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HomeMy WebLinkAboutPacket Health Board Sep 7 2021Whatcom County Council as the Health Board COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360) 778-5010 Meeting Agenda Tuesday, September 7, 2021 10 AM Virtual Meeting VIRTUAL MEETING - Joint Health Board and PHAB COUNCILMEMBERS Rud Browne Barry Buchanan Tyler Byrd Todd Donovan Ben Elenbaas Carol Frazey Kathy Kershner CLERK OF THE COUNCIL Dana Brown -Davis, C.M.C. Council as the Health Board Meeting Agenda September 7, 2021 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. Welcome COVID Community Health Impact Assessment (CCHIA) 1. AB2021-519 Discussion on COVID Community Health Impact Assessment Racism is a Public Health Crisis Resolution 1. AB2021-520 Discussion on Racism as a Public Health Crisis Update on Foundational Public Health Services (FPHS) Funding 1. AB2021-521 Update on Foundational Public Health Services (FPHS) Funding Wrap up Items Added by Revision Other Business Adjournment Whatcom County Page 2 Printed on 21812024 AGENDA Joint Session Health Board and PHAB September 7, 2021 1 10:00 am — 1:00 pm www.whatcomcounty.us/joinvirtualcounciI Facilitator: Holly O'Neil, Facilitator, Crossroads Consulting Presenters: - Barry Buchanan, Chair, County Health Board Roles: - Erika Lautenbach, Director, WCHD - Sterling Chick, Public Health Advisory Board Chair - Astrid Newell, Community Health Manager, WCHD - Steve Bennett, Public Health Advisory Board Vice Chair Participants: All WCHD Managers, Health Board, and PHAB Members • Get acquainted and strengthen the working relationship between our three groups — Health Board, PHAB, and WCHD Management Team. Session • Identify opportunities we would like to advance in 2022, relative to COVID Impacts Outcomes: and Racism is a Public Health Crisis Resolution, to inform our future budgeting and policy decisions. TIME Agenda Items Presenters Outcomes Welcome 10:00-10:30 am o Intended Outcomes for Today Holly O'Neil Get Acquainted (30 minutes) o Ground rules for participation o Introductions: (1 minute each) COVID Community Health Impact Erika Identify opportunities the Assessment (CCHIA) Lautenbach Health Board would like to o Report: Feedback from advance (which will inform Community Presentations (15 min) our future budgeting and 10:30-11:20 am policy decisions). (50 minutes) o Question: Based on the findings of the CHIA Assessment and feedback from the community thus far, what opportunities do you see for Health Board action in 2022? 11:20-11:30 am Break (10 minutes) Racism is a Public Health Crisis Resolution Identify opportunities the Health Board would like to o Report: PHAB Racial Equity Steve advance (which will inform 11:30-12:15 am Subgroup Recommendations Bennett our future budgeting and (45 minutes) o Question What opportunities do policy decisions). you see for Health Board action in 2022? Update on Foundational Public Health Services (FPHS) Funding Astrid Provide information about 12:15 — 12:30 o Report: Funding that will help Newell state funding that will help (15 minutes) supplement critical gaps in support public health in our public health community. 12:30 — 1:00 Wrap up Holly O'Neil Attached: o COVID Community Health Impact Assessment Presentation o PHAB Racial Equity Subgroup Recommendations o Approved Resolution #2020-0054 Affirming that Racism is a Public Health Crisis o Foundational Public Health Services Overview Presentation 2of21 COVID-19 community health impact assessment Population._ , HEALTH DETERMINANTS EDUCATION HOU5ING COMMUNITY INCOME SOCIAL EMPLOYMENT SECURITY SAFETY& &POVERTY SUPPORT VIOLENCE BUILT AIR&WATER TRANSPORTATION ENVIRONMENT QUALITY ®© ",00 ,. ALCOHOL& NUTRITION& SEXUAL TOBACCO USE IMMUNIZATIONS DRUG USE PHYSICALACTNITY HEALTH o •. (D 4) ACCESS TO QUALIIYOE CARL CARE R ' HEALTH OUTCOMES 3of21 kindergarten readiness child care housing security � homelessness behavioral health 9Jk WM — County HEALTH Department Racism is a Public Health Crisis Res!, lutit-7 n 2020-054 PHAB Racial Equity Subgroup Recommendations for the Annual Joint Retreat Discussion September 7t", 2021 Racism Rest= lutip-n ik N H Department The resolution commits the Health Board to actively participate in the dismantling of systemic racism through deliberate funding and policy decisions. Specific actions identified in the resolution include: 5of21 flk Racism Res.c lutic n H m HEALTHTH Department • Implementing training on the following topics for all elected officials, County staff and members of boards, commissions and committees: • Implicit bias, trauma informed practices, and review of health disparities. • Assessing and revising County department policies, procedures, and ordinances to ensure racial equity and transparency are core elements. • Ensuring that hiring practices provide equitable opportunities for people of color to be employed to help ensure the diversity in our workforce represents the diversity in our community. Racism Res.c luticz n wna. om C—ty HEALTH Department • Promoting diversity of race within county boards and commissions. • Supporting community efforts to alleviate issues of racism and bias and engaging actively and authentically with communities of color wherever they live. • Building and strengthening alliances with other organizations that are confronting racism, encouraging other agencies to recognize racism as a crisis, including considering County membership in the Government Alliance on Race and Equity (GARE), and involving community representation and input in matters of historic and continued racial injustice. 6of21 flk Racism Res.! luti!� H n m HEALTHTH D ppa rtm 2nt Additionally, the Resolution commits the Health Board to evaluate and support policies that are consistent with the principles of equity of access, services, and treatment of all people regardless of race, color, or ethnicity and ensure that such policies do not perpetuate or exacerbate racial disparities within the county. THE WPRK HAS ALREADY BEGUN 7of21 Racial Equity Ma-mentum (as of 9/21h* HEALTH Department County GARE Working Group Launched Spring 2021 • Cross -departmental leadership engagement • Planning staff dialogue series for Fall 2021 (voluntary) • Application for County membership in Govt Alliance on Racial Equity (GARE) Racial Equity Commission County provided funding and is participating in the development of a County Racial Equity Commission through collaboration with City of Bellingham, Chuckanut Health Foundation and numerous community partners Healthy Whatcom Community Engagement of diverse partners and community members in planning process Health Improvement Developing community strategies to promote racial equity with focus on early childhood Child and Family Well-being Recruitment of diverse task force members Task Force Racial equity training and focus embedded throughout TF work Incarceration and Prevention Focusing on increasing racial equity data and addressing racial inequities in Task Force incarceration. Also planning to apply GARE racial equity toolkit to priority issues. COVID -19 Community Outreach Allocating WCHD staff and resources to ensure BIPOC communities have access to information, testing, vaccines �rJl1{K PHAB's W!z rk HEALTH Department • Land Acknowledgement • Increasing community engagement • Communication • Comprehension • General recruitment and tribal representation • Convening Health Department boards/committees/commissions. • Working group • Best practices • Challenges 8of21 ik M!zvIn Forward WM — County HEALTH Department • Assessing and revising County department policies, procedures, and ordinances to ensure racial equity and transparency are core elements. • Promote diversity of race within county boards and commissions. • Supporting community efforts to alleviate issues of racism and bias and engaging actively and authentically with communities of color wherever they live. What a ppa rtunities dr yq u see f!? r the Health Br4ard actir-n to 20227. and how can PHAB help? 9of21 PROPOSED BY: PUBLIC HEALTH ADVISORY BOARD INTRODUCED: NOVEMBER 24, 2020 RESOLUTION NO. 2020-054 AFFIRMING THAT RACISM IS A PUBLIC HEALTH CRISIS WHEREAS, even before the foundation of America's colonies, racism has existed in America. Examples of this are many, including Indigenous people being forcefully removed from ancestral homelands, familial kinship systems, natural resources, cultural ways of life, and language resulting in generational hardships including social, and economic, and political disadvantages as well as physical, psychological and spiritual trauma; and WHEREAS, the public health community is aware that Native Americans and Alaska Natives have a higher burden of illness, injury, and premature mortality than non -Hispanic Whites; and WHEREAS, the Black experience in America beginning with slavery, Jim Crow laws, Grandfather Clause, and the long delayed recognition of the 14t" Amendment -and other violations of the 14th Amendment, redlining & other forms of housing discrimination all of which have allowed preferential opportunities for White Americans for generations while subjecting people of color to hardships, disadvantages and violence in every area of life and created a legacy of inherited trauma and economic oppression across generations; and WHEREAS, systemic racism refers to how large-scale, political and economic forces, which are historically deep and play out over generations, result in deep-seated and often ignored social, economic, and power inequities which then shape the distribution of health risks and inequitable access to resources for health, resulting in the disparate social and spatial clustering of negative health outcomes; and WHEREAS, throughout the history of the United States systemic racism and inequality has manifested itself by acts of discrimination and oppression directed towards Black, Indigenous and people of color (BIPOC) and their communities resulting in fear, anxiety, trauma, terror, and long-term physical and mental health impairments, as well as causing economic oppression for the targets of racism, their communities and subsequent generations; and WHEREAS, in response to the killing of George Floyd and the unnecessary death of countless others in the same pointless fashion, people across the country have risen up to protest the historic economic, environmental, and social injustices occurring towards people of various races and ethnicities, which continues to disproportionately affect the Black community; and WHEREAS, systemic racism has resulted in race as a social determinant of health, with persistent racial disparities in all aspects of health including housing, education, healthcare, employment, worker protections, criminal justice, climate impacts, food access, and technology, and Center for Health Progress has reported that data shows, race, income, and ZIP Code have a bigger impact on health than behavior or medical care; and WHEREAS, BIPOC individuals and communities are disproportionately suffering in part due to long standing, unaddressed health disparities as well as systemic racism and other socioeconomic inequities, and these persistent disparities in health outcomes are not due to genetic or biological differences between the races, but to the entrenched systemic racism in American society; and 10 of 21 WHEREAS, BIPOC residents of Whatcom county are not immune or separate from the significant trends of health disparities that we see in national and state public health data; and WHEREAS, the current COVID-19 pandemic has exacerbated the racial disparities within our nation's BIPOC communities ranging from health care access to risk exposure, and there is a clear correlation between maps showing rates of COVID-19 hospitalizations and neighborhoods with high social vulnerability; and WHEREAS, lack of culturally and ►inguistically competent healthcare has resulted in less utilization of services and poorer health outcomes among BIPOC individuals; and National Academy of Medicine (NAM) found "racial and ethnic minorities receive lower - quality health care than white people —even when insurance status, income, age, and severity of conditions are comparable" and evidence from social psychological and health disparities research suggests that clinician -patient racial/ethnic concordance may improve minority patient health outcomes; and WHEREAS Black women are at least three times as likely to die in childbirth as White mothers, and Black newborns are more than twice as likely to die as White newborns, a disparity that is wider today than it was in 1850 when the majority of Black Americans were enslaved, and one that is not related to the economic or educational status of the mother; and WHEREAS, Black Americans also have higher levels of low birth weights, and Black children are more likely to endure asthma and have more severe symptoms than White children; and WHEREAS, while the health disparities faced by indigenous and black populations are often the most reported, Whatcom county has multiple minority populations that face negative health consequences as a result of systemic racism; and WHEREAS, racism impacts child development, and in Whatcom County only 23% of AI/AN children and only 27% of Hispanic children entering kindergarten were ready for school, as opposed to 54% of White children; and WHEREAS, racism impacts mental health, and in Whatcom County 66% of AI/AN 10th graders, 43% of Black 10th graders and 44% of multi -racial 10th graders reported feeling depression, as opposed to 36% of White 10th graders; and WHEREAS, racism impacts education, a determinant of health, and in Whatcom County 63% of AI/AN and 71% of Hispanic young people graduate on time, as opposed to 82% of White young people; and WHEREAS, racism impacts economic stability, a determinant of health, with the median household income of Black families in Whatcom County being less than half of that of White or Asian families, and Multi -racial, AI/AN, and Native Hawaiian/Pacific Islanders have a median household income over $20,000 less than White or Asian families; and WHEREAS, disparities in health outcomes and determinants of health by race are clearly evident in Whatcom County where life expectancy for American Indian/Alaska Native populations is 69 years compared with 81 years for White population; where 2 out of 3 American Indian/Alaska Native youth experience depression compared with 1 out of 3 White youth; where median income is significantly lower for American Indian/Alaska Native, Hispanic, Black, and Multi -Racial populations than for White and Asian populations; where children who are American Indian/Alaska Native or Hispanic are half as likely to enter kindergarten with skills needed to succeed in school and are also significantly less likely to graduate from high school on time; and 11 of 21 WHEREAS, a just public health system would hold all of our individual choices to the fundamental principles of social equity and public welfare that were built into the very foundation of that system. It would not permit individual bias to persist on the policy or operational level. While it would not, and could never, eliminate racial bias in individuals, it would neuter its effects, by holding each of us to the standards of equity and fairness upon which our metrics are based; and WHEREAS, we are concerned with public policy. Policy is the province of governance. As individuals, and as representatives of our institution, we identify racism as a systemic flaw, and an enemy to the public, wherever we encounter it. We commit to evaluating and reforming our policies, our practices, and our leadership, to reflect our commitment to this mission; and WHEREAS, the American Public Health Association, National Association of County and City Health Officials, and the American Academy of Pediatrics have declared racism as a public health crisis. The disparities caused by systemic racism that we have outlined in this resolution represent a public health crisis which affects us all. NOW, THEREFORE BE IT RESOLVED this Health Board will advocate that Whatcom County government implement, with intent and fidelity, policies and practices that reflect a conscious effort to ensure racial equity, equity of access and service, and further to ensure the equitable treatment of all people, regardless of race or ethnicity. Section 1. This Health Board declares that racism is a public health crisis. Section 2. This Health Board is committed to making Whatcom County a welcoming, inclusive, and safe community for everyone. While we promote free thought and speech, we condemn racism and brutality, hate speech, bigotry, violence and prejudice in any form. Section 3. This Health Board endorses the continued implementation and use of policies and practices for employee conduct and equitable treatment of all people and honors, by approval of this Resolution, the common humanity of all people, regardless of race or ethnicity. Section 4. This Health Board commits to actively participating in the dismantling of systemic racism and its impacts in Whatcom County by: A. Implementing training on the following topics for all elected officials, County staff and members of boards, commissions and committees: implicit bias, trauma informed practices, and review of health disparities. B. Assessing and revising County department policies, procedures, and ordinances to ensure racial equity and transparency are core elements. C. Ensuring that hiring practices provide equitable opportunities for people of color to be employed to help ensure the diversity in our workforce represents the diversity in our community. D. Promote diversity of race within county boards and commissions. E. Supporting community efforts to alleviate issues of racism and bias and engaging actively and authentically with communities of color wherever they live. F. Building and strengthening alliances with other organizations that are confronting racism, and encouraging other agencies to recognize racism as a crisis, including considering County membership in the Government Alliance on Race and Equity (GARE), which is a national network of local government agencies working to achieve racial equity and advance opportunities for all. Additionally, involve community representation and input in matters of historic and continued racial injustice. 12 of 21 Section 5. This Health Board will continue to, through its goodwill, dialogue, and decision - making efforts and powers, evaluate and support policies that are consistent with the principles of equity of access, services, and treatment of all people regardless of race, color, or ethnicity and ensure that such policies do not perpetuate or exacerbate racial disparities within the county. Section 6. This Health Board shall facilitate keeping data and monitoring progress on the goals set up on the resolution. APPRC1F Ye.g 16174y, of 24th of November !®� ��• �� t©W ®m cs cscC��"� ®''o' `�' AT3E Dana=Brown-Da�1@kotheuncil APPP,O,VED A f t ifi'$ 1�3ta /s/ Rovice 14U6ki!n2ham.l.. Civil Deputy Prosecutor 2020. WHATCOM COUNTY HEALTH BOARD CHAIR WHATCOM COUNTY, WASHINGTON �A rp-wc Barry Bu hanan, Council Chair 13 of 21 Faundatir-nal Public Health Services (FPHS) -Overview Astrid Newell Cnmmunity Health Manager September 7, 2021 Whatcom County HEALTH ITM fJILDepartment 14 of 21 In a nutshell FPHS are... HEEAA`LLTH i Department • A limited defined set of core services provided by the Governmental Public Health System, and... • A collaborative process to transform public health in WA State through adequate funding and innovative service delivery models FPHS Visk, n and Gcals w� ,r HEALTH Department VISIPN • A responsive and viable grsvernmental public health system is essential for healthy. and economically vital communities across Washington GPAL • Full funding of FPHS, statewide, using a long- term, building block approach r rd State Departmentth of Health (SBOH) (DOH) L35 Local Sovereign Tribal Health Nations&Indian ctions Health Programs (LH)s) (IHP) RCW 42.70.512 & 515 15 of 21 FPHS Pbjectives 1. Adgpt a limited statewide set o7f core public health services 2. Fund FPHS through state funds and fees that are predictable, sustainable and responsive tc demands and cost 3. Provide and use kcal revenue generating 2ptians tr� address Ircal public health priorities �lalllC wn-.C-tr HEALTH Department 4. Deliver FPHS in ways that maximize efficiency and effectiveness 5. Complete a triba% led pracess tc define how the FPHS framework will apply tc tribal public health 6. Allocate resources thro7ugh a ccllab?rative prcess between state, Kcal and tribal governmental public health system partners Lim ted set c f cc re public HEALTH was omC-ty i Department health services Faundatir_nal Pragrams • Vital Records • Environmental Public Health • Communicable Disease • Maternal, Child & Family Health • Chronic Disease & Injury • Access to Health Care (Medical, Behavioral, Oral) Faundatknal Capabilities • Assessment • Emergency Preparedness & Response • Communications • Policy Development • Community Partnerships • Business Competencies (Accounting, Payroll, etc) 16 of 21 Why FPHS matter w-«om co-tY y HEALTH Department • Chronic underfunding of public health system, particularly at local level 4 gaps in services • Fragmentation and silo-ing of services across the state 4 inefficiencies and lack of effectiveness • Current public health system is not achieving desired health outcomes and equity FPHS Funding Need Additional Funds Needed from State Government for Full Implementation of FPHS (Baseline) 0: Foundational Program or Capability Environmental Public Health Additional from State in millions 39 / year; Funds Needed Go�ernment, (rounded) 78 / biennium Prevention and Control of Communicable Disease & $37 year; $74 /biennium Other Notifiable Conditions Maternal/Child/Family Health 16 / year; 32 / biennium Access/Linkage with Medical, Oral, and Behavioral $7 /year; $14 /biennium Health Care Services Chronic Disease, Injury and Violence Prevention 14 / year; 28 / biennium Vital Records $0 Assessment Surveillance and Epidemiology) $30 / year; 60 / biennium Emergency Preparedness All Hazards $9 / year; 18 / biennium Communication $10 / year; 20 / biennium Policy Development and Su ort $8 / year; 16 / biennium Community Partnership Develo ment 1 $10 / year; 20 / biennium Business Competencies 1 $45 / year; 9 biennium Total 225 / year; $450 / biennium ' Berk 2018. Washington State Public Health Transformation Assessment Report 17 of 21 A Long -Term, Multi -Biennia, Phased, Building Block Approach to Full Funding and Implementation of FPHS 17-19 I 19-21 21-23 23-25 25-27 27-29 29-31 onward ' Establish a process and mechanism so funding keeps up with inflation, population size, demand for service and changes in FPHS definitions. Diagram is conceptual and not to scale (updated 8-4-2020) Hcw FPHS Impact Whatcc m HEALTH Department County • Builds local capacity to deliver core public health services • Provides opportunity to try new ways of delivering public health services in partnership with other LHJs, state, tribes. • Offers opportunity for Whatcom County public health leaders to participate in shaping public health system in WA State 18 of 21 WCH D FPHS Funding • Current funding for Communicable Disease staff • Expecting additional funding this year for: • Environmental Public Health • Communicable Disease • Assessment • Other Foundational Capabilities • Future funding for other Foundational Programs ik w—c.. county HEALTH Department WCHD FPHS Funds (not final) HEALTH Department Foundational Communicable $148,699 (current) Ongoing + more Currently use FPHS for Programs Disease plus $ 236,006 CD (additional) Environmental Public $ 475,000 Ongoing + more Specific program uses Health (food, schools) Other Programs: N/A N/A Future budget request Maternal/Child/Family Health, Chronic Disease/Injury, Access to Care Foundational Assessment $ 30,000 Ongoing + For CHA/CHIP support Capabilities Any Cross Cutting $ TBD Ongoing + This is part of Capability WSALPHO request to be considered on 9/2 $ TBD SFY=State Fiscal Year (July 1 --> June 30) 19 of 21 FPHS Service Deliver HEEAA`LLTH Y Department • Shared services models • Communicable Disease • New servicef • E.g., School Environmental Health Program • Coordination with state and other local health jurisdictions FPHS Leadership& wHHna.�omALCo�I,rT Department Participation • FPHS Steering Committee • Astrid Newell (Co -Chair) • FPHS Subject Matter Expert Groups • Cindy Hollinsworth (CD) • Amy Hockenberry (Assessment) • WSALPHO Board of Directors • Erika Lautenbach, Astrid Newell 20 of 21 Questic ns? 21 of 21 Whatcom County Agenda Bill Report File Number: AB2021-519 COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 File ID: AB2021-519 Version: 1 Status: Discussed File Created: 09/02/2021 Entered by: JGay@co.whatcom.wa.us Department: Health Department File Type: Discussion Assigned to: Council as the Health Board Final Action: 09/07/2021 Agenda Date: 09/07/2021 Enactment M Primary Contact Email: elautenb@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Discussion on COVID Community Health Impact Assessment SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Feedback from community presentations of the COVID Community Health Impact Assessment and discussion on opportunities for Health Board action in 2022. HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 09/07/2021 Council as the Health Board DISCUSSED Attachments: Presentation Whatcom County Page 1 Printed on 2/8/2024 Ad ft-11 qV COVID-19 Imo► community V health impact assessment Population._ , HEALTH DETERMINANTS EDUCATION HOU5ING COMMUNITY INCOME SOCIAL EMPLOYMENT SECURITY SAFETY& &POVERTY SUPPORT VIOLENCE BUILT AIR&WATER TRANSPORTATION ENVIRONMENT QUALITY ®© ",00 ,. ALCOHOL& NUTRITION& SEXUAL TOBACCO USE IMMUNIZATIONS DRUG USE PHYSICALACTNITY HEALTH o •. (D 4) ACCESS TO QUALIIYOE CARL CARE R ' HEALTH OUTCOMES kindergarten readiness child care housing security � homelessness behavioral health Whatcom County Agenda Bill Report File Number: AB2021-520 COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 File ID: AB2021-520 Version: 1 Status: Discussed File Created: 09/02/2021 Entered by: JGay@co.whatcom.wa.us Department: Health Department File Type: Discussion Assigned to: Council as the Health Board Final Action: 09/07/2021 Agenda Date: 09/07/2021 Enactment M Primary Contact Email: bennet63@www.edu TITLE FOR AGENDA ITEM: Discussion on Racism as a Public Health Crisis SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Report on PHAB Racial Equity Subgroup recommendations and discussion on opportunities for Health Board action in 2022. HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 09/07/2021 Council as the Health Board DISCUSSED Attachments: Presentation, Approved Resolution 2020-054 Whatcom County Page 1 Printed on 2/8/2024 9Jk WM — County HEALTH Department Racism is a Public Health Crisis Res!, lutit-7 n 2020-054 PHAB Racial Equity Subgroup Recommendations for the Annual Joint Retreat Discussion September 7t", 2021 Racism Rest= lutip-n ik N H Department The resolution commits the Health Board to actively participate in the dismantling of systemic racism through deliberate funding and policy decisions. Specific actions identified in the resolution include: flk Racism Res.c lutic n H m HEALTHTH Department • Implementing training on the following topics for all elected officials, County staff and members of boards, commissions and committees: • Implicit bias, trauma informed practices, and review of health disparities. • Assessing and revising County department policies, procedures, and ordinances to ensure racial equity and transparency are core elements. • Ensuring that hiring practices provide equitable opportunities for people of color to be employed to help ensure the diversity in our workforce represents the diversity in our community. Racism Res.c luticz n wna. om C—ty HEALTH Department • Promoting diversity of race within county boards and commissions. • Supporting community efforts to alleviate issues of racism and bias and engaging actively and authentically with communities of color wherever they live. • Building and strengthening alliances with other organizations that are confronting racism, encouraging other agencies to recognize racism as a crisis, including considering County membership in the Government Alliance on Race and Equity (GARE), and involving community representation and input in matters of historic and continued racial injustice. flk Racism Res.! luti!� H n m HEALTHTH D ppa rtm 2nt Additionally, the Resolution commits the Health Board to evaluate and support policies that are consistent with the principles of equity of access, services, and treatment of all people regardless of race, color, or ethnicity and ensure that such policies do not perpetuate or exacerbate racial disparities within the county. THE WPRK HAS ALREADY BEGUN Racial Equity Ma-mentum (as of 9/21h* HEALTH Department County GARE Working Group Launched Spring 2021 • Cross -departmental leadership engagement • Planning staff dialogue series for Fall 2021 (voluntary) • Application for County membership in Govt Alliance on Racial Equity (GARE) Racial Equity Commission County provided funding and is participating in the development of a County Racial Equity Commission through collaboration with City of Bellingham, Chuckanut Health Foundation and numerous community partners Healthy Whatcom Community Engagement of diverse partners and community members in planning process Health Improvement Developing community strategies to promote racial equity with focus on early childhood Child and Family Well-being Recruitment of diverse task force members Task Force Racial equity training and focus embedded throughout TF work Incarceration and Prevention Focusing on increasing racial equity data and addressing racial inequities in Task Force incarceration. Also planning to apply GARE racial equity toolkit to priority issues. COVID -19 Community Outreach Allocating WCHD staff and resources to ensure BIPOC communities have access to information, testing, vaccines �rJl1{K PHAB's W!z rk HEALTH Department • Land Acknowledgement • Increasing community engagement • Communication • Comprehension • General recruitment and tribal representation • Convening Health Department boards/committees/commissions. • Working group • Best practices • Challenges ik M!zvIn Forward WM — County HEALTH Department • Assessing and revising County department policies, procedures, and ordinances to ensure racial equity and transparency are core elements. • Promote diversity of race within county boards and commissions. • Supporting community efforts to alleviate issues of racism and bias and engaging actively and authentically with communities of color wherever they live. What a ppa rtunities dr yq u see f!? r the Health Br4ard actir-n to 20227. and how can PHAB help? PROPOSED BY: PUBLIC HEALTH ADVISORY BOARD INTRODUCED: NOVEMBER 24, 2020 RESOLUTION NO. 2020-054 AFFIRMING THAT RACISM IS A PUBLIC HEALTH CRISIS WHEREAS, even before the foundation of America's colonies, racism has existed in America. Examples of this are many, including Indigenous people being forcefully removed from ancestral homelands, familial kinship systems, natural resources, cultural ways of life, and language resulting in generational hardships including social, and economic, and political disadvantages as well as physical, psychological and spiritual trauma; and WHEREAS, the public health community is aware that Native Americans and Alaska Natives have a higher burden of illness, injury, and premature mortality than non -Hispanic Whites; and WHEREAS, the Black experience in America beginning with slavery, Jim Crow laws, Grandfather Clause, and the long delayed recognition of the 14t" Amendment -and other violations of the 14th Amendment, redlining & other forms of housing discrimination all of which have allowed preferential opportunities for White Americans for generations while subjecting people of color to hardships, disadvantages and violence in every area of life and created a legacy of inherited trauma and economic oppression across generations; and WHEREAS, systemic racism refers to how large-scale, political and economic forces, which are historically deep and play out over generations, result in deep-seated and often ignored social, economic, and power inequities which then shape the distribution of health risks and inequitable access to resources for health, resulting in the disparate social and spatial clustering of negative health outcomes; and WHEREAS, throughout the history of the United States systemic racism and inequality has manifested itself by acts of discrimination and oppression directed towards Black, Indigenous and people of color (BIPOC) and their communities resulting in fear, anxiety, trauma, terror, and long-term physical and mental health impairments, as well as causing economic oppression for the targets of racism, their communities and subsequent generations; and WHEREAS, in response to the killing of George Floyd and the unnecessary death of countless others in the same pointless fashion, people across the country have risen up to protest the historic economic, environmental, and social injustices occurring towards people of various races and ethnicities, which continues to disproportionately affect the Black community; and WHEREAS, systemic racism has resulted in race as a social determinant of health, with persistent racial disparities in all aspects of health including housing, education, healthcare, employment, worker protections, criminal justice, climate impacts, food access, and technology, and Center for Health Progress has reported that data shows, race, income, and ZIP Code have a bigger impact on health than behavior or medical care; and WHEREAS, BIPOC individuals and communities are disproportionately suffering in part due to long standing, unaddressed health disparities as well as systemic racism and other socioeconomic inequities, and these persistent disparities in health outcomes are not due to genetic or biological differences between the races, but to the entrenched systemic racism in American society; and WHEREAS, BIPOC residents of Whatcom county are not immune or separate from the significant trends of health disparities that we see in national and state public health data; and WHEREAS, the current COVID-19 pandemic has exacerbated the racial disparities within our nation's BIPOC communities ranging from health care access to risk exposure, and there is a clear correlation between maps showing rates of COVID-19 hospitalizations and neighborhoods with high social vulnerability; and WHEREAS, lack of culturally and ►inguistically competent healthcare has resulted in less utilization of services and poorer health outcomes among BIPOC individuals; and National Academy of Medicine (NAM) found "racial and ethnic minorities receive lower - quality health care than white people —even when insurance status, income, age, and severity of conditions are comparable" and evidence from social psychological and health disparities research suggests that clinician -patient racial/ethnic concordance may improve minority patient health outcomes; and WHEREAS Black women are at least three times as likely to die in childbirth as White mothers, and Black newborns are more than twice as likely to die as White newborns, a disparity that is wider today than it was in 1850 when the majority of Black Americans were enslaved, and one that is not related to the economic or educational status of the mother; and WHEREAS, Black Americans also have higher levels of low birth weights, and Black children are more likely to endure asthma and have more severe symptoms than White children; and WHEREAS, while the health disparities faced by indigenous and black populations are often the most reported, Whatcom county has multiple minority populations that face negative health consequences as a result of systemic racism; and WHEREAS, racism impacts child development, and in Whatcom County only 23% of AI/AN children and only 27% of Hispanic children entering kindergarten were ready for school, as opposed to 54% of White children; and WHEREAS, racism impacts mental health, and in Whatcom County 66% of AI/AN 10th graders, 43% of Black 10th graders and 44% of multi -racial 10th graders reported feeling depression, as opposed to 36% of White 10th graders; and WHEREAS, racism impacts education, a determinant of health, and in Whatcom County 63% of AI/AN and 71% of Hispanic young people graduate on time, as opposed to 82% of White young people; and WHEREAS, racism impacts economic stability, a determinant of health, with the median household income of Black families in Whatcom County being less than half of that of White or Asian families, and Multi -racial, AI/AN, and Native Hawaiian/Pacific Islanders have a median household income over $20,000 less than White or Asian families; and WHEREAS, disparities in health outcomes and determinants of health by race are clearly evident in Whatcom County where life expectancy for American Indian/Alaska Native populations is 69 years compared with 81 years for White population; where 2 out of 3 American Indian/Alaska Native youth experience depression compared with 1 out of 3 White youth; where median income is significantly lower for American Indian/Alaska Native, Hispanic, Black, and Multi -Racial populations than for White and Asian populations; where children who are American Indian/Alaska Native or Hispanic are half as likely to enter kindergarten with skills needed to succeed in school and are also significantly less likely to graduate from high school on time; and WHEREAS, a just public health system would hold all of our individual choices to the fundamental principles of social equity and public welfare that were built into the very foundation of that system. It would not permit individual bias to persist on the policy or operational level. While it would not, and could never, eliminate racial bias in individuals, it would neuter its effects, by holding each of us to the standards of equity and fairness upon which our metrics are based; and WHEREAS, we are concerned with public policy. Policy is the province of governance. As individuals, and as representatives of our institution, we identify racism as a systemic flaw, and an enemy to the public, wherever we encounter it. We commit to evaluating and reforming our policies, our practices, and our leadership, to reflect our commitment to this mission; and WHEREAS, the American Public Health Association, National Association of County and City Health Officials, and the American Academy of Pediatrics have declared racism as a public health crisis. The disparities caused by systemic racism that we have outlined in this resolution represent a public health crisis which affects us all. NOW, THEREFORE BE IT RESOLVED this Health Board will advocate that Whatcom County government implement, with intent and fidelity, policies and practices that reflect a conscious effort to ensure racial equity, equity of access and service, and further to ensure the equitable treatment of all people, regardless of race or ethnicity. Section 1. This Health Board declares that racism is a public health crisis. Section 2. This Health Board is committed to making Whatcom County a welcoming, inclusive, and safe community for everyone. While we promote free thought and speech, we condemn racism and brutality, hate speech, bigotry, violence and prejudice in any form. Section 3. This Health Board endorses the continued implementation and use of policies and practices for employee conduct and equitable treatment of all people and honors, by approval of this Resolution, the common humanity of all people, regardless of race or ethnicity. Section 4. This Health Board commits to actively participating in the dismantling of systemic racism and its impacts in Whatcom County by: A. Implementing training on the following topics for all elected officials, County staff and members of boards, commissions and committees: implicit bias, trauma informed practices, and review of health disparities. B. Assessing and revising County department policies, procedures, and ordinances to ensure racial equity and transparency are core elements. C. Ensuring that hiring practices provide equitable opportunities for people of color to be employed to help ensure the diversity in our workforce represents the diversity in our community. D. Promote diversity of race within county boards and commissions. E. Supporting community efforts to alleviate issues of racism and bias and engaging actively and authentically with communities of color wherever they live. F. Building and strengthening alliances with other organizations that are confronting racism, and encouraging other agencies to recognize racism as a crisis, including considering County membership in the Government Alliance on Race and Equity (GARE), which is a national network of local government agencies working to achieve racial equity and advance opportunities for all. Additionally, involve community representation and input in matters of historic and continued racial injustice. Section 5. This Health Board will continue to, through its goodwill, dialogue, and decision - making efforts and powers, evaluate and support policies that are consistent with the principles of equity of access, services, and treatment of all people regardless of race, color, or ethnicity and ensure that such policies do not perpetuate or exacerbate racial disparities within the county. Section 6. This Health Board shall facilitate keeping data and monitoring progress on the goals set up on the resolution. APPRC1F Ye.g 16174y, of 24th of November !®� ��• �� t©W ®m cs cscC��"� ®''o' `�' AT3E Dana=Brown-Da�1@kotheuncil APPP,O,VED A f t ifi'$ 1�3ta /s/ Rovice 14U6ki!n2ham.l.. Civil Deputy Prosecutor 2020. WHATCOM COUNTY HEALTH BOARD CHAIR WHATCOM COUNTY, WASHINGTON �A rp-wc Barry Bu hanan, Council Chair Whatcom County Agenda Bill Report File Number: AB2021-521 COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 File ID: AB2021-521 Version: 1 Status: Reported File Created: 09/02/2021 Entered by: JGay@co.whatcom.wa.us Department: Health Department File Type: Discussion Assigned to: Council as the Health Board Final Action: 09/07/2021 Agenda Date: 09/07/2021 Enactment M Primary Contact Email: anewell@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Update on Foundational Public Health Services (FPHS) Funding SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Update on Foundational Public Health Services funding that will help supplement critical gaps in public health. HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 09/07/2021 Council as the Health Board REPORTED Attachments: Presentation Whatcom County Page 1 Printed on 2/8/2024 Faundatir-nal Public Health Services (FPHS) Pverview Astrid Newell Cnmmunity Health Manager September 7, 2021 Whatcom County AOL HEALTH ITM fJILDepartment In a nutshell FPHS are... HEEAA`LLTH i Department • A limited defined set of core services provided by the Governmental Public Health System, and... • A collaborative process to transform public health in WA State through adequate funding and innovative service delivery models FPHS Visk, n and Gcals w� ,r HEALTH Department VISIPN • A responsive and viable grsvernmental public health system is essential for healthy. and economically vital communities across Washington GPAL • Full funding of FPHS, statewide, using a long- term, building block approach r rd State Departmentth of Health (SBOH) (DOH) L35 Local Sovereign Tribal Health Nations&Indian ctions Health Programs (LH)s) (IHP) RCW 42.70.512 & 515 FPHS Pbjectives 1. Adgpt a limited statewide set o7f core public health services 2. Fund FPHS through state funds and fees that are predictable, sustainable and responsive tc demands and cost 3. Provide and use kcal revenue generating 2ptians tr� address Ircal public health priorities 9 fk wnar�o CC t, HEALTH Department 4. Deliver FPHS in ways that maximize efficiency and effectiveness S. Complete a triba% led pracess tc define how the FPHS framework will apply tc tribal public health 6. Allocate resources thro7ugh a ccllab?rative prcess between state, Kcal and tribal governmental public health system partners Lim ted set c f cc re public HEALTH was omC-ty i Department health services Fzzundatir_nal Pragrams • Vital Records • Environmental Public Health • Communicable Disease • Maternal, Child & Family Health • Chronic Disease & Injury • Access to Health Care (Medical, Behavioral, Oral) Ra undatk, nal Capabilities • Assessment • Emergency Preparedness & Response • Communications • Policy Development • Community Partnerships • Business Competencies (Accounting, Payroll, etc) Why FPHS matter w-«om co-tY y HEALTH Department • Chronic underfunding of public health system, particularly at local level 4 gaps in services • Fragmentation and silo-ing of services across the state 4 inefficiencies and lack of effectiveness • Current public health system is not achieving desired health outcomes and equity FPHS Funding Need Additional Funds Needed from State Government for Full Implementation of FPHS (Baseline) 0: Foundational Program or Capability Environmental Public Health Additional from State in millions 39 / year; Funds Needed Go�ernment, (rounded) 78 / biennium Prevention and Control of Communicable Disease & $37 year; $74 /biennium Other Notifiable Conditions Maternal/Child/Family Health 16 / year; 32 / biennium Access/Linkage with Medical, Oral, and Behavioral $7 /year; $14 /biennium Health Care Services Chronic Disease, Injury and Violence Prevention 14 / year; 28 / biennium Vital Records $0 Assessment Surveillance and Epidemiology) $30 / year; 60 / biennium Emergency Preparedness All Hazards $9 / year; 18 / biennium Communication $10 / year; 20 / biennium Policy Development and Su ort $8 / year; 16 / biennium Community Partnership Develo ment 1 $10 / year; 20 / biennium Business Competencies 1 $45 / year; 9 biennium Total 225 / year; $450 / biennium ' Berk 2018. Washington State Public Health Transformation Assessment Report A Long -Term, Multi -Biennia, Phased, Building Block Approach to Full Funding and Implementation of FPHS 17-19 I 19-21 21-23 23-25 25-27 27-29 29-31 onward ' Establish a process and mechanism so funding keeps up with inflation, population size, demand for service and changes in FPHS definitions. Diagram is conceptual and not to scale (updated 5-4-2020) Hcw FPHS Impact Whatcc m HEALTH Department County • Builds local capacity to deliver core public health services • Provides opportunity to try new ways of delivering public health services in partnership with other LHJs, state, tribes. • Offers opportunity for Whatcom County public health leaders to participate in shaping public health system in WA State WCH D FPHS Funding • Current funding for Communicable Disease staff • Expecting additional funding this year for: • Environmental Public Health • Communicable Disease • Assessment • Other Foundational Capabilities • Future funding for other Foundational Programs ik w—c.. county HEALTH Department WCHD FPHS Funds (not final) HEALTH Department Foundational Communicable $148,699 (current) Ongoing + more Currently use FPHS for Programs Disease plus $ 236,006 CD (additional) Environmental Public $ 475,000 Ongoing + more Specific program uses Health (food, schools) Other Programs: N/A N/A Future budget request Maternal/Child/Family Health, Chronic Disease/Injury, Access to Care Foundational Assessment $ 30,000 Ongoing + For CHA/CHIP support Capabilities Any Cross Cutting $ TBD Ongoing + This is part of Capability WSALPHO request to be considered on 9/2 $ TBD SFY=State Fiscal Year (July 1 --> June 30) FPHS Service Deliver HEEAA`LLTH Y Department • Shared services models • Communicable Disease • New servicef • E.g., School Environmental Health Program • Coordination with state and other local health jurisdictions FPHS Leadership& wHHna.�omALCo�I,rT Department Participati!c n • FPHS Steering Committee • Astrid Newell (Co -Chair) • FPHS Subject Matter Expert Groups • Cindy Hollinsworth (CD) • Amy Hockenberry (Assessment) • WSALPHO Board of Directors 0 Erika Lautenbach, Astrid Newell