HomeMy WebLinkAboutPacket Health Board Oct 4 2022Whatcom County
Council as the Health Board
COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
Meeting Agenda
Tuesday, October 4, 2022
10 AM
Hybrid Meeting
HYBRID MEETING (PARTICIPATE IN -PERSON, SEE REMOTE JOIN
INSTRUCTIONS AT www.whatcomcounty.us/joinvirtualcouncil, OR CALL
360.778.5010) JOINT MEETING WITH THE PUBLIC HEALTH ADVISORY
COMMITTEE
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 October 4, 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.
PHAB and Health Board call to order. Land acknowledgment. Roll call of PHAB and
Health Board members. Approve PHAB September 2022 minutes (pages 2-5)
Public comment
Health Board/County Council update on relevant items
Community Health Assessment/Community Health Improvement Plan (pages 6-21)
Meeting evaluation
Other Business
Adiournment
Whatcom County Page 2 Printed on 211212024
WHATCOM
COUNTY
HEALTH DEPARTMENT
Erika Lautenbach, MPH, Director
Amy Harley, MD, MPH, Co -Health officer
Greg Thompson, MD, MPH, Co -Health Officer
HEALTH BOARD AND PUBLIC HEALTH ADVISORY
BOARD JOINT SESSION
October 4, 2022
10:00 a.m. to 11:30 a.m.
Hybrid Meeting
In person: County Council Chambers, 311 Grand Avenue, Bellingham, WA 98225.
SEE REMOTE JOIN INSTRUCTIONS AT www.whatcomcounty.us/joinvirtualcouncil,
OR CALL 360.778.5010
AGENDA
1.
PHAB and Health Board call to order. Land
acknowledgment. Roll call of PHAB and Health Board
10:00 —
Steve Bennett, PHAB Chair
members. Approve PHAB September 2022 minutes
10:05
Todd Donovan, HB Chair
(pages 2-5 .
2.
Public comment
10:05 —
Steve Bennett, PHAB Chair
10:15
Todd Donovan, HB Chair
3.
Health Board/County Council update on relevant items
10:15 -
Health Board Members
10:25
4.
Community Health Assessment/Community Health
10:25 —
Emily O'Connor, Amy Hockenberry,
Improvement Plan (pages 6-21
11:25
Amy Rydel
5.
Meeting evaluation
11:25 -
All PHAB/HB Members
11:30
The public is invited to email written comments on agenda items or other topics of interest to the Public Health
Advisory Board at PHAB(a)co.whatcom.wa.us. Please put "PHAB Public Comment" in the subject line.
Next regular meeting of the Public Health Advisory Board: November 3, 2022
Community members who require special assistance to participate in a committee meeting are
asked to contact the meeting facilitator at least 4 business days in advance.
Whatcorn County
HEALTH
Department
WHATCOM COUNTY Erika Lautenbach, MPH, Director
U
Health Department Amy Harley, MD, MPH, Co -Health Officer
Greg Thompson, MD, MPH, Co -Health Officer
WHATCOM COUNTY PUBLIC HEALTH ADVISORY BOARD
MEETING MINUTES
SEPTEMBER 8, 2022
Present: Steve Bennett (Chair), Leah Wainman, Lindsey Karas, Shamika Brooks, Sterling Chick
Absent: Barry Buchanan, Therese Horan, Edna Revey, Les Seelye
Topic
Discussion/Outcome
Call to order
Steve presented a land acknowledgement. Roll call of Public Health Advisory Board (PHAB) Members.
Approve Minutes
Sterling moved that the minutes from the March meeting be approved as presented, Leah seconded. The board
voted and the motion passed. Ayes: 3, Nays: 0, Abstain: 2
Public Comment
The following people spoke:
• Natalie Chavez
• Darcy Hocker
Health
None.
Board/County
Council Update
Health
Co -Health Officer, Dr. Greg Thompson presented a brief update on COVID including:
Director/Health
• Current case rates, test positivity rates, hospitalization rates, and deaths;
Officer Update
• Community case levels across the country (Washington State is in the low community case level as
defined by the CDC);
• An update on vaccines and bivalent boosters;
• Death rates by vaccination status for the course of the pandemic.
Dr. Thompson also presented a brief update on MPV (Monkeypox):
• 488 cases have been identified in Washington State and only 1 in Whatcom County,
• Testing is available at most clinical offices,
• Treatment and vaccine are available locally.
Discussion centered on:
• How are COVID rates being monitored now that so many people are testing at home? In Whatcom
County we are still tracking reported infections. Since not all positive home tests are reported, we also
look at test positivity rates from the airport testing site to give us a sense of the trend. We also look at the
number of visits to PeaceHealth clinics and emergency room visits with COVID diagnoses associated
with them. Those can give us a rough estimate of the direction cases are trending in the community.
• Do you think COVID will become like the flu with annual vaccine boosters available? It's hard to say
since we are still learning so much about it. Currently, COVID is putting out new variants at four times
the rate we usually see with flu. We will need to see how that looks over the next few years and if we see
seasonality associated with COVID like we do with the flu.
Whatcom County
509 Girard Street
Bellingham, WA 98225-4005
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HEALTH
1500 North State Street
Bellingham, WA 98225-4551
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360.778.6100 � FAX360778778.6101
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WhatcomCoHealth
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www'whatcomcounty.us/health
Page 2 of 21
• Flu vaccination rates were high the first year of COVID and then dipped significantly the following year.
Since so many people are back in schools and workplaces now, do we communication planned about
the importance of flu vaccination? Our winter flu predictions are often based on what happens in the
Southern Hemisphere the winter before. It was a worse than average flu year in Australia, so we can
likely expect something similar here, especially as we are seeing less masking and social distancing
now. There is also less built in immunity with fewer people being vaccinated last year and fewer people
infected with flu recently. As a Health Department we need to be communicating the importance of
getting the flu vaccine this year.
Community
Amy Hockenberry gave a presentation on the Community Health Assessment (CHA). The slides were shared
Health
with members in the agenda packet.
Assessment
Update
Discussion included:
One potential role for PHAB in the CHA may be to bring more community engagement to the process.
• When the COVID Health Impact Assessment was done, there was a group convened to review drafts
and provide feedback and high-level reviews. Perhaps PHAB could take a similar role for the CHA,
especially as PHAB is growing and will have representatives from the other Health Department boards
and committees.
• It's exciting to hear there is a focus on assets -based reviews instead of only needs -based reviews.
• It will be interesting to see how things like school performance measures and day care spots look
compared to pre -pandemic and if we are getting back to closer to normal.
• Our 2018 CHA was the first assessment we had done that contained such comprehensive data. Now
that we have that under our belt, and also have the Community Health Improvement Process (CHIP) and
our COVID Community Health Assessment, we're not starting from scratch. It will be interesting to see
how we incorporate what we have previously learned into the CHA.
• How do we make sure that this CHA doesn't take us off course of areas of need that our community has
noted in CHIP, while still taking note of areas we've improved or areas where we are tracking worse than
the State as a whole? How do we balance the need to move those CHIP priorities with providing
flexibility to incorporate new priorities that might come up?
• We could consider setting up a task force of PHAB members to assist the group working on the CHA as
a first contact point from PHAB. Then the Health Department and that task force could determine points
in time when this work should be brought back to the full PHAB group.
• About an hour of the PHAB/Health Board joint meeting in October will be dedicated to the CHA and
CHIP.
• Five years ago we had great community engagement in this process. How are we looking at what
groups in our community may have been missed or places where we're falling short? We will use
lessons learned from these past experiences so we can tell the stories of those in our community, with
the help of those in our community.
• Amy will work with Erika and Steve to draft a proposal based on this feedback to bring back to PHAB
with a roadmap for working together on the CHA.
• It would be helpful to include a timeline for the CHA over the next year or year and a half and what each
of the phases of work would look like.
PHAB Member
Laura Todd works as a consultant for the Health Department and was in attendance to facilitate a discussion on
Priorities and
PHAB member priorities and interests and to foster team building. PHAB members and pending members were
Interests/Team
asked to speak on the following questions.
Building
• Name and role with PHAB.
• What is your passion, interest and/or hope for your/our community?
• What are you bringing to PHAB (passion, expertise, connections, commitment)?
• What might you want to learn from this experience?
Introductions from members and pending members:
Page 3 of 21
• Chris Brown is a member of the Veterans Advisory Board, a clinical social worker at the Bellingham Vet
Center, and board president of Growing Veterans. Chris will be joining PHAB to bring that experience to
the group. He's interested in how to build a stronger link between PHAB and the Veterans Advisory
Board.
• Sterling Chick has been a PHAB member for four years. He is the clinical director of Catholic Community
Services. His work centers on mental health, especially for children and low-income families.
• Lindsey Karas works for Mercy Housing as the housing and education manager. A real highlight of being
a PHAB member has been the breadth and depth of what the group is able to explore and Lindsey looks
forward to continuing to learn more about the community through this work. She's learned a lot about
how Council works and wants to continue organizing with the community to make change.
• Mike Massanari is a retired physician and professor of medicine. He spent his career as an internal
medicine specialist and infectious disease specialist, and also trained in preventative medicine and
epidemiology. Mike is a pending PHAB member representing the Behavioral Health Advisory Board.
Mike is committed to advocate for those who are marginalized in our society and he has an interest in
the broader issue of community health. Several years ago, he was involved in one of the county
community health assessments and wanted to say an affirmation about Amy Hockenberry and her work,
as he has seen the CHA has been much improved over the years.
• Shamika Brooks is a new member of PHAB and a nurse practitioner. As a nurse practitioner, she has
always been an advocate for community health. She is committed to PHAB's work and excited to learn
how policy is made at the local level and how her professional experience can help.
• Teri Bryant is a pending PHAB member, director of the Whatcom Homeless Service Center, and serves
on the Housing Advisory Committee. Teri's passion is ending homelessness. She stressed the impact
homelessness has on health, both while an individual is homeless and how those impacts persist even
for individuals who move on to stable housing situations.
• Christine Espina is a faculty member in the Western Washington University nursing program, member of
Healthy Whatcom, and a pending PHAB member. Personally, as the mother of a five -year -old, she has
been navigating child care and the Bellingham Public School system. She has been closely involved with
CHA and CHIP through her Healthy Whatcom work. Her passion is community health and she is trained
as a community health nurse and has done some international work. Working in the hospital system and
seeing how broken the health care system is pushed her upstream to want to work with students. She
views her work in education as upstream intervention. She will bring her passion and expertise, but also
her lived experience as a woman of color here in Whatcom County, to the table as a PHAB member.
• Steve Bennett is a professor of public health at Western Washington University. Steve started as a
member of PHAB about three meetings before COVID hit. Steve expressed how happy he is that PHAB
took this time to get to know each other. Being reminded of the diversity of experience and the passion
of all the new and existing members is really exciting, as is seeing how PHAB can continue to partner
with the Health Department on developing impactful policy for the county. Steve is a parent of two five-
year -olds and is personally struggling with navigating after school child care. Infectious disease and
health equity are of particular interest, but Steve will dive into any and all public health topics.
• Leah Wainman is a PHAB member and this year is serving as the vice chair. She started as a PHAB
member maybe two meetings before COVID hit. Her undergrad degree is in sociology, but then she
went into the Peace Corps and fell in love with public health. As she has become more familiar with
community coalitions and county government, she sees this work as a beautiful example of our
democratic process where community voices can really guide public policy. It's nice to be able to make
change at the local level without getting bogged down in national politics. Leah works in public health for
a neighboring county. She's excited to build relationships with other advisory groups and to continue to
help our policy makers make good decisions about public health.
• Erika Lautenbach, director of the Health Department, noted that public health impacts everything and
everything impacts public health. While it is one of the most challenging areas of policy, it is also one of
the most impactful. Public health offers Erika a way to help others and to be in a position to make our
community better
• Greg Thompson, WCHD Co -Health Officer, mentioned that he was at a statewide health board
orientation, with Council Members Frazey and Galloway. The orientation meeting really brought to light
the challenges we face statewide, with Council Members not being full time employees and with so
Page 4 of 21
many issues for them to stay apprised of, the amount of time they have to dedicate to public health is
limited. The more we can package and present public health information in a useful way to the Health
Board, the better for the community.
Laura asked members to continue the conversation by talking about what kind of resources would be helpful to
them in their work on PHAB:
• Leah mentioned that the state health board training included a good primer on governmental public
health that would be useful for PHAB members to see where we are in the bureaucratic process. Leah
will see if she can access those slides to share with the group.
It would be useful to have a clear manual for PHAB members including things like how many members
can serve on a task force, how to engage in the policy process, deadlines/timelines for getting agenda
items to Council, how far in advance materials need to be ready for PHAB meetings, lists of other
advisory boards, membership processes, the difference between proclamations and ordinances, etc.
PHAB members are very empowered in the policy process and understanding the nuts and bolts of the
process would help.
• Whatcom County is a member of the Government Alliance on Race and Equity (GARE). However,
GARE information is not easily accessible to PHAB members. While we are engaged in racial equity
work, it would be useful to have easier access to GARE resources.
• It would be helpful to have more our role as a PHAB member more clearly defined role and to know
more about where we can exert our power.
• Is there a possibility of more staff support for PHAB? Erika noted that the Health Department has put in a
request to use Foundational Public Health Services funding for a policy position that could support PHAB
and the Health Board, in addition to all the other boards and commissions that the Health Department
staffs. This position could take a higher level look at how each board and commission decides which
issues to bring forward rather than boards and commissions just being reactive to issues staff bring
forward.
• For 2023, we want to create a work plan for PHAB incorporating what everyone shared today. We will
build on themes and concepts to get us to common goals and build on that over the course of the year.
We would like to do work plans like this with all our boards and commissions as a way to use our
volunteer members time more effectively.
Meeting
• Lindsey appreciated hearing more about everyone, and learning about their interests and passions.
evaluation
• Leah agreed with Lindsey and expressed enthusiasm for all the support for public health.
• Sterling noted that this will be an interesting year coming up with all the new members and he hopes
PHAB can start 2023 with momentum brought by our new members.
• Steve is really happy we took the time to do this team building today. Understanding what drives people
can determine what policy emerges from this group. He noted hearing themes of equity, access, social
determinants of health, housing, economics, and lived experience. All these passions and experience
will intersect to make an exceptionally strong PHAB moving forward.
Adjourn
8:30 am
Next Meeting
Next regular meeting — Joint meeting with the Health Board—10/4/2022
Page 5 of 21
AGdM CO
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HEALTH BOARD AND PUBLIC HEALTH ADVISORY BOARD JOINT SESSION
DISCUSSION FORM
October 4, 2022
AGENDA ITEM #4: Community Health Assessment/Community Health Improvement
Plan
PRESENTERS: Amy Rydel, Amy Hockenberry, Emily O'Connor
BOARD ACTION: ❑ Action Item ❑x Discussion ❑ FYI - Only
SIGNIFICANT POINTS OR EXECUTIVE SUMMARY
As part of the 10 essential public health services, the Health Department is responsible for
assessing and monitoring our population's health status, understanding factors that influence
health, identifying emerging health issues, and strengthening, supporting, and mobilizing
communities and partnerships to improve health. One of the ways the Department accomplishes
this is through the community health improvement process. During this process, we conduct a
countywide Community Health Assessment (CHA). Data from the CHA is used by community
members to identify key priorities and develop a Community Health Improvement Plan (CHIP), a
collaborative strategic plan owned by multiple stakeholders. This process aims to focus resources
and efforts and improve or change policies and practices to reduce inequities in the opportunities
and resources needed by our residents to be healthier. Community Health Improvement is both a
best practice and a requirement for accreditation. Whatcom County's community health
improvement process and the team guiding this work is called Healthy Whatcom. As a team,
Healthy Whatcom is responsible for developing and implementing a process that ensures robust
community participation. The purpose of this presentation is to provide an overview of community
health improvement, describe how this best practice is being implemented in Whatcom County,
and discuss ways for the board to contribute and participate in this work.
EQUITY CONSIDERATIONS
Healthy Whatcom centers its work on the principles of racial equity and health equity so that
children of all races and ethnicities can thrive through fair and just opportunities to be as healthy
as possible. Historically, large-scale community planning efforts rely on system providers' input
and exclude or, at best, minimally engage those who are impacted by important community
decisions. Throughout each phase of community health improvement, participants have been an
intentional mix of people with personal experience of racism or marginalization and/or trying to
access the systems we're trying to change, working alongside those with resources and power
within the system to make change. To address the root cause of problems and transform our
systems, we need both groups co -creating and working together for better outcomes for all
Whatcom County residents.
BOARD ROLE/ACTION REQUESTED
Discuss potential options for Health Board and PHAB involvement and contributions to
community health improvement.
ATTACHMENT(S)
Slide presentation Whatcom County
ffflh HEALTH
Page 6of21 Debartment
Whatcom County's Community Health
Improvement Process: Healthy Whatcom
Presenters;
Emily O'Connor, Lydia Place/Healthy Whatcom/PHAB
Amy Hockenberry, Whatcom County Health Department
Amy Rydel, Whatcom County Health Department/Healthy Whatcom
Page 7 of 21
Community Health Improvement
A PUBLIC HEALTH FRAMEWORK FOR REDUCING HEALTH INEQUITIES
BAY AREA REGIONAL HEALTH INEQUITIES INITIATIVE
DOWNSTREAMUPSTREAM
RISK DISEASE & MORTALITY
SOCIAL INSTITUTIONAL LIVING CONDITIONS BEHAVIORS INJURY Infant Mortality
INEQUITIES INEQUITIES Physical Environment Social Environment Smoking Communicable Ufe Expect—y
Class Corporations & Land Use Expedenre of Class, Poor Nutrition ++ Disease
Race/Ethnicity BusinessesTransportationRacismaM1oender, Low Ph sisal 7 Chronic Disease
Y
rmmi ation Status Government Agencies Housin migr Activity In'ury [intentional
9r 9 Culture -Ads -Media &Illntntentional)
Gender Schools Residential Segregation Violence
Laws & Regulations Ez to Toxins Violence Alcohol & other
Sexual Orientation posure Drugs
Ni Sexual Behavior
Organizations Economic &Work Serv
ice Envimnment
Etrvironmenl Health Care
Employment Education
Income Social Services
Reta,l Businesses
- Cccupatlonal Hazards -
'• y
Emerging Public Health Practice Current Public Health Practice
Page 8 of 21
Assess
Pnr
ESSENTIAL PUBLIC HEALTH SERVICE #1
Assess and monitor population
health status, factors that influence
health, and community needs and
assets
ESSENTIAL PUBLIC HEALTH SERVICE #4
Strengthen, support, and mobilize
communities and partnerships to
improve health
PHAB STANDARD 5.2: Develop and
implement community health
improvement strategies collaboratively.
Page 9 of 21
Questions?
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healthy
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Community Health Improvement in
Whatcom County
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healthy
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• Group guiding Whatcom County's Communii
Health Improvement Process.
• Represent a variety of organizations,
perspectives, and experiences.
• Come together to eliminate health
disparities caused by systemic racism.
r
Page 11 of 21
HEALTH
DETERMINANTS
EDUCATION
HOUSING
COMMUNITY
SECURITY
SAFETY&
VIOLENCE
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AIR &WATER TRANSPORTATION
ENVIRONMENT
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ACCESS TO
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Page 12 of 21
❑I!1
What is Results -Based Accountability (RBA)?
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ORGANIZE \
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2021-25: EVALUATE ASSESS NEEDS &
Community ACTIONS RESOURCES
Health WORK TOGETHER
Improvement Plan ENGAGE THE COMMUNITY
COMMUNICATE
05 SUSTAIN 03
ACT ON WHAT'S IMPROVEMENT FOCUS ON WHAT'S
IMPORTANT RESULTS IMPORTANT
2020-21: Getting to 04
CHOOSE EFFECTIVE
Results & Racial POLICIES & PROGRAMS
Equity workshops
2018-19:
Community
Health
Assessment
2019:
Identify
community
priorities
Website: www.healthvwhatcom.ore
Page 14 of 21
Healthy Whatcom's Results -Based Accountability (RBA) Framework
Early Learning & Care Housing Child & Youth Mental Health
Children of all races and
ethnicities in Whatcom
County have opportunities for
high -quality, culturally
relevant, affordable,
accessible, and professional
child care and early learning
experiences.
Children and families of all
races and ethnicities in
Whatcom County have
housing justice, the assurance
of stable, high -quality, safe,
and affordable housing.
Children, youth, and
caregivers of all races and
ethnicities have the support,
connections, and healthy
relationships they need to
belong and thrive.
Page 15 of 21
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How wre'll get there:
• Put anti -racism into practice by strategically changing the policies, processes, and
decision -making of organizations supporting child, youth, and family mental well-being.
• Increase resources and funding for child and youth mental health approaches focusing
on prevention.
• Develop a peer support model to support youth and their families, especially for LGBTQ+
and BIPOC children and youth.
Page 16 of 21
1.1
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How we'll get there:
• Ensure early learning and care is culturally responsive and free of implicit bias.
• Support professional teachers and administrators to obtain the qualifications and training
necessary to support children and their families.
• Develop and implement a business model that ensures quality care is sustainable for
providers, affordable for families, and educators are well -compensated.
• Ensure early learning and care programs meet families' individual needs: location,
hours of operation, program model, integration of family support, and culturally responsive
resources.
Page 17 of 21
♦♦►
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How wrelll get there:
• Restructure access to housing assistance to focus on prevention, remove implicit bias,
and center child well-being and racial equity.
• Put anti -racism into practice by strategically changing the policies, processes, and
decision -making of organizations supporting child, youth, and family mentalwell-being.
• Increase the supply of available homes for rent and purchase.
2021-25:
Community
Health
Improvement Plan
06
EVALUATE
ACTIONS
W
ENGAC
C
- 05
ACT ON WHAT'S
IMPORTANT
01
2018:
ORGANIZE
Community
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Health
02
ASSESS NEEDS &
Assessment
KTOGETHER
RESOURCES
THE COMMUNITY
AMUNICATE
2019:
SUSTAIN
03
Identify
ROVEMENT
FOCUS ON WHAT'S
community
RESULTS
IMPORTANT
priorities
1
workshops 04
CHOOSE EFFECTIVE
POLICIES &PROGRAMS
1
Family Action Plan
Website: www.healthvwhatcom.orQ
Page 18 of 21
Page 19 of 21
Alignment with the Health Board and
PHAB Focus Areas
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healthy
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Areas of Alignment & Opportunity
• Developing structural alignment between groups.
• Building community capacity through cultivating &
supporting local leaders.
• Establishing efficient data and reporting systems.
• Demonstrating transparency and accountability.
a"fil
pities do
between the Health Board,
ee for collaboration
OHAB, and Healthy
Whatcom in the community health improvement
process?
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