HomeMy WebLinkAboutPacket Health Board Feb 1 2022Whatcom County
Council as the Health Board
COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
Meeting Agenda
Tuesday, February 1, 2022
10 AM
Virtual Meeting
VIRTUAL MEETING - VIEW ONLINE
COUNCILMEMBERS
Barry Buchanan
Tyler Byrd
Todd Donovan
Ben Elenbaas
Carol Frazey
Kaylee Galloway
Kathy Kershner
CLERK OF THE COUNCIL
Dana Brown -Davis, C.M.C.
Council as the Health Board Meeting Agenda February 1, 2022
Call To Order
Roll Call
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.
Public Comment
Public Health Advisory Board (PHAB) Update
Big Work 2022
Health Board Composition
COVID update
Adjournment
Whatcom County Page 2 Printed on 21912024
WHATCOM COUNTY COUNCIL
SPECIAL COUNCIL MEETING
AS THE
HEALTH BOARD
10:00 a.m. Tuesday, February 1, 2022
Council Chambers, 311 Grand Avenue
(if virtual: www.whatcomcounty.us/loinvirtualcouncil)
AGENDA
Meetin_g Topics
1. Roll Call
2. Public Comment
3. Public Health Advisory Board (PHAB) Update
4. Big Work 2022
5. Health Board Composition
6. COVID update
Whatcom County
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Department
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HEALTH BOARD
Discussion Form
February 1, 2022
AGENDA ITEM #4: Big Work for 2022
PRESENTERS: Erika Lautenbach
BOARD ACTION: Action Item 0 Discussion FYI - Only
The COVID-19 pandemic has stalled much of the Health Department's strategic and operational work, but there are
opportunities and deadlines for some major efforts in 2022. The work falls into three categories: strategic,
operational, and workforce. This briefing will highlight some of this work, and identify potential areas for Health Board
involvement.
EQUITY CONSIDERATIONS
(include data or information about how topic impacts or could impact equity,
including racial equity)
Key strategic work in 2022 will incorporate equity, including the existing work on CHNCHIP, the Strategic Plan,
consideration of Health Board/PHAB membership, support for and participation in Racial Equity Commission
stakeholder group, and work relating to children and families. Workforce development initiatives will include
opportunities for hiring staff that better reflect the diverse populations in Whatcom County, and training and practice
to provide more inclusive and trauma -informed services.
BOARD ROLE/ACTION REQUESTED
Update/Discussion only
ATTACHMENT(S)
None
Whatcom County
' ll HEALTH
Department
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HEALTH BOARD
Discussion Form
AGENDA ITEM #5
PRESENTERS:
BOARD ACTION:
February 1, 2022
Health Board/Public Health Advisory Board Composition
Erika Lautenbach
Action Item Q Discussion FYI - Only
In 2021, the Washington State Legislature took two significant actions regarding public health. First, they passed a
budget that included a significant and permanent increase in funding for foundational public health services (FPHS).
This resulted in the Whatcom County Health Department (WCHD) having the ability to hire seven new positions, as
approved by the Whatcom County Council in the 2022 mid -biennium budget. Second, they passed a policy bill that
requires both non -charter and charter counties without a community advisory board to change their composition to
include non -elected members. In counties like Whatcom, where there is a community advisory board (Public Health
Advisory Board (PHAB)), the Health Board is not required to change its composition. There are, however,
requirements for community advisory boards, so either the Health Board will need to change its composition or the
PHAB will need to make changes in some of its operations.
If the Health Board chooses to incorporate the requirements of state policy bill (1152), those changes would include:
• Non -elected members of the Health Board must equal the number of elected officials on a local board of
health. Elected members of the local board of health may not constitute a majority.
• Non -elected members include three categories:
o Public Health, health care facilities, and providers;
o Consumers of public health; or
o Other community stakeholders, including non-profit organizations, armed services members, the
business community or the environmental public health regulated community.
• Each of our federally recognized tribes also must have a representative selected by the American Indian
Health Commission.
• County Council would set terms, compensation or reimbursement and process for how applicants will be
approved and appointed.
• Only county and city elected officials on the Health Board would vote on decisions relating to setting or
modifying permit, licensing, and application fees imposed by the Health Department.
If the Health Board chooses not to incorporate requirements, changes the PHAB would need to incorporate (by
January 1, 2022) are:
• Provide input to the local board of health in the recruitment and selection of an administrative officer,
pursuant to RCW 70.05.045, and local health officer, pursuant to RCW 70.05.050
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• Use a health equity framework to conduct, assess, and identify the community health needs of the
jurisdiction, and review and recommend public health policies and priorities for the local health jurisdiction
and advisory board to address community health needs
• Evaluate the impact of proposed public health policies and programs, and assure identified health needs
and concerns are being met
• Promote public participation in and identification of local public health needs
• Provide community forums and hearings as assigned by the local board of health
• Establish community task forces as assigned by the local board of health
• Review and make recommendations to the local health jurisdiction and local board of health for an annual
budget and fees
• Review and advise on local health jurisdiction progress in achieving performance measures and outcomes
to ensure continuous quality improvement and accountability.
• The advisory board shall consist of nine to 21 members appointed by the local board of health. The local
health officer and a member of the local board of health shall serve as ex officio members of the board.
EQUITY CONSIDERATIONS
(include data or information about how topic impacts or could impact equity,
including racial equity)
The legislation for Health Boards includes a requirement that consumers be included on the board, which provides
opportunities for people with lived experience to weigh in on health policy matters countywide. The legislation states
that:
• `It is strongly encouraged that individuals from historically marginalized and underrepresented communities
are given preference."
The legislation for Community Health Advisory Boards includes a specific requirement to use a health equity
framework for identifying and addressing community health needs. The legislation also reinforces the importance of
diversity on the advisory board, including the following requirement:
• "The local health jurisdiction and local board of health must actively recruit advisory board members in a
manner that solicits broad diversity to assure representation from marginalized communities including
tribal, racial, ethnic, and other minorities."
BOARD ROLE / ACTION REQUESTED
Review new requirements and identify next steps
Set timeline for decision -making
ATTACHMENT(S)
Engrossed Second Substitute House Bill 1152 (2021 Legislative Session)
Statewide matrix of current Board of Health composition
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FINAL BILL REPORT
E2SHB 1152
C205L21
Synopsis as Enacted
Brief Description: Establishing comprehensive health services districts.
Sponsors: House Committee on Appropriations (originally sponsored by Representatives
Riccelli, Leavitt, Stonier, Ormsby, Lekanoff, Pollet, Bronoske and Bateman; by request of
Office of the Governor).
House Committee on Health Care & Wellness
House Committee on Appropriations
Senate Committee on Health & Long Term Care
Senate Committee on Ways & Means
Background:
Department of Health.
The Department of Health (DOH) administers various programs and services that promote
public health through disease and injury prevention, immunization, newborn screening,
professional licensing, and public education. Public health services are provided primarily
by a decentralized system of 35 local health jurisdictions, the DOH, and the Washington
State Board of Health (State Board).
Local Health Department or District.
Counties' legislative authorities are charged with establishing either a county health
department or a health district to assure the public's health. Local health departments and
health districts may take various forms and include a single county health department or
district, a combined city and county health department, or a multi -county health district.
Each local public health jurisdiction is governed by a local board of health (board), the
membership of which depends on whether the county is a home rule county or part of a
local health district. For example, in home rule counties, the membership of the board is
governed by the county charter. Elected officials from cities and towns in the county may
be appointed to the board. The board may also include individuals who are not elected
This analysis was prepared by non partisan legislative staff for the use of legislative
members in their deliberations. This analysis is not part of the legislation nor does it
constitute a statement of legislative intent.
House Bill Report - 1 - E2SHB 1152
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officials, but such individuals may not constitute a majority of the board. In non -home rule
counties that are not part of a local health district, the county's board of commissioners
constitutes the board. The county may expand the membership of the board to include
elected officials from cities or towns. The board may also include individuals who are not
elected officials, but such individuals may not constitute a majority of the board.
Each local health jurisdiction must appoint a local health officer, who must be an
experienced physician or osteopathic physician who has a Master of Public Health degree or
equivalent.
Foundational Public Health Services.
"Foundational public health services" is defined as a limited statewide set of defined public
health services within the following areas: control of communicable diseases and other
notifiable conditions; chronic disease and injury prevention; environmental public health;
maternal, child, and family health; access to and linkage with medical, oral, and behavioral
health services; vital records; and cross -cutting capabilities including assessing the health of
populations, public health emergency planning, communications, policy development and
support, community partnership development, and business competencies. "Governmental
public health system" means the DOH, the State Board, local health jurisdictions, sovereign
tribal nations, and Indian health programs located in Washington.
Funding for foundational public health services must be appropriated to the Office of
Financial Management (OFM). The OFM may only allocate funding to the DOH if the
DOH, after consultation with federally recognized Indian tribes, jointly certifies, with a
state association representing local health jurisdictions and the State Board, to the OFM that
there has been an agreement on the distribution and uses of state foundational public health
services funding. If joint certification is not provided, the appropriation for foundational
public health services lapses.
Summary:
Public Health Advisory Board.
The Public Health Advisory Board (Advisory Board) is established within the Department
of Health (DOH). The Advisory Board consists the following members appointed by the
Governor, in addition to four nonvoting, ex officio legislative members:
• the Governor's Office;
• the Director of the State Board of Health (State Board) or the Director's designee;
• the Secretary of Health (Secretary) or the Secretary's designee;
• the chair of the Governor's Interagency Council on Health Disparities;
• two representatives from the tribal government public health sector selected by the
American Indian Health Commission;
• one member of the legislative county authority from an Eastern Washington selected
by a statewide association representing counties;
• one member of the legislative county authority from a Western Washington selected
House Bill Report - 2 - E2SHB 1152
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by a statewide association representing counties;
• on organization representing businesses in a region of the state;
• a statewide association representing community and migrant health centers;
• a statewide association representing Washington cities;
• four representatives from local health jurisdictions representation counties of a certain
size and location selected by a statewide association representation local public health
officials;
• a statewide association representing Washington hospitals;
• a statewide association representing Washington physicians;
• a statewide association representing Washington nurses;
• a statewide association representing Washington public health or public health
professionals; and
• a consumer nonprofit organization representing marginalized populations.
The Advisory Board must:
• advise and provide feedback to the governmental public health system and provide
formal public recommendations on public health;
• monitor the performance of the governmental public health system;
• develop goals and a direction for public health and provide recommendations to
improve public health performance and to achieve the identified goals and direction;
• advise and report to the Secretary;
• coordinate with the Governor's Office, DOH, State Board, local health jurisdictions,
and the Secretary;
• evaluate public health emergency response and provide recommendations for future
response, including coordinating with relevant committees, task forces, and
stakeholders to analyze the COVID-19 public health response; and
• evaluate the use of foundational public health services funding by the governmental
public health system.
The DOH must provide staff support for the Advisory Board.
Local Boards of Health.
In addition to existing members of the local board of health (board), each board must
include members from the following three categories (who may not be elected) that are
selected consistent with State Board rules:
• public health practitioners, employees of health care facilities, and health care
providers, which include: medical ethicists; epidemiologists; individuals experienced
in environmental public health, such as a registered sanitarian; community health
workers; holders of master's degrees or higher in public health or its equivalent;
employees of a hospital located in the county; and physicians or osteopathic
physicians, advanced registered nurse practitioners, physician assistants, nurses,
dentists, naturopaths, or pharmacists, holding an active or retired state -issued license
in good standing;
• consumers of public health, which include residents who have self -identified as
House Bill Report - 3 - E2SHB 1152
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having faced significant health inequities or as having lived experiences with public
health -related programs; and
other community stakeholders, which consist of persons representing the following
types of organizations: community -based organizations or nonprofits that work with
populations experiencing health inequities in the county; active, reserve, or retired
armed service members; the business community; or the environmental public health
regulated community.
If the number of board members selected from these three categories is evenly divisible by
three, there must be an equal number of members selected from each of the three
categories. If there are one or two members over the nearest multiple of three, those
members may be selected from any of the three categories. However, if the board
demonstrates that it attempted to recruit members from all three categories and was unable
to do so, the board may select members only from the other two categories. There may be
no more than one member selected from one type of background or position.
If a federally recognized Indian tribe holds reservation, trust lands, or has usual and
accustomed areas within the county, or if a 501 organization registered in Washington that
serves American Indian and Alaska Native people and provides services within the county,
the board must include a tribal representative selected by the American Indian health
commission. The number of members selected from the three categories and the tribal
representative (if required) must equal the number city and county elected officials on the
board. At the first meeting of the board of health, the members must select a chair to serve
for a period of one year.
Any decision by the board related to the setting or modification of permit, licensing, and
application fees may only be determined by the city and county elected officials on the
board.
A local board of health comprised solely of elected officials may retain its composition if
the local health jurisdiction had a public health advisory committee or board with its own
bylaws established on January 1, 2021. By January 1, 2022, the public health advisory
committee or board must meet the requirements for community health advisory boards
established in the act. A local board of health comprised solely of elected officials and
made up of three counties east of the Cascade Mountains may retain its composition if the
local health jurisdiction has a public health advisory committee or board that meets the
requirements established in the act for community health advisory boards by July 1, 2022.
If such a local board of health does not establish the required community health advisory
board by July 1, 2022, it must comply with the requirements for elected and unelected
membership established in the act. Any future changes to local board of health composition
must also meet the requirements for elected and unelected membership.
The State Board must adopt rules establishing the appointment process for members of the
board who are not elected officials.
House Bill Report - 4 - E2SHB 1152
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Community Health Advisory Boards.
A community health advisory board must:
• provide input to the local board of health on the selection of administrative officers
and local health officers;
• use a health equity framework to assess community health needs and review and
recommend public health policies and priorities;
• evaluate the impact of proposed public health policies and programs;
• promote public participation in and identification of public health needs;
• provide community forums and hearings as assigned by the local board of health;
• establish community task forces as assigned by the local board of health;
• review and make recommendations on the annual budget and fees; and
• review and advise on the jurisdiction's progress in achieving performance measures.
An advisory board must consist of nine to 21 members appointed by the local board of
health. The membership must be diverse and include:
• members with expertise in and experience with health care access and quality;
physical environment; housing, education, and employment; business and
philanthropy; communities that experience inequities; and government and tribal
government;
• community members with lived experience in the above areas;
• consumers of public health services; and
• community stakeholders including nonprofit organizations, the business community,
and those regulated by public health.
The jurisdiction's local health officer and a member of the local board of health must serve
as ex officio members of the board. At the first meeting each year, the advisory board must
select a chair and vice chair. Staffing for the advisory board must be provided by the local
health jurisdiction.
Votes on Final Passage:
House 56 41
Senate 26 22 (Senate amended)
House 60 37 (House concurred)
Effective: July 25, 2021
July 1, 2022 (Sections 3-6)
House Bill Report - 5 - E2SHB 1152
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UP
owon WSRLPHO
1MSMIRTMI SfAIE 8550� 11R I OF LRCRL P BLIC if iL R C f CIR_R
Washington State Local Board of Health Composition
C: 1-22-2021; U: 5-21-21
Local Total
County
City
Tribal
Health
Community
Advisory
Expanded
Notes
Health Members
Elected
Elected
care/
Member
Board
LBOH
Jurisdiction
Officials
Officials
Medical
Needed
�. 3
3
Yes
• 6
3
3
Yes
• 6
3
Yes
Both county's commissioners make up
LBOH
8
4
4
Yes
2 county and 2 city representatives from
•
each county
7
3
1
1
2
Yes
5
5
X
No
• 3
3
Yes
• 3
3
Yes
• 5
3
2
Yes
Retired nurse and former public health
staffer
7
1
6
Yes
3
•
3
Yes
• 5
3
1
1
1*
X
No
5th voting Board member is a Whidbey
Health Hospital District Commissioner
(elected by district), Commanding Officer of
Naval Hospital Oak Harbor is invited to
serve as an ex-officio member of the Board,
Health Officer is the Executive Secretary of
the Board
7
3
1
1
2
Yes
7
3
4
Yes
3
3
2
X
No
Medical members: Physician specializing in
harm reduction, and nurse who is hospital's
Emergency Department Director
5
3
2
Yes
Current citizen members are both MPH
3
3
X
No
3
3
Yes
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vP
owon WSRLPHO
'jgrwinCROn 5fpfE BSSOCr TIOP BR LRC RL PUBLIC if iL-R L; PCIR_S
• 6
3
1
2
2
Yes
Citizen members are fire district
commissioner, school board member
• 9
•
•
6
3
Yes* have
until
7/1/22 to
create a
LPHAB
Each county has two members and a city
member
: 7
3
1
1
2
Yes
Healthcare member is currently a practicing
ARNP
3
3
Yes
11
3 and
one
alternate
5 and
three
alternates
3
Yes
Alternates also attend meeting, 2 of the
healthcare members are voting, one is a
non -voting member
7
3
1
3
Yes
3
3
1
1
X
Yes
No bylaws in place for local PH advisory
board
3
3
Yes
15
5
10
X
No
12
3
6
3
X
Yes
•
8
4
2
1
1
No—
interpreting
as 70.08
LHJ
County: 3 council members and executive
City: Tacoma council and mayor
Healthcare: Pierce Co Medical Society
Community: Towns Association
•
3
3
Yes
* currently exploring expansion ordinance
3
3
X
No
u
3
3
X
No
7
7
X
No
3
3
Yes
7
3
2
2
Yes
County Health Department
County Health & Human Services
Health District
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HEALTH BOARD
Discussion Form
February 1, 2022
AGENDA ITEM #6: COVID update
PRESENTERS: Erika Lautenbach, Dr. Greg Thompson
BOARD ACTION: Action Item 0 Discussion FYI - Only
The COVID-19 pandemic has continued to impact Whatcom County and has had amplified impacts on healthcare
delivery in recent months with the Omicron surge. The Health Department Director and Health Officer will update on
case rate trends, testing, vaccine, healthcare capacity, isolation facilities, and other topics associated with COVID-19.
EQUITY CONSIDERATIONS
(include data or information about how topic impacts or could impact equity,
including racial equity)
COVID-19 has disproportionately impacted vulnerable populations and the presentation will cover how the Health
Department is prioritizing our work to meet the needs of such populations.
BOARD ROLE/ACTION REQUESTED
Update/Discussion only
ATTACHMENT(S)
None
Whatcom County
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Department
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