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Packet Health Board Oct 1 2024
Whatcom County Council as the Health Board COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360) 778-5010 Meeting Agenda Tuesday, October 1, 2024 10 AM Council Chambers / Hybrid Meeting JOINT HEALTH BOARD/PUBLIC HEALTH ADVISORY BOARD MEETING - ADJOURNS BY 12:OOPM (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 Cathy Halka, AICP, CMC Council as the Health Board Meeting Agenda October 1, 2024 Call To Order Roll Call - Health Board Roll Call - Public Health Advisory Board Announcements Individuals who require special assistance to participate in the Council's meetings are asked to contact the Council Office at 360.778.5010 at least 96 hours in advance. This committee meeting is also noticed as a meeting of the Whatcom County Council, with the agenda limited to committee business. Public Comment Special Presentation AB2024-631 Update from Public Health Advisory Board Chair AB2024-632 Update from Health Director and Health Officer AB2024-635 Presentation on Budget and Foundational Public Health Services Funding AB2024-637 Update from the Whatcom County Health and Community Services Department on the Operations Plan for Fentanyl Executive Order Discussion AB2024-634 Discussion of 2025 Public Health Advisory Board (PHAB) Work Plan Other Business Adiournment Whatcom County Pure 2 Printed on 413012025 • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-631 File ID: AB2024-631 Version: 1 Status: Reported File Created: 09/18/2024 Entered by: nervin@co.whatcom.wa.us Department: Health Department File Type: Report Assigned to: Council as the Health Board Final Action: 10/01/2024 Agenda Date: 10/01/2024 Enactment #: Primary Contact Email: stergnil@gmail.com TITLE FOR AGENDA ITEM: Update from Public Health Advisory Board Chair SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: None HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 10/01/2024 Council as the Health Board REPORTED Attachments: Whatcom County Page 1 Printed on 4/30/2025 • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-632 File ID: AB2024-632 Version: 1 Status: Reported File Created: 09/18/2024 Entered by: nervin@co.whatcom.wa.us Department: Health Department File Type: Report Assigned to: Council as the Health Board Final Action: 10/01/2024 Agenda Date: 10/01/2024 Enactment #: Primary Contact Email: elautenb@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Update from Health Director and Health Officer SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: None HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 10/01/2024 Council as the Health Board REPORTED Attachments: Department Report Whatcom County Page 1 Printed on 4/30/2025 Department Report October 2024 Whatcom County Health and Community Services - Equity - Collaboration - Compassion - Transparency - Innovation - Service Division Updates Leadership: Health Director A few major events occurred in the last quarter. First, Health and Community Services (HCS) submitted our biennial budget in August. Thank you to our financial team for thoughtfully crafting a budget that meets our reduction target, continues support for priority programs, and retains strategies to meet our strategic plan goals, including staff support. Second, the Public Health Advisory Board (PHAB) held a retreat for the first time in over five years. The focus was on PHAB roles, priorities and a 2025 work plan. More will be shared in the joint Health Board/PHAB meeting as well as over the course of the coming months. Third, the Way Station is nearly complete.... Fourth, leaders and staff in a number of HCS divisions have been involved in supporting broader county efforts, including an evaluation of jail health services, implementing justice project priorities, partnering with the Sheriff's Office on the HCA jail medicaid reimbursement project, making progress on the fentanyl operations plan, responding to current public health crisis resolutions, preparing for winter shelter operations, and planning for a climate summit in the winter. These are all in addition to the core services and programs provided by HCS. Last, on September 26, HCS held their third annual All Staff Retreat. This was an opportunity to relationship -build in service on increased collaboration; reinforce the department vision, strategic plan and direction; and provide a forum to recognize the achievements of staff and teams. Health Officer Over the past quarter, Dr. Harley has been engaged in key initiatives aimed at enhancing community health. She collaborates with partners to provide better support for pregnant individuals and new parents, focusing on both direct assistance and the development of comprehensive care systems. Additionally, she is glad to have welcomed Dr. Shannon Boustead to the department in August as an Opioid Response Medical Advisor. Dr. Boustead is actively engaged in raising awareness and enhancing access to medications for opioid use disorder (MOUD). Dr. Harley is collaborating with TB program staff to develop educational programs on tuberculosis prevention and is involved with the CD&E division to expand services for refugee health screenings and better address the unique needs of this population. Furthermore, Dr. Harley is dedicated to strengthening public health connections and communication with healthcare partners. Communicable Disease and Epidemiology (CD&E): The CD&E division's public health nurses and staff within the CD&E division continue clinical service outreach and educational events in the community. Immunizations Program Public Health Nurses completed five community outreach events in August, collaborating with various school districts to increase access to vaccination services for youth returning to school. In addition, Public Health Nurses continue to provide monthly outreach at Basecamp to provide this vulnerable population with access to vaccination services. In August, the outreach events combined served 93 children and 14 adults, with 231 vaccines provided. These events are a vital service to the community to help decrease barriers to accessing healthcare and one strategy among many to increase health equity. Opioid Awareness Day In August, our SSP Public Health Nurses, in partnership with the Response Systems Division and the Prevention team in Community Health & Human Services, helped organize an event in front of Bellingham City Hall to mark International Overdose Awareness Day. This could not have been done without the help of many HCS department staff and community partners, including Whatcom EMS, Opportunity Council, Lummi Nation Health Center, North West Youth Services (NWYS), IDEAL options, and so many more! We gave out over 100 naloxone kits and trained many of those participants on how to use this life-saving medication. Our remembrance table honored those we have lost to overdose. We plan to showcase the special notes to those loved ones in our building to keep the messages present and visible to the public. Increasing Community Naloxone Access A naloxone box pilot project is currently underway based on a recommendation from the Syringe Services Program public health nurses. To increase the access and availability of naloxone and overdose prevention supplies, HCS has purchased nine Naloxone boxes to be placed strategically at various locations throughout Whatcom County. Working closely with community partners, the project aims to ensure inclusion and access to supplies, such as naloxone, for those facing the most significant barriers to accessing care. Limited hours, lack of transportation, and stigma create substantial obstacles to the populations that benefit from accessing naloxone. The confirmed locations include Bellingham Food Bank, East Whatcom Regional Resource Center, and Ferndale Community Center. We will continue to work with community partners to identify other locations in Whatcom County. Community and Organizational Development (COD): Health Information and Assessment Several links to community health data available to the public on a few key HCS focus areas: Respiratory Virus Data Dashboards- As flu season approaches, find up to date data on local rates and hospitalizations for Flu, COVID, and RSV. Whatcom Overdose Prevention- Local data on overdoses from HCS in collaboration with the Medical Examiner, and Emergency Medical Services. Whatcom County Health Insights- This site provided a range of public health data and information on the well-being of Whatcom County's residents, with a focus on health equity. Emergency Preparedness & Resiliency We are partnering with the Department of Emergency Management to update our Public Health Emergency Plan, Continuity of Operations Plan, develop safety and risk mitigation plans, and provide important staff training. All staff will engage in baseline incident command training, while those identified as part of the Incident Management Team will receive additional training to be prepared to respond for public health emergencies. Coming Soon! Health and Community Services Intranet Frequently sought out internal resources and central services will soon be available on the Intranet! This will include: 1. Department -wide information, resources, and links 2. Business Office rules, standards, processes, technical assistance, and forms 3. Community & Organizational Development project request steps, guidelines, and resources The soft launch will be in late -September. Community Health and Human Services (CH&HS): Public Education Some of the CH&HS leadership have been busy talking about their programs to various audiences around the county. Sarah Simpson, Amanda Burnette and Ann Beck recorded the Whatcom Report on KGMI radio focused on Veterans, Developmental Disability and Healthy Children's Funded programs. Sarah also presented an update on Healthy Children's Fund work to the Bellingham City Council during their August 12th meeting and the team is looking forward to sharing more with the Rotary Club and Small Cities meetings in the coming months. All of these shared stories about the impact of our programs in the community has been a great opportunity to highlight the successful work being done across the county. Point in Time Count Whatcom's Annual Homelessness Report was published in August, and used a more comprehensive approach to looking at the numbers of those experiencing homelessness in our community. When those surveyed were asked about causes of homelessness, the largest factor (47%) was housing affordability. The team continues to move forward in the work and was happy to share that 1,365 households (2397 individuals) received new or continued housing support from Whatcom County's Coordinated Entry partners. Permanent Supportive Housing Evaluation Village Reach was selected as a consultant to evaluate Whatcom County's Permanent Supportive Housing system and will provide data comparing local programs to those throughout Washington, and the US. The evaluation will also look into the strengths and needs of the system and individual PSH programs to better serve the increasingly complex group of folks in these programs. The final report will be available in the spring of 2025, with various progress pieces of the report coming out throughout the next 6 months. Housing Capital Projects Whatcom County recently signed contracts with non-profit housing providers who applied for the first ever small capital request for proposals (RFP) developed by our housing team. Using local sales and use tax, Lydia Place, YWCA and DVSAS will be creating new housing or preserving current units for individuals and families at 60% AMI or less. Whatcom County, in partnership with the City of Bellingham, has helped to fund the YWCA's purchase of a building that will be renovated to shelter women and children 0-5 years old. With a contribution of $1 million from Whatcom County, this facility will offer shelter to about 20 women and their children. This is exciting momentum towards building capacity in Whatcom County for families and children living unhoused. Whatcom County provided $2M in funding for an affordable housing project at the Belis Fair Mall complex. This complex will provide 65 units of affordable housing, including three studios, 36 one -bedroom units, 23 two -bedroom units, and three 3-bedroom units. Total project cost is $38M, which is provided by City of Bellingham, Low Income Housing Tax Credits, Washington State and Federal Housing Trust Funds, Connecting Housing to Infrastructure Program (CHIP), and a federal appropriation. The property will have a 50 year affordability covenant to ensure longevity of the model. Healthy Children's Fund The Children and Families team executed contracts on the first Whatcom County free doula services program for Medicaid eligible families, which were launched with Healthy Children's Fund. Referrals have begun for birth and postpartum services for the doulas who have signed on. In addition to doula services, over $1 million in funding for basic needs such as diapers, wipes, transportation assistance and other essentials for families has been signed into community contracts. Access to these items will now be easier for families with children 0-5 who also access resources like food banks. The Childcare Innovations RFP is scheduled to close on 10/29 and the team expects to see responses for opportunities to improve access to affordable and high quality childcare. A weekly newsletter here describes all the funding and program opportunities provided by the Healthy Children's fund. Prevention The 2023-24 school services report of programs funded by the Behavioral Health Fund has been released. The numbers reflect that over 7000 community members were reached through events and training supported by this fund. School based community members received individual and group services, 1460 of them were youth and 454 were parents. These funds continue to reach throughout the community and cost benefit estimates show that effective school based programs can save $18 for every $1 spent. Developmental Disabilities Our Developmental Disabilities is planning a training in December for individuals to learn how to provide person centered planning to young adults seeking employment and engagement in the community, which will benefit the individual as they transition from school and the community they live and work in. There have been very few providers available to do this kind of essential planning, so this training will help to increase the workforce who can provide it throughout the region. Environmental Health (EH): The EH program has continued to build and create new partnerships in several areas: Climate Change Response Since the completion of the Climate Vulnerability Assessment in June, partnerships with the libraries, Northwest Clean Air Authority, Opportunity Council, Tribes and food banks to distribute DIY Air Cleaner Kits. Enhanced partnerships also continue with the City of Bellingham and County Public Works for potential future adaptation and resilience projects. Water Quality To best mitigate and respond to pollution events, EH has participated in tabletop exercises with Lake Whatcom Water and Sewer District. We've also partnered with ReSources to pilot a lake monitoring program and continue to work on our Harmful Algal Bloom project for Wiser Lake through a Department of Ecology grant. We also continue to work with the various cities in response to pollution events, data integration, and to update the Coordinated Water System Plan (CWSP). The CWSP update, done every 5 years, provides EH the opportunity to regularly meet with water systems and districts, understanding their specific water quality and quantity situations as well as forecast future challenges. On -Site Septic EH Onsite team has empowered over 314 community members to steward our soil and water resources through onsite sewage system training from June 2024- Sept 12t" 2024. On September 11, 2024 County Council passed spending authority to use grant funds from WA DOH to implement operations and maintenance programs for septic systems. This funding stream will support property owners seeking rebates for septic system maintenance and support transitions anticipated for our database. Food Safety The Food Safety Team celebrates Jennifer Ayrey passing the Registered Sanitarian exam and Christine Hasbrouk completing new food inspector training. The team is now fully staffed and building experience and expertise, following disruption and re- assignment during the pandemic. The team completed food permitting for the Northwest Washington Fair and dozens of other community events from May — August. 290 temporary event permits were issued to date. Solid Waste Living Environment The Living Environment team has successfully restored the water recreation program that has been operating in a limited capacity since 2020. This summer they completed 100% of their backlog of inspections! School Safety In collaboration with the Solid Waste program, several schools received chemical clean up kits and participated in a Rehab the Lab project, where old, unused hazardous chemicals were removed and disposed of properly. Of special note was Lynden High School, who spent $11,000 to remove hazardous chemicals from their laboratories. Financial Service (FAS): Budget The FAS division submitted the department's biennial budget in August. Since then, they have been working with the county to finalize the department's biennial budget requests. Year End The FAS division is preparing for the financial year end. The state year end finished on June 30th and reporting is being finalized. This allows for the Business Office to start their grant accountability reports. The department is also preparing for contracts to start January 1 st and making their final plans on spending to fully utilize the 2024 funds. Response Systems (RSD): Response Systems Division continues to focus on large, system -level projects that improve the continuum of care for those community members experiencing challenges with mental health, substance use disorder, homelessness, crisis, legal involvement and poverty. The What is Addiction? Plain Talk for the Community event put on by Bellingham Library and partners is an example of the community -based efforts to move the needle in a real and meaningful way! RSD staff, in coordination with County leadership, is working on a variety of projects in partnership with the City of Bellingham, Incarceration Prevention and Reduction Taskforce (IRPTF), BHASO, HCA and community providers. The projects line up includes: • 23 Hour Crisis Relief Center • Development of our Therapeutic Campus at Division • Didgwallic Mobile Medical Units to provide MOUD services at Division Campus • Justice Project Implementation Plan o Prosecutorial Diversion Program/Behavioral Care Center • Sequential Intercept Model mapping RSD Direct Service Programs RSD direct services programs are operating at full capacity. We are currently fully - staffed across the programs with some expansion coming in the 4th quarter. Let Everyone Advance with Dignity/Law Enforcement Assisted Diversion (LEAD) We're in the process of hiring two additional LEAD staff through LEAD expansion funds. Street Medicine In partnership with the Syringe Services Program (SSP), a new Behavioral Health specialist will join the teams to provide case management and care coordination to recovery supports. Alternative Response Team (ART) Finalized the 2024 ART Evaluation report. Overdose Prevention and Response RSD is moving forward with a new temporary position to support the recovery continuum for individuals after an overdose or who are at high risk of overdose. This position will provide person -centered engagement and provide resource navigation to the many community MOUD/SUD services. Referrals will be made through Community Paramedics/EMS providers, Crisis Stabilization Center, Jail BH/Re-Entry team, Law Enforcement, MCOT/DCR teams, PeaceHealth, RSD staff, Syringe services and WhatComm 911. • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-635 File ID: AB2024-635 Version: 1 Status: Presented File Created: 09/18/2024 Entered by: nervin@co.whatcom.wa.us Department: Health Department File Type: Presentation Assigned to: Council as the Health Board Final Action: 10/01/2024 Agenda Date: 10/01/2024 Enactment #: Primary Contact Email: ELautenb@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Presentation on Budget and Foundational Public Health Services Funding SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: None HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 10/01/2024 Council as the Health Board PRESENTED Attachments: Presentation, FPHS Funding Breakdown, Revised Presentation Whatcom County Page 1 Printed on 4/30/2025 Health and Community Services Budget and F P H S Snapshot Sabrina Hcuck, Financial Services Manager Erika Lautenbach, Direct , r October 1, 2024 fifILWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES WCHCS Purpose WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES We serve Whatc m Cc unty by advancing equity and partnering with a ur cc mmunity tc= c • prcm?te health through policy and systems [mprrvement • prevent disease and Injury • pvcvide accurate and reliable health ccmmunicatirn, Infcrmati?n and data • prepare f , r and respr nd to emergencies • preserve a healthy envirrnment where everyrne can thrive 2025-26 Bud Revenue e t P u t k 0 so 1. General Fund Reductions due tn projected deficit 2. End nf ARPA and COVID-19 related funds ending Expenditures 1. Increased Personnel and Administrative Services casts 2. Maintain FTE's and care public health services W14ATCOM COUNTY HEALTH AND COMMUNITY SERVICES Health and Oammunity Services Department Budget budget, Whatcom (;ountyHealth & Community Services) Source: www.whatcomcounty.us/3992/2023-2024-Biennial-Budget $60 Annual Budget in Millions $50 M $51M $51 M $50 M $50 $46 M $40 $46 M $30 $24 M $20 $10 $0 2019 2020 2021 2022 2023 2024 2025 3 Budget $49 M Estimated Revenue by Fund Healthy Children's Fund 19% Affordble Hsg, Beh Health 2% Solid Waste 5% Affordable & Supportive Hsg 1% Mental Hlth & Dev Disb 2% Behavioral Health 2 5 ..�meless Housing 10% W14ATCOM COUNTY HEALTH AND COMMUNITY SERVICES State Funding FPHS and ConCon 34% General Fund (General County) 5% Veterans 1% Low Income Housing 1% Estimated Expenditure by Fund Healthy Children's Fund 17% Affordble Hsg, Beh Health 3% Solid Waste 5% Affordable & Supportive Hsg 4%— Mental Hlth & Dev Disb 2% Behavioral Health 27% 5 ess Housing 10% State Funding FPHS and ConCon 27% WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES General Fund (General County) 4% Veterans 1% Low Income Housing 0% 2025m2O26 Bud BPA Item # 1❑ 'Mission Statement 2❑ 'Objectives 3❑ Additional Service Request(s) 4❑ 'Inventory of Services 5 © Fund Balance Analysis 6 'Personnel Step Dates - Year 1 7 'Personnel Step Dates - Year 2 8 r❑ 'Personnel Cost Summary - Year 1 9❑ 'Personnel Cost Summary - Year 2 10 ® Unified Fee Schedule Non-BPA Items: ❑ "JD Edwards Budget Narrative Print-out ❑ 'Organizational Chart ❑ Other: let WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES These are the basic items requred from all departments. Other items listed may also be required depending on department. FPHS Investmentst Impact at WCHCS MAO sari nal wtir e�tlsur jemance and Fpidern oro w ySeSs� gyi / P ey � 4� or Communicable Q Disease v0F Control by m t •y J Vital o Records 3 3 a /�o Environmental Asa Public Health o� �P �o a1:5 enr A 'y0 �0G N� N G �O O Maternal " Child Family Ln Health m F vo Accessto Clinical Care a, aj Se\ 411er$ency Pre paredne55$`iLec-9O Chronic Disease & Injury Prevention w Ah State Board of Health Local Health Jurisdictions State Department of Health Tribal Health and other Departments Am■AnwIM"Am FPHS Summar WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Tcd ta I F P H &0 $ 3,701,300 Category Total Spending Communicable Diseases $1,009,850 Environmental Public Health $1,151,700 Maternal/Child/Family Health $504,000 Access/Linkage with Medical, Oral, and Behavioral Health Care Services $126,100 Chronic Disease, Injury, and Violence Prevention $83,300 Foundational Capabilities $733,850 FPHS Im acts WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Capacity Building • New Environmental Health positions o food, land -use, water, climate and homelessness • Health Equity, Policy, Assessment, Communication, Evaluation positions • Additional Emergency Preparedness staff o severe weather response . Increased workforce development capacity • Communicable disease prevention in high risk settings and schools/daycares jl�,MfLl Quest[ P... ns? WHATCOM COUNTY WEALTH AND COMMUNITY SERVICES FPHS Investment by Scope of Work Allocation FPHS 2023-24 Summary SFY24 Award Communicable Disease & Epidemiology (CD&E) 1,003,068 Environmental Health Health Information & Assessment Administration 1,132,334 299,075 1,258,523 Community Health & Human Services (CH&HS) 150,000 3,843,000 Communicable Disease & Epidemiology SFY24 Award CDE General 422,068 Immunization Outreach, Education & Response 225,000 Hepatitis C 41,000 Case Investigative Capacity 296,000 Tuberculosis Program 19,000 w Environmental Health SFY24 Award Environmental Health General 555,334 Environmental Public Health Policy & Leadership Capacity 150,000 Toxicology & Environmental Epidemiology 75,000 Safe & Healthy Communities 47,000 Climate Change Response 80,000 Water System Capacity 75,000 Homelessness Response 150,000 Health Information & Assessment SFY24 Award HIA General 59,075 Assessment Reinforcing Capacity 60,000 Assessment-CHA/CHIP 30,000 Assessment -Localized Epidemiology Capacity 150,000 Admin SFY24 Award Admin (610525) 104,523 Full Lifecourse Workforce Capacity 687,000 Strengthening Local Finance Capacity 62,000 Public Health Communications 200,000 Emergency Preparedness & Response -Capacity & 205,000 Capability CH & HS SFY24 Award Illicit Substance Use & Overdose 150,000 GRAND TOTALS 3,843,000 Health and Community Services Budget and F P H S Snapshot Sabrina Hcuck, Financial Services Manager Erika Lautenbach, Direct , r October 1, 2024 fifILWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES WCHCS Purpose WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES We serve Whatc m Cc unty by advancing equity and partnering with a ur cc mmunity tc= c • prcm?te health through policy and systems [mprrvement • prevent disease and Injury • pvcvide accurate and reliable health ccmmunicatirn, Infcrmati?n and data • prepare f , r and respr nd to emergencies • preserve a healthy envirrnment where everyrne can thrive 2025-26 Bud Revenue e t P u t k 0 so 1. General Fund Reductions due tn projected deficit 2. End nf ARPA and COVID-19 related funds ending Expenditures 1. Increased Personnel and Administrative Services casts 2. Maintain FTE's and care public health services W14ATCOM COUNTY HEALTH AND COMMUNITY SERVICES Health and Oammunity Services Department Budget budget, Whatcom (;ountyHealth & Community Services) Source: www.whatcomcounty.us/3992/2023-2024-Biennial-Budget $60 Annual Budget in Millions $50 M $51M $51 M $50 M $50 $46 M $40 $31 M $30 $24 M $20 $10 $0 2019 2020 2021 2022 2023 2024 2025 3 Budget $49 M Estimated Revenue by Fund Healthy Children's Fund 19% Affordble Hsg, Beh Health 2% Solid Waste 5% Affordable & Supportive Hsg 1% Mental Hlth & Dev Disb 2% Behavioral Health 2 5 ..�meless Housing 10% W14ATCOM COUNTY HEALTH AND COMMUNITY SERVICES State Funding FPHS and ConCon 34% General Fund (General County) 5% Veterans 1% Low Income Housing 1% Estimated Expenditure by Fund Healthy Children's Fund 17% Affordble Hsg, Beh Health 3% Solid Waste 5% Affordable & Supportive Hsg 4%— Mental Hlth & Dev Disb 2% Behavioral Health 27% 5 ess Housing 10% State Funding FPHS and ConCon 27% WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES General Fund (General County) 4% Veterans 1% Low Income Housing 0% 2025m2O26 Bud BPA Item # 1❑ 'Mission Statement 2❑ 'Objectives 3❑ Additional Service Request(s) 4❑ 'Inventory of Services 5 © Fund Balance Analysis 6 'Personnel Step Dates - Year 1 7 'Personnel Step Dates - Year 2 8 r❑ 'Personnel Cost Summary - Year 1 9❑ 'Personnel Cost Summary - Year 2 10 ® Unified Fee Schedule Non-BPA Items: ❑ "JD Edwards Budget Narrative Print-out ❑ 'Organizational Chart ❑ Other: let WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES These are the basic items requred from all departments. Other items listed may also be required depending on department. FPHS Investmentst Impact at WCHCS MAO sari nal wtir e�tlsur jemance and Fpidern oro w ySeSs� gyi / P ey � 4� or Communicable Q Disease v0F Control by m t •y J Vital o Records 3 3 a /�o Environmental Asa Public Health o� �P �o a1:5 enr A 'y0 �0G N� N G �O O Maternal " Child Family Ln Health m F vo Accessto Clinical Care a, aj Se\ 411er$ency Pre paredne55$`iLec-9O Chronic Disease & Injury Prevention w Ah State Board of Health Local Health Jurisdictions State Department of Health Tribal Health and other Departments Am■AnwIM"Am FPHS Summar WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Tcd ta I F P H &0 $ 3,701,300 Category Total Spending Communicable Diseases $1,009,850 Environmental Public Health $1,151,700 Maternal/Child/Family Health $504,000 Access/Linkage with Medical, Oral, and Behavioral Health Care Services $126,100 Chronic Disease, Injury, and Violence Prevention $83,300 Foundational Capabilities $733,850 FPHS Im acts WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Capacity Building • New Environmental Health positions o food, land -use, water, climate and homelessness • Health Equity, Policy, Assessment, Communication, Evaluation positions • Additional Emergency Preparedness staff o severe weather response . Increased workforce development capacity • Communicable disease prevention in high risk settings and schools/daycares jl�,MfLl Quest[ P... ns? WHATCOM COUNTY WEALTH AND COMMUNITY SERVICES • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-637 File ID: AB2024-637 Version: 1 Status: Presented File Created: 09/20/2024 Entered by: nervin@co.whatcom.wa.us Department: Health Department File Type: Presentation Assigned to: Council as the Health Board Final Action: 10/01/2024 Agenda Date: 10/01/2024 Enactment #: Primary Contact Email: ELautenb@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Update from the Whatcom County Health and Community Services Department on the Operations Plan for Fentanyl Executive Order SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: None HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 10/01/2024 Council as the Health Board PRESENTED Attachments: Staff Memo, Presentation, Status Report Whatcom County Page 1 Printed on 4/30/2025 WHATCOM COUNTY Health and Community Services Memorandum TO: SATPAL SIDHU, COUNTY EXECUTIVE FROM: ERIKA LAUTENBACH DATE: 09/13/2024 Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Greg Thompson, MD, MPH. Co -Health Officer RE: PROGRESS UPDATE ON OPERATIONS PLAN FOR FENTANYL EXECUTIVE ORDER The County Council passed a Resolution to Declare an Emergency re: fentanyl in April. The subsequent Executive Order resulted in a Health and Community Services (HCS) Operations Plan designed to address fentanyl and overdoses in Whatcom County within the scope of HCS services. HCS is providing an update on the progress to date operational izing the plan. Staff will also provide an update on opioid settlement funds collected to date and how those funds are projected to be spent. Please call Erika Lautenbach at (360) 778-6000 with questions. Thank you. ErIg Girard Street Bellir&Dl,am, WA 98225-4005 WHATCOM COUNTY HEALTH AND fil COMMUNITY SERVICES Main Line. (3W) 778-6000 ,www.whatcomcounty.us/health WCHCS Fentanyl Operations Plan Update Erika Lautenbach, Director October 1, 2024 WHATCOM COUNTY • HEALTH AND COMMUNITY` SERVICES WCHCS Purpose WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES We serve Whatcom County by advancing equity and partnering with our community to: • promote health through policy and systems improvement • prevent disease and injury • provide accurate and reliable health communication, information and data • prepare for and respond to emergencies • preserve a healthy environment where everyone can thrive Where are we Number of Emergency Department vi : *Any drug overdose Opioid overdose 0 g sa 84 co so 77 79 77 75 86 WHATCOM COUNTY 14FAI TH ANn as 7 65 4 65 63 61 1 6 LU 55 54 55 4 55 55 50 51 49 53 53 a 424 47 42 44 41 43 44 45 E 37 34 31 28 34 30 31 36 36 29 1 31 z z0 5 2327 26 M& 0 2-1{,fJ # Q} Q1 Q% Q� L * # Q} * [fJ Q1 Q} Q1 Q} L `M CL Q} `, z ❑ ❑ �y 2022 2023 204 "Any drug overdose includes opioid overdoses Where are we? WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Year Suspected Opioid Total Suspected Overdoses Opioid Inciderrt % —K4 ;ni 586 1060 55% 2023 962 1458 66% FnWWO 2024 560 960 58% EMS Dispatch Calls for Suspected Overdoses by Month Show as a table Drill up U�+hatcam County EMS Systerrl Q aOpioid • Non Opicid 151 155 150 13� 129 '34 135 119 120 119 120 12� 112 113 11/ 114 116 103 0 9fi y 99 10d 1Q9 100 U 100 89 83 54 76 75 7A 65 6A c 50 n 9 9 m # rn s o o s s m ¢ m s Au z d z d 2022 2023 2024 J%sp�ctgd Querdo g: dentified by EMS personnel based on vital=_/scene indicators. Actial overdoses can only be confirmed by toxicology results pe ric rrri sd by s licensad healthcare provider. Opioid Related -Suspected Overdoses are identified as opioid related based on evidenee on scene and/or improvement after Narcan was given_ 6aia Thmugh: W19r202d Where are we? Number of overdose -related deaths (all drugs) Overdose Death Status • Confirmed * Probable fIL WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES 22 20 2022 Deaths 16 17 p 1 14 15 9 12 12 12 0 11 i0 10 10 10 11 10 9 S S 8 8 2023 Death: 6 5 � � 6 6 3 3 3 13 ■ 1■ ■ 1 Ills -E — = _ = 2024 Deathi Op 3 3 Q} O W J Q] m (to date) m as m LL- 2022 2023 2024 71 Overdase-related death data for2022-2023 are provided by the Whatcom County Medical Examiners Office. These data represent deaths that have occurred in Whatcom Count}, but do not include Whatcom County residents who died outside the county. Probable indicates a positive result from a drug screening test during death investigation; laboratory analysis has not yet been completed. Confirmed overdose -related deaths have been confirmed by laboratory analysis. These deaths may not have drug overdose listed as the primary, undedying cause of death. These data are updated monthly, Where are we? Rolling 12-month U.S. drug overdose deaths Provisional predicted rolling 12-month total; January 2015 to April 2024 2018 2020 2022 2024 Data: CDC Axios Visuals 101.2k WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Fentanyl Operations Plan PITA Model Programs that prevent onset or curtail before regular use occurs, including Universal (targets general population with community -wide strategies), Selective (targets groups at risk or a sub -set of population), and Indicated (targets individuals who are exhibiting early signs of opioid use disorder) Programs that reduce the risk of harm and decrease negative health outcomes associated with opioid use disorder, ranging from early intervention to ongoing support for chronic and sustained opioid use disorder Programs that improve social functioning, quality of life, and life expectancy through diagnosis and the use of intentional intervention in the physical health, behavior, and substance use of an individual Programs that support stability, recovery, and relapse prevention Prevention Highlightsf.'W4_1fLf1 WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES • Applied for and was recommended for a nearly $8M Trueblood Housing grant • Planning for winter/severe weather shelter • Installed healthcare vending machine and four community - based free naloxone kit boxes • Co -organized and presented to healthcare providers, community on prevention and MOUD; creating opportunities for more field -based initiation of MOUD Intervention Highlights WHATCOM COUNTY HEALTH AND COMMUNITY • Way Station SERVICES • Didgwalic Wellness Center partnership • LEAD Expansion • Substance Use Professional at Emergency Department • Overdose Response Behavioral Health Specialist • Distributed 5,218 doses of naloxone (so far) in 2024; this doesn't include EMS trainings and distribution Treatment Highlights f.,wo-IfLCI WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES • 23 hour facility is in active planning and fundraising; plan to break ground summer of 2025 • Consultant making recommendations on enhancing and expanding existing health and supports in jail; report will be complete in early 2025 • Consultant making recommendations for improving permanent supportive housing; report will be complete in early 2025 Aftercare/Recovery Highlights WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES • $1M in funding for expanded recovery and supported housing • Recovery Coalition opened aCafe/drop in center in September for people to connect and build community* *This is not county sponsored or operated; these are great community members who saw a need and made the effort to meet it! opiol*d Settlement Funds Opioid Settlement Funds WHATCOM COUNTY HEALTH AND COMMUNITY • Settlements are ongoing and variable SERVICES • Bellingham, Ferndale, Lynden and Whatcom County are only jurisdictions large enough to qualify for payments • Currently funds are reflected in the general fund • Defined allowable expenses and rigorous reporting requirements Opioid Settlement Funds - Current WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES -0000000B-- Jurisdiction $1,299,145 $93,487 $119,678 $2,007,849 $3,520,159 *These numbers are estimates and do not reflect the latest McKinsey settlement distributed on 9/11/24 Settlement Fund Allowable Uses 1. Prevent opioid misuse WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Opioid Task Force Top Priorities • Substance use focus in schools • Evidence based programs like Strengthening Families, Nurse Family Partnership, etc. • Pro -social events for youth Additional Service priorities related to goal 1 • Mental health counseling • Public education • Training in youth mental health first aid, resilience and coping, etc. • Suicide prevention expansion Settlement Fund Allowable Uses 2. Identify and treat substance use disorder Opioid Task Force Top Priorities • SUD treatment • Medication assisted treatment • Workforce development • Suboxone bridge to treatment • Jail and re-entry assessments • Navigator/Peer support WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Settlement Fund Allowable Uses 3. Ensure and improve the health and wellness of individuals that use drugs Opioid Task Force Top Priorities • Naloxone distribution WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES • EMS response support • Pregnancy services • Street medicine program • Training for physicians, responders, and trauma -informed care for providers Settlement Fund Allowable Uses 4. Support individuals in recovery WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Opioid Task Force Top Priorities • Recovery housing • Jail transition support • School -based services • Resource directory • Access to interventions like recovery court or mental health court Settlement Fund Spending — one-time am $1,000,000 $1,007,849 $2,007,849 Priority projects will be presented during the budget process for Council policy discussion and decision -making fIL WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Settlement Fund Spending — ongoing $20,000 $35,000 $65,000 $75,000 $85,000 $280,000 *In Fentanyl Operations Plan +Priority of Opioid Task Force ^Already started/Council approved There will likely be $300k-$350k available per year, tapering at intervals as settlements reach their conclusion fIL WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Quest*ions? WHATCOM COUNTY HEALTH & COMMUNITY SERVICES FENTANYL OPERATIONS PLAN UPDATE OCTOBER 1, 2024 Preventic n Strategy Initiative 1a Multi -jurisdictional education and prevention campaign, including proper storage and disposal of unused medications, resources for services and treatment, and Good Samaritan Law *1 b Continue prevention coalition and other work to explore and apply evidence -based prevention models Department/ Division Responsible HCS/ COD WHATCOM COUNTY fLHEALTH AND COMMUNITY SERVICES Timeline for Status Completion* Short-term Planned launch by early December; applying for a grant from the state to expand reach HCS/ CH&HS/ Ongoing RSD/CD&E *1C Expand opportunities for community, first HCS/ CH&HS/ Medium -term responder, and medical training on opioids, Health Officer/ overdose prevention and intervention, and RS and EMS use of medication for opioid use disorder (MOUD) 1d Increase litter clean-up and encampment mitigation 1e Implement strategies to reduce the number of people experiencing unsheltered homelessness and mitigate the individual and public health impacts of encampments if Purchase and distribute lock bags for personal use safe storage of both prescription and illicit drugs Ongoing; All Hands Learning series; tabling and support at community events like "What is Addiction" talk by Bellingham Public Library Hired Medical Advisor; Convene partners through MAC subgroup; sponsored provider training; convene healthcare leadership; PeaceHealth holding a training in October HCS/ EH Ongoing Ongoing — Sheriff's office and private contract HCS Long-term Applied for Trueblood grant; making plans for winter shelter; funded additional shelter beds and facilities including $1 M for YWCA family shelter HCS/ Health Short-term Lock bags will be purchased this fall and Officer/ CDE/ distributed shortly thereafter CH&HS and EMS *19 Install and promote the use of at least one naloxone vending machine at a central location *1 h Ensure community resource hub and website include service and treatment options for fentanyl Intervention HCS/ CDE Short-term Division HCS/ CH&HS Short-term Complete — have installed 4, with plans to install 5 more this fall, including at Way Station; currently installed at East Whatcom Regional Resource Center, Bellingham Food Bank, Ferndale Community Services Resource Center, Ground Floor (NWYS) RFP closed; contractor selected; contract pending internal review Strategy Initiative Department/ Timeline for Status Division Completion* Responsible *2a Embed Substance Use Disorder HCS/ RS/ Medium -term Applied for a received a grant to fund Professionals (SUDP) in key sites like Health Officer service; contract for embedded SUDP at the Emergency Room to connect people in partnership ER approved by Council on 9/24 who have recently overdosed, or new with parents who are currently using fentanyl, PeaceHealth with treatment beds and resources 2b Embed Community Health Workers and HCS/ RS/ Medium -term Working to identify providers; applied for Social Workers in outpatient healthcare CH&HS and received grant funding to embed a clinics to improve outcomes, particularly behavioral health specialist with the for mothers and infants street medicine and SSP programs *2c Explore making non -fatal overdoses a HCS/ Health Medium -term Researching best practices in other notifiable condition to HCS, implement Officer and IT jurisdictions and exploring reporting electronic notification system software *2d Work with partners to open a temporary HCS/ Medium -term Partnership with Didgwalic Wellness recovery facility, until a 23-hour crisis RS/CD&E Center to open a MOUD and stabilization care center is built, to provide a range of facility in November services to individuals who need a safe place to recover post -overdose or transition from jail or other institutions to community 2e Partner with fire and emergency medical EMS, HCS/ Medium -term Overdose Response position closed systems and other jurisdictions to RS/ Health 9/22; working on notification systems support an Overdose Response Team Officer/CD&E, to connect people to follow up care and Fire Districts, services Providers, PeaceHealth 2f Expand community -wide access to EMS, HCS/ Short-term So far in 2024, distributed 5,218 doses of services and supplies, such as RS/ Health naloxone from website requests, at front naloxone, that decrease harm/risk to Officer/ CDE/ desk, through outreach programs, via those who use fentanyl CH&HS vending boxes and at events 2g Explore the development of additional HCS/ RS/ Long-term In process via Council resolution on emergency shelter and transitional CH&HS shelter housing options specifically dedicated to substance use disorder 2h Increase Law Enforcement Assisted HCS/ IRS Short-term Position recruitment in October Diversion (LEAD) Caseload by adding additional Behavioral Health Specialists; explore options for expanding Alternative Response Team (ART) *2i Explore options for use of MOUD in the HCS/ Health Medium -term Hired Medical Advisor; Convene partners field Officer through MAC subgroup; Unity Care NW will provide MOUD at Way Station *2j Partner with a community provider to HCS in Short-term Partnership with Didgwalic Wellness add mobile MOUD services partnership Center to open a MOUD and stabilization with City of facility and mobile units in November Bellingham and provider *2k Create an overdose death review panel HCS/ Health Medium -term On hold until new Medical Examiner is with relevant partners Officer, Medical selected Examiner, Sheriff's office, Prosecutor Treatment Strategy Initiative Department/ Timeline for Status Division Completion* Responsible 3a Identify opportunities at the behavioral HCS/ RS Long-term 23-hour facility planning in place; will health campus on Division for break ground in summer of 2025; public/private treatment projects or received a pledge from Bellingham to investments and develop a pipeline and help fund; pursuing pledges with prioritization of facility -based treatment Ferndale and Lynden projects, informed by stakeholder input 3b Enhance existing treatment and housing HCS/ CH&HS Short to Published an RFP to assess services to add capacity or improve Medium -term opportunities for improvement and outcomes program enhancement in permanent supportive housing; will include a treatment focus in homeless housing strategic plan *3c Expand and diversify jail treatment HCS and Medium -term Working with Sheriff and a consultant services Sheriff firm hired to assess services; will have recommendations in early 2025 3d Support Lummi Nation's Stabilization and Executive's Short-term Executive Sidhu sent letters of support to Withdrawal Management Services Office state and federal funders (SWMS) facility 3e Incentivize treatment providers to expand WCHCS Long-term Gauging interest in local expansion or and hire locally new entrants; will work to develop incentive options for Council consideration Aftercare/Recovery Strategy Initiative Department/ Timeline for Status Division Completion* Responsible *4a Increase recovery housing WCHCS/ Medium -term In process to provide $1.5M in funding CH&HS/ RS to Lake Whatcom Treatment Center to complete or rehab three facilities that will provide recovery and case management services; Applied for a nearly $8M grant to provide housing for Trueblood class members *4b Provide land for a recovery -based tiny WCHCS/ Long-term On hold until after severe weather home village and work to secure CH&HS shelter season permanent recovery housing 4c Partner to create additional recovery WCHCS/ RS Medium- term Recovery Cafe opened 9/18 by support facilities and community networks and CH&HS Coalition in partnership with Chuckanut Health Foundation *4d Enhance supported employment services WCHCS and Medium to MAC subgroup convened with partners partners in Long-term who provide supported employment; employment building strategies services *4e Partner to provide additional WCHCS/ IRS, Long-term Awaiting results of jail assessments and transportation resources between EMS, Service progress on HCA Medicaid grant jail/hospital/services providers *Indicates priority as identified by MAC Group • Whatcom County COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 • Agenda Bill Master Report File Number: AB2024-634 File ID: AB2024-634 Version: 1 Status: Discussed and Motion(s) Approved File Created: 09/18/2024 Entered by: nervin@co.whatcom.wa.us Department: Health Department File Type: Discussion Assigned to: Council as the Health Board Final Action: 10/29/2024 Agenda Date: 10/29/2024 Enactment #: Primary Contact Email: ELautenb@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Discussion of 2025 Public Health Advisory Board (PHAB) Work Plan SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: 10 HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 10/01/2024 Council as the Health Board DISCUSSED 10/29/2024 Council as the Health Board DISCUSSED AND MOTION(S) APPROVED Attachments: 2025 PHAB Work Plan Draft, Work Plan Template Whatcom County Page 1 Printed on 4/30/2025 WHATCOM COUNTY Health and Community Services To work on: Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Health Officer Public Health Advisory Board DRAFT ANNUAL WORKPLAN TOPICS 1. Declared Public Health Crises (racism, shelter, opioids, maybe food) 2. PHAB Work & Processes 3. CHA/CHIP 4. Healthcare Access 5. Equity Framework 6. Education, prevention, outreach for youth 7. Housing Learn more about: 1. CHA/CHIP 2. Community Forums 3. Justice Project 4. Equity Framework 5. WCHCS budget & Priorities Continue: • Hub and Spoke workgroup • Communications workgroup • Equity workgroup • Nominations/code changes workgroups as needed .909 Girard Street Bellingham, WA 98225-4005 WHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Main Line: (360) 778-6000 www.%whatcorricounty.us/health WHATCOM COUNTY Erika Lautenbach, MPH, Director Amy Harley, MD, MPH, Co -Health Officer Health and Community Services Greg Thompson, MD, MPH, Co -Health Officer Public Health Advisory Board ANNUAL WORKPLAN Review the mission and goals of the Health Board as well as Health and Community Services. Within the scope and authority of the group, identify critical success factors- "what must be done to achieve the mission?" What should it look like in 3-5 years? ❑ Prioritize strategies to get there ❑ Discuss barriers (real and perceived) and identify who is not at the table that could provide insight Chair: WCHCS Staff: Goals Tasks Resources/expertise needed to accomplish task Contact Add or remove lines as needed- should stay within 1-4 main goals and no more than 6-8 tasks in a year. 509 Girard Street Bellingham, WA 98225-4005 nWHATCOM COUNTY HEALTH AND COMMUNITY SERVICES Main Line: (360) 778-6000 www.whatcomcounty.us/health