vaccine Clinics: The immunization team continues to offer monthly vaccine clinics and clinic appointments to increase access for residents with barriers. The team recently received an expression of gratitude for their partnership with Hoagland's Pharmacy to ensure the administration of COVID-19 and influenza vaccines for residents who are insured but homebound due to disability or illness. This vulnerable population often has high barriers to accessing care due to physical disability and high medical risk, which 3 of 32 prevents them from accessing healthcare through traditional methods. From January to February 2024, we served 54 clients and administered 134 vaccines. Candida Auris: The Infection Prevention team, in concert with the state Department of Health, is collaborating with the local hospital and long-term care facilities on surveillance and infection prevention protocols for Candida Auris. Cases were recently identified in Washington State. Candida Auris is a multi -drug -resistant fungus that can cause severe illness and spread within healthcare facilities. School/Childcare Support: Our Public Health Nurse and Liaison for School and Childcare Health is collaborating with the state Department of Health on creating a tool to help schools and childcare facilities standardize reporting of absenteeism for certain notifiable conditions and facilitate prompt notification of clusters/outbreaks to local health jurisdictions. The tool will help streamline data collection and reduce the reporting burden on the public school system. Syphilis: Syphilis cases continue to trend upward on the local and national levels. The Sexual Health Provider Education virtual presentation series, which was organized by CD&E, begins in March. Syphilis is the first of three presentations by expert faculty from the University of Washington. This virtual education series will help with healthcare providers' knowledge deficits regarding managing STDs/STIs. Tuberculosis: The Tuberculosis Team is currently managing five active TB cases. TB nurses often provide clinical care and case management to medically complex individuals. The public health nurse went above and beyond duty to contact a patient's specialty providers to prevent an adverse outcome from the client's reaction to their cardiac medication. The same client was admitted to the hospital recently. This nurse collaborated with the hospital case management team to advocate for this client to receive a home health nurse at discharge. Drug Testing: The public health nurses in the SSP/Harm Reduction Program have started rounding with the street medicine outreach team to increase participant engagement. Collaborating with the University of Washington and the Addiction, Drug, & Alcohol Institute (ADAI), they have started offering a new service, which is drug testing to help participants identify potentially harmful substances circulating in the community. In addition, both public health nurses are participating in the Community - Law Enforcement Aligning in Response to Substance Use (CLEARS) Project, a one- year project to develop regional solutions to improve interactions between law enforcement and people who use drugs. Community and Organizational Development (COD): 4 of 32 The Community and Organizational Development division facilitates collaboration across the divisions and provides accurate, meaningful, and timely information, data, and training. Specialty areas include data, assessment, epidemiology, informatics, performance management, evaluation, communications, media relations, emergency preparedness, equity and belonging work, and workforce development. A few key areas of focus at this time are: Equity: The newly formed HEAL (Healing -centered, Equity and Leadership) Team launched on February 29thl This team will receive professional development in trauma - informed care, healing -centered practices, antiracism and health equity to create foundational learning in preparation for actionizing health equity. In late Spring, an organizational climate and care survey will be launched to assess the strengths and needs of WCHCS. Performance Management: Quality Improvement (QI) Council launched March 7t" This is a cross -divisional collaborative team that will execute the Quality Improvement strategic priority to improve the use of data to drive decision- making, inform improvements, and foster a culture of transparency and accountability. The council will focus on alignment and standardization of our department's quality improvement efforts, bring new innovations to the departments' programs, and increase accountability to leadership and our stakeholders. Data: A new Child Wellness Survey focused on infants and children ages 6 months to 11 years is being conducted by WA DOH. Typically, the results would be available at a state -level however, through Healthy Children's Fund, Whatcom County will survey our county and get data specific to our community. This will allow more meaningful results that reflect children and their families who live in the county. The survey will ask parents of children in this age group about the health and development of their child, access to childcare, and other topics including mental health. Whatcom County will be a model for other smaller counties in Washington State that would like to have their own county - specific sample. Community Health and Human Services (CH&HS): Retreat: CH&HS held a retreat on January 25th and nearly every staff member of the now 30+ people in the division were able to attend and share their programs, commitments and priorities for 2024. This year the focus is on intentional programming and commitments in our work, to make sustainable long-term impacts. The retreat also created space for several of our program teams to connect and find ways to collaborate. 5 of 32 The Veterans Program and the Child and Family team met shortly after the retreat and are now working on ways to support childcare needs for veteran households. Severe Weather Shelter: The Severe Weather Shelter has officially closed for the season, as of March 15th. Over the 20 nights that it was open, over 197 unique guests were served. The shelter was staffed using a pool of 11 temporary staff and 22 permanent Health & Community Services employees. In partnership with the Response Systems Division, over 730 hours of training were completed for the individuals who worked or volunteered for the operation. It was a very large lift, and involved staff across the department, but with 947 utilizations by guests over those 20 nights and 5 days, many of our vulnerable neighbors kept warm during some life -threatening temperatures. Youth RFPs: Supporting youth is very much a focus across several of our programs right now. It is really exciting to have three different Requests for Proposals (RFP) open to the community with a youth focus. We are seeking proposals ranging from homeless prevention strategies for families with children 0-5 (closes 3/12), Outreach work focused on preventing youth from using opioids (closes 4/2) and an opportunity to support families seeking services and referrals for their children with healthcare needs (closes 4/2). Each of these is an opportunity to prevent further harm or trauma for many of the youth in the community, and it is exciting to be one step closer to getting programs to the people and places they are needed most. Healthy Children's Fund: Over the last month, the Children and Family Programs have released a Housing Stability RFP, solicited proposals from Doulas to serve Medicaid eligible pregnant parents and finalized a Basic Needs RFP that will be released in early April for families with Children 0-5. All funded through the Healthy Children's Fund. The Child and Family Well Being Task Force will be hosting its first annual retreat on March 29th, with focus on building a work plan and connection amongst the group moving into the new year. Opioids/Behavioral Health: Our Prevention staff continue to support the work of the All Hands team, and so far in 2024, there have been four successful events. The staff are also excited as they are just beginning the scoring of the proposals from a recently closed RFP seeking providers able to offer school based teletherapy in Whatcom County. This will mean added capacity for youth mental health services in our schools. Environmental Health (EH): EH programs focus on protecting groups of people from threats to their health and safety posed by their environments. EH programs include various sanitation areas such as food safety, drinking water, on -site sewage and solid waste. 6 of 32 New Leadership: With the recent promotion of an environmental health specialist into a supervisor position within the division, there has been a shift and reorganization of programmatic responsibilities. This expansion in leadership will allow for more support in programs including food safety, living environment, school safety and solid waste. Smoke and Heat Response: Using Foundational Public Health Services funding, EH is building a program to support frontline communities during wildfire smoke and extreme heat events. Several public education events, including at senior centers around the county, and focused conversations are scheduled in April 2024. This qualitative assessment will inform the recommendations of the Climate Vulnerability Assessment, which will be completed June 30, 2024. Coordinated Water System Plan: The division is leading the Coordinated Water System Plan update to dovetail with the County's larger Comprehensive Plan update. Changes and updates to the plan intend to address complex issues such as the impact of climate change on water systems. Financial Services: The Financial & Administrative Services division supports the department by coordinating financial services such as contract processing, payment processing, grant billing, payroll processing and other various audit functions. New Manager: The new Financial Services Manager started February 26' and this position will coordinate and oversee the daily departmental financial and accounting activities. Year End: The Business Office has wrapped up the 2023 financial year end process. This process included creating grant accountability worksheets for the 33 Federal Grants ($2.8M) and 51 State Grants ($15.7M) that were reviewed and reconciled. Contracts: Our Contracts Coordinator is successfully managing 129 active contracts and 15 Letter of Agreements (LOA's) to help support the $34.2M the department has budgeted to contractual services in 2024. Response Systems: The Response Systems Division (RSD) programs aim to address the needs of individuals lacking adequate care for behavioral health challenges and basic needs within our community. These programs seek to alleviate the reliance on emergency services such 7 of 32 as 911, crisis interventions, and the legal system. By implementing innovative approaches like the Alternative Response Team (ART), Ground -Level Response and Coordinated Engagement (GRACE) program, Law Enforcement Assisted Diversion/Let Everyone Advance with Dignity (LEAD) program, Co -Responder program, Mental Health Court and Street Medicine Team, we strive to provide comprehensive support to individuals in need while also enhancing the efficiency of our emergency response and care coordination systems. A few program highlights include: ART: The Alternative Response Team (ART) is fully staffed as of March 4th. ART continues to respond to 911 calls in lieu of law enforcement when appropriate. In addition to the ART response team, RSD was able to hire a Behavioral Health Aide who support ART and community providers with transportation needs. In March, RSD will report back to County and City of Bellingham councils on how the first year of ART has gone, what we have learned and where we hope to go. Co -Response: In partnership with the Whatcom County Sheriff's Office, the Co - Responder program is in full swing. With two highly trained and skilled Behavioral Health (BH) specialists, the team is able to respond with deputies to calls for service that have a BH concern. Co -Responders are able to bring services and support to community members in the moment, provide some follow-up and free up deputies to be available for other calls. Similar to ART, we are working with a 3rd party evaluator in the pilot year of Co - Response to assist our community in understanding the need for a Co -Responder program, areas of growth and data analysis. In April, staff members from the Co -Responder and GRACE programs will attend the 2nd annual Co -Responder Outreach Alliance of WA conference. This will be an opportunity to meet with co -responder programs from across WA state. 8 of 32 wr ° c� C1' � 4 fir'"'• � 'v „� <. . + ` K WHATCOM COUNTY HEALTH AND fi COMMUNITY SERVICES Ann I Report 9 of 32 A Letter Frcrn The Dlrectc.4 r We live in a different world than five years ago. While many of the most significant impacts of COVID-19 are behind us, new threats to our health and community have emerged, or become more pronounced. Fentanyl has devastated families, and in Whatcom County, there has been a nearly 50% increase in overdose deaths from 2022 to 2023. Mental illness, while a long-term priority, has now reached a crisis level for families, schools and our young people. Key drivers of homelessness - affordability and accessibility - are worse, while services for the chronically homeless are not keeping pace with the growing numbers of people living unsheltered. Access to affordable childcare, food, and other basic needs has declined due to inflation and other economic drivers. The increase in severe weather events and temperatures we're experiencing are impacting our homes and way of life. Life has changed for you in these last five years — and it's changed for us, as well. Our department, which serves every geographic corner of the county in cities and unincorporated communities alike, is a different organization in so many ways. Coming out of the COVID-19 crisis response, we have been able to utilize our growing number of staff to expand public health work in our County. Two years ago, we created the Response Systems Division, which brought our crisis outreach and intensive case management programs in-house. Last year, we launched our new five-year strategic plan and changed our name to Whatcom County Health and Community Services. Nearly half of our staff now work in human services or behavioral health, and this change honors the complexity and diversity of our work and commitment to our community. Through state and federal grants, we've expanded programs in nearly every division in our department. We're implementing the goals of the Healthy Children's Fund, passed in 2022, and beginning work on designing the behavioral health components of the Public Health, Safety, and Justice ballot measure passed in 2023. While our team, and budget, are nearly double what they were just five years ago, only 6% of our revenue comes from the county's general fund. We are proud to have built programs and services that have gained the trust and financial commitment of outside funders. Today, the public health system is more visible than it has ever been before. We recognize that for some in our community, it may be hard to trust government agencies due to both historical traumas and recent challenges. The best way that we can grow that trust is to earn it. We intend to do that every day by providing timely services with the customer service you expect, while tackling the important issues that matter to Whatcom County. If we have learned anything in the last several years, it's that nothing important can be accomplished without the support and collaboration of our partners and our community. I invite you to move forward with us into a new era for Whatcom County Health and Community Services. We look forward to working with you, and for you. In Community, Erika Lautenbach, MPH Director, Whatcom County Health and Community Services 10 of 32 page 2 Whatcom County Health and Community Services 2023 Annual Report Purprse, Pric ritles, Values ADVANCING EQUITY = PARTNERING WITH OUR COMMUNITY • Community Partnerships & Engagement Partner collaboratively to find community -based solutions that advance health and health equity. F O'iE APO- '1 04,0 PROVIDE Organizational Infrastructure 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 anc 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. • collawmation • Compassion • Transparency • Innovation • Service What We Dre� The Communicable Disease and Epidemiology division works to stop the spread of disease. They work to prevent and investigate infectious diseases, provide screenings and clinical/community support referrals, and provide vaccinations and harm reduction services. They work to prevent and control the spread of communicable diseases like tuberculosis, measles, COVID-19, RSV, influenza, hepatitis C, HIV, syphilis, MRSA, and many more. Programs include: • Immunizations • Tuberculosis • Syringe Services Program • Communicable Disease • Sexual Health The Community and Organizational Development division provides services that cross -cut and connect all divisions within the department. They help the department to carry out its priorities and projects more effectively and implement WCHCS's 2023-2027 Strategic Plan. Programs include: • Health Information & Assessment • Epidemiology • Assessment & Evaluation • Data & Informatics • Partnerships & Strategy • Communications • Emergency Preparedness & Resiliency • Equity • Policy • Workforce Development The Community Health & Human Services division promotes health and well-being for everyone in our community. They aim to reduce health disparities and encourage healthy behaviors. They offer services in areas such as housing, food and nutrition, and substance use prevention, as well as support for children and families, veterans, and people with disabilities. Programs include: • Nurse -Family Partnership • Food Systems • Homeless Housing • Developmental Disabilities • Veterans • Substance use prevention • Children with Special Health Care Needs • Childcare and Early Learning • LatinX Outreach page 4 Whatcom County Health and Community Services 2023 Annual Report The Environmental Health division works to promote a healthy and safe environment. They focus on disease and injury prevention and adherence to environmental health mandates and requirements. They monitor drinking and recreational water quality; conduct restaurant inspections and monitor food recalls in order to prevent foodborne illnesses; prevent exposure to hazards like lead, asbestos, or mold in homes or school environments, and much more. Programs include: • Solid Waste • Food Safety • School Health & Safety • Living Environment • On -site Septic • Drinking Water • Climate Change Response The Financial and Administrative Services division makes sure services run smoothly. They provide customer service to community members in accessing information and resources. They manage vital records like birth and death certificates, permits, and other health -related public records. They also oversee the department budget, grants and contracts, and financial services. Programs include: • Community customer services including vital records, permitting, and complaints • Financial Services and Contracts • Internal administrative services The Response Systems division provides intensive case management services to vulnerable community members. They work closely with first responders, healthcare providers, social services, and the legal system to coordinate services for their clients and reduce utilization of emergency services and incarceration. Programs include: • Ground -Level Response and Coordinated Engagement (GRACE) • Law Enforcement Assisted Diversion (LEAD) • Alternative Response Team (ART) • Mental Health Court • Co -Responder program with Behavioral Health Sheriff Deputies • Behavioral health contracts and coordination Whatcom County Health and Community Services 2023 Annual Report page 5 YAL7 : FF Behavioral Health Funds Improve Outcomes for Our Kids All seven school districts in Whatcom County provided behavioral health services in the previous and current school years using Behavioral Health Funds administered through our department. All Whatcom County kids benefit from this, with 57% of people served outside Bellingham. The funds go towards substance use prevention professionals and programs, mental and behavioral health practitioners, coordination of community services, and outreach. Reducing risk in these areas also impacts other `life indicators,' such as improving school performance and a child's interactions with family and community. These services demonstrate: • Cost savings to the community. • Improved behavioral health outcomes. • Referrals and connections to treatment for mental health, substance use, or both. • Leveraged resources. Cost -benefit estimates show that effective school -based programs can save $18 for every $1 spent. Wiser Lake: Our year -long data collection effort will help understand & mitigate harmful algae blooms. Improving the Health of Wiser La ke For the last two years we've been studying the consistent presence of harmful algae blooms (HABs) at Wiser Lake. Through a grant from the Washington State Department of Health, we worked with local groups to collect 12 months of data - the first step in discovering the cause of HABs. An additional grant from the Department of Ecology will start in July and fund analysis of the data we are currently collecting. Then, we can develop a set of recommendations based on the results. For updates on this project, or to sign up for notifications via email or text, visit https://www.whatcomcounty.us/wiser. Whatcom County Made Historic Childcare Investments Last May, Whatcom County awarded $5.8 million in federal American Rescue Plan Act (ARPA) funding to create 277 new early learning slots and preserve 84 existing slots, including investments in Ferndale, Bellingham, and the Meridian School District. Awardees include: • Whatcom Family YMCA Barkley • Western Washington University's Child Development Center • Opportunity Council Bellis Project • Gabriel's Art Kids, Ferndale • Meridian School District The County also awarded a $750,000 grant to the Boys and Girls Clubs of Whatcom County to mitigate financial impacts from the COVID-19 pandemic after its March 2020 acquisition of Kids' World. In addition, with ARPA funding from Whatcom County and the City of Bellingham, Opportunity Council's Center for Retention and Expansion of Childcare (C-RECC) has awarded grants to over 32 local childcare providers, ranging from $10,000 to $100,000 per provider. With these grants, providers have been able to raise wages, meet urgent maintenance needs, purchase supplies, and create enriched early learning environments with high -quality curriculum and services. Further funding from Whatcom County has supported emergency childcare vouchers for families, business leadership and technical assistance, and professional development scholarships for childcare workers. 14 of 32 page 6 Whatcom County Health and Community Services 2023 Annual Report Innovative New Program Provides Alternative to Law Enforcement for 911 Calls Last year WCHCS launched Whatcom County's Alternative to respond to the most serious 911 calls. From July through Response Team (ART), a program that sends behavioral health December 2023, 830 calls to 911 were dispatched directly to specialists to respond to specific non-violent behavioral health ART. Less than one percent of those calls needed to be referred 911 calls in Bellingham, instead of law enforcement. to law enforcement for back-up support. ART works to de-escalate tense situations and engage someone experiencing a behavioral health crisis. Feedback from law enforcement and other community partners is that most ART calls have been resolved without additional backup from law enforcement, and thus freeing up Bellingham Police Officers Taking Action to Address the Opioid Crisis in Our Community Responding to the opioid crisis in our community continues to be a WCHCS top priority. Every division at WCHCS is working to address the opioid crisis by supporting children, youth, and families facing addiction; preventing overdose deaths by distributing Naloxone and training community members on how to use it; working on the street directly with clients with addiction issues to connect them to housing, medical care, and other essential services; operating the Syringe Services Program; providing training and education regarding fentanyl and other opioids; working to increase access to treatment and recovery options; advocating for system -wide improvements; and leading county -wide prevention coalitions. In June, the department launched the website whatcomoverdoseprevention.org, where individuals and groups can request free Naloxone kits and find information, resources, and up-to-date local data on the opioid crisis. In August, WCHCS formed the County -wide Multi -Agency Coordination (MAC) Group formed to coordinate response efforts. The MAC group is made up of 70+ organizations and agencies focused on substance use disorder prevention, treatment, intervention, and recovery; members include leaders in healthcare, social services, housing, law enforcement, courts, EMS, libraries, schools, and tribal health. 2023 By The Numbers: For more information, visit the ART webpage at https://www.whatcomcounty.us/RSD. (Left to Right) WCHCS Co -Health Officer Dr. Greg Thompson, Whatcom County EMS Specialist Steven Cohen and WCHCS Supervisor Lela Riherd providing information and training at a Sehome High School community event. Communicable Disease & Epidemiology • 734 vaccine outreach events were held - • i served over 500 clients, more than 7,000 invaccines were administered • 300 scheduled clinical visits completed 15 of 32 Whatcom County Health and Community Services 2023 Annual Report Provided approximately 125 syringe services program/harm reduction clinics and trainings for community partners page 7 Partnership With Ferndale Community Services Supports County Severe Weather Shelter Ferndale • • Community Services Serving North Whatcom County WCHCS manages the county's contract to provide up to $75,450 to Ferndale Community Services, funded by the federal American Rescue Plan Act. This local nonprofit operates the only Whatcom County shelter outside the city limits of Bellingham. The group's typical service area includes Ferndale, Custer, Blaine, Birch Bay, Lynden, and the surrounding unincorporated county areas. This shelter can accept up to 15 guests and provides shower and laundry facilities, along with a warm place to sleep during extremely cold weather. In addition to the severe weather shelter, Ferndale Community Services provides year-round support to community members in need through: • A Community Resource Center with clothing and household items • The Other Bank providing hygiene supplies • The Utility Fund for help with City of Ferndale water and sewer bills • Computer and phone usage • Housing and job search assistance • Transportation services • Shower and laundry referrals Learn more at https://ferndalecs.org/ 2023 By The Numbers: Environmental Health Partnership with Local Veterans Clinic Enhances, Expands Veterans Services WCHCS has supported military veterans in Whatcom County with resource referrals and financial assistance for over a decade with a single staff member. In 2023, the department added a second veterans specialist position whose office is located at the Bellingham's Vet Center. The Bellingham Vet Center is a one -stop -shop for qualifying veterans seeking mental health counseling, veteran resources, and disability benefits/claims processing. Having county staff co -located in the same building has strengthened the partnership with Bellingham -based VA employees, maintained open communication with other veteran service providers, and increased collaboration with outreach opportunities, in order to better support veterans in our community. Many Whatcom County vets served in Vietnam, and many live in rural parts of the County with limited transportation options. Having two locations where they can get services (as well as the ability to connect over email, phone, or text) has helped make services much more accessible. In 2023, WCHCS staff submitted 1,132 claims on behalf of Whatcom County veterans. The two veterans staff members at WCHCS have been able to complement each other's work and support veterans in new ways, such as presenting to elected officials to educate them on veterans' needs, providing clinics for Border Patrol staff who are military veterans, and meet people `where they're at' in their workplaces. Both staff are veterans, which allows them to better connect and understand the services and agencies they work with on bethalf of other veterans. • Tracked over 29,000 onsite sewage Supported at least 830 individual water systems connections • Trained 874 homeowners to maintain Increased access to sewage disposal for their onsite sewage system over 300 properties 16 of 32 page 8 Whatcom County Health and Community Services 2023 Annual Report Congratulations to our Partner, Sustainable Connections, on 1 Million Pounds in the Food Recovery Program The WCHCS Solid Waste Program provides local nonprofit Sustainable Connections with $30,000 annually to support the Food Recovery Program (FRP). This program aims to reduce food insecurity, divert edible items that would otherwise go into landfills, and address climate change by redistributing surplus, nutritious food from local businesses to neighbors experiencing hunger, rather than sending that food to the landfill. The program started in 2019 and reached the one million pound mark in 2023. The FRP is also the umbrella program for the "Freedge", a refrigerated food pantry located at the RE Store in Bellingham. In their 2022-23 annual report, Sustainable Connections reported that: • 16 new businesses were recruited to the FRP • 10 new businesses were consulted in how to to divert their inedible food to compost instead of landfills • 3 local events were supported in diverting food and organics from the landfill. For more information on the Food Recovery Program, visit https:Hsustainableconnections.org/tag/foodrecoveryprogram/ Sustainable Connections (COMMUN17Y BRIDGE) Oro!"1 ®PEN TODAY 2023 By The Numbers: Nurse Family Partnership • 89 families served • 25 babies born • 750 home visits and 250 telehealth visits We held two free drop-off tire recycling events in 2023. We collected an estimated 72,500 tires across 755 loads - several thousand more than in past years. These events were made possible by funding from the Washington State Department of Ecology. ....................... y Care*Van Caravana de Salud Care -A -Van Clinics Offer Free Vaccine Clinics to Underserved Communities Care -a -Van Mobile Health Clinics are a partnership between WCHCS and the State Department of Health to increase access to health services in rural Whatcom County. Care -A -Van also partners with tribal nations, elder care facilities, and Western Washington University to offer free vaccines to people without health insurance. In 2023 WCHCS and Care -A -Van co -hosted 13 vaccine clinics through this program, offering free vaccines for COVID-19, flu, Hepatitis A, Hepatitis B, Tdap, Mpox, and routine childhood vaccines. 2023 Naloxone Distribution 11,824 Naloxone doses distributed in Whatcom County 17 of 32 Whatcom County Health and Community Services 2023 Annual Report page 9 Leadership Erika Lautenbach, Department Director Dr. Amy Harley, Co -Health Officer Dr. Greg Thompson, Co -Health Officer Management Ann Beck, Community Health & Human Services Lynnette Bennett, Community & Organizational Development Malora Christensen, Response Systems Sabrina Houck, Financial Services Shamika Brooks, Communicable Disease & Epidemiology Sue Sullivan, Environmental Health Advisory Groups Public Health Advisnry Bnard Sterling Chick, Chair Emily O'Connor, Vice Chair Behavinral Health Advisnry Cnmmittee Nicholas Evans, Chair Child & Family Wellbeing Taskfnrce Christina Jackson, Co -Chair Ray Deck, Co -Chair Developmental Disabilities Advisnry Bnard Raegen Miller, Co -Chair Lindsay Foreman -Murray, Co -Chair Fnnd Systems Committee Riley Sweeney, Chair Margaret Gerard, Vice Chair Solid Waste Advisnry Cnmmittee Rodd Pemble, Chair Brandi Hutton, Co -Chair Solid Waste Executive Cnmmittee F Satpal Sidhu, Chair Veterans Advisnry Bnard Lynne Graham, Co -Chair Andrea Vance, Co -Chair Whatcnm Cnunty Hnusing Advisnry Cnmmittee Dan Dunne, Chair Ashley Thomasson, Vice Chair Healthy Whatcnm (Community Health Improvement) • 39% 35.5% 8% 7% 5% 4.5% 7% 'A= ancial 35.5% Way Station Along with our partners, we look forward to opening the doors of the Way Station this fall. The Way Station, located at 1500 State Street in Bellingham, will offer respite beds for individuals exiting the hospital, hygiene services, medical and behavioral health care and connections, as well as case management and referral services. These services will be provided by PeaceHealth, Opportunity Council, and Unity Care NW. The second floor will co -locate Whatcom County EMS and WCHCS teams including syringe services, GRACE and LEAD. Concept illustration of the State Street Way Station Facility. Climate Vulnerability Assessment Our Environmental Health division is conducting a Climate Vulnerability Assessment, with plans to release a final report in Summer 2024. The Climate Vulnerability Assessment, is specifically focused on extreme heat and wildfire smoke impacts on the health of residents of Whatcom County. The assessment will include stakeholder feedback, smoke/heat data analysis, and results of focus groups with frontline communities on needs and gaps. 2023 By The Numbers: Healthy Children's Fund We expect to release a wide range of Requests for Proposals (RFPs) to identify service providers who will receive funding to support the two overarching goals of the Healthy Children's Fund, passed by voters in 2022: 1) Increase access and affordability of early learning and care and 2) Provide support for vulnerable children and families. Selected providers will make progress on these goals by increasing childcare slots, providing systems of support for families ranging from prenatal services to early intervention, as well as addressing developmental delays, housing concerns, and meeting basic needs to stabilize families. Fentanyl response In 2024, our department will dedicate significant resources to addressing the fentanyl crisis in our community, including utilization of opioid settlement funding to provide trainings and public education about fentanyl, identifying additional intervention and treatment options for people struggling with opioid use disorder, and continued coordination with partners to ensure the most effective delivery of existing and future services. Public Health Nurse Sarah Best demonstrates how to administer Narcon on Overdose Awareness Day in August 2023. Financial and Administrative Services • 8,060 Death Certificates issued ($189,88S • Answered over 9,000 phone calls from in revenue) the public in 2023. • 3,99S Birth Certificates issued ($99,87S in • Processed 326 public records requests revenue) 19 of 32 Whatcom County Health and Community Services 2023 Annual Report page 11 WHATCOM COUNTY HEALTH AND Alk j� COMMUNITY KIMM SERVICES 509 Girard Street Bellingham, WA 98225 Phone: 360-778-6000 Fax: 360-778-6001 www.whatcomcounty.us/Health Front Cover Photo: Randy Rydel, Whatcom County Public Works Department Rear Cover Photo: Vincent Alvarez, Whatcom County Information Technology Department HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 AGENDA ITEM #4: Resolution Declaring a State of Emergency re: Fentanyl PRESENTERS: Barry Buchanan and Ben Elenbaas; Co-sponsors of the resolution BOARD ACTION: Q Action Item ❑ Discussion ❑ FYI -Only On February 6, Councilmembers Elenbaas and Buchanan introduced a resolution that would declare the fentanyl crisis an emergency. This was an additional step following 7-0 passage by Council of resolutions requesting the President and Governor declare declarations of emergency. While the declaration was discussed in the Committee of the Whole on February 6, no action was taken, as the Council wished to talk with stakeholders including relevant county staff and elected officials and outside boards, commissions, and task forces. Councilmembers met with a variety of stakeholders and used that feedback to create a new draft. On March 7, Councilmember Buchanan joined the PHAB meeting to discuss the resolution and gather feedback from members. A number of PHAB members provided comments and suggestions at the meeting as well as in writing the following week. Council co-sponsors have indicated they would like to take a final vote as the Health Board at this meeting. PHAB members may also choose to take an advisory vote on the resolution. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Declaring fentanyl an emergency will position Whatcom County to receive any emergency funding to combat and prevent fentanyl use. Certain populations, including residents who are unsheltered and those with pre-existing behavioral health, substance use disorder, or history of trauma, are at risk of developing opioid use disorder. Supporting these populations will impact those most vulnerable to overdose death or poor health outcomes. BOARD ROLE/ACTION REQUESTED 21 of 32 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Take a final vote on the Resolution. ATTACHMENT(S) Resolution AB2024-xxx WHATCOM COUNTY nit HEALTH AND COMMUNITY 22 of 32 SERVICES 1 PROPOSED BY: BUCHANAN, ELENBAAS 2 INTRODUCTION DATE: FEBRUARY 6, 2024 3 4 5 RESOLUTION NO. 6 7 IDENTIFYING WHATCOM COUNTY APPROACHES 8 TO THE FENTANYL EMERGENCY 9 10 WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom 11 County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year 12 since 2018; and 13 14 WHEREAS, the United States is facing the worst drug crisis in its history, and the 15 resulting tragedies are decimating families and contributing to extraordinary levels of despair in 16 our communities; and 17 18 WHEREAS, there exists a substantial likelihood of risk to persons and property unless 19 further efforts are taken to reduce the threat from fentanyl; and 20 21 WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a 22 potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times 23 more potent than heroin; and 24 25 WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making 26 it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of 27 fentanyl; and 28 29 WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must 30 be different than our approach to other illegal drug use in our community; and 31 32 WHEREAS, the use of fentanyl continues spreading throughout our community, and new 33 and immediate avenues to enhance capabilities, coordination, and collaboration across local, 34 state, tribal, and federal agencies are needed to promote public health and safety; and 35 36 WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, 37 community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: 38 Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response 39 to the devastating consequences of fentanyl, meth, and opioids; and 40 41 WHEREAS, in June 2023, a coalition of government agencies, community -based 42 organizations, healthcare providers, and others from across Whatcom County formed a Multi- 43 Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and 44 45 WHEREAS, according to the Federal Emergency Management Agency (FEMA), a 46 multiagency coordination system (MAC) is used for extraordinarily large, complex incidents 47 occurring in the city or county involving numerous agencies and/or jurisdictions; and 23 of 32 1 2 WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide 3 response efforts to the opioid crisis, identify and prioritize additional short-term objectives and 4 strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety 5 in Whatcom County; and 6 7 WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and 8 Overdose Response (SOOR) plan, which includes five priority goals 9 1. Prevent opioid misuse, 10 2. Identify and treat substance use disorder, 11 3. Ensure and improve the health and wellness of individuals that use drugs, 12 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and 13 evaluate interventions, 14 5. Support individuals in recovery; and 15 16 WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved 17 Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and 18 19 WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new 20 and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, 21 local, state, and federal agencies and bring together state agencies, local law enforcement, and 22 internal and external partners to pursue and achieve solutions that promote public health and 23 safety on the Lummi Reservation; and 24 25 WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 26 041 supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in 27 response to the fentanyl crisis; and 28 29 WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and 30 Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid 31 epidemic and open additional resources and authorities to address the crisis; and 32 33 WHEREAS, the Whatcom County Council understands coordination between all agencies 34 in our county as well as state and federal supports is needed to fight the fentanyl crisis; and 35 WHEREAS, declarations of emergency at the federal, state, and county levels can open up 36 additional resources, funding, and assistance to address the fentanyl emergency; and 37 38 WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as 39 the independent legal advisor of the legislative authority, prosecutor of all criminal and civil 40 actions, including felony charges, among other duties; and 41 42 WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in 43 the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; 44 and 45 24 of 32 1 WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County 2 Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by 3 the community and categorized in five key strategy areas: 4 I. Ensure Oversight, Accountability, and Transparency 5 II. Increase Access to Behavioral Health Services 6 III. Build Facilities Needed to Promote Public Health, Safety, and Justice 7 IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration 8 V. Make Systems Changes with Local, Regional, State, and Federal Partners; and 9 10 WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the 11 Governor of the State of Washington declare a statewide emergency to address the fentanyl 12 crisis; and 13 14 WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the 15 President of the United States declare a national emergency to address the fentanyl crisis; and 16 17 WHEREAS, community leaders, agency staff, and other stakeholders convened in early 18 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; 19 and 20 WHEREAS, this resolution details near term approaches, which are not intended to 21 replace the long-term approaches detailed in more comprehensive county policy documents. 22 23 NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges 24 there is a countywide fentanyl crisis impacting people, businesses, and properties in our 25 communities; and 26 27 NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council 28 recommends the following near -term approaches to address the fentanyl crisis: 29 30 Government Coordination: 31 1. Advocate for the declaration of emergencies at state and federal levels, thereby 32 opening up additional resources to address the crisis. 33 2. Unite national efforts by getting as many jurisdictions as possible to approve a 34 resolution to request an emergency be declared at the state and federal levels. 35 3. County Executive Order declaring an emergency and detailing specific action items 36 (use of opioid settlement funds, one-time reserve funds) to jump start efforts based on 37 Opioid Task Force and MAC group recommendations. 38 4. Advocate for a legislative fix for the legal inability to issue warrants based on a 39 juvenile's risk to themselves. raj, 41 Accountabilit 42 5. Advocate to change state law (RCW 9A.42.100) to make it a class B felony to expose a 43 child to fentanyl. 44 6. Sheriff and local police to track data on who is not going to jail because of booking 45 restrictions. 46 7. Streamlined testing for fentanyl to, confirming substance for court cases. 25 of 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 8. Make non -fatal overdoses reportable in order to find true data and get people connected to resources, interrupt overdose cycle. 9. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 10. Use reckless endangerment and Assault in the Third Degree to hold persons accountable for exposing children to fentanyl. 11. Address the need to confirm substances by using test strips and training police to identify fentanyl (can attest with an affidavit that it's fentanyl). 12.Identify potential modifications to booking restrictions in the jail. 13. Prepare to address an increase in jail population when booking restrictions are altered. 14. Fully staff the jail, using corrections hiring and retention bonuses. 15. Use the involuntary treatment act (ITA) process to get people help for substance abuse. People may be committed to inpatient medical treatment for behavioral health disorders AND substance abuse disorders under the ITA. a. Would require additional staffing for an ITA attorney in the Public Defender's Office. 16. Encourage use of the full force of the law to address major crimes and offenses related to fentanyl, for distribution, imposing the strictest sentences available for fentanyl related crimes. 17. More youth diversion, especially for people ages 18-25 years old. 18. Evaluate alternative court programs for higher utilization and capacity. Prevention and Community Supports: 19. More lower cost housing and creative housing solutions (such as dorm style housing opportunities - room with shared kitchen and bath). 20. Multi -language public education program, including youth public education. 21. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. Treatment 22. Provide training for healthcare providers on Medication -assisted treatment. 23. Advocate for involuntary commitment laws as a way to create an option for those who are unable to walk away from addiction themselves and without help; strengthen Ricky's Law. 24. Increase funding for treatment programs to increase availability of detox beds, provide voluntary treatment while waiting for sentencing, provide access to treatment instead of sentencing. 25. Provide additional resources for recovery court, including a secure facility other than the jail. 26. Ensure services are available for juveniles, not just adults. 27. Fund hiring and longevity incentives (bonuses) for correctional deputies in order to fill staffing vacancies in the jail facility. 28. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services. 29. Ensure continuity of care between medically assisted treatment (MAT) programs inside and outside the jail; medication should be the same in both environments. 26 of 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 30. Provide support and training for first responder dealing with trauma and burnout related to overdose responses. 31. Create and implement an overdose response team. 32. Create a Secure Withdrawal Management and Stabilization (SWMS) facility that allows for involuntary commitment of 72 hours, with the potential to extend for up to 14 days. 33. Provide 24-hour responses for diversion (LEAD) 34. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward the aforementioned near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. ATTEST: Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: /s/ Royce Buckingham/by email 3/13/2024/ch Civil Deputy Prosecutor WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Barry Buchanan, Council Chair 27 of 32 AGENDA ITEM #5 PRESENTERS: BOARD ACTION: HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 Action Plan — Fentanyl Response Executive's office ❑ Action Item Q Discussion ❑ FYI - Only While Whatcom County government has taken many steps to address opioids locally, the urgency of the issue requires new strategies, both new and re -prioritized funding, and more immediate action across the prevention, intervention, treatment, and aftercare/recovery continuum. The Executive appreciates Council's leadership in bringing the urgency of the fentanyl crisis further into the public sphere, enhancing coordination amongst different branches and levels of government, and engaging in thoughtful work with stakeholders. We want to be responsive to any Health Board action and are working with Health & Community Services, the Sheriff's OfficelDEM, and EMS on assembling a set of actions that can be implemented quickly for maximum impact, consistent with recommendations from the MAC group and the Whatcom County Justice Project Implementation Plan. This is an opportunity to discuss at a high-level the types of actions the community can expect to see. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Certain populations, including residents who are unsheltered and those with pre-existing behavioral health, substance use disorder, or history of trauma, are at risk of developing opioid use disorder. Supporting these populations will impact those most vulnerable to overdose death or poor health outcomes. BOARD ROLE / ACTION REQUESTED Provide high level feedback on concept or actions. 28 of 32 nWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES ATTACHMENT(S) None WHATCOM COUNTY nit HEALTH AND COMMUNITY 29 of 32 SERVICES HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 AGENDA ITEM #6: Whatcom Community Health Insights PRESENTERS: Amy Hockenberry, Health Information and Assessment Supervisor and Dr. Chris Laugen, Epidemiologist, Whatcom County Health and Community Services BOARD ACTION: ❑ Action Item ❑ Discussion Q FYI - Only The Whatcom Community Health Insights (WCHI) is a web -based platform to share local data, trends, and comparisons with Washington State and National averages. It will include stratification by subpopulations when possible and will provide links to relevant resources and community partners working to address the issue. The purpose of the WCHI is to: • Provide meaningful & easily accessible population health data for Whatcom County; • Give community partners, elected officials, and other community groups easy access to current data on an ongoing basis; • Help inform partners' planning, decision -making, grant applications, etc.; and • Increase transparency in sharing public health data. Staff will provide an overview and a preview of the tool, which will be released in early April. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The WCHI will both stratify subpopulations by race/ethnicity, age, geography, etc., when possible, it will also highlight disparities among populations to advance equity and prompt community action. BOARD ROLE / ACTION REQUESTED None. 30 of 32 nWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES ATTACHMENT(S) None WHATCOM COUNTY nit HEALTH AND COMMUNITY 31 of32 SERVICES AGENDA ITEM #7 PRESENTERS: BOARD ACTION: HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 Healthy Children's Fund update Erika Lautenbach, Health and Community Services Director ❑ Action Item E1 Discussion ❑FYI - Only Whatcom County Health & Community Services (WCHCS) staff will present a brief update on the implementation of the Healthy Children's Fund (HCF). In the 2022 general election, voters in Whatcom County approved Proposition 5, the Healthy Children's Fund, a property tax measure estimated to raise approximately $9.98M each year for 10 years, for investments in early learning and care and vulnerable families. There are 10 strategies contained in the implementation plan, and this briefing will focus on the strategies staff are prioritizing for RFPs, cooperative agreements, and contracts. The briefing will also discuss the current funding opportunities and the forthcoming opportunities in both the early learning and care and the vulnerable children and families categories. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The priorities of the Healthy Children's Fund will advance geographic, economic, and racial equity for young children and their families. BOARD ROLE / ACTION REQUESTED None. ATTACHMENT(S) None (power point presentation forthcoming at meeting and will be shared following meeting) 32 of 32 nWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES WHATCOM COUNTY COUNCIL COUNCIL MEETING AS THE HEALTH BOARD JOINT MEETING WITH THE PUBLIC HEALTH ADVISORY BOARD 10:00 a.m. Tuesday, March 26, 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 10:0--10:05 2. Public comment No paper 10:05-10:15 3. Health Officer/Health Director update (Pages 2-20) 10:15-10:25 4. Council Resolution re: Fentanyl (AB2024-090) (Pages 21-29) 10:25-11:00 5. Action Plan — Fentanyl Response (Pages 30-31) 11:00 —11:10 6. Whatcom Community Health Insights Preview (Pages 32-33) 11:10 —11:25 7. Healthy Children's Fund briefing and discussion (Page 34-39) 11:25 —11:55 g. Closing/Next Steps No paper 11:55-12:00 WHATCOM COUNTY h HEALTH AND COMMUNITY SERVICES WHATCOM COUNTY Erika Lautenbach, MPH, Director T c;. Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH. Co -Health Officer Department Report March, 2024 Equity — Collaboration — Compassion — Transparency — Innovation - Service Leadership: Health Director work has focused on communication/outreach, legislative session, meetings with federal legislators, and key issues including Healthy Children's Fund and fentanyl/overdose Executive action. Annual Report and City Council Briefings: Whatcom County Health and Community Services published our first Annual Report in March. In conjunction with the release and to re -open communication with local elected officials, I provided presentations to every city council in March. Topics included department/division overview, budget, strategic plan, 2023 accomplishments and 2024 projects/initiatives. Legislative Advocacy: Through Washington State Association of Local Public Health Officials (WSALPHO) and National Association of City and County Health Officials (NACCHO), I met with state and federal legislators, respectively, to share local priorities, challenges, and requests for support. Two of the three WSALPHO legislative priorities passed and were signed into law by the Governor. Priority Topics: I've worked with our staff team to move our proposed RFPs for the Healthy Children's Fund through the county process, and partnered with Executive Staff and stakeholders to develop a budget and recommendations for immediate action re: fentanyl. I look forward to the Council and Executive actions and the opportunity to move forward with a variety of new activities and initiatives. Health Officer work has focused on the opioid crisis, communicable diseases, behavioral health, and collaboration with community healthcare providers. Opioids: We have continued engaging with elected officials and community partners in addressing the opioid crisis. Within the department the Health Officers are working inter - divisionally, particularly with RSD and CDE, around improving capacity, treatment options, and interfaces between people who use drugs and the jail, hospital, outpatient medical providers, Lummi Nation, and Opioid Use Disorder treatment providers. Dr. Thompson recently attended a 2-day addiction medicine conference and is working to WHATCOM COUNTY HEALTH AND rO9 Girard street COMMUNITY Main Line: (364) 778-6000 Bellingham, WA 98225-4005 L SERVICES www.%whatcomcounty.us/health Page 2 of 39 connect the Swedish Hospital addiction medicine fellowship program and Whatcom County healthcare institutions. Dr. Harley is working to improve support for pregnant people, young families, and youth with mental health concerns. The Health Officers are also convening meetings of medical leadership to increase collaboration and communication between healthcare institutions in our county. Communicable Disease: Respiratory virus guidance is evolving to better respond to the current situation of less severe outcomes from COVID-19, and harmonize COVID guidance with that around other respiratory infections. These efforts are balanced with caution around the ongoing deaths and severe disease from COVID-19 illness, particularly in those over 65 years of age. Still at the forefront is the prevention message that vaccination continues to significantly reduce health risks from COVID-19. We are alert to up -trending measles cases nationally this year, with a number of cases within Washington state among unimmunized adults. We appreciate efforts by healthcare, schools, childcare and our immunizations nurses to improve measles immunity in our county through MMR vaccination. Other work: We continue to engage regularly around communication and media requests, data presentation and interpretation, collaboration with the Medical Examiner's office, and the Whatcom Community Health Insights project. Communicable Disease and Epidemiology (CD&E): Public health nurses and staff within the CD&E division continue clinical service outreach and educational events in the community. Refugee Health: With the assistance of Dr. Amy Harley, we are working with the state Department of Health and the federal Department of Health and Human Services to contract with a local community health center in Whatcom County to start offering Refugee Health Screenings. Refugees who resettle in Whatcom County must travel to Snohomish County for Refugee Health Screenings. Offering this service locally can reduce barriers for refugees seeking health services. Reducing barriers to healthcare access for this population is vital for infectious disease surveillance in the community. Vaccine Clinics: The immunization team continues to offer monthly vaccine clinics and clinic appointments to increase access for residents with barriers. The team recently received an expression of gratitude for their partnership with Hoagland's Pharmacy to ensure the administration of COVID-19 and influenza vaccines for residents who are insured but homebound due to disability or illness. This vulnerable population often has high barriers to accessing care due to physical disability and high medical risk, which Page 3 of 39 prevents them from accessing healthcare through traditional methods. From January to February 2024, we served 54 clients and administered 134 vaccines. Candida Auris: The Infection Prevention team, in concert with the state Department of Health, is collaborating with the local hospital and long-term care facilities on surveillance and infection prevention protocols for Candida Auris. Cases were recently identified in Washington State. Candida Auris is a multi -drug -resistant fungus that can cause severe illness and spread within healthcare facilities. School/Childcare Support: Our Public Health Nurse and Liaison for School and Childcare Health is collaborating with the state Department of Health on creating a tool to help schools and childcare facilities standardize reporting of absenteeism for certain notifiable conditions and facilitate prompt notification of clusters/outbreaks to local health jurisdictions. The tool will help streamline data collection and reduce the reporting burden on the public school system. Syphilis: Syphilis cases continue to trend upward on the local and national levels. The Sexual Health Provider Education virtual presentation series, which was organized by CD&E, begins in March. Syphilis is the first of three presentations by expert faculty from the University of Washington. This virtual education series will help with healthcare providers' knowledge deficits regarding managing STDs/STIs. Tuberculosis: The Tuberculosis Team is currently managing five active TB cases. TB nurses often provide clinical care and case management to medically complex individuals. The public health nurse went above and beyond duty to contact a patient's specialty providers to prevent an adverse outcome from the client's reaction to their cardiac medication. The same client was admitted to the hospital recently. This nurse collaborated with the hospital case management team to advocate for this client to receive a home health nurse at discharge. Drug Testing: The public health nurses in the SSP/Harm Reduction Program have started rounding with the street medicine outreach team to increase participant engagement. Collaborating with the University of Washington and the Addiction, Drug, & Alcohol Institute (ADAI), they have started offering a new service, which is drug testing to help participants identify potentially harmful substances circulating in the community. In addition, both public health nurses are participating in the Community - Law Enforcement Aligning in Response to Substance Use (CLEARS) Project, a one- year project to develop regional solutions to improve interactions between law enforcement and people who use drugs. Community and Organizational Development (COD): Page 4 of 39 The Community and Organizational Development division facilitates collaboration across the divisions and provides accurate, meaningful, and timely information, data, and training. Specialty areas include data, assessment, epidemiology, informatics, performance management, evaluation, communications, media relations, emergency preparedness, equity and belonging work, and workforce development. A few key areas of focus at this time are: Equity: The newly formed HEAL (Healing -centered, Equity and Leadership) Team launched on February 29thl This team will receive professional development in trauma - informed care, healing -centered practices, antiracism and health equity to create foundational learning in preparation for actionizing health equity. In late Spring, an organizational climate and care survey will be launched to assess the strengths and needs of WCHCS. Performance Management: Quality Improvement (QI) Council launched March 7t" This is a cross -divisional collaborative team that will execute the Quality Improvement strategic priority to improve the use of data to drive decision- making, inform improvements, and foster a culture of transparency and accountability. The council will focus on alignment and standardization of our department's quality improvement efforts, bring new innovations to the departments' programs, and increase accountability to leadership and our stakeholders. Data: A new Child Wellness Survey focused on infants and children ages 6 months to 11 years is being conducted by WA DOH. Typically, the results would be available at a state -level however, through Healthy Children's Fund, Whatcom County will survey our county and get data specific to our community. This will allow more meaningful results that reflect children and their families who live in the county. The survey will ask parents of children in this age group about the health and development of their child, access to childcare, and other topics including mental health. Whatcom County will be a model for other smaller counties in Washington State that would like to have their own county - specific sample. Community Health and Human Services (CH&HS): Retreat: CH&HS held a retreat on January 25th and nearly every staff member of the now 30+ people in the division were able to attend and share their programs, commitments and priorities for 2024. This year the focus is on intentional programming and commitments in our work, to make sustainable long-term impacts. The retreat also created space for several of our program teams to connect and find ways to collaborate. Page 5 of 39 The Veterans Program and the Child and Family team met shortly after the retreat and are now working on ways to support childcare needs for veteran households. Severe Weather Shelter: The Severe Weather Shelter has officially closed for the season, as of March 15th. Over the 20 nights that it was open, over 197 unique guests were served. The shelter was staffed using a pool of 11 temporary staff and 22 permanent Health & Community Services employees. In partnership with the Response Systems Division, over 730 hours of training were completed for the individuals who worked or volunteered for the operation. It was a very large lift, and involved staff across the department, but with 947 utilizations by guests over those 20 nights and 5 days, many of our vulnerable neighbors kept warm during some life -threatening temperatures. Youth RFPs: Supporting youth is very much a focus across several of our programs right now. It is really exciting to have three different Requests for Proposals (RFP) open to the community with a youth focus. We are seeking proposals ranging from homeless prevention strategies for families with children 0-5 (closes 3/12), Outreach work focused on preventing youth from using opioids (closes 4/2) and an opportunity to support families seeking services and referrals for their children with healthcare needs (closes 4/2). Each of these is an opportunity to prevent further harm or trauma for many of the youth in the community, and it is exciting to be one step closer to getting programs to the people and places they are needed most. Healthy Children's Fund: Over the last month, the Children and Family Programs have released a Housing Stability RFP, solicited proposals from Doulas to serve Medicaid eligible pregnant parents and finalized a Basic Needs RFP that will be released in early April for families with Children 0-5. All funded through the Healthy Children's Fund. The Child and Family Well Being Task Force will be hosting its first annual retreat on March 29th, with focus on building a work plan and connection amongst the group moving into the new year. Opioids/Behavioral Health: Our Prevention staff continue to support the work of the All Hands team, and so far in 2024, there have been four successful events. The staff are also excited as they are just beginning the scoring of the proposals from a recently closed RFP seeking providers able to offer school based teletherapy in Whatcom County. This will mean added capacity for youth mental health services in our schools. Environmental Health (EH): EH programs focus on protecting groups of people from threats to their health and safety posed by their environments. EH programs include various sanitation areas such as food safety, drinking water, on -site sewage and solid waste. Page 6 of 39 New Leadership: With the recent promotion of an environmental health specialist into a supervisor position within the division, there has been a shift and reorganization of programmatic responsibilities. This expansion in leadership will allow for more support in programs including food safety, living environment, school safety and solid waste. Smoke and Heat Response: Using Foundational Public Health Services funding, EH is building a program to support frontline communities during wildfire smoke and extreme heat events. Several public education events, including at senior centers around the county, and focused conversations are scheduled in April 2024. This qualitative assessment will inform the recommendations of the Climate Vulnerability Assessment, which will be completed June 30, 2024. Coordinated Water System Plan: The division is leading the Coordinated Water System Plan update to dovetail with the County's larger Comprehensive Plan update. Changes and updates to the plan intend to address complex issues such as the impact of climate change on water systems. Financial Services: The Financial & Administrative Services division supports the department by coordinating financial services such as contract processing, payment processing, grant billing, payroll processing and other various audit functions. New Manager: The new Financial Services Manager started February 26' and this position will coordinate and oversee the daily departmental financial and accounting activities. Year End: The Business Office has wrapped up the 2023 financial year end process. This process included creating grant accountability worksheets for the 33 Federal Grants ($2.8M) and 51 State Grants ($15.7M) that were reviewed and reconciled. Contracts: Our Contracts Coordinator is successfully managing 129 active contracts and 15 Letter of Agreements (LOA's) to help support the $34.2M the department has budgeted to contractual services in 2024. Response Systems: The Response Systems Division (RSD) programs aim to address the needs of individuals lacking adequate care for behavioral health challenges and basic needs within our community. These programs seek to alleviate the reliance on emergency services such Page 7 of 39 as 911, crisis interventions, and the legal system. By implementing innovative approaches like the Alternative Response Team (ART), Ground -Level Response and Coordinated Engagement (GRACE) program, Law Enforcement Assisted Diversion/Let Everyone Advance with Dignity (LEAD) program, Co -Responder program, Mental Health Court and Street Medicine Team, we strive to provide comprehensive support to individuals in need while also enhancing the efficiency of our emergency response and care coordination systems. A few program highlights include: ART: The Alternative Response Team (ART) is fully staffed as of March 4th. ART continues to respond to 911 calls in lieu of law enforcement when appropriate. In addition to the ART response team, RSD was able to hire a Behavioral Health Aide who support ART and community providers with transportation needs. In March, RSD will report back to County and City of Bellingham councils on how the first year of ART has gone, what we have learned and where we hope to go. Co -Response: In partnership with the Whatcom County Sheriff's Office, the Co - Responder program is in full swing. With two highly trained and skilled Behavioral Health (BH) specialists, the team is able to respond with deputies to calls for service that have a BH concern. Co -Responders are able to bring services and support to community members in the moment, provide some follow-up and free up deputies to be available for other calls. Similar to ART, we are working with a 3rd party evaluator in the pilot year of Co - Response to assist our community in understanding the need for a Co -Responder program, areas of growth and data analysis. In April, staff members from the Co -Responder and GRACE programs will attend the 2nd annual Co -Responder Outreach Alliance of WA conference. This will be an opportunity to meet with co -responder programs from across WA state. Page 8 of 39 � 4 wr ° c� C1' fir'"'• � 'v „� <. . + ` K WHATCOM COUNTY HEALTH AND fi COMMUNITY SERVICES Ann I Report Page 9 of 39 A Letter Frcrn The Dlrectc.4 r We live in a different world than five years ago. While many of the most significant impacts of COVID-19 are behind us, new threats to our health and community have emerged, or become more pronounced. Fentanyl has devastated families, and in Whatcom County, there has been a nearly 50% increase in overdose deaths from 2022 to 2023. Mental illness, while a long-term priority, has now reached a crisis level for families, schools and our young people. Key drivers of homelessness - affordability and accessibility - are worse, while services for the chronically homeless are not keeping pace with the growing numbers of people living unsheltered. Access to affordable childcare, food, and other basic needs has declined due to inflation and other economic drivers. The increase in severe weather events and temperatures we're experiencing are impacting our homes and way of life. Life has changed for you in these last five years — and it's changed for us, as well. Our department, which serves every geographic corner of the county in cities and unincorporated communities alike, is a different organization in so many ways. Coming out of the COVID-19 crisis response, we have been able to utilize our growing number of staff to expand public health work in our County. Two years ago, we created the Response Systems Division, which brought our crisis outreach and intensive case management programs in-house. Last year, we launched our new five-year strategic plan and changed our name to Whatcom County Health and Community Services. Nearly half of our staff now work in human services or behavioral health, and this change honors the complexity and diversity of our work and commitment to our community. Through state and federal grants, we've expanded programs in nearly every division in our department. We're implementing the goals of the Healthy Children's Fund, passed in 2022, and beginning work on designing the behavioral health components of the Public Health, Safety, and Justice ballot measure passed in 2023. While our team, and budget, are nearly double what they were just five years ago, only 6% of our revenue comes from the county's general fund. We are proud to have built programs and services that have gained the trust and financial commitment of outside funders. Today, the public health system is more visible than it has ever been before. We recognize that for some in our community, it may be hard to trust government agencies due to both historical traumas and recent challenges. The best way that we can grow that trust is to earn it. We intend to do that every day by providing timely services with the customer service you expect, while tackling the important issues that matter to Whatcom County. If we have learned anything in the last several years, it's that nothing important can be accomplished without the support and collaboration of our partners and our community. I invite you to move forward with us into a new era for Whatcom County Health and Community Services. We look forward to working with you, and for you. In Community, Erika Lautenbach, MPH Director, Whatcom County Health and Community Services Page 10 of 39 page 2 Whatcom County Health and Community Services 2023 Annual Report . Purpc:tse, Pricritles, Values ADVANCING EQUITY = PARTNERING WITH OUR COMMUNITY • Community Partnerships & Engagement Partner col la boratively to find community -base solutions that advanc health and health equity. P �00- pRFs�, 0 0 'C W APOVIDE 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 anc 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. • ConaVorarlon • Compassion • Transparency • Innovation • Service What We Dre� The Communicable Disease and Epidemiology division works to stop the spread of disease. They work to prevent and investigate infectious diseases, provide screenings and clinical/community support referrals, and provide vaccinations and harm reduction services. They work to prevent and control the spread of communicable diseases like tuberculosis, measles, COVID-19, RSV, influenza, hepatitis C, HIV, syphilis, MRSA, and many more. Programs include: • Immunizations • Tuberculosis • Syringe Services Program • Communicable Disease • Sexual Health The Community and Organizational Development division provides services that cross -cut and connect all divisions within the department. They help the department to carry out its priorities and projects more effectively and implement WCHCS's 2023-2027 Strategic Plan. Programs include: • Health Information & Assessment • Epidemiology • Assessment & Evaluation • Data & Informatics • Partnerships & Strategy • Communications • Emergency Preparedness & Resiliency • Equity • Policy • Workforce Development The Community Health & Human Services division promotes health and well-being for everyone in our community. They aim to reduce health disparities and encourage healthy behaviors. They offer services in areas such as housing, food and nutrition, and substance use prevention, as well as support for children and families, veterans, and people with disabilities. Programs include: • Nurse -Family Partnership • Food Systems • Homeless Housing • Developmental Disabilities • Veterans • Substance use prevention • Children with Special Health Care Needs • Childcare and Early Learning • LatinX Outreach page 4 Whatcom County Health and Community Services 2023 Annual Report The Environmental Health division works to promote a healthy and safe environment. They focus on disease and injury prevention and adherence to environmental health mandates and requirements. They monitor drinking and recreational water quality; conduct restaurant inspections and monitor food recalls in order to prevent foodborne illnesses; prevent exposure to hazards like lead, asbestos, or mold in homes or school environments, and much more. Programs include: • Solid Waste • Food Safety • School Health & Safety • Living Environment • On -site Septic • Drinking Water • Climate Change Response The Financial and Administrative Services division makes sure services run smoothly. They provide customer service to community members in accessing information and resources. They manage vital records like birth and death certificates, permits, and other health -related public records. They also oversee the department budget, grants and contracts, and financial services. Programs include: • Community customer services including vital records, permitting, and complaints • Financial Services and Contracts • Internal administrative services The Response Systems division provides intensive case management services to vulnerable community members. They work closely with first responders, healthcare providers, social services, and the legal system to coordinate services for their clients and reduce utilization of emergency services and incarceration. Programs include: • Ground -Level Response and Coordinated Engagement (GRACE) • Law Enforcement Assisted Diversion (LEAD) • Alternative Response Team (ART) • Mental Health Court • Co -Responder program with Behavioral Health Sheriff Deputies • Behavioral health contracts and coordination Whatcom County Health and Community Services 2023 Annual Report page 5 YAL7 : FF Behavioral Health Funds Improve Outcomes for Our Kids All seven school districts in Whatcom County provided behavioral health services in the previous and current school years using Behavioral Health Funds administered through our department. All Whatcom County kids benefit from this, with 57% of people served outside Bellingham. The funds go towards substance use prevention professionals and programs, mental and behavioral health practitioners, coordination of community services, and outreach. Reducing risk in these areas also impacts other `life indicators,' such as improving school performance and a child's interactions with family and community. These services demonstrate: • Cost savings to the community. • Improved behavioral health outcomes. • Referrals and connections to treatment for mental health, substance use, or both. • Leveraged resources. Cost -benefit estimates show that effective school -based programs can save $18 for every $1 spent. Wiser Lake: Our year -long data collection effort will help understand & mitigate harmful algae blooms. Improving the Health of Wiser La ke For the last two years we've been studying the consistent presence of harmful algae blooms (HABs) at Wiser Lake. Through a grant from the Washington State Department of Health, we worked with local groups to collect 12 months of data - the first step in discovering the cause of HABs. An additional grant from the Department of Ecology will start in July and fund analysis of the data we are currently collecting. Then, we can develop a set of recommendations based on the results. For updates on this project, or to sign up for notifications via email or text, visit https://www.whatcomcounty.us/wiser. Whatcom County Made Historic Childcare Investments Last May, Whatcom County awarded $5.8 million in federal American Rescue Plan Act (ARPA) funding to create 277 new early learning slots and preserve 84 existing slots, including investments in Ferndale, Bellingham, and the Meridian School District. Awardees include: • Whatcom Family YMCA Barkley • Western Washington University's Child Development Center • Opportunity Council Bellis Project • Gabriel's Art Kids, Ferndale • Meridian School District The County also awarded a $750,000 grant to the Boys and Girls Clubs of Whatcom County to mitigate financial impacts from the COVID-19 pandemic after its March 2020 acquisition of Kids' World. In addition, with ARPA funding from Whatcom County and the City of Bellingham, Opportunity Council's Center for Retention and Expansion of Childcare (C-RECC) has awarded grants to over 32 local childcare providers, ranging from $10,000 to $100,000 per provider. With these grants, providers have been able to raise wages, meet urgent maintenance needs, purchase supplies, and create enriched early learning environments with high -quality curriculum and services. Further funding from Whatcom County has supported emergency childcare vouchers for families, business leadership and technical assistance, and professional development scholarships for childcare workers. Page 14 of 39 page 6 Whatcom County Health and Community Services 2023 Annual Report Innovative New Program Provides Alternative to Law Enforcement for 911 Calls Last year WCHCS launched Whatcom County's Alternative to respond to the most serious 911 calls. From July through Response Team (ART), a program that sends behavioral health December 2023, 830 calls to 911 were dispatched directly to specialists to respond to specific non-violent behavioral health ART. Less than one percent of those calls needed to be referred 911 calls in Bellingham, instead of law enforcement. to law enforcement for back-up support. ART works to de-escalate tense situations and engage someone experiencing a behavioral health crisis. Feedback from law enforcement and other community partners is that most ART calls have been resolved without additional backup from law enforcement, and thus freeing up Bellingham Police Officers Taking Action to Address the Opioid Crisis in Our Community Responding to the opioid crisis in our community continues to be a WCHCS top priority. Every division at WCHCS is working to address the opioid crisis by supporting children, youth, and families facing addiction; preventing overdose deaths by distributing Naloxone and training community members on how to use it; working on the street directly with clients with addiction issues to connect them to housing, medical care, and other essential services; operating the Syringe Services Program; providing training and education regarding fentanyl and other opioids; working to increase access to treatment and recovery options; advocating for system -wide improvements; and leading county -wide prevention coalitions. In June, the department launched the website whatcomoverdoseprevention.org, where individuals and groups can request free Naloxone kits and find information, resources, and up-to-date local data on the opioid crisis. In August, WCHCS formed the County -wide Multi -Agency Coordination (MAC) Group formed to coordinate response efforts. The MAC group is made up of 70+ organizations and agencies focused on substance use disorder prevention, treatment, intervention, and recovery; members include leaders in healthcare, social services, housing, law enforcement, courts, EMS, libraries, schools, and tribal health. 2023 By The Numbers: For more information, visit the ART webpage at https://www.whatcomcounty.us/RSD. (Left to Right) WCHCS Co -Health Officer Dr. Greg Thompson, Whatcom County EMS Specialist Steven Cohen and WCHCS Supervisor Lela Riherd providing information and training at a Sehome High School community event. Communicable Disease & Epidemiology • 734 vaccine outreach events were held - • i served over 500 clients, more than 7,000 invaccines were administered • 300 scheduled clinical visits completed Page 15 of 39 Whatcom County Health and Community Services 2023 Annual Report Provided approximately 725 syringe services program/harm reduction clinics and trainings for community partners page 7 Partnership With Ferndale Community Services Supports County Severe Weather Shelter Ferndale • • Community Services Serving North Whatcom County WCHCS manages the county's contract to provide up to $75,450 to Ferndale Community Services, funded by the federal American Rescue Plan Act. This local nonprofit operates the only Whatcom County shelter outside the city limits of Bellingham. The group's typical service area includes Ferndale, Custer, Blaine, Birch Bay, Lynden, and the surrounding unincorporated county areas. This shelter can accept up to 15 guests and provides shower and laundry facilities, along with a warm place to sleep during extremely cold weather. In addition to the severe weather shelter, Ferndale Community Services provides year-round support to community members in need through: • A Community Resource Center with clothing and household items • The Other Bank providing hygiene supplies • The Utility Fund for help with City of Ferndale water and sewer bills • Computer and phone usage • Housing and job search assistance • Transportation services • Shower and laundry referrals Learn more at https://ferndalecs.org/ 2023 By The Numbers: Environmental Health Partnership with Local Veterans Clinic Enhances, Expands Veterans Services WCHCS has supported military veterans in Whatcom County with resource referrals and financial assistance for over a decade with a single staff member. In 2023, the department added a second veterans specialist position whose office is located at the Bellingham's Vet Center. The Bellingham Vet Center is a one -stop -shop for qualifying veterans seeking mental health counseling, veteran resources, and disability benefits/claims processing. Having county staff co -located in the same building has strengthened the partnership with Bellingham -based VA employees, maintained open communication with other veteran service providers, and increased collaboration with outreach opportunities, in order to better support veterans in our community. Many Whatcom County vets served in Vietnam, and many live in rural parts of the County with limited transportation options. Having two locations where they can get services (as well as the ability to connect over email, phone, or text) has helped make services much more accessible. In 2023, WCHCS staff submitted 1,132 claims on behalf of Whatcom County veterans. The two veterans staff members at WCHCS have been able to complement each other's work and support veterans in new ways, such as presenting to elected officials to educate them on veterans' needs, providing clinics for Border Patrol staff who are military veterans, and meet people `where they're at' in their workplaces. Both staff are veterans, which allows them to better connect and understand the services and agencies they work with on bethalf of other veterans. • Tracked over29,000 onsite sewage Supported at least 830 individual water systems connections • Trained 874 homeowners to maintain Increased access to sewage disposal for their onsite sewage system over 300 properties Page 16 of 39 page 8 Whatcom County Health and Community Services 2023 Annual Report Congratulations to our Partner, Sustainable Connections, on 1 Million Pounds in the Food Recovery Program The WCHCS Solid Waste Program provides local nonprofit Sustainable Connections with $30,000 annually to support the Food Recovery Program (FRP). This program aims to reduce food insecurity, divert edible items that would otherwise go into landfills, and address climate change by redistributing surplus, nutritious food from local businesses to neighbors experiencing hunger, rather than sending that food to the landfill. The program started in 2019 and reached the one million pound mark in 2023. The FRP is also the umbrella program for the "Freedge", a refrigerated food pantry located at the RE Store in Bellingham. In their 2022-23 annual report, Sustainable Connections reported that: • 16 new businesses were recruited to the FRP • 10 new businesses were consulted in how to to divert their inedible food to compost instead of landfills • 3 local events were supported in diverting food and organics from the landfill. For more information on the Food Recovery Program, visit https:Hsustainableconnections.org/tag/foodrecoveryprogram/ Sustainable Connections (COMMUN17Y BRIDGE) ® .� ®PEN TODAY 2023 By The Numbers: Nurse Family Partnership • 89 families served • 25 babies born • 750 home visits and 250 telehealth visits We held two free drop-off tire recycling events in 2023. We collected an estimated 72,500 tires across 755 loads - several thousand more than in past years. These events were made possible by funding from the Washington State Department of Ecology. ....................... y Care*Van Caravana de Salud Care -A -Van Clinics Offer Free Vaccine Clinics to Underserved Communities Care -a -Van Mobile Health Clinics are a partnership between WCHCS and the State Department of Health to increase access to health services in rural Whatcom County. Care -A -Van also partners with tribal nations, elder care facilities, and Western Washington University to offer free vaccines to people without health insurance. In 2023 WCHCS and Care -A -Van co -hosted 13 vaccine clinics through this program, offering free vaccines for COVID-19, flu, Hepatitis A, Hepatitis B, Tdap, Mpox, and routine childhood vaccines. 2023 Naloxone Distribution 11,824 Naloxone doses distributed in Whatcom County Page 17 of 39 Whatcom County Health and Community Services 2023 Annual Report page 9 Leadership Erika Lautenbach, Department Director Dr. Amy Harley, Co -Health Officer Dr. Greg Thompson, Co -Health Officer Management Ann Beck, Community Health & Human Services Lynnette Bennett, Community & Organizational Development Malora Christensen, Response Systems Sabrina Houck, Financial Services Shamika Brooks, Communicable Disease & Epidemiology Sue Sullivan, Environmental Health Advisory Groups Public Health Advisnry Bnard Sterling Chick, Chair Emily O'Connor, Vice Chair Behavinral Health Advisnry Cnmmittee Nicholas Evans, Chair Child & Family Wellbeing Taskfnrce Christina Jackson, Co -Chair Ray Deck, Co -Chair Developmental Disabilities Advisnry Bnard Raegen Miller, Co -Chair Lindsay Foreman -Murray, Co -Chair Fnnd Systems Cnmmittee Riley Sweeney, Chair Margaret Gerard, Vice Chair Solid Waste Advisnry Cnmmittee Rodd Pemble, Chair Brandi Hutton, Co -Chair Solid Waste Executive Cnmmittee F Satpal Sidhu, Chair Veterans Advisnry Bnard Lynne Graham, Co -Chair Andrea Vance, Co -Chair Whatcnm Cnunty Hnusing Advisnry Cnmmittee Dan Dunne, Chair Ashley Thomasson, Vice Chair Healthy Whatcnm (Community Health Improvement) ► Financials • 4.5% 501 7% 8% 39% 35.5% 8% 7% 5% 4.5% 7% 'A` 35.5% Way Station Along with our partners, we look forward to opening the doors of the Way Station this fall. The Way Station, located at 1500 State Street in Bellingham, will offer respite beds for individuals exiting the hospital, hygiene services, medical and behavioral health care and connections, as well as case management and referral services. These services will be provided by PeaceHealth, Opportunity Council, and Unity Care NW. The second floor will co -locate Whatcom County EMS and WCHCS teams including syringe services, GRACE and LEAD. Concept illustration of the State Street Way Station Facility. Climate Vulnerability Assessment Our Environmental Health division is conducting a Climate Vulnerability Assessment, with plans to release a final report in Summer 2024. The Climate Vulnerability Assessment, is specifically focused on extreme heat and wildfire smoke impacts on the health of residents of Whatcom County. The assessment will include stakeholder feedback, smoke/heat data analysis, and results of focus groups with frontline communities on needs and gaps. 2023 By The Numbers: Healthy Children's Fund We expect to release a wide range of Requests for Proposals (RFPs) to identify service providers who will receive funding to support the two overarching goals of the Healthy Children's Fund, passed by voters in 2022: 1) Increase access and affordability of early learning and care and 2) Provide support for vulnerable children and families. Selected providers will make progress on these goals by increasing childcare slots, providing systems of support for families ranging from prenatal services to early intervention, as well as addressing developmental delays, housing concerns, and meeting basic needs to stabilize families. Fentanyl response In 2024, our department will dedicate significant resources to addressing the fentanyl crisis in our community, including utilization of opioid settlement funding to provide trainings and public education about fentanyl, identifying additional intervention and treatment options for people struggling with opioid use disorder, and continued coordination with partners to ensure the most effective delivery of existing and future services. Public Health Nurse Sarah Best demonstrates how to administer Narcon on Overdose Awareness Day in August 2023. Financial and Administrative Services • 8,060 Death Certificates issued ($189,88S • Answered over 9,000 phone calls from in revenue) the public in 2023. • 3,99S Birth Certificates issued ($99,87S in • Processed 326 public records requests revenue) Page 19 of 39 Whatcom County Health and Community Services 2023 Annual Report page 11 WHATCOM COUNTY HEALTH AND Alk j� COMMUNITY KIMM SERVICES 509 Girard Street Bellingham, WA 98225 Phone: 360-778-6000 Fax: 360-778-6001 www.whatcomcounty.us/Health Front Cover Photo: Randy Rydel, Whatcom County Public Works Department Rear Cover Photo: Vincent Alvarez, Whatcom County Information Technology Department - _ qg-e-2S-of3-9 +C'r,OM CO HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 AGENDA ITEM #4: Resolution Declaring the Fentanyl Crisis an Emergency in Whatcom County and Identifying Approaches to the Emergency PRESENTERS: Barry Buchanan and Ben Elenbaas; Co-sponsors of the resolution BOARD ACTION: Q Action Item ❑ Discussion ❑ FYI -Only On February 6, Councilmembers Elenbaas and Buchanan introduced a resolution that would declare the fentanyl crisis an emergency. This was an additional step following 7-0 passage by Council of resolutions requesting the President and Governor declare declarations of emergency. While the declaration was discussed in the Committee of the Whole on February 6, no action was taken, as the Council wished to talk with stakeholders including relevant county staff and elected officials and outside boards, commissions, and task forces. Councilmembers met with a variety of stakeholders and used that feedback to create a new draft. On March 7, Councilmember Buchanan joined the PHAB meeting to discuss the resolution and gather feedback from members. A number of PHAB members provided comments and suggestions at the meeting as well as in writing the following week. Council co-sponsors have indicated they would like to take a final vote as the Health Board at this meeting. PHAB members may also choose to take an advisory vote on the resolution. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Certain populations, including residents who are unsheltered and those with pre-existing behavioral health, substance use disorder, or history of trauma, are at risk of developing opioid use disorder. Supporting these populations will impact those most vulnerable to overdose death or poor health outcomes. BOARD ROLE/ACTION REQUESTED WHATCOM COUNTY HEALTH AND COMMUNITY Pit, Page 21 of 39SERVICES Take a final vote on the Resolution. ATTACHMENT(S) Resolution AB2024-xxx Page 22 of 39 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES PROPOSED BY: BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. !BENT-IFYI G r+ECLARING THE FENTANYL CRISIS AN EMERGENCY IN WHATCOM COUNTY AND IDENTIFYING APPROACHES TO THE FENT NNI EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and WHEREAS, in June 2023, a coalition of government agencies, community -based organizations, healthcare providers, and others from across Whatcom County formed a Multi - Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and Page 23 of 39 WHEREAS, according to the Federal Emergency Management Agency (FEMA), a multiagency coordination system (MAC) is used for extraordinarily large, complex incidents occurring in the city or county involving numerous agencies and/or jurisdictions; and WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide response efforts to the opioid crisis, identify and prioritize additional short-term objectives and strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety in Whatcom County; and WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and Overdose Response (SOOR) plan, which includes five priority goals 1. Prevent opioid misuse, 2. Identify and treat substance use disorder, 3. Ensure and improve the health and wellness of individuals that use drugs, 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions, 5. Support individuals in recovery; and WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, local, state, and federal agencies and bring together state agencies, local law enforcement, and internal and external partners to pursue and achieve solutions that promote public health and safety on the Lummi Reservation; and WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 041 supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in response to the fentanyl crisis; and WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid epidemic and open additional resources and authorities to address the crisis; and WHEREAS, the Whatcom County Council understands coordination between all agencies in our county as well as state and federal supports is needed to fight the fentanyl crisis; and WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and Page 24 of 39 WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by the community and categorized in five key strategy areas: I. Ensure Oversight, Accountability, and Transparency II. Increase Access to Behavioral Health Services III. Build Facilities Needed to Promote Public Health, Safety, and Justice IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration V. Make Systems Changes with Local, Regional, State, and Federal Partners; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a statewide emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis; and WHEREAS, community leaders, agency staff, and other stakeholders convened in early 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; and WHEREAS, Bellingham Mayor Kimberley Lund issued Executive Order 2024-01 on February 20, 2024 to address the fentanyl crisis in Downtown Bellingham; anJW WHEREAS, this resolution details near term approaches, which are not intended to replace the long-term approaches detailed in more comprehensive county policy documents. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends the following near -term approaches to address the fentanyl crisis: Government Coordination: 1. Advocate for the declaration of emergencies at state and federal levels, thereby opening up additional resources to address the crisis. 2. Unite national efforts by encouraging other localgetting as n9any jurisdictions -as pessible to approve a resolution -to requesting an emergency be declared at the state and federal levels. 3. Encourage Executive Sidhu to release a County Emergency Declaration or Executive Order that detailsifrg specific action items and funding options to intensif r� , one time reserve funds) to jun9p Page 25 of 39 start efforts,, in alignment wither Opioid Task Force and MAC group recommendations. 4. Develop a budget and plan to address staffing shortages, positions needed in order to implement an Emergency Declaration or Executive Order, and action steps requiring funding. S-;—may- fr5. Using whatcomoverdoseprevention.org website and Council Committee of the Whole, provide regular updates to the public on progress of action steps, outcomes of efforts, and funds expended on initiatives. Accountability and Data Collection : 6Advocate for a -legislative changes that strengthen laws regarding children's exposure to fentanyl, Ricky's law, and other related measures. fi)( feF the legal inability te issue 4 7. Enhance legal methods to address fenta nyl -related crimes, distinguish fentan ll related crimes from other drug crimes, and offer treatment and recovery options in lieu of lengthy sentences when appropriate. ehmid --.—Request that Sheriff and local police to track data on utilization of Medication Assisted Treatment (MAT) in jail and what arrests do not end inwhe us net geing te jail time because of booking restrictions. � • Y[�� \�1�1 I��l�ll��� J`��l �i� 1►1R►���1: � Ill��i1 6--.9. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services; and. -- - -- ---- - -- -- - - - - -- - - --- -- -- ---- -- - --- -- - -- - -- -- -- - - -- - -- -- - -- -- --- - - - :1•wiio-r�:��w �uuuu�w:�� �•i�:. - - - - - - - - - - - - �� - - - - - - Il�iilJ!T-7 - - - • - - r IVA FA Page 26 of 39 11 • 11 • M WE ■ I � 1/ Mill 1 Rieky's Law. y^ '} veluntaFy tFeatn9ent whole waiting for sentencing, PFeVide access to tFeatn9ent ins he Ja"' juveniles, 26. Fund hiring and lengevity ineentives (benHses) f8F eeFreetmenal deputies On eFdeF te fill staffing vacancies in the jai' facility. MAMAS W 1.00 . NaFEetie Aleehelies ., / / / eeunseling) NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends thi—_ Whatcom County Elected officials such as the Executive, Prosecutor, and Sheriff, consider items in Exhibit A for One'usmen inExeeutmv, 4Fd-... �- future action; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward the aforementioned near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. Page 27 of 39 ATTEST: Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: Deputy Prosecutor WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Barry Buchanan, Council Chair Page 28 of 39 EXHIBIT A During stakeholder meetings to refine and develop the Council's resolution, members heard the following suggestions, ideas, and requests for action. Council requests that the Executive consider these exhibit items for potential inclusion in an Executive Declaration of Emergency or Order. 1. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 2. Expand the ability to use test strips beyond Health and Community Services to law enforcement and first responders. 3. Provide additional training on common and emerging illicit drugs to police for improved response and identification of fentanyl and other drugs. 4. Identify potential modifications to booking restrictions in the jail and develop operational plans to address inmate increases. 5. Encourage using Strict Legal measures to address maior crimes and offenses related to fentanyl, for distribution. 6. Provide more opportunities for youth diversion, especially for people ages 18-25 years old. 7. Evaluate alternative court programs for higher utilization and capacity. 8. Identify options and funding sources to provide more lower cost housing and creative housing solutions. 9. Fund and launch a multi -jurisdictional, multi -language public education program, including youth public education. 10. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. 11. Provide training for healthcare providers and first responders on the benefits of and how to administer Medication -assisted treatment. 12. Increase funding for treatment programs to increase availability of detox beds,, provide voluntary treatment while waiting for sentencing, provide access to treatment in lieu of sentencing. 13. Provide additional resources for recovery court, including a secure facility other than the jail. 14. Ensure services are available for juveniles, not just adults. 15. Ensure medically assisted treatment (MAT) offerings inside the jail match community - based options. 16. Provide support and training for first responders and behavioral health staff dealing with trauma and burnout related to overdose responses. 17. Create and implement an overdose response team. 18. Support efforts by Lummi Nation to build a Secure Withdrawal Management and Stabilization (SWMS) facility. 19. Analyze options for expanding the Alternative Response Team, including providing 24- hour responses. 20. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) Page 29 of 39 AGENDA ITEM #5 PRESENTERS: BOARD ACTION: HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 Action Plan — Fentanyl Response Executive's office ❑ Action Item Q Discussion ❑ FYI - Only While Whatcom County government has taken many steps to address opioids locally, the urgency of the issue requires new strategies, both new and re -prioritized funding, and more immediate action across the prevention, intervention, treatment, and aftercare/recovery continuum. The Executive appreciates Council's leadership in bringing the urgency of the fentanyl crisis further into the public sphere, enhancing coordination amongst different branches and levels of government, and engaging in thoughtful work with stakeholders. We want to be responsive to any Health Board action and are working with Health & Community Services, the Sheriff's OfficelDEM, and EMS on assembling a set of actions that can be implemented quickly for maximum impact, consistent with recommendations from the MAC group and the Whatcom County Justice Project Implementation Plan. This is an opportunity to discuss at a high-level the types of actions the community can expect to see. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) Certain populations, including residents who are unsheltered and those with pre-existing behavioral health, substance use disorder, or history of trauma, are at risk of developing opioid use disorder. Supporting these populations will impact those most vulnerable to overdose death or poor health outcomes. BOARD ROLE / ACTION REQUESTED Provide high level feedback on concept or actions. WHATCOM COUNTY HEALTH AND niiL COMMUNITY Page 30 of 39 SERVICES ATTACHMENT(S) None Page 31 of 39 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 AGENDA ITEM #6: Whatcom Community Health Insights PRESENTERS: Amy Hockenberry, Health Information and Assessment Supervisor and Dr. Chris Laugen, Epidemiologist, Whatcom County Health and Community Services BOARD ACTION: ❑ Action Item ❑ Discussion Q FYI - Only The Whatcom Community Health Insights (WCHI) is a web -based platform to share local data, trends, and comparisons with Washington State and National averages. It will include stratification by subpopulations when possible and will provide links to relevant resources and community partners working to address the issue. The purpose of the WCHI is to: • Provide meaningful & easily accessible population health data for Whatcom County; • Give community partners, elected officials, and other community groups easy access to current data on an ongoing basis; • Help inform partners' planning, decision -making, grant applications, etc.; and • Increase transparency in sharing public health data. Staff will provide an overview and a preview of the tool, which will be released in early April. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The WCHI will both stratify subpopulations by race/ethnicity, age, geography, etc., when possible, it will also highlight disparities among populations to advance equity and prompt community action. BOARD ROLE / ACTION REQUESTED None. WHATCOM COUNTY HEALTH AND njiL COMMUNITY Page 32 of 39 SERVICES ATTACHMENT(S) None Page 33 of 39 flitWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES AGENDA ITEM #7 PRESENTERS: BOARD ACTION: HEALTH BOARD PUBLIC HEALTH ADVISORY BOARD Discussion Form March 26, 2024 Healthy Children's Fund update Erika Lautenbach, Health and Community Services Director ❑ Action Item E1 Discussion ❑FYI - Only Whatcom County Health & Community Services (WCHCS) staff will present a brief update on the implementation of the Healthy Children's Fund (HCF). In the 2022 general election, voters in Whatcom County approved Proposition 5, the Healthy Children's Fund, a property tax measure estimated to raise approximately $9.98M each year for 10 years, for investments in early learning and care and vulnerable families. There are 10 strategies contained in the implementation plan, and this briefing will focus on the strategies staff are prioritizing for RFPs, cooperative agreements, and contracts. The briefing will also discuss the current funding opportunities and the forthcoming opportunities in both the early learning and care and the vulnerable children and families categories. EQUITY CONSIDERATIONS (include data or information about how topic impacts or could impact equity, including racial equity) The priorities of the Healthy Children's Fund will advance geographic, economic, and racial equity for young children and their families. BOARD ROLE / ACTION REQUESTED None. ATTACHMENT(S) Slide Presentation WHATCOM COUNTY HEALTH AND njiL COMMUNITY Page 34 of 39 SERVICES 3/21 /2024 Investing in early childhood_ • 90% of human brain development happens befores the age of 5. • Only 50% of kinds in Whatcom County enter kindergarten fully ready to learn • Children who attend high -quality early learning & care are more likely to be on track with their reading skills by third grade and graduate high school and attend college, technical school, or training program that lead to good jobs as adults. • Whatcom County has 5000 fewer early learning & care slots than we need, especially in rural areas. ■ Over 85% of Whatcom County businesses report staffing challenges from lack of early learning and care. ■ For every dollar invested in early childhood programs, between $7 and $13 are saved through benefits like lower incarceration rates and lower healthcare costs. Page 35 of 39 3/21 /2024 Healthy Children's Fund + Affordable 14 • Accessible High Quality • Professional r"'k • Expand mental and behavioral health services • Prevent and reduce homelessness M_ Support for parents/caregivers Year 1 & 2 Fund Priorities Early Learning and Care • Small Capital Projects • Professional Development • Subsidies • Workforce Expansion & Retention ■ Hubs a Innovative Strategies Vulnerable Children a Behavioral Health • Housing • Early Parenting Supports • Resource Navigation 2 Page 36 of 39 3/21 /2024 Healthy Children's Fund: Expected Timeline* 2023 2024 2025 Infrastructure Built Initial Proj $ April -December 2023 February -March 2024 Implementation Team formed Staff hued Processes/policies deyela Development of Initial Strategies Initial July -October 2023 April Funding mechanisms and -June logistics designed Strategy prioritization timeline pub�ished Implementation Plan Approved March 2023 Initi l Funding Advertised 0clvhei 2023•January 2024 Rchok assistance available aWrear aiM communication to providers Ann al Report and Implemen tian Update March 2024 Evaluation, rununicailvn., and Community Engngcn_ pl um published Selected Bi-annual Evaluation Late 2025 cts Executed 01 Process Evaluation Annual Report i Report Implementation December 2024 Plan for Years 3 March 2025 ARPA Funding -Birth to 5 Council -directed ARPA funding • Capital Funding and Expansion • Stabilization and Emergency Childcare Vouchers • Home -based childcare businesses • Second Round of Capital Funding Page 37 of 39 3/21 /2024 Early Learning & Care Projects ( "i Strategy #1.• Small Capital Grants Cap t Strategy #2: Pathways to a Stable EL&C Workforce Strategy #3 & 4: Subsidies and Workforce Strategy #5: Create Regional Hubs Strategy #6: Innovative Projects Vulnerable Children Projects I � Strategy #7. Behavioral Health Workforce Recruitment Strategy #8: Housing/Homelessness Strategy #9: Expand and Enhance Early Parenting Supports Strategy #10: Expand and Enhance Early Parenting Support M Page 38 of 39 3/21 /2024 What's Coming Evaluation, Communications, and Community Engagement Plans • RFPs and Contracts for nearly every strategy • Planning process for next implementation plan (due March 2025) * Performance Audit Questions? Learn more and sign-up for updates at https:ffwww.whatcomcounty.us/4069/HeaLthy- ChiLdrens-Fund Page 39 of 39 5 • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-090 File ID: AB2024-090 Version: 1 Status: Substitute Approved File Created: 01/12/2024 Entered by: CHalka@co.whatcom.wa.us Department: Council Office File Type: Resolution Assigned to: Council Committee of the Whole Final Action: 04/09/2024 Agenda Date: 04/09/2024 Enactment #: RES 2024-017 Primary Contact Email: chalka@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Resolution identifying Whatcom County approaches to the fentanyl emergency SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Resolution identifying Whatcom County approaches to the fentanyl emergency HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 02/06/2024 Council Committee of the Whole FORWARDED TO COUNCIL WITH RECOMMENDED MOTION(S) Aye: 6 Buchanan, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 1 Byrd 02/06/2024 Council DISCUSSED AND MOTION(S) APPROVED 03/26/2024 Council as the Health Board REFERRED TO Council Committee of the Whole COMMITTEE Aye: 6 Buchanan, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 Absent: 1 Byrd 04/09/2024 Council Committee of the Whole RECOMMENDED FOR APPROVAL WITH PROPOSED AMENDMENT(S) Aye: 7 Buchanan, Byrd, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Whatcom County Page 1 Printed on 4/21/2025 Agenda Bill Master Report Continued (AB2024-090) Nay: 0 04/09/2024 Council SUBSTITUTE APPROVED Aye: 7 Buchanan, Byrd, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 Attachments: Agenda Bill Report, Approved Resolution 2024-017, Proposed Resolution, Substitute Revised Resolution for 4.9.2024 as Amended in Committee, Revised Resolution for 4.9.2024, Revised Resolution for 3.26.2024 Health Board - staff input, Alternate Resolution for 3.26.2024 Health Board, Letter - Riveters Collective Whatcom County Page 2 Printed on 4/21/2025 Whatcom County Agenda Bill Report File Number: AB2024-090 COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 File ID: AB2024-090 Version: 1 Status: Substitute Approved File Created: 01/12/2024 Entered by: CHalka@co.whatcom.wa.us Department: Council Office File Type: Resolution Assigned to: Council Committee of the Whole Final Action: 04/09/2024 Agenda Date: 04/09/2024 Enactment #: RES 2024-017 Related Files: Primary Contact Email: chalka@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Resolution identifying Whatcom County approaches to the fentanyl emergency SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Resolution identifying Whatcom County approaches to the fentanyl emergency HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 02/06/2024 Council Committee of the Whole FORWARDED TO COUNCIL WITH RECOMMENDED MOTION(S) Aye: 6 Buchanan, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 1 Byrd 02/06/2024 Council DISCUSSED AND MOTION(S) APPROVED 03/26/2024 Council as the Health Board REFERRED TO Council Committee of the Whole COMMITTEE Aye: 6 Buchanan, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 Absent: 1 Byrd 04/09/2024 Council Committee of the Whole RECOMMENDED FOR APPROVAL WITH PROPOSED AMENDMENT(S) Whatcom County Page 1 Printed on 411012024 Agenda Bill Report Continued (AB2024-090) Aye: 7 Buchanan, Byrd, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 04/09/2024 Council SUBSTITUTE APPROVED Aye: 7 Buchanan, Byrd, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 Attachments: Proposed Resolution, Revised Resolution for 4.9.2024 as Amended in Committee, Revised Resolution for 4.9.2024, Revised Resolution for 3.26.2024 Health Board - staff input, Alternate Resolution for 3.26.2024 Health Board, Letter - Riveters Collective Whatcom County Page 2 Printed on 411012024 Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360) 778-5010 Agenda Bill Report File Number: AB2024-090 File ID: AB2024-090 Version: 1 Status: Substitute Approved File Created: 01/12/2024 Entered by: CHalka@co.whatcom.wa.us Department: Council Office File Type: Resolution Assigned to: Council Committee of the Whole Final Action: 04/09/2024 Agenda Date: 04/09/2024 Enactment #: RES 2024-017 Related Files: Primary Contact Email: chalka@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Resolution identifying Whatcom County approaches to the fentanyl emergency SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Resolution identifying Whatcom County approaches to the fentanyl emergency HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 02/06/2024 Council Committee of the Whole FORWARDED TO COUNCIL WITH RECOMMENDED MOTION(S) Aye: 6 Buchanan, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 1 Byrd 02/06/2024 Council DISCUSSED AND MOTION(S) APPROVED 03/26/2024 Council as the Health Board REFERRED TO Council Committee of the Whole COMMITTEE Aye: 6 Buchanan, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 Absent: 1 Byrd 04/09/2024 Council Committee of the Whole RECOMMENDED FOR APPROVAL WITH PROPOSED AMENDMENT(S) Whatcom County Page 1 Printed on 411012024 Agenda Bill Report Continued (AB2024-090) Aye: 7 Buchanan, Byrd, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 04/09/2024 Council SUBSTITUTE APPROVED Aye: 7 Buchanan, Byrd, Donovan, Elenbaas, Galloway, Scanlon, and Stremler Nay: 0 Attachments: Proposed Resolution, Revised Resolution for 4.9.2024 as Amended in Committee, Revised Resolution for 4.9.2024, Revised Resolution for 3.26.2024 Health Board - staff input, Alternate Resolution for 3.26.2024 Health Board, Letter - Riveters Collective Whatcom County Page 2 Printed on 411012024 PROPOSED BY: _BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. 2024-017 RECOGNIZING THE FENTANYL CRISIS AS AN EMERGENCY IN WHATCOM COUNTY AND IDENTIFYING APPROACHES TO THE EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHERAS, involuntarily displacement of people experiencing homelessness is estimated to worsen overdose and hospitalizations, decrease initiations of medications for opioid use disorder, and contribute to deaths among people experiencing homelessness; and WHEREAS, the housing crisis in Whatcom County limits access and availability to safe, secure, supportive, and affordable housing which is essential for stability, recovery, sobriety, and preventing drug use and overdose; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and WHEREAS, in June 2023, a coalition of government agencies, community -based organizations, healthcare providers, and others from across Whatcom County formed a Multi - Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and WHEREAS, according to the Federal Emergency Management Agency (FEMA), a multiagency coordination system (MAC) is used for extraordinarily large, complex incidents occurring in the city or county involving numerous agencies and/or jurisdictions; and WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide response efforts to the opioid crisis, identify and prioritize additional short-term objectives and strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety in Whatcom County; and WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and Overdose Response (SOOR) plan, which includes five priority goals 1. Prevent opioid misuse, 2. Identify and treat substance use disorder, 3. Ensure and improve the health and wellness of individuals that use drugs, 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions, 5. Support individuals in recovery; and WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, local, state, and federal agencies and bring together state agencies, local law enforcement, and internal and external partners to pursue and achieve solutions that promote public health and safety on the Lummi Reservation; and WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 041 supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in response to the fentanyl crisis; and WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid epidemic and open additional resources and authorities to address the crisis; and WHEREAS, the Whatcom County Council understands coordination between all agencies in our county as well as state and federal supports is needed to fight the fentanyl crisis; and WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by the community and categorized in five key strategy areas: I. Ensure Oversight, Accountability, and Transparency II. Increase Access to Behavioral Health Services III. Build Facilities Needed to Promote Public Health, Safety, and Justice IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration V. Make Systems Changes with Local, Regional, State, and Federal Partners; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a statewide emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis; and WHEREAS, community leaders, agency staff, and other stakeholders convened in early 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; and WHEREAS, Bellingham Mayor Kimberley Lund issued Executive Order 2024-01 on February 20, 2024 to address the fentanyl crisis in Downtown Bellingham; and WHEREAS, this resolution details near term approaches, which are not intended to replace the long-term approaches detailed in more comprehensive county policy documents. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends the following near -term approaches to address the fentanyl crisis: Government Coordination: 1. Advocate for the declaration of emergencies at state and federal levels, thereby opening up additional resources to address the crisis. 2. Unite national efforts by encouraging other local jurisdictions to approve a resolution requesting an emergency be declared at the state and federal levels. 3. Encourage Executive Sidhu to release an Executive Order with action plan that details specific action items and funding options to intensify efforts, in alignment with Opioid Task Force and MAC group recommendations. 4. Develop a budget and plan to address staffing shortages, positions needed in order to implement an Executive Order with action plan, and action steps requiring funding. 5. Using whatcomoverdoseprevention.org website and Council Committee of the Whole, provide regular updates to the public on progress of action steps, outcomes of efforts, and funds expended on initiatives. Accountability and Data Collection: 6. Advocate for legislative changes that strengthen laws regarding children's exposure to fentanyl, Ricky's law, and other related measures. 7. Enhance legal methods to address fentanyl-related crimes, distinguish fentanyl related crimes from other drug crimes, and offer treatment and recovery options in lieu of lengthy sentences when appropriate. 8. Request that Sheriff and local police to track data on utilization of Medication Assisted Treatment (MAT) in jail and what arrests do not end in jail time because of booking restrictions. 9. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends Whatcom County Elected officials such as the Executive, Prosecutor, and Sheriff, consider items in Exhibit A for future action; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward near -term approaches to address the fentanyl crisis. APPROVED this 9th day of April 2024. ATTEST: 0C. a �� �e Danaa Wn vis,¢¢, ' of the Council APPROy, D AS. . Civil Deputy Prosecutor WHATCOM COUNTY COUNCIL V COUNT , WASHINGTON nan, Council Chair EXHIBIT A During stakeholder meetings to refine and develop the Council's resolution, members heard the following suggestions, ideas, and requests for action. Council requests that the Executive consider these exhibit items for potential inclusion in an Executive Order with action plan. 1. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 2. Expand the ability to use test strips beyond Health and Community Services to law enforcement and first responders. 3. Provide additional training on common and emerging illicit drugs to police for improved response and identification of fentanyl and other drugs. 4. Identify potential modifications to booking restrictions in the jail and develop operational plans to address inmate increases. 5. Encourage using strict legal measures to address major crimes and offenses related to fentanyl. 6. Provide more opportunities for youth diversion, especially for people ages 18-25 years old. 7. Evaluate alternative court programs for higher utilization and capacity. 8. Identify options and funding sources to provide more lower cost housing and creative housing solutions. 9. Fund and launch a multi -jurisdictional, multi -language public education program, including youth public education. 10. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. 11. Provide training for healthcare providers and first responders on the benefits of and how to administer Medication -assisted treatment. 12.Increase funding for treatment programs to increase availability of detox beds, provide voluntary treatment while waiting for sentencing, provide access to treatment in lieu of sentencing. 13. Provide additional resources for recovery court, including a secure facility other than the jail. 14. Ensure services are available for juveniles, not just adults. 15. Ensure medically assisted treatment (MAT) offerings inside the jail match community - based options. 16. Provide support and training for first responders and behavioral health staff dealing with trauma and burnout related to overdose responses. 17.Create and implement an overdose response team. 18. Support efforts by Lummi Nation to build a Secure Withdrawal Management and Stabilization (SWMS) facility. 19.Analyze options for expanding the Alternative Response Team, including providing 24- hour responses. 20. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling). 21.Create a publicly accessible monitoring and evaluation system to track goals, outcomes, and data regarding Whatcom County's response to the fentanyl emergency. 22. Expand the community paramedics program. 23.Identify options to expand supportive housing programs and re-entry housing for people seeking substance use disorder treatment who have a history of incarceration. 24. Explore partnerships with neighboring SWISS counties, Whatcom County cities, Lummi Nation, Nooksack Tribe, North Sound ACH, state, and federal agencies to fund a coordinated response to the fentanyl emergency. 25. Study new local sources of revenue to fund Whatcom County's response to the fentanyl emergency. 26. Explore additional substance use disorder treatment options for pre- and postpartum patients. 27. Continue to work with the Incarceration Prevention and Reduction Task Force to identify policy options to reduce and prevent incarceration. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 PROPOSED BY: BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. IDENTIFYING WHATCOM COUNTY APPROACHES TO THE FENTANYL EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132 to date) exceed deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to the fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of Fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and 1 WHEREAS, in June 2023, a coalition of government agencies, community -based 2 organizations, healthcare providers, and others from across Whatcom County formed a Multi- 3 Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and 4 5 WHEREAS, according to the Federal Emergency Management Agency (FEMA), a 6 Multiagency coordination system (MAC) is used for extraordinarily large, complex incidents 7 occurring in the city or county involving numerous agencies and/or jurisdictions; and 8 9 WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide 10 response efforts to the opioid crisis, identify and prioritize additional short-term objectives and 11 strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety 12 in Whatcom County; and 13 14 WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and 15 Overdose Response (SOOR) plan, which includes five priority goals 16 1. Prevent opioid misuse, 17 2. Identify and treat substance use disorder, 18 3. Ensure and improve the health and wellness of individuals that use drugs, 19 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and 20 evaluate interventions, 21 5. Support individuals in recovery; and 22 23 WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved 24 Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and 25 26 WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new 27 and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, 28 local, state, and federal agencies and bring together state agencies, local law enforcement, and 29 internal and external partners to pursue and achieve solutions that promote public health and 30 safety on the Lummi Reservation; and 31 32 WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 33 041 supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in 34 response to the fentanyl crisis; and 35 36 WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and 37 Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid 38 epidemic and open additional resources and authorities to address the crisis; and 39 40 WHEREAS, the Whatcom County Council understands coordination between all agencies 41 in our county as well as state and federal supports is needed to fight the fentanyl crisis; and 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a national emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council recommends the following approaches to the fentanyl crisis: 1. Request official declarations of emergency. a. Request that both state and federal emergency declarations be made to expand efforts and open up additional resources and tools to protect the lives, public health, and safety of our community members b. Request that the Whatcom County Executive in coordination with the County Sheriff, declare a countywide emergency for fentanyl in accordance with the Comprehensive Emergency Management Plan (CEMP) allowing the following: i. Entering into contracts and incurring obligations necessary to combat such emergency situations to protect the health and safety of persons; and ii. Providing appropriate emergency assistance to victims, and iii. Other actions deemed appropriate by the Health Officer and Director of Emergency Management or their designees. 2. Enhance legal methods to address fentanyl-related crimes. a. Encourage using the full force of the law to address major crimes and offenses related to fentanyl; b. Request that the judicial branch and courts impose the strictest sentences available for fentanyl related crimes; c. Request that the judicial branch and courts offer treatment and recovery options in lieu of lengthy sentences when appropriate and effective to persuade people to choose treatment over punishment; 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 d. Request that the Whatcom County Prosecutor utilize their power and discretion to prioritize the prosecution of fentanyl-related crimes and seek strict sentences; e. Advocate at the state and federal levels to increase sentencing for fentanyl- related crimes above and beyond levels for other drug crimes. 3. Provide staffing and financial resources to local efforts. a. Prioritize county staff and financial resources to address the fentanyl crisis; and b. Explore options to expand navigator programs to increase efforts on overdose prevention; and c. Provide full support to the MAC group working on the fentanyl crisis. APPROVED this day of , 2024. ATTEST: Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: /s/ Royce Buckingham/by email 1/9/2023/ch Civil Deputy Prosecutor WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Barry Buchanan, Council Chair Health Board edits 3/26/2024 Additional'lits received after Health Board Amended in Committee of the Whole 4.9.2024 PROPOSED BY: BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. DEGLARING RECOGNIZING THE FENTANYL CRISIS AN EMERGENCY IN WHATCOM COUNTY AND IDENTIFYING APPROACHES TO THE EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHERAS, involuntarily displacement of people experiencing homelessness is estimated to worsen overdose and hospitalizations, decrease initiations of medications for opioid use disorder, and contribute to deaths among people experiencing homelessness; and WHEREAS, the housing crisis in Whatcom County limits access and availability to safe, secure, supportive, and affordable housing which is essential for stability, recovery, sobriety, and preventing drug use and overdose; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and WHEREAS, in June 2023, a coalition of government agencies, community -based organizations, healthcare providers, and others from across Whatcom County formed a Multi - Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and WHEREAS, according to the Federal Emergency Management Agency (FEMA), a multiagency coordination system (MAC) is used for extraordinarily large, complex incidents occurring in the city or county involving numerous agencies and/or jurisdictions; and WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide response efforts to the opioid crisis, identify and prioritize additional short-term objectives and strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety in Whatcom County; and WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and Overdose Response (SOOR) plan, which includes five priority goals 1. Prevent opioid misuse, 2. Identify and treat substance use disorder, 3. Ensure and improve the health and wellness of individuals that use drugs, 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions, 5. Support individuals in recovery; and WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, local, state, and federal agencies and bring together state agencies, local law enforcement, and internal and external partners to pursue and achieve solutions that promote public health and safety on the Lummi Reservation; and WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 04E supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in response to the fentanyl crisis; and WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid epidemic and open additional resources and authorities to address the crisis; and WHEREAS, the Whatcom County Council understands coordination between all agencies in our county as well as state and federal supports is needed to fight the fentanyl crisis; and WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by the community and categorized in five key strategy areas: I. Ensure Oversight, Accountability, and Transparency II. Increase Access to Behavioral Health Services III. Build Facilities Needed to Promote Public Health, Safety, and Justice IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration V. Make Systems Changes with Local, Regional, State, and Federal Partners; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a statewide emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis; and WHEREAS, community leaders, agency staff, and other stakeholders convened in early 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; and WHEREAS, Bellingham Mayor Kimberley Lund issued Executive Order 2024-01 on February 20, 2024 to address the fentanyl crisis in Downtown Bellingham; and WHEREAS, this resolution details near term approaches, which are not intended to replace the long-term approaches detailed in more comprehensive county policy documents. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends the following near -term approaches to address the fentanyl crisis: Government Coordination: 1. Advocate for the declaration of emergencies at state and federal levels, thereby opening up additional resources to address the crisis. 2. Unite national efforts by encouraging other local jurisdictions to approve a resolution requesting an emergency be declared at the state and federal levels. 3. Encourage Executive Sidhu to release an Geunty EngeFgency Deelaratien eF Executive Order with action plan that -details specific action items and funding options to intensify- efforts, in alignment with Opioid Task Force and MAC group recommendations. 4. Develop a budget and plan to address staffing shortages, positions needed in order to implement an Engergeney DeelaFatien Executive Order with action plan, and action steps requiring funding. 5. Using whatcomoverdoseprevention.org website and Council Committee of the Whole, provide regular updates to the public on progress of action steps, outcomes of efforts, and funds expended on initiatives. Accountability and Data Collection: 6. Advocate for legislative changes that strengthen laws regarding children's exposure to fentanyl, Ricky's law, and other related measures. 7. Enhance legal methods to address fentanyl-related crimes, distinguish fentanyl related crimes from other drug crimes, and offer treatment and recovery options in lieu of lengthy sentences when appropriate. 8. Request that Sheriff and local police to track data on utilization of Medication Assisted Treatment (MAT) in jail and what arrests do not end in jail time because of booking restrictions. 9. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends Whatcom County Elected officials such as the Executive, Prosecutor, and Sheriff, consider items in Exhibit A for future action; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. WHATCOM COUNTY COUNCIL ATTEST: WHATCOM COUNTY, WASHINGTON Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: Civil Deputy Prosecutor Barry Buchanan, Council Chair EXHIBIT A During stakeholder meetings to refine and develop the Council's resolution, members heard the following suggestions, ideas, and requests for action. Council requests that the Executive consider these exhibit items for potential inclusion in an Executive Order with action plan. 1. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 2. Expand the ability to use test strips beyond Health and Community Services to law enforcement and first responders. 3. Provide additional training on common and emerging illicit drugs to police for improved response and identification of fentanyl and other drugs. 4. Identify potential modifications to booking restrictions in the jail and develop operational plans to address inmate increases. 5. Encourage using strict legal measures to address major crimes and offenses related to fentanyl, fee diSt_ibUtOOH 6. Provide more opportunities for youth diversion, especially for people ages 18-25 years old. 7. Evaluate alternative court programs for higher utilization and capacity. 8. Identify options and funding sources to provide more lower cost housing and creative housing solutions. 9. Fund and launch a multi -jurisdictional, multi -language public education program, including youth public education. 10. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. 11. Provide training for healthcare providers and first responders on the benefits of and how to administer Medication -assisted treatment. 12. Increase funding for treatment programs to increase availability of detox beds, provide voluntary treatment while waiting for sentencing, provide access to treatment in lieu of sentencing. 13. Provide additional resources for recovery court, including a secure facility other than the jail. 14. Ensure services are available for juveniles, not just adults. 15. Ensure medically assisted treatment (MAT) offerings inside the jail match community - based options. 16. Provide support and training for first responders and behavioral health staff dealing with trauma and burnout related to overdose responses. 17. Create and implement an overdose response team. 18. Support efforts by Lummi Nation to build a Secure Withdrawal Management and Stabilization (SWMS) facility. 19. Analyze options for expanding the Alternative Response Team, including providing 24- hour responses. 20. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) Create a publicly accessible monitoring and evaluation system to track goals, outcomes, and data regarding Whatcom County's response to the fentanyl emergency 21. Expand the community paramedics program. 22. Identify optio portive housing programs and re-entry housing for people seeking 'suTsTaaFrWeAsksorder treatment who have a history of incarceration. 23. Explore partnerships with neiqTboring SWISS counties, Whatcom County cities, Lummi Nation, Nooksack Tribe, North Sound ACH, state, and federal agencies to fund a coordinated response to the fentanyl emergency 24. Study new local sources of revenue to fund Whatcom County's response to the fentanyl emergency 25. Explore additional substance use disorder treatment options for pre- and postpartum patients 26. Continue to work with the Incarceration Prevention and Reduction Task Force to identify_ policy options to reduce and prevent incarceration Health Board edits 3/26/2024 after Health Board PROPOSED BY: BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. DEGLARING RECOGNIZING THE FENTANYL CRISIS AN EMERGENCY IN WHATCOM COUNTY AND IDENTIFYING APPROACHES TO THE EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and WHEREAS, in June 2023, a coalition of government agencies, community -based organizations, healthcare providers, and others from across Whatcom County formed a Multi - Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and WHEREAS, according to the Federal Emergency Management Agency (FEMA), a multiagency coordination system (MAC) is used for extraordinarily large, complex incidents occurring in the city or county involving numerous agencies and/or jurisdictions; and WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide response efforts to the opioid crisis, identify and prioritize additional short-term objectives and strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety in Whatcom County; and WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and Overdose Response (SOOR) plan, which includes five priority goals 1. Prevent opioid misuse, 2. Identify and treat substance use disorder, 3. Ensure and improve the health and wellness of individuals that use drugs, 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions, 5. Support individuals in recovery; and WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, local, state, and federal agencies and bring together state agencies, local law enforcement, and internal and external partners to pursue and achieve solutions that promote public health and safety on the Lummi Reservation; and WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 04E supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in response to the fentanyl crisis; and WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid epidemic and open additional resources and authorities to address the crisis; and WHEREAS, the Whatcom County Council understands coordination between all agencies in our county as well as state and federal supports is needed to fight the fentanyl crisis; and WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by the community and categorized in five key strategy areas: I. Ensure Oversight, Accountability, and Transparency II. Increase Access to Behavioral Health Services III. Build Facilities Needed to Promote Public Health, Safety, and Justice IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration V. Make Systems Changes with Local, Regional, State, and Federal Partners; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a statewide emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis; and WHEREAS, community leaders, agency staff, and other stakeholders convened in early 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; and WHEREAS, Bellingham Mayor Kimberley Lund issued Executive Order 2024-01 on February 20, 2024 to address the fentanyl crisis in Downtown Bellingham; and WHEREAS, this resolution details near term approaches, which are not intended to replace the long-term approaches detailed in more comprehensive county policy documents. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends the following near -term approaches to address the fentanyl crisis: Government Coordination: 1. Advocate for the declaration of emergencies at state and federal levels, thereby opening up additional resources to address the crisis. 2. Unite national efforts by encouraging other local jurisdictions to approve a resolution requesting an emergency be declared at the state and federal levels. 3. Encourage Executive Sidhu to release an Geunty Engergeney Deelaratien eF Executive Order with action plan that -details specific action items and funding options to intensify- efforts, in alignment with Opioid Task Force and MAC group recommendations. 4. Develop a budget and plan to address staffing shortages, positions needed in order to implement an EffieFgeney DeelaFatien Executive Order with action plan, and action steps requiring funding. 5. Using whatcomoverdoseprevention.org website and Council Committee of the Whole, provide regular updates to the public on progress of action steps, outcomes of efforts, and funds expended on initiatives. Accountability and Data Collection: 6. Advocate for legislative changes that strengthen laws regarding children's exposure to fentanyl, Ricky's law, and other related measures. 7. Enhance legal methods to address fentanyl-related crimes, distinguish fentanyl related crimes from other drug crimes, and offer treatment and recovery options in lieu of lengthy sentences when appropriate. 8. Request that Sheriff and local police to track data on utilization of Medication Assisted Treatment (MAT) in jail and what arrests do not end in jail time because of booking restrictions. 9. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends Whatcom County Elected officials such as the Executive, Prosecutor, and Sheriff, consider items in Exhibit A for future action; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. WHATCOM COUNTY COUNCIL ATTEST: WHATCOM COUNTY, WASHINGTON Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: Civil Deputy Prosecutor Barry Buchanan, Council Chair EXHIBIT A During stakeholder meetings to refine and develop the Council's resolution, members heard the following suggestions, ideas, and requests for action. Council requests that the Executive consider these exhibit items for potential inclusion in an Executive Deelai=atien ef Emergency OF Order with action plan. 1. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 2. Expand the ability to use test strips beyond Health and Community Services to law enforcement and first responders. 3. Provide additional training on common and emerging illicit drugs to police for improved response and identification of fentanyl and other drugs. 4. Identify potential modifications to booking restrictions in the jail and develop operational plans to address inmate increases. 5. Encourage using strict legal measures to address major crimes and offenses related to fentanyl, fer distributien 6. Provide more opportunities for youth diversion, especially for people ages 18-25 years old. 7. Evaluate alternative court programs for higher utilization and capacity. 8. Identify options and funding sources to provide more lower cost housing and creative housing solutions. 9. Fund and launch a multi -jurisdictional, multi -language public education program, including youth public education. 10. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. 11. Provide training for healthcare providers and first responders on the benefits of and how to administer Medication -assisted treatment. 12. Increase funding for treatment programs to increase availability of detox beds, provide voluntary treatment while waiting for sentencing, provide access to treatment in lieu of sentencing. 13. Provide additional resources for recovery court, including a secure facility other than the jail. 14. Ensure services are available for juveniles, not just adults. 15. Ensure medically assisted treatment (MAT) offerings inside the jail match community - based options. 16. Provide support and training for first responders and behavioral health staff dealing with trauma and burnout related to overdose responses. 17. Create and implement an overdose response team. 18. Support efforts by Lummi Nation to build a Secure Withdrawal Management and Stabilization (SWMS) facility. 19. Analyze options for expanding the Alternative Response Team, including providing 24- hour responses. 20. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) 24-;-Create a publicly accessible monitoring and evaluation system to track goals, outcomes, and data regarding Whatcom County's response to the fentanyl emergency 21. Expand the community paramedics program. 22. 1 PROPOSED BY: BUCHANAN, ELENBAAS 2 INTRODUCTION DATE: FEBRUARY 6, 2024 3 4 5 RESOLUTION NO. 6 7 IDENTIFYING WHATCOM COUNTY APPROACHES 8 TO THE FENTANYL EMERGENCY 9 10 WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom 11 County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year 12 since 2018; and 13 14 WHEREAS, the United States is facing the worst drug crisis in its history, and the 15 resulting tragedies are decimating families and contributing to extraordinary levels of despair in 16 our communities; and 17 18 WHEREAS, there exists a substantial likelihood of risk to persons and property unless 19 further efforts are taken to reduce the threat from fentanyl; and 20 21 WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a 22 potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times 23 more potent than heroin; and 24 25 WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making 26 it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of 27 fentanyl; and 28 29 WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must 30 be different than our approach to other illegal drug use in our community; and 31 32 WHEREAS, the use of fentanyl continues spreading throughout our community, and new 33 and immediate avenues to enhance capabilities, coordination, and collaboration across local, 34 state, tribal, and federal agencies are needed to promote public health and safety; and 35 36 WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, 37 community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: 38 Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response 39 to the devastating consequences of fentanyl, meth, and opioids; and 40 41 WHEREAS, in June 2023, a coalition of government agencies, community -based 42 organizations, healthcare providers, and others from across Whatcom County formed a Multi- 43 Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and 44 45 WHEREAS, according to the Federal Emergency Management Agency (FEMA), a 46 multiagency coordination system (MAC) is used for extraordinarily large, complex incidents 47 occurring in the city or county involving numerous agencies and/or jurisdictions; and 1 2 WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide 3 response efforts to the opioid crisis, identify and prioritize additional short-term objectives and 4 strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety 5 in Whatcom County; and 6 7 WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and 8 Overdose Response (SOOR) plan, which includes five priority goals 9 1. Prevent opioid misuse, 10 2. Identify and treat substance use disorder, 11 3. Ensure and improve the health and wellness of individuals that use drugs, 12 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and 13 evaluate interventions, 14 5. Support individuals in recovery; and 15 16 WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved 17 Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and 18 19 WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new 20 and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, 21 local, state, and federal agencies and bring together state agencies, local law enforcement, and 22 internal and external partners to pursue and achieve solutions that promote public health and 23 safety on the Lummi Reservation; and 24 25 WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 26 041 supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in 27 response to the fentanyl crisis; and 28 29 WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and 30 Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid 31 epidemic and open additional resources and authorities to address the crisis; and 32 33 WHEREAS, the Whatcom County Council understands coordination between all agencies 34 in our county as well as state and federal supports is needed to fight the fentanyl crisis; and 35 WHEREAS, declarations of emergency at the federal, state, and county levels can open up 36 additional resources, funding, and assistance to address the fentanyl emergency; and 37 38 WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as 39 the independent legal advisor of the legislative authority, prosecutor of all criminal and civil 40 actions, including felony charges, among other duties; and 41 42 WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in 43 the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; 44 and 45 1 WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County 2 Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by 3 the community and categorized in five key strategy areas: 4 I. Ensure Oversight, Accountability, and Transparency 5 II. Increase Access to Behavioral Health Services 6 III. Build Facilities Needed to Promote Public Health, Safety, and Justice 7 IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration 8 V. Make Systems Changes with Local, Regional, State, and Federal Partners; and 9 10 WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the 11 Governor of the State of Washington declare a statewide emergency to address the fentanyl 12 crisis; and 13 14 WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the 15 President of the United States declare a national emergency to address the fentanyl crisis; and 16 17 WHEREAS, community leaders, agency staff, and other stakeholders convened in early 18 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; 19 and 20 WHEREAS, this resolution details near term approaches, which are not intended to 21 replace the long-term approaches detailed in more comprehensive county policy documents. 22 23 NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges 24 there is a countywide fentanyl crisis impacting people, businesses, and properties in our 25 communities; and 26 27 NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council 28 recommends the following near -term approaches to address the fentanyl crisis: 29 30 Government Coordination: 31 1. Advocate for the declaration of emergencies at state and federal levels, thereby 32 opening up additional resources to address the crisis. 33 2. Unite national efforts by getting as many jurisdictions as possible to approve a 34 resolution to request an emergency be declared at the state and federal levels. 35 3. County Executive Order declaring an emergency and detailing specific action items 36 (use of opioid settlement funds, one-time reserve funds) to jump start efforts based on 37 Opioid Task Force and MAC group recommendations. 38 4. Advocate for a legislative fix for the legal inability to issue warrants based on a 39 juvenile's risk to themselves. r_,it, 41 Accountabilit 42 5. Advocate to change state law (RCW 9A.42.100) to make it a class B felony to expose a 43 child to fentanyl. 44 6. Sheriff and local police to track data on who is not going to jail because of booking 45 restrictions. 46 7. Streamlined testing for fentanyl to, confirming substance for court cases. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 8. Make non -fatal overdoses reportable in order to find true data and get people connected to resources, interrupt overdose cycle. 9. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 10. Use reckless endangerment and Assault in the Third Degree to hold persons accountable for exposing children to fentanyl. 11. Address the need to confirm substances by using test strips and training police to identify fentanyl (can attest with an affidavit that it's fentanyl). 12. Identify potential modifications to booking restrictions in the jail. 13. Prepare to address an increase in jail population when booking restrictions are altered. 14. Fully staff the jail, using corrections hiring and retention bonuses. 15. Use the involuntary treatment act (ITA) process to get people help for substance abuse. People may be committed to inpatient medical treatment for behavioral health disorders AND substance abuse disorders under the ITA. a. Would require additional staffing for an ITA attorney in the Public Defender's Office. 16. Encourage use of the full force of the law to address major crimes and offenses related to fentanyl, for distribution, imposing the strictest sentences available for fentanyl related crimes. 17. More youth diversion, especially for people ages 18-25 years old. 18. Evaluate alternative court programs for higher utilization and capacity. Prevention and Community Supports: 19. More lower cost housing and creative housing solutions (such as dorm style housing opportunities - room with shared kitchen and bath). 20. Multi -language public education program, including youth public education. 21. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. Treatment 22. Provide training for healthcare providers on Medication -assisted treatment. 23. Advocate for involuntary commitment laws as a way to create an option for those who are unable to walk away from addiction themselves and without help; strengthen Ricky's Law. 24. Increase funding for treatment programs to increase availability of detox beds, provide voluntary treatment while waiting for sentencing, provide access to treatment instead of sentencing. 25. Provide additional resources for recovery court, including a secure facility other than the jail. 26. Ensure services are available for juveniles, not just adults. 27. Fund hiring and longevity incentives (bonuses) for correctional deputies in order to fill staffing vacancies in the jail facility. 28. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services. 29. Ensure continuity of care between medically assisted treatment (MAT) programs inside and outside the jail; medication should be the same in both environments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 30. Provide support and training for first responder dealing with trauma and burnout related to overdose responses. 31. Create and implement an overdose response team. 32. Create a Secure Withdrawal Management and Stabilization (SWMS) facility that allows for involuntary commitment of 72 hours, with the potential to extend for up to 14 days. 33. Provide 24-hour responses for diversion (LEAD) 34. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward the aforementioned near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. ATTEST: Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: /s/ Royce Buckingham/by email 3/13/2024/ch Civil Deputy Prosecutor WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Barry Buchanan, Council Chair PROPOSED BY: BUCHANAN, ELENBAAS INTRODUCTION DATE: FEBRUARY 6, 2024 RESOLUTION NO. !DENT-IFYI G DECLARING THE FENTANYL CRISIS AN EMERGENCY IN WHATCOM COUNTY AND IDENTIFYING APPROACHES TO THE FENT NY EMERGENCY WHEREAS, according to WhatcomOverdosePrevention.org, overdose deaths in Whatcom County in 2023 (132) exceeded deaths in the prior year and have markedly increased every year since 2018; and WHEREAS, the United States is facing the worst drug crisis in its history, and the resulting tragedies are decimating families and contributing to extraordinary levels of despair in our communities; and WHEREAS, there exists a substantial likelihood of risk to persons and property unless further efforts are taken to reduce the threat from fentanyl; and WHEREAS, the U.S. Department of Drug Enforcement (DEA) identifies fentanyl as a potent synthetic opioid drug approximately 100 times more potent than morphine and 50 times more potent than heroin; and WHEREAS, Seven out of ten DEA tested pills with fentanyl are potentially deadly making it likely that 'one pill can kill,' and in 2023, the DEA seized over 360 million deadly doses of fentanyl; and WHEREAS, our community's approach to fentanyl use and fentanyl-related crimes must be different than our approach to other illegal drug use in our community; and WHEREAS, the use of fentanyl continues spreading throughout our community, and new and immediate avenues to enhance capabilities, coordination, and collaboration across local, state, tribal, and federal agencies are needed to promote public health and safety; and WHEREAS, in June 2023, healthcare workers, tribal leaders, educators, businesses, community members and law enforcement gathered for a 2-day workshop, All Hands Whatcom: Opioid Summit, as a call to listening, healing, and action for the Whatcom community in response to the devastating consequences of fentanyl, meth, and opioids; and WHEREAS, in June 2023, a coalition of government agencies, community -based organizations, healthcare providers, and others from across Whatcom County formed a Multi - Agency Coordination (MAC) Group in response to the local opioid and overdose crisis; and WHEREAS, according to the Federal Emergency Management Agency (FEMA), a multiagency coordination system (MAC) is used for extraordinarily large, complex incidents occurring in the city or county involving numerous agencies and/or jurisdictions; and WHEREAS, the mission of the MAC Group is to coordinate the ongoing community -wide response efforts to the opioid crisis, identify and prioritize additional short-term objectives and strategies to reduce drug -related deaths, and mitigate the impacts on property and public safety in Whatcom County; and WHEREAS, the Whatcom County MAC group aligns with the Washington State Opioid and Overdose Response (SOOR) plan, which includes five priority goals 1. Prevent opioid misuse, 2. Identify and treat substance use disorder, 3. Ensure and improve the health and wellness of individuals that use drugs, 4. Use data to detect opioid misuse/abuse, monitor illness, injury and death, and evaluate interventions, 5. Support individuals in recovery; and WHEREAS, on September 22, 2023, the Lummi Indian Business Council approved Resolution 2023-145, declaring a state of emergency in response to the fentanyl crisis; and WHEREAS, Resolution 2023-145 provides the Lummi Indian Business Council with new and immediate avenues to enhance capabilities, coordination, and collaboration across tribal, local, state, and federal agencies and bring together state agencies, local law enforcement, and internal and external partners to pursue and achieve solutions that promote public health and safety on the Lummi Reservation; and WHEREAS, on October 24, 2023, the Whatcom County Council approved Resolution 2023- 04E supporting the Lummi Indian Business Council's (LIBC) state of emergency declaration in response to the fentanyl crisis; and WHEREAS, on December 12, 2023, Whatcom County Councilmembers Buchanan and Elenbaas sent a letter requesting that President Biden declare a national emergency on the opioid epidemic and open additional resources and authorities to address the crisis; and WHEREAS, the Whatcom County Council understands coordination between all agencies in our county as well as state and federal supports is needed to fight the fentanyl crisis; and WHEREAS, declarations of emergency at the federal, state, and county levels can open up additional resources, funding, and assistance to address the fentanyl emergency; and WHEREAS, Chapter 36.27 RCW establishes the Whatcom County Prosecuting Attorney as the independent legal advisor of the legislative authority, prosecutor of all criminal and civil actions, including felony charges, among other duties; and WHEREAS, Chapter 9.94A RCW establishes accountable standard ranges for sentencing in the criminal justice system, and the Prosecuting Attorney makes sentencing recommendations; and WHEREAS, on July 11, 2023, Whatcom County Council adopted the Whatcom County Justice Project Implementation Plan (Ord. 2023-039), which identifies priority projects vetted by the community and categorized in five key strategy areas: I. Ensure Oversight, Accountability, and Transparency II. Increase Access to Behavioral Health Services III. Build Facilities Needed to Promote Public Health, Safety, and Justice IV. Expand the Capacity of Programs to Reduce Incarceration/Re-incarceration V. Make Systems Changes with Local, Regional, State, and Federal Partners; and WHEREAS, Whatcom County Council Resolution 2024-002 respectfully requests that the Governor of the State of Washington declare a statewide emergency to address the fentanyl crisis; and WHEREAS, Whatcom County Council Resolution 2024-003 respectfully requests that the President of the United States declare a national emergency to address the fentanyl crisis; and WHEREAS, community leaders, agency staff, and other stakeholders convened in early 2024 to informally discuss near term solutions to address the fentanyl crisis in our community; and WHEREAS, Bellinaham Mavor Kimberlev Lund issued Executive Order 2024-01 on February 20, 2024 to address the fentanyl crisis in Downtown Bellingham; and WHEREAS, this resolution details near term approaches, which are not intended to replace the long-term approaches detailed in more comprehensive county policy documents. NOW THEREFORE BE IT RESOLVED that the Whatcom County Council acknowledges there is a countywide fentanyl crisis impacting people, businesses, and properties in our communities; and NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends the following near -term approaches to address the fentanyl crisis: Government Coordination: 1. Advocate for the declaration of emergencies at state and federal levels, thereby opening up additional resources to address the crisis. 2. Unite national efforts by encouraging other localgetting as n9any jurisdictions -as pess+b+e to approve a resolution4e requesting an emergency be declared at the state and federal levels. 3. Encourage Executive Sidhu to release a County Emergency Declaration or Executive Order that detailsifrg specific action items and funding options to intensify , ene tinge reserve funds) te jump start efforts in alignment withbased-en Opioid Task Force and MAC group recommendations. 4. Develop a budget and plan to address staffing shortages, positions needed in order to implement an Emergency Declaration or Executive Order, and action steps requiring funding. rr.—may. fr5. Using whatcomoverdoseprevention.org website and Council Committee of the Whole, provide regular updates to the public on progress of action steps, outcomes of efforts, and funds expended on initiatives. Accountability and Data Collection: 6Advocate for a -legislative changes that strengthen laws regarding children's exposure to fentanyl, Ricky's law, and other related measures. fix fei= the legal inability te issue 4 7. Enhance legal methods to address fentanyl -related crimes, distinguish fentan ll related crimes from other drug crimes, and offer treatment and recovery options in lieu of lengthy sentences when appropriate. ehm!El --.—Request that Sheriff and local police to track data on utilization of Medication Assisted Treatment (MAT) in jail and what arrests do not end inwhe is net geing te jail time because of booking restrictions. � • Yl�� \�1�1 I��l�ll��� J\•L�l �i� 1►1Rr)•��1: fr9. Make non -fatal overdoses reportable; interrupt overdose cycle and connect individuals to treatment and services; and. - - - - - - -- -- - - -- - -- - --- -- -- - --- -- - --- -- - -- - -- iiii-- - - -- - - - - - - --- -- --- --- -- - -- - - -- -- -- - - -- - -- -- - -- -- --- - - � :1•wiio-r�:�ww iii�iiu��w:�+ i�i�:. - - - � - - � - - -- -- - - -- -- - -- -- - - -- - - - - -- -- IWI -- -- -- ---- -- -- -- - -- -- - -- - -- --- . . . . . . .. . . . ... . . . . . .. . ----- - - -- --11 111 - 1- - - - - - - -- - - -- - ---- - -- --Mill- - - - Riekj's L-aw. 23. , PFeVide veluntaFy tFeatngent whole waiting fer sentencing, PFeVide aecess te treatment ins of senteneing-. 24 PFeViEle additienal FeseLiFees feF FeeeveFy eeUFt, . jail.the 2rjuveniles, net just aElu 26. Fund hiring and lengevity ineentives (benuses) fer eerreetienal deputies in eFdeF te full staffing vaeanemes in the jam' faeilit�­ 1111 -- - -- -- ---- M -- -- - -- -- --- - -- - -- ------ . . 3 . 31. GFeate a Secure Withdrawal Managengent and Stabilization (SWMS) faeolity that allews fer involuntary eemmitn9ent ef 72 heUFS, with the potential te extend feF Up te 14 di-efs-. 3 , eeunseling) NOW THEREFORE BE IT FURTHER RESOLVED that the Whatcom County Council recommends th,-- Whatcom County Elected officials such as the Executive, Prosecutor, and Sheriff, consider items in Exhibit A for One'usmen inExeeutmv, GFd-... �_ future action; and NOW THEREFORE BE IT FINALLY RESOLVED that the Whatcom County Council respectfully requests that the Executive, Sheriff, local municipalities, and other community partners consider their roles and take action to move forward the afer ,...,.Mien d near -term approaches to address the fentanyl crisis. APPROVED this day of , 2024. ATTEST: Dana Brown -Davis, Clerk of the Council APPROVED AS TO FORM: Civil Deputy Prosecutor WHATCOM COUNTY COUNCIL WHATCOM COUNTY, WASHINGTON Barry Buchanan, Council Chair EXHIBIT A During stakeholder meetings to refine and develop the Council's resolution, members heard the following sug_aestions, ideas, and requests for action. Council requests that the Executive consider these exhibit items for potential inclusion in an Executive Declaration of Emergency or Order. 1. Fund and employ narcotics -detection dogs to keep drugs out of the jail. 2. Expand the ability to use test strips beyond Health and Community Services to law enforcement and first responders. 3. Provide additional training on common and emerging illicit drugs to police for improved response and identification of fentanyl and other drugs. 4. Identify potential modifications to booking restrictions in the jail and develop operational plans to address inmate increases. 5. Encourage using Strict Legal measures to address major crimes and offenses related to fentanyl, for distribution. 6. Provide more opportunities for youth diversion, especially for people ages 18-25 years old. 7. Evaluate alternative court programs for higher utilization and capacity. 8. Identify options and funding sources to provide more lower cost housing and creative housing solutions. 9. Fund and launch a multi -jurisdictional, multi -language public education program, including youth public education. 10. Consider the benefits and potential local applications of the Icelandic Model, a community -based approach to substance use that decreases the likelihood of adolescent substance use by strengthening the supportive role of parents and schools and the network of opportunities around them. 11. Provide training for healthcare providers and first responders on the benefits of and how to administer Medication -assisted treatment. 12. Increase funding for treatment programs to increase availability of detox beds,, provide voluntary treatment while waiting for sentencing, provide access to treatment in lieu of sentencing. 13. Provide additional resources for recovery court, including a secure facility other than the jail. 14. Ensure services are available for juveniles, not just adults. 15. Ensure medically assisted treatment (MAT) offerings inside the jail match community - based options. 16. Provide support and training for first responders and behavioral health staff dealing with trauma and burnout related to overdose responses. 17. Create and implement an overdose response team. 18. Support efforts by Lummi Nation to build a Secure Withdrawal Management and Stabilization (SWMS) facility. 19. Analyze options for expanding the Alternative Response Team, including providing 24- hour responses. 20. Provide programs in the jail (e.g., Narcotic Anonymous, Alcoholics Anonymous, GED, counseling) JUSTICE _I_ SYSTEM COMMITTEE March 21, 2024 Dear Council and Public Health Advisory Board members, The Justice System Committee of the Riveters Collective applauds council members for taking action to address the fentanyl crisis in our community. We agree an emergency declaration is needed to respond to the growing death toll and devastation caused by fentanyl use. We are pleased to see the additions to the revised resolution, including the Government Coordination, Accountability, Prevention and Community Supports, and Treatment recommendations. We support prioritizing treatment for users and full law enforcement options for fentanyl dealers. Prior to approval of the fentanyl emergency resolution, however, we request that you address and modify the resolution around the following details: • Identify and publicly share specific outcomes to measure success of the resolution. • In any funding associated with this declaration, include details and tools for data collection that evaluate the success of the actions spurred by this resolution. Thank you, in advance, for advocating for a humane and data -driven response to curbing this crisis. Sincerely, Justice System Committee Riveters Collective cc: Executive Satpal Sidhu Health Director Erika Lautenbach