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Home My WebLink AboutPacket Health Board Feb 4 2020Whatcom County Council as the Health Board COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360) 778-5010 Meeting Agenda Tuesday, February 4, 2020 10 AM Council Chambers 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 February 4, 2020 Call To Order Roll Call Public Session Child and Family Action Plan Presentation AB2020-070 Presentation Regarding Child and Family Action Plan Director's Report Health Officer Update on Coronavirus (2019 nCoV) Other Business Adiournment Whatcom County Page 2 Printed on 21512024 WHATCOM COUNTY COUNCIL SPECIAL COUNCIL MEETING AS THE HEALTH BOARD 10:00 a.m. Tuesday, February 4, 2020 Council Chambers, 311 Grand Avenue AGENDA Meetin_p Topics 1. Public Session 2. Child and Family Action Plan Presentation 3. Director's Report 4. Health Officer Update on Coronavirus (2019 nCoV) faWhatcom County HEALTH Department Pages Time no ppr 10:00-10:20 1-59 10:20-11:25 no ppr 11:25-11:30 no ppr 11:30-Noon HEALTH BOARD Discussion Form February 4, 2020 AGENDA ITEM #2: Child and Family Action Plan PRESENTERS: Rachel Lucy, Emily O'Connor, Debbie Ahl, Heather Flaherty, Meredith Hayes, Sterling Chick, Chi-Na Stoane, Regina Delahunt, Astrid Newell, Mardi Solomon BOARD ACTION: Q Action Item Discussion FYI - Only In April 2019, the County Health Board adopted a resolution affirming commitment to Whatcom County's young children and families. As part of this resolution, the Health Board tasked the Public Health Advisory Board (PHAB), working in collaboration with Health Department (WCHD) staff and Generations Forward partners, to create a Whatcom County Child and Family Action Plan by January 31, 2020. The purpose of this plan is to provide recommendations to the Health Board about steps County Government can take to support young children and families in Whatcom County. Since April, PHAB members, WCHD staff, community partners, and family representatives have been actively working to develop the Child and Family Action Plan. The plan includes a series of recommendations that have been brought forward through a collaborative community process, along with background information and resources. Members of the Public Health Advisory Board, Health Department staff, and several community partners who were part of the planning process will present the plan and answer Health Board questions. BOARD ROLE/ACTION REQUESTED o Adopt Child and Family Action Plan as a guiding document for county action o Formally commit to the four "Proposed Next Steps" outlined in the plan ATTACHMENT(S) o Whatcom Working Towards Well-being: An Action Plan for County Government, January 2020 o Letters of Support o PowerPoint Presentation Whatcom County f HEALTH Department 020420 Health Board Agenda Packet Page 1 _M WHATCOM WORKING WARDWELL-BEING JANUARY 2020 Develop1jin a Collaboration between Whatcom County Public Health Advisory Board, Whatcom County Health Department, Generations Forward, and Healthy Whatcom 11 TABLE OF CONTENTS Acknowledgements ........................................ 3 1. Executive Summary ................................. 4 2. Introduction .............................................. 6 3. Challenges & Opportunities ...................... 8 4. Action Plan ............................................. 19 Appendix A: History..................................23 Appendix B: Resolution ............................25 Appendix C: Planning Participants ...........28 Appendix D: Generations Forward ...........31 Appendix E: Theory of Change ................32 Appendix F: Proposed Indicators .............33 Resources .................................................... 37 Notes............................................................ 38 020420 Health Board Agenda Packet Page 3 Whatcom Working Towards Well-being An Action Plan for County Government ACKNOWLEDGEMENTS Key Groups and Organizations informing Whatcom Working Towards Well-being: An Action Plan for County Government (Action Plan) Generations Forward Family Council Policy, Advocacy, and Funding Action Team Honoring Equity and Culture Team Healthy Whatcom Perinatal Mental Health Task Force Whatcom County Public Health Advisory Board United Way — Child Care Initiative Whatcom County Health Department Whatcom County Housing Advisory Committee Whatcom Taking Action Special thanks to the following people for their time, thoughtful input, passion, support, and dedication to this planning process and commitment to making our community a place where all children and families can thrive: • Debbie AN Julie Mauermann • Hilde Alden Keith Montoya • April Barker Jennifer Moon • Monica Burke • Melissa Morin • Sterling Chick Astrid Newell, M.D. • Chris D'Onofrio Emily O'Connor • Heather Flaherty • Mike Parker • Carol Frazey Amy Rydel • Ken Gass, M.D. Jessica Sankey • Daniel Hammill • Paul Schissler • Meredith Hayes • Chi-Na Stoane, M.D. • Galen Herz Michele Waltz • Monica Koller • David Webster • Rachel Lucy • Allison Williams • Samya Lutz Judy Ziels Prepared with the support of CROSSROADS CONSULTING 020420 Health Board Agenda Packet Page 4 3 Whatcom Working Towards Well-being An Action Plan for County Government 1. EXECUTIVE SUMMARY VISION Community members from across Whatcom County have come together to envision a "Beloved Community" in which every child in every family flourishes. Achieving this vision will require the time, talents, and resources of change agents across the community working together for the well-being of children and families. COUNTY GOVERNMENT'S ROLE Whatcom County government has an important role to play in realizing the community's vision, which begins with making a commitment to promote the health and well-being of all children and families in Whatcom County, with a special focus on the critical first years of life, and families that experience disproportionate challenges due to social and economic factors, discrimination, and health issues. Since the passage of County Health Board Resolution 2019-020 in April 2019, the Public Health Advisory Board has worked in collaboration with Whatcom County Health Department staff, partners from the Generations Forward Children's Collaborative, and representatives from many related organizations and initiatives to develop this Child and Family Action Plan as a guiding document for County action to create tangible, positive results. RECOMMENDATIONS FOR COUNTY ACTION This participatory community process resulted in a proposed Action Plan, and four next steps that the County can take to demonstrate ongoing commitment to children and families. Summary of Action Plan Recommendations I 1. • Build county infrastructure to embed a focus on child and family well-being Establish new across county government. structures and processes to elevate • Adopt a "children and families first" approach for county policy and funding the well-being of all decisions. children and families • Pursue new funding mechanisms to significantly increase local resources as a county priority for well-being promotion and crisis prevention. • Promote family -friendly employment policies and practices within the County and serve as a model employer. 2. Leverage existing county resources • Support community initiatives to eliminate family homelessness and and public -private improve family housing stability. partnerships to . Contribute to community efforts to stabilize and expand access to child address immediate care and early learning opportunities. child and family needs Provide resources to improve access to and navigation of family services and supports, including behavioral health services. 020420 Health Board Agenda Packet Page 5 4 Whatcom Working Towards Well-being An Action Plan for County Government Proposed Next Steps for the County to Implement These Recommendations The Public Health Advisory Board and community partners identified the following specific next steps the County can take to make progress toward these high-level recommendations: Request the Office of the County Executive assess infrastructure and budget needs required to realize commitment to an integrated focus on child and family well-being across county government departments. a. Receive from the County Executive a proposed infrastructure model to implement, aiming toward establishment of an "Office of Child and Family Well-being" or other structure that will embed a focus on children and families across county government. b. Request that biennial budget proposals be submitted to support actions contained in this Action Plan, with a focus on housing, child care, and behavioral health care. 2. Develop an ordinance to create a county task force, or other official county committee, with high-level staffing and resources to ensure that diverse community partners are informed, coordinated, and included in the implementation of this Action Plan, make additional recommendations, and regularly report progress to the County Council. a. Using the highly effective Incarceration Prevention and Reduction Task Force as a model, the task force will include representatives from government, community organizations, and families. The task force will focus on tracking and furthering progress of community efforts to achieve the desired results for children and families. 3. Support and actively participate in fiscal analysis in early 2020 to identify existing and potential funding streams for child and family programs. Potential new funding streams may include a future bond, levy, taxes, federal funding, etc. 4. Fulfill prior commitments to resource and fund two critical efforts, including: a) adoption of culturally and linguistically appropriate services and trauma -informed approaches in all County departments; and b) development of a culturally and linguistically responsive health navigation system for families seeking information and assistance with health and social services. 020420 Health Board Agenda Packet Page 6 5 Whatcom Working Towards Well-being An Action Plan for County Government 2. INTRODUCTION Over the last two decades, evidence for the importance of the early childhood period has been growing. A child's early experiences have the power to create a trajectory toward health and well-being throughout the lifespan or, conversely, to set-up profound challenges that need to be overcome.' Communities and leaders are being called upon to invest more resources and attention to ensure that all children have a healthy start. Indeed, the call is urgent. Each year over 2,200 babies are born in Whatcom County. The environments into which these babies are born and the care that they receive in their first few years will lay the foundation for their lifetimes and will impact the entire community. Vision for Whatcom County Organizations, community leaders and individuals in Whatcom County have heard the call to action and are responding. Community members have prioritized a focus on young children and families as part of the Whatcom County Community Health Improvement Plan, the Generations Forward Children's Collaborative, the County Health Board's policy focus on children and families, and other initiatives. The Generations Forward Children's Collaborative has embraced the concept of a "Beloved Community" — a term popularized by Dr. Martin Luther King Jr. `Dr. King's Beloved Community is a global vision in which all people can share in the wealth of the earth. In the Beloved Community, poverty, hunger and homelessness will not be tolerated because international standards of human decency will not allow it. Racism and all forms of discrimination, bigotry and prejudice will be replaced by an all-inclusive spirit of sisterhood and brotherhood. ,2 "Our goal is to create a beloved community and this will require a qualitative change in our souls as well as a quantitative change in our lives. " - Martin Luther King Jr. In describing how a Beloved Community may be manifested in Whatcom County, community members are uniting around a shared vision for the future in which all children are safe, healthy, and ready to learn; families are strong, stable, and supported from the start; and communities are welcoming and supportive places for children and families to live, learn, work, and play. A key to becoming a Beloved Community is to prioritize equity, particularly racial equity. This will require a richer understanding of who in our community has access to opportunities and what structural barriers are in place preventing certain children and families from having full access. 020420 Health Board Agenda Packet Page 7 6 Whatcom Working Towards Well-being An Action Plan for County Government When we make investments that support young children and families early on, we can build more RESILIENT COMMUNITIES and we can create a future where EVERYONE THRIVES N%6 COMMUNITIES FAMILIES are strong, stable, & supported from the HILDREN start. are safe. healthy. & ready to learn. are welcoming & supportive places for children & families to live, Learn, work, & play. In order to achieve these results, action is needed at all levels of the community, from families and community members, to program and service providers, to system partners and policymakers. County Government's Role Whatcom County government has an important role to play in realizing the community's vision, which began by making an ongoing commitment to promote the health and well-being of all children and families in Whatcom County, with a special focus on the critical first years of life. Over the past ten years, the County Health Board has shown leadership and resolve to address the issues that are impacting families with young children in our county (for recent history see Appendix A). In April 2019, the County Health Board passed a resolution in which the Health Board tasked the Public Health Advisory Board "to collaborate with Generations Forward partners and Health Department staff to create a Whatcom County Child and Family Action Plan, building on Generations Forward commitments and using a public health approach" (see Resolution, Appendix B). This work has involved reviewing the data and conclusions from the Community Health Improvement processes to date, and reports and recommendations from many relevant community advisory groups and initiatives (e.g., Generations Forward, Housing Advisory Committee, Health Protection for Immigrant Families Task Force). Significant progress has been made towards implementing supports needed by families of young children, and yet there are many ways in which the system remains intractable and in need of restructuring. 020420 Health Board Agenda Packet Page 8 7 Whatcom Working Towards Well-being An Action Plan for County Government 3. CHALLENGES & OPPORTUNITIES Challenges & Opportunities Faced by Young Children and Families in Whatcom County In October 2017, over 74 community partners and families gathered for three days to explore issues facing young children and families in Whatcom County as part of the Generations Forward Future Search Conference: Envisioning a Future where All Whatcom County Children Thrive. Participants identified the most significant trends shaping the future of families with young children in Whatcom County. These trends were: • Decrease in child care availability • Growing mental health needs and inadequate mental health services • Increased demands on school districts, including demand for social and emotional supports • Increase in housing need and decrease in affordable housing • Increase in cultural diversity • Increase in opioid abuse, disrupting families The 2018 Whatcom County Community Health Assessment reinforced the theme that many young children and families in Whatcom County are experiencing a high level of stress which is negatively impacting their development in a variety of ways including their physical and mental health, social and emotional development, and learning ability.4 Families in Whatcom County, especially those with low/no incomes, racial/ethnic minorities, and those with members who have special health or behavioral healthcare needs, face significant challenges in finding safe and stable housing, and affordable child care so they can attend school and work. The time and effort involved in navigating complex social and health care service systems is a job in itself and presents additional challenges. Inability to find or access timely behavioral health services and supports impact daily quality of life. For immigrant families and those living in rural areas, the challenges for meeting children's and families' needs are even greater. Stories and statistics shed light on the issues. Local case managers, health care providers, educators, and families themselves share accounts of some of the challenges and the kinds of choices families feel they must make to provide for their children. The good news is that there are effective approaches to addressing these issues that can make an enormous difference in the lives of children, families, and the community as a whole. 020420 Health Board Agenda Packet Page 9 8 Whatcom Working Towards Well-being An Action Plan for County Government Child Development and School Readiness School readiness at kindergarten entry (typically age 5) is a common measure of healthy child development, and is a reflection of nurturing relationships and environments in the first years of a child's life. In 2017-18, less than half (46%) of children in Whatcom County were developmentally ready for kindergarten in all domains (social -emotional, physical, cognitive, language, literacy, mathematics). Children of color, English -language learners, and children from low-income families are less likely to meet the developmental milestones for kindergarten. Percent of children entering kindergarten ready for school, by various factors Whatcom County, 2017-2018 Source: Office of Superintendent of Public Instruction 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% ■ ■ Whatcom avg = 46% WA avg = 47% (#) = total count of students in category 59% 54% 52% 51% 47% 0 46% a•■riti•tti•■ rr•■• 44/o r41%mtti•rititi •a•M•rr•■•mea•■•� • 23% 27% 26% 19% `\ 1cp sl\ bA\\ Q`Q� Q�`oo �`°�� 4�\p� `.roc\y\ g\ `e 40 411, Without adequate support, children who aren't ready for school may have trouble catching up and may experience emotional and behavioral issues that set them on a difficult path and increase risk of academic underachievement, relationship problems, and involvement with the criminal justice system. One local child mental health care provider describes it like this: Many kids that parents bring in for counseling are coming because of problems at school. We see underlying depression and/or anxiety; the school sees misbehavior. We might see a 10- year old with multiple school suspensions for aggressive behavior toward peers, or a 12-year old who refuses to go to school, or maybe a 15-year old who brought a knife to school. When families give a history of the problem, almost every time we see struggles that began in kindergarten and first grade. Small things at first such as not meeting standard for math or struggles with sitting still. By third grade, there are reports of in -school suspension for rough play at recess. By the fourth grade the kid reports he/she has no friends and is starting to not like school anymore. It is often complicated when it comes to root causes, but rather simple about what happened — those kids were not ready for school. 020420 Health Board Agenda Packet Page 10 9 Whatcom Working Towards Well-being An Action Plan for County Government For families experiencing social and economic challenges, family financial assistance and other concrete supports, home visiting and other parenting programs, and high -quality early care and education experiences are among the proven strategies that improve child outcomes and school readiness. Childhood Adversity and Family Functioning The rate of referrals for child abuse and neglect that are accepted for further action by Child Protective Services is one indicator of the scope of child adversity, family functioning, and toxic stress6 in a community. In Whatcom County, the rate of accepted referrals has remained higher (worse) than the state average for over 10 years and is trending in the wrong direction. Over 2,000 children are identified as victims of abuse or neglect each year. Young children under age 5 are most likely to be identified as victims of maltreatment, particularly neglect. Victims of child abuse and neglect, 2006-2018 Rate of accepted referrals per 1,000 persons aged 0-17 Whatcom County vs Washington State Source: Community Risk Profiles, Washington State Department of Social and Health Services Victims of child Abuse and Neglect in Accepted Referrals 60 so jw - 'Ar-- -------- Rate Per 30 - - - - 1' 20 10 0 Whatcom County f CUunties Like Us - -W - State ---A--- National 2011 2012Mia 20141 i National 47.2 49.4 48.1 44.5 41_9 52.1 52.6 51.1 State 34.0 31.6 32.0 31.8 33_g 34.3 34.4 32.4 31.9 34.0 37.8 39.2 Counties Like Us 33.9 31.1 32.7 29.8 31.6 32.6 32.5 31.1 112 33.6 37.9 40.2 Whatoom County 43.6 37.2 39.9 37.7 46.2 50.5 43.0 42.4 41.1 45.8 50.9 50.6 Accepted Victims 1,848 1,579 1,6BA U92 1.967 2,1114 L926 1,9D5 L760 1.991 2,227 Z235 Petrone, birth-17 42,179 42,377 4ZZ56 42,235 AZ614 42.475 42,511 47,5% 42,S12 43,247 43.750 44,201 Parental or caregiver substance abuse remains a leading contributor to child abuse and neglect. Opioids along with alcohol, methamphetamines, and other substances have significant ramifications for children and families in Whatcom County, as parents struggling with drug addiction have difficulty meeting children's basic needs. Exposure to family economic hardship, housing instability, social isolation, parental incarceration or criminal history, and parental mental illness can also impact family functioning and put children at risk for maltreatment and toxic stress. 020420 Health Board Agenda Packet Page 11 10 Whatcom Working Towards Well-being An Action Plan for County Government One local case manager tells this heartbreaking story: Two parents came into my office one day quite a while ago asking for help finding housing. They both worked but he had a criminal record from his late teens and their income wasn't high enough to afford Bellingham rents. They were sleeping in their car while they had left each of their three daughters with different people in different places in the County to give them a roof over their heads. One of their daughters was sexually assaulted in the home and the parents were devastated that, while doing the best they could to keep their kids safe and housed, the result was this trauma. Many of the strategies that work to improve school readiness (family financial assistance, evidence - based home visiting, connecting families to community resources) also work to reduce child maltreatment. In addition, interventions that address parental mental health and substance use, support parents who are incarcerated or involved in the criminal justice system and their children, and those that promote trauma -informed healing for children and adults who have experienced maltreatment or other forms of childhood adversity, can help mitigate the harmful impacts of adversity on health and well-being. Child & Family Economic Insecurity The proportion of families with young children under age 5 living at or below 100% of the Federal Poverty Level is one indicator of child and family economic insecurity. In Whatcom County, approximately 12% of families with young children meet this criterion. Households headed by single females are significantly more likely to experience poverty than married couple households. Families below the poverty level with children under 5 years Whatcom County vs Washington State Source: US Census Bureau, American Community Survey (Table DP03), 2014-2018 5-year estimate 60% 5R� 40 30% 20% 10% 0% All families Married couple families Families with female householder, no husband present 020420 Health Board Agenda Packet Page 12 11 Whatcom Working Towards Well-being An Action Plan for County Government According to the 2016 Whatcom County ALICE Report', one out of three (35%) of all families are at or below the ALICE threshold. ALICE refers to households that are asset -limited, income -constrained, and employed. These families may struggle to meet their basic needs. In Whatcom County, the 2016 Household Survival Budget for a family of four was $66,480 which is nearly three times the Federal Poverty Level for a family of four ($24,300). Children who grow up in families without adequate financial resources are at higher risk of housing instability, food insecurity, school challenges, and health problems such as asthma and obesity. The two biggest expenses for families with young children are housing and child care. In Whatcom County, skyrocketing housing costs combined with high child care costs make it increasingly difficult for families to get by. Housing is very expensive, and over 50% of renters in Whatcom County are cost - burdened (the Washington State Affordable Housing Board defines affordability as "when a household pays no more than 30% of its income for all housing costs.")8 Even if families have resources, housing inventory is low, making any housing very hard to find. We (Lydia Place) are working with a single mother of two who works full-time making $16 per hour. She simply can't afford any housing in Whatcom County. She has cut her budget down to bare bones and is still nearly $1000 short every month. There are simply no affordable housing options for her. My friend's rent increased suddenly by $1400 and they were forced to move out of Bellingham. They are still commuting in, with over $3000 owed to collections. Child and Family Housing Stability The number of families with children who are literally homeless and the number and percent of school age students who experienced a housing crisis during the school year are two indicators of child and family housing stability. In Whatcom County, concentrated community efforts over the past several years have led to a 29% reduction in the number of families who were literally homeless between 2008-2019, but limited resources for housing assistance services have resulted in a recent uptick in homeless families. Families with children experiencing homelessness (sheltered or unsheltered) Whatcom County, 2008-2019 Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports Whatcom County Annual Homeless Census Nameless Families vAth Children 2008-2019 128 124 a ov 92 94 89 82 3 70 68 72 2008 2009 2010 2011 2012 2013 2014 2015 2015 2017 2018 2019 020420 Health Board Agenda Packet Page 13 12 Whatcom Working Towards Well-being An Action Plan for County Government Data from schools show an increasing number of children and youth in unstable housing situations, from doubled up with other families, to couch surfing, to living in a vehicle or unsheltered. Nearly 1,000 children and youth experience a housing crisis each school year, and this number likely underestimates actual need. Students who experienced a housing crisis during the school year Whatcom County Public School Districts, 2007-2018 Source: Office of Superintendent of Public Instruction cited in A Home for Everyone: Strategic Plan to End Homelessness in Whatcom County, "2019 Local Plan Update, Whatcom County Health Department 1200 3.7% 3.6% 4.0% 3.5/° ° 1000 3.1 °I° 0°/° 3.1 °I°3.2°/° 3.30%, 3.5°I°2 �'%/& 2.6°/° 2.6°/° 981 gsi9 966 3.0% 800 847 821 823 846 854 2.5% 771 600 699 705 2.0% 1. 5% 400 1.0% 200 Number of students Percent of enrollment 0.5% 0 0. 0% -� 1°0 o° IV o° o° oo` oo` 1 ti oo` oZ ti T While housing is a basic need for everyone, a safe, stable home environment is especially important during the critical first years of life. Children who are homeless are less likely to be developmentally ready for and succeed in school and are more likely to experience social and emotional distress. In addition to strategies that address lack of affordable housing (a primary driver of family housing instability), effective programs and services such as case management, rental assistance, and Rapid Re -housing make a significant difference in improving housing stability for families. 020420 Health Board Agenda Packet Page 14 13 Whatcom Working Towards Well-being An Action Plan for County Government Child Care Availability and Affordability The number of slots in licensed child care facilities per eligible child is a common measure of child care access in a community. In Whatcom County, there are only about half as many child care slots as are needed for children with parents who work full-time,9 qualifying the county for distinction as a "Child Care Desert" and one of the counties in Washington State with the least access to child care. Child care slots available to meet needs of working families Whatcom County 2019 Source: Child Care Supply, Demand, and Cost in Whatcom County, Updated Oct. 2019 Indicator Number Children < 5 years 13,308 • Children < 5 years whose parents work full-time 8,070 Licensed Child Care Slots 3,608 • Slots that Accept State Child Care Subsidy 3,199 Additional Slots Needed to Meet Demand 4,462 For families with young children struggling to make ends meet, economic security often depends on parents being able to get some type of safe, dependable child care for their children so that they can work. While some families qualify for state child care subsidies, the rules to qualify for these benefits are based on income cut-offs which create barriers to access and barriers to employment success as well. Many local families have stories related to their challenges with child care: A single mother of three is navigating multiple systems while working as a small business owner. Her kids span in age from a first -generation college student (age 19) to a 4-year old son. Her youngest is enrolled in developmental preschool as well as a child care center to allow her to work full-time. Four days a week, she must leave work to pick up her son from preschool near Ferndale and drive him to child care in Bellingham. With the potential closure of Kid's World, she is faced with the challenge of finding another center that would accommodate part-time, subsidized care for her son. She has found one other child care center closer to home that is intending to increase their slots and eventually will have the ability to accept her son, but the center's expansion has been delayed for a long time as it awaits licensing approval. Another single mom of three kids reports that "My children need child care so I can work. Family court ordered the father to pay that cost, but there is no accountability when he doesn't pay because 1 don't have money for a lawyer. After school care is nearly $1000 per month upfront and 1 can't gather this to start them [in a program] without that financial help. I don't qualify for supported child care. " 020420 Health Board Agenda Packet Page 15 14 Whatcom Working Towards Well-being An Action Plan for County Government "Casey, " who is a local social service housing client and is employed, recently experienced the "benefits ledge. " She received a notice that due to her increased income in November earned from working overtime to meet the demand of her company, she would no longer be eligible for child care benefits. With the high cost of child care, she wouldn't be able to afford the cost to send her daughter to attend the day care. In order to take care of her child without day care, Casey might have to quit a job she has worked hard in for almost two years and this would force her back into unemployment. As many clients of supportive housing programs and throughout the community gain financial independence, they approach this benefits' ledge. While it is possible to overcome, more often than not, it inhibits progress. Even for families with greater economic means, lack of child care availability has significant implications for work productivity and quality of life. For businesses, reliable access to child care for employees is critical for success including ability to recruit needed talent. One local employer described it like this: We have been working to recruit for a specialized position. We found the perfect candidate who was excited to come to the community with her family. The lack of child care options was a deal -breaker. A 2019 Washington State report10 on the cost and availability of child care found that 27% of workers quit their jobs or left school or training due to child care issues, and 27% went from full-time to part- time. The same study showed that turnover due to child care issues cost employers over $2 billion in 2017. Employees who missed work due to child care issues cost employers $53 million in 2017. The study calculated that Washington's economy lost about $6.5 billion dollars in combined direct costs to employers and missed consumer spending due to child care issues. Effective strategies to support families in meeting child care needs include policy changes that increase state child care subsidy amounts and expand eligibility to more families, increased public and private investment in child care facility development and operations, and family friendly workplace policies such as paid family leave and flexible work schedules that allow families to work and also meet their children's needs. 020420 Health Board Agenda Packet Page 16 15 Whatcom Working Towards Well-being An Action Plan for County Government Behavioral Health Services and Supports Qualitative data from families, educators, health care and social services providers reveal concerns about increasing numbers of young children and parents who are experiencing social, emotional and behavioral health issues, and a lack of available services and supports to help address these needs. Limited quantitative data about young children makes it difficult to quantify the extent of need in this population, but local data from older youth show increasing rates of depression, anxiety, and suicidality.11 My sister had to wait for three months to get my 14 year -old niece into mental health counseling. My sister was excluded from any therapy sessions and felt left out and was concerned about what they were teaching my niece. A joint therapy session with both mother and child should also be included in the treatment. Effective strategies to support child and family behavioral health needs include expanding access to perinatal mental health services, increasing infant mental health consultation in child care and other settings, locating child mental health services in schools and other community settings, and ensuring services use a dual generation (family -child) approach. Developing the Child & Family Action Plan With these challenges and opportunities in mind, the Child and Family Action Plan (CFAP) development process began. There is significant work to build on. The Health Board's commitment has been an inspiration and set the direction for this planning process. Declaring "children and families" as a focus area of the Health Board for two consecutive years (2017 and 2018) laid the groundwork that was followed up by the passage of resolution 2019-020 in April 2019. Other foundational work done by the Health Board and County Council includes addressing the issues of immigrant families, responding to the potential closure of local child care facilities, and dedicating resources to the Incarceration Prevention Task Force. The CFAP is a guide for how the County can build on the strong foundation it has laid and continue to move toward prevention and upstream thinking and away from a perpetual crisis response system. Meetings and work sessions since April have brought together community organizations along with representatives from many advisory groups, committees, and action teams focused on child and family well-being (for list of participants see Appendix C). Everyone on the list of participants was invited to review and comment on each draft of the CFAP, and the voices of families and service providers have shaped this plan in an iterative way. While participation has been quite broad and has included many families and community members, engagement of families and community members will need to continue during the next phase of planning and implementation with a particular focus on engaging our tribal neighbors and families furthest from opportunity. Community partners stressed that it is necessary to address systemic inequities first and foremost for all children and families to thrive. This will require embedding a focus on equity, and particularly racial equity, to guide and influence all areas of work. An essential action for building equity is to have authentic family involvement in efforts to develop policies and practices that meet the needs of all children and families. Generations Forward fully embraces this orientation and their approach to promoting the well-being of children and families and addressing systemic inequities resonates through the CFAP (see Generations Forward 2020 Priority diagram in Appendix D). 020420 Health Board Agenda Packet Page 17 16 Whatcom Working Towards Well-being An Action Plan for County Government Supporting the recommendations made in this CFAP requires adequate infrastructure and resources to increase cross -agency and cross -sector coordination between the various organizations and initiatives working to improve services and create conditions that help families flourish. In addition to these systems -level changes, the CFAP planning process built off of the Community Health Improvement planning and implementation work, the direction of Generations Forward, and the Health Protection for Immigrant Families planning process, as well as the focus of the Whatcom County Business and Commerce Committee and other community efforts, all of which have identified three priority issues requiring immediate attention: 1. Family homelessness and housing instability. 2. Shortage of safe, accessible child care and early learning opportunities. 3. Challenges for families to access health and social service information and resources, including behavioral health services for children and their families. The recommendations in this CFAP are based on a theory of change in which key stakeholders work together to establish new structures and processes to help "turn the curve"12 on key indicators of child, family and community well-being (see Theory of Change diagram below and Appendix E). A prevention -oriented approach will cost our county less over time by reducing the number of families in crisis. It also will be necessary to leverage existing non -dedicated funds and existing public -private partnerships, and pursue new funding mechanisms to achieve the desired results. Theory of Change Families & Community • Peer & community support • Advocacy & leadership Program & Service Providers • Evidence -based programs • High quality service delivery System Partners & Policymakers • Policy & funding support • System coordination & improvement Safe, healthy children • Child maltreatment • School readiness Strong, stable families • Economic stability • Housing stability Supportive, welcoming communities • Affordable housing • Affordable child care • Access to behavioral health 020420 Health Board Agenda Packet Page 18 17 Whatcom Working Towards Well-being An Action Plan for County Government Child & Family Action Plan Recommendations The extensive CFAP planning process will help inform the work of many groups addressing the needs of children and families. The types of results that these groups are working toward, and some indicators for measuring progress toward achieving these results are presented in Appendix F. These results are beyond the scope of county government's role, but the County has an essential role to play in making this important work possible. The architects of this CFAP have focused specifically on the recommendations that are within the purview of county government, and these are presented in the following chart. The two core recommendations are: 1) Establish new structures and processes to elevate the well-being of all children and families as a county priority. 2) Leverage existing county resources and public -private partnerships to address immediate child and family needs. 020420 Health Board Agenda Packet Page 19 18 Whatcom Working Towards Well-being An Action Plan for County Government 4. ACTION PLAN Establish new structures and processes to elevate the well - Recommendation #1 being of all children and families as a county priority Action Recommended steps Build county Commit resources to facilitate the adoption of equity and trauma - infrastructure to informed policies and practices across county government. embed a focus on child and Support countywide training for County staff to promote culturally and family well-being linguistically appropriate services and trauma -informed approaches in all across county County departments. government • Conduct policy reviews using equity tools and processes to assess existing policies and programs. Explore changes to existing County policies and practices, and create new ones, to support equity broadly and race equity specifically. • Become a member of the Government Alliance on Race and Equity (GARS), a national network that offers resources and strategies for government agencies working to change policies and practices to achieve racial equity. Dedicate high-level staffing and resources to lead cross -agency and cross -sector efforts on behalf of children and families. • Develop an ordinance to create a county task force or other official county committee, with governmental, family, and community representation to focus on child and family well-being results. - Request a proposal from the County Executive for an infrastructure model to embed a focus on children and families across county government. • Ensure new structures add capacity versus replacing existing resources. • Request biennial budget proposals to support actions contained in this Action Plan with focus on housing, child care, and behavioral health. • Include data, evaluation, and communication capacity within new resources. • Disaggregate data to more fully understand which populations are most likely to be negatively impacted by current conditions and inform the design of new resources with this knowledge. *Shaded items are tagged for immediate recommended action 020420 Health Board Agenda Packet Page 20 19 Whatcom Working Towards Well-being An Action Plan for County Government Establish new structures and processes to elevate the well - Recommendation #1 being of all children and families as a county priority (cont....) Action Recommended steps Adopt a "children Develop and use policy and program review tools to ensure that local and families first" governmental services and programs consistently consider and approach for prioritize child and family needs. policy and funding Engage leadership and staff from all departments and programs including decisions health, human services, criminal justice, law enforcement, planning, public works, and parks and recreation to use appropriate review tools. Fully integrate parents, caregivers and child -serving providers into all committees, task forces and workgroups where policy strategies that impact young children and their families are considered. • Require county departments and committees to have strategies in place to gather input from parents, caregivers and community members around issues/policies impacting children and families, ensuring culturally responsive outreach to underrepresented community members. • Include stakeholders who are from underserved populations (e.g., indigenous community members, people of color, immigrants, people with disabilities, low-income), and provide compensation for their time and language translation/ interpretation as needed. Develop processes to ensure that county funding decisions prioritize maintaining and increasing funding for children and families, and protect existing programs and services from harmful cuts. • Request that departments and committees that develop budget or funding recommendations include child and family impact assessments in their processes. Pursue new Support and actively participate in a 2020 fiscal analysis to identify funding existing and potential new funding streams for child and family mechanisms to programs. significantly Learn from other communities that have successfully pursued innovative increase resources for approaches including new tax revenue, use of federal block grants, levies, well-being etc. (e.g., "Best Starts for Kids Levy" in King County). promotion and Generate new and sustainable revenue for evidence -based and crisis prevention innovative child and family programs and services based on recommendations from fiscal analysis. *Shaded items are tagged for immediate recommended action 20 020420 Health Board Agenda Packet Page 21 Whatcom Working Towards Well-being An Action Plan for County Government Establish new structures and processes to elevate the well - Recommendation #1 being of all children and families as a county priority (cont....) Action Recommended steps Promote family- Institutionalize family -friendly employment policies and practices. friendly employment Identify opportunities to expand or adopt infant at work policy, policies and breastfeeding support, child care benefits, and flexible work scheduling practices within across all departments. the County and Promote family -friendly employment practices to other community serve as a model employers. employer Consider partnering with other governmental agencies such as the City of Bellingham and small cities on a coordinated effort. Leverage existing county resources and public -private Recommendation #2 partnerships to meet immediate family needs Action Recommended steps Support Allocate resources to scale up effective prevention and intervention community systems for family homelessness. initiatives to eliminate family Include crisis response, rental assistance, case management, linkage to homelessness financial and other supports and resources for families with young children and improve experiencing homelessness or unstable housing. family housing Work with partners to expand availability of affordable family housing stability options and accompanying services throughout the County. • Establish a Whatcom County Affordable Housing Investment Fund. • Improve zoning for modestly -priced housing. • Offer surplus and underutilized public land for affordable housing. 21 020420 Health Board Agenda Packet Page 22 Whatcom Working Towards Well-being An Action Plan for County Government Leverage existing county resources and public -private Recommendation #2 partnerships to meet immediate family needs (cont....) Action Recommended steps Contribute to Join with businesses, community partners, and state government to community advocate for strategies to address urgent child care shortages. efforts to stabilize and Coordinate with Whatcom County Business and Commerce Committee expand access to and other efforts focused on this issue. child care and • Provide cities with technical assistance to improve policy and code early learning changes. opportunities Provide access to land, grants and/or loans to support the start- up/expansion of child care and early learning programs. • Leverage private sector funding with local and non -local public funding. Provide Support funding for a culturally and linguistically responsive health resources to navigation system for families seeking information and assistance with improve access health and social services. to family services and supports, Set aside county funds for system planning, building on effective including existing community models such as the Single Entry Access to behavioral health Services program. services Prioritize preservation and expansion of behavioral health funds to increase availability of child and family mental health programs and services integrated within child care, school, healthcare and other community settings. *Shaded items are tagged for immediate recommended action Proposed Next Steps for the County to Implement these Recommendations As we all work together to create a beloved community in which all children are safe, healthy, and ready to learn; families are strong, stable, and supported from the start; and communities are welcoming and supportive places for children and families to live, learn, work and play, there are specific steps that county government can take to make progress on the above recommendations. See page 5 for listing. 020420 Health Board Agenda Packet Page 23 22 Whatcom Working Towards Well-being An Action Plan for County Government Appendix A: History Recent History of Efforts Addressing Child & Family Well -Being ❑ = Community Health Improvement (CHIP) ❑ = Health Board Resolutions ❑ = Generations Forward (GF) When Activities What happened 2010-11 First cycle of Community Health • Community Health Improvement Plan 2012-16 developed. Improvement — Joint project between Peace Health and Health Dept.: Did community • Decided to focus on Adverse Childhood visioning process, had a leadership council (all Experiences and drivers of ACES the foundation leaders, hospital, WCHD, OC, • Continue ongoing community activities re health City of Bellingham), did assessments, had care access, food access, etc. retreats • Unclear ownership and metrics 2013 "Compassionate Communities Resolution" called for compassionate, trauma -informed approaches to health and human services, recognizing impacts of childhood adversity on lifelong health and well- being. 2015 The "Healthy Planning Resolution" affirmed the County's commitment to incorporating a health perspective in all County planning processes and calls out consideration of children and families. Nov. The CHIP Leadership Council decided • Whatcom Community Foundation funded a 2016 Opportunity Council and WCHD would lead consultant to do an assessment of child & family the development of an "Even Start" initiative. needs (prenatal to age 5) "Even Start" was later renamed Generations • Initiated planning for a robust community Forward. engagement process to address two key priorities: equity and early childhood health and well-being. 2017 -18 In 2017 and again in 2018, the Health Board adopted an annual focus on early childhood. Oct. Opportunity Council and Health Dept. Launched the Generations Forward initiative, a 2017 organized the Future Search Conference multi -sector collaborative working to promote "Generations Forward: Envisioning a Future well-being of young children and their families and where all Whatcom County Children Thrive" — close opportunity gaps associated with race, 3 day retreat, 74 people ethnicity, income, and family adversity. Generations Forward (GF) began meeting Sustainable Financing group was led by Center for quarterly. Established action teams Philanthropy and focused on what is needed to put corresponding with GF Commitments: levy in place. Hired consultant to do fiscal analysis of where funding comes from and future funding. 1. Equity and honoring cultures Equity group was very active under leadership of 2. Community building Shirley Williams from Lummi Nation. Focused on 3. Family support and parent education historical trauma, reconciliation and healing. 4. Child care 5. Housing Groups have morphed and dwindled over time. 6. Economic mobility Hard to do self -organized action. Conclusion: Need 7. Integrated -coordinated care more coordination and infrastructure to support 8. Sustainable financing action. • Generations Forward Report 3/19 23 020420 Health Board Agenda Packet Page 24 Whatcom Working Towards Well-being An Action Plan for County Government When Activities What happened 2018 Conduct Community Health Assessment • Community Health Assessment report identified determinants of health • Healthy Whatcom formed to work on Community Health Improvement process 2018 Health Dept. applied for Project HOPE grant • Hired Family Champion and Program Coordinator. and got it. That money funded Project NOW . Project NOW has a core team that is very focused on (Networks of Opportunity for Child Well- family stories and infrastructure that will move us being). toward equity (main focus of GF quarterly meetings) Transitioned Sustainable Funding Action • Proposed Resolution No. 2019-020 and included Team (Whatcom Center for Philanthropy) to Child & Family Action Plan in it. new GF Policy Advocacy & Funding Action Team. 2019 • The Health Board adopted Resolution No. 2019-020 "Affirming Commitment to Whatcom County's Young Children and their Families." Tasked the Public Health Advisory Board to collaborate with Generations Forward partners and Health Department staff to create this CFAP, building on the Generations Forward commitments and using a public health approach. • The Resolution also stated that the CFAP shall include an accountability process that outlines desired results and key indicators of success, an approach to ongoing monitoring and evaluation of progress, and transparent mechanisms for sharing progress with the community. • Additionally, the Resolution affirmed that the Health Board shall ensure that the needs of young children and families are included and prioritized in County plans and policies addressing: Housing, Behavioral Health, Incarceration Prevention, Economic Development, and Land Use. April Healthy Whatcom conducts Community • Selected housing, child care, and youth behavioral 2019 Health Improvement prioritization data health as top priorities. carousel to choose top CHIP priorities. • Fall 2019 — decided to focus on youth behavioral health needs first. They will develop an action plan, and also provide Results Based Accountability training to all partners. 2019 Two GF action teams, Coordinated Services • A NextGen action plan is in development. Strategies and Economic Stability, were approached by for making services more accessible will be aligned DSHS to participate in a state poverty with this CFAP's recommendations for developing a reduction initiative regarding how families culturally and linguistically responsive information access services. They are going through a and navigation system to facilitate access to child human-centered/user-centered design and family health and social services. process. The project is called NextGen. 24 020420 Health Board Agenda Packet Page 25 Whatcom Working Towards Well-being An Action Plan for County Government Appendix B: Resolution PROPOSED BY: Health INTRODUCED: RESOLUTION NO. 1019-020 Resolution Affirming Commitment to Whatcom County's Young Children and their Families WHEREAS, mounting scientific evidence points to the first years of life as a critical time period for the healthy development of the brain and other body systems; and WHEREAS, the Center on the Developing Child -Harvard University, a national center of excellence focused on the science of child development, identifies three necessary ingredients for healthy development in the first years of life —stable nurturing relationships; sound nutrition; and safe, supportive environments; and WHEREAS, family adversity, such as financial hardship, homelessness, parental incarceration, substance use, or mental illness, can interfere with parent and caregiver ability to provide stable nurturing care, sound nutrition, and safe environments for young children; and WHEREAS, a toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity such as physical, sexual or emotional abuse; chronic neglect; caregiver substance abuse or mental illness; exposure to violence; and/or the accumulated burdens of family economic hardship —without adequate adult support; and WHEREAS, toxic stress and emotional trauma in the first years of life impact brain development and contribute to physical and behavioral health concerns, and future social and academic challenges; and WHEREAS, Indigenous children, children of color, children with disabilities, and children and families living in poverty are more likely to experience adversity due to historical and persistent patterns of discrimination, oppression and lack of equitable opportunities; and WHEREAS, disproportionate levels of adversity contribute to health and social disparities and inequities; and WHEREAS, investment in healthy development for young children is a promising cross- cutting strategy to promote lifelong physical and mental health, academic success, and future employment; to reduce criminal justice involvement and other social challenges; and to advance equity; and WHEREAS, return -on -investment for evidence -based programs focused on young children and families is as high as 9:1; and WHEREAS, families, community members, and organizational partners from many sectors working together in a coordinated and systematic way can create the environments and opportunities children and families need to thrive; and 25 020420 Health Board Agenda Packet Page 26 Whatcom Working Towards Well-being An Action Plan for County Government WHEREAS, community leaders in Whatcom County have recognized the importance of and have come together as part of the Generations Forward initiative to envision a future where all Whatcom County children thrive; and WHEREAS, the Whatcom County Health Department and Opportunity Council co-sponsor the Generations Forward initiative; and WHEREAS, the Generations Forward initiative involves more than 100 families and stakeholders representing diverse sectors throughout Whatcom County; and WHEREAS, the Generations Forward initiative focuses on young children and families, emphasizing the prenatal and early childhood periods to age 8 years; and WHEREAS, while young children are the primary focus of Generations Forward, participants and community partners acknowledge that trauma and hardship can show up in a family at any stage and will consider that while proposing and creating solutions for young children and their families; and WHEREAS, Generations Forward is working to achieve the following results in Whatcom County: • Children are safe, healthy, and ready to learn, • Families are strong, stable, and supported from the start, • Communities are supportive and welcoming places for children and families to live, learn, work and play; and WHEREAS, participants in the Generations Forward initiative have adopted a series of collective commitments focused on: • Equity: honoring all families and the diversity therein • Parenting Education and Family Support: expanding family support, mentoring, and education + Family Economic Stability: removing barriers to upward economic mobility Child Care and Early Learning: increasing access to quality, affordable child care and early learning opportunities • Housing: increasing access to safe, affordable family housing throughout the county • Health and Social Services: improving access to coordinated family -centered services and integrated health care, including behavioral health services and supports • Neighborhoods and Communities: building community connections and resilience • Funding: developing reliable financing for child and family programs and services; and WHEREAS, the Health Board adopted an annual focus on early childhood in 2017 and again in 2018; and WHEREAS, the Health Board adopted a Healthy Planning Resolution in 2015 that affirms the county's commitment to incorporating a health perspective in all county planning processes and calls out consideration of children and families; and WHEREAS, the Health Board adopted a Compassionate Communities Resolution in 2013 calling for compassionate, trauma -informed approaches to health and human services, recognizing the impacts of childhood adversity on lifelong health and well-being; 26 020420 Health Board Agenda Packet Page 27 Whatcom Working Towards Well-being An Action Plan for County Government THEREFORE BE IT RESOLVED that the Health Board shall affirm the Generations Forward collective commitments and take steps to support policy and funding that align with these commitments; and THEREFORE BE IT FURTHER RESOLVED that the Health Board shall appoint one member to participate in the Generations Forward initiative to recommend policy options and explore development of a sustainable public financing mechanism for child and family programs and services; and THEREFORE BE IT FURTHER RESOLVED that the Health Board shall task the Public Health Advisory Board to collaborate with Generations Forward partners and Health Department staff to create a Whatcom County Child and Family Action Plan, building on Generations Forward commitments and using a public health approach; and THEREFORE BE IT FURTHER RESOLVED that the Child and Family Action Plan shall include an accountability process that outlines desired results and key indicators of success, an approach to ongoing monitoring and evaluation of progress, and transparent mechanisms for sharing progress with the community; and THEREFORE BE IT FURTHER RESOLVED that the Child and Family Action Plan shall be presented to the Health Board no later than January 31, 2020; and THEREFORE BE IT FURTHER RESOLVED that the Health Board shall ensure that the needs of young children and families are included and prioritized in county plans and policies addressing: Housing, Behavioral Health, Incarceration Prevention, Economic Development, and Land Use; and BE IT FINALLY RESOLVED that the Health Board will review this resolution on an annual basis. APPROVED�4tihj , 21 d day of April o J AV y Darla Brown �is' Clerl,bf the Council APPROVED AS TO FORM: a ivil Deputy Prosecutor 19. WHAT COUNTY HEALTH BOARD WHA C M CO N , WASHINGTON Rud rowne, Health Board Chair 27 020420 Health Board Agenda Packet Page 28 Whatcom Working Towards Well-being An Action Plan for County Government Appendix Q Planning Participants *Key to Organizations GF FC = Generations Forward (GF) Family Council GF PAF = GF Policy, Advocacy, & Funding Action Team GF HEC = GF Honoring Equity & Culture Team HW = Healthy Whatcom TA = Whatcom Taking Action Child Care = United Way Child Care Initiative Housing = Whatcom County. Housing Advisory Committee Name Organization* Committees/ Action Groups Attended 1 or more meetings about CFAP Participated Workrou 9 ps Reviewed draft plans Generations Forward Family Council Crystal Bevis GF FC Hilde Alden GF FC x Monica Burke The Arc of W.C. GF FC, TA x x x Michelle Burkhart GF FC Brian Dewey GF FC Monica Koller GF FC x x Susan Marks GF FC Julie Mauermann GF HEC x Keith Montoya GF FC x Barbara Roxas GF FC x Kevin Roxas GF FC Olivia Rutherford GF FC Michael Sidwell GF FC x Brittany Sullateskee GF FC Other Committees Debbie AN Mt. Baker Foundation GF PAF x x x April Barker Bellingham City Council GF PAF x x Kate Bartholomew City of Bellingham Sterling Chick Catholic Community Services PHAB, TA x x x Kyle Davidson Unity Care Northwest GF PAF x 28 020420 Health Board Agenda Packet Page 29 Whatcom Working Towards Well-being An Action Plan for County Government Attended Participated Committees/ 1 or more Reviewed Action Groups meetings Work rou s 9 p draft plans Name Organization* about CFAP Whatcom County Health Kathryn DeFilippo Dept. TA x Derek Delvalle Unity Care Northwest HW x Western Washington Christine Espina University (WWU) W.C. Health Dept. - Housing & Homeless Chris D'Onofrio Services Program Housing x Chuckanut Health Heather Flaherty Foundation HW, GF PAF x x x Javier Flores Opportunity Council HW Carol Frazey Whatcom County Council GF PAF x x Katherine Freimund Whatcom Literacy Council HW x Ken Gass, MD TA, GF PAF x x Housing Authority Board of Stephen Gockley Commissioners HW Cathy Halka W.C. Health Dept. Daniel Hammill Bellingham City Council PHAB x x Child Care, Meredith Hayes GF PAF x x x Kulshan Community Land Housing, Galen Herz Trust PHAB x David Jefferson John Korsmo WWU HW Rose Lathrop Sustainable Connections GF PAF, Rachel Lucy PeaceHealth PHAB x x x City of Bellingham Housing Samya Lutz & Services Program Housing, HW x x Whatcom Transportation Janet Malley Authority Whatcom Community Sam Martinez Foundation HW 29 020420 Health Board Agenda Packet Page 30 Whatcom Working Towards Well-being An Action Plan for County Government Name Organization* Committees/ Action Groups Attended 1 or more meetings about CFAP Participated Work rou s 9 p Reviewed draft plans April McMurry WWU HW x Jennifer Moon Unity Care Northwest TA x Melissa Morin W.C. Health Dept. x Astrid Newell, MD W.C. Health Dept. TA, GF PAF x x x Emily O'Connor Lydia Place Housing, GF PAF x x x Wilanne 011ila-Perry Opportunity Council Child Care x Mike Parker Opportunity Council Homeless Service Center Housing, PHAB x x Kim Perry Bellingham Technical College x Gretchen Pfleuger Bellingham Public Schools HW Brian Rick Bellingham Public Schools Amy Rydel W.C. Health Dept. HW x x x Jessica Sankey Bellingham Public Schools HW x x x Paul Schissler Housing x x Katie Stanford W.C. Health Dept. HW x Chi-Na Stoane, MD PHAB PHAB, GF PAF x x x Travis Tennessen WWU Michele Waltz Bellingham Technical College HW x x David Webster Opportunity Council GF PAF, Child Care x x Emily West W.C. Health Dept. Chris Wiebe W.C. Health Dept. Bellingham Schools GF PAF x x Allison Williams W.C. Health Dept. TA, GF PAF x x x Judy Ziels W.C. Health Dept. TA, GF PAF x x x 30 020420 Health Board Agenda Packet Page 31 Whatcom Working Towards Well-being An Action Plan for County Government Appendix D: Generations Forward .0 R C. 31 020420 Health Board Agenda Packet Page 32 Whatcom Working Towards Well-being An Action Plan for County Government Appendix E: Theory of Change Health Determinants Social/Physical Barriers: Homelessness/ Equity Issues: Health Issues: Housing Instability Racism � Illness Social Isolation Immigrant Status Disabilities Transportation'C Language Barriers Addiction 1 Economic Barriers: Poverty Unemployment Lack Education Lack Health Care/Insurance Current Priorities Accessible, culturally -responsive, trauma - informed health & social service info & resources, including behavioral health services for children & families Safe and stable housing Safe, accessible child care & early learning opportunities Child & Adult Education/Training Mental Health & Employment Implement recommended system -level and targeted actions • Establish new structures and processes to elevate the well-being of all children and families as a county priority (see action plan for targeted actions) • Leverage existing county resources and public -private partnerships to address immediate child and family needs (see action plan for targeted actions) Indicators t Child School Availability of Homelessness Cost - Availability of Affordable Families i burdened I 1 1 Maltreatment Readiness HousingRe Child Care Results • Children are safe, healthy & ready to learn • Families are strong, stable & supported from the start • Communities are welcoming & supportive places for children & families to live, learn, work, & play 32 020420 Health Board Agenda Packet Page 33 Whatcom Working Towards Well-being An Action Plan for County Government Appendix F: Proposed Indicators Result 1: Children are safe, healthy and ready to learn Indicator 1.1: Child maltreatment Victims of child abuse and neglect, 2006-2017 Rate of accepted referrals per 1,000 persons aged 0-17 Source: Community Risk Profiles, Washington State Department of Social and Health Services 80 70 60 Washington —0—Whatcom County 50 —Bellingham 40 Blaine Ferndale 30 O ■ t lynden 20 Mount Baker Nooksack Valley 10 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 33 020420 Health Board Agenda Packet Page 34 Whatcom Working Towards Well-being An Action Plan for County Government Indicator 1.2: School readiness Percent of children entering kindergarten ready for school, by various factors Whatcom County, 2017-2018 Source: Office of Superintendent of Public Instruction 100% 90% ' ' Whatcom avg = 46% 80% 70% 60% 54% 50% 47% 44% 40% 30% 23% 27% 20% 10% 0% K. P♦Pe1 ps��o o°��\ �`°♦", e\ WA avg = 47% (#) = total count of students in category 59% 52% 51% 46% 46% 19% `bib\ r��, �` ♦, fie` �,1�`°1♦�\ fed` �Ooi Ass ♦��o ♦r�o �� o Result 2: Families are strong, stable and supported from the start Indicator 2.1: Family Economic Security Families below the poverty level with children under 5 years Whatcom County vs Washington State Source: US Census Bureau, American Community Survey (Table DP03), 2014-2018 5-year estimate 60% 50% 40% 30% 20% All families married couple famflfes Families with female householder, no husband present 020420 Health Board Agenda Packet Page 35 34 Whatcom Working Towards Well-being An Action Plan for County Government Indicator 2.2: Family Homelessness Families with children experiencing homelessness Whatcom County, 2008-2019 Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports Whatcom County Annual Homeless Census Homeless Families with Children 2008-2019 123 114 1a 00 94 92 89 3 72 70 68 Number of Homeless Families with children decreased 29%since 2008 2008 2009 2010 2021 2012 2013 2014 2015 2016 2017 2028 2019 Students who experienced a housing crisis during the school year Whatcom County Public School Districts, 2007-2018 Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports 1200 3.7% 3.6% 3.5/o ° 4.0% 1000 3.10 ° 0�31 3.2%3.3% 3.5% 2.9 /0 3.0 / 2.6% 2.6% 981 959 �966 3.0% 800 847 771 821 823 846 854 2.5% 600 699 705 2.0% 400 1.5% Number of students Percent of enrollment 1.0% 200 0.5% 0 0.0% ^o Nrti ^3 �� ^(' �O ^ O ^, N0 35 020420 Health Board Agenda Packet Page 36 Whatcom Working Towards Well-being An Action Plan for County Government Result 3: Communities are welcoming and supportive places for children and families to live, learn, work and play Indicator 3.1: Housing Affordability Percentage of cost -burdened households paying 30% or more of monthly income toward housing Whatcom County, 2010-2017, 5-year estimates Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports 100% +Renters ♦Owners 90% 80% 70% 57% 57% 57% 57% 60% Ah 50% 40% 44% 30% 20% 29% 27% 26% 10% 0% 2010-2014 2011-2015 2012-2016 2013-2017 Indicator 3.2: Child Care Availability Child care slots available to meet needs of working families Whatcom County 2019 Source: Child Care Supply, Demand, and Cost in Whatcom County, Updated Oct. 2019 Indicator Number of Children < 5 years 13,308 • Number of Children < 5 years whose parents work full-time 8,070 Number of Licensed Child Care Slots 3,608 • Slots that Accept State Child Care Subsidy 3,199 Number of Additional Slots Needed to Meet Demand 4,462 Indicator 3.3: Behavioral Health Service Availability Anecdotally, families and providers describe very limited availability of behavioral health services for children and youth. Quantitative data is not available currently and is needed. 020420 Health Board Agenda Packet Page 37 36 Whatcom Working Towards Well-being An Action Plan for County Government RESOURCES Frameworks Strengthening Families: Increasing Positive Outcomes for Children and Families. Center for the Study of Social Policy. Working Toward Well-being: Community Approaches to Toxic Stress. Cailin O'Connor, Center for the Study of Social Policy. Early Learning Community Action Guide and Progress Rating Tool. Center for the Study of Social Policy, May 2018. Results -Based Accountability. Clear Impact. Reports 2018 Whatcom County Community Health Assessment. Whatcom County Health Dept., 2018. A Home for Everyone: Strategic Plan to End Homelessness in Whatcom County. Whatcom County Health Dept., 2019 Local Plan Update, Phase 5. Child Care Supply, Demand, and Cost in Whatcom County, Updated October 18, 2019. Child Care Aware and Opportunity Council, 2019. Generations Forward Progress Report. (March 2019). The Mounting Costs of Child Care: Impacts of child care affordability and access to Washington's employers and economy, Dept. of Commerce and collaborators, 2019. Whatcom Working Toward Well-being: Select indicators of child, family and community well-being in Whatcom County. Whatcom County Health Dept., Oct. 2017. 020420 Health Board Agenda Packet Page 38 37 Whatcom Working Towards Well-being An Action Plan for County Government NOTES Whatcom County Health Dept. (Oct. 2017). Whatcom Working Toward Well-being: Select indicators of child, family and community well-being in Whatcom County. 2 The King Center, The King Philosophy. 3 Center for the Study of Social Policy & National League of Cities (2018). Early Learning Community Action Guide and Progress Rating Tool. 4 Whatcom County Health Dept. (2018). 2018 Whatcom County Community Health Assessment. 5 Dept. of Commerce and collaborators (2019). The Mounting Costs of Child Care: Impacts of child care affordability and access to Washington's employers and economy. 6 Center on the Developing Child, Harvard University (online). Key Concepts: Toxic Stress. 7 The United Ways of Washington (2018). ALICE in Whatcom County: 2016 Point -in -Time Data 8 Whatcom County Health Dept. (2019). A Home for Everyone: Strategic Plan to End Homelessness in Whatcom County, Local Plan Update, Phase 5. 9 Child Care Aware and Opportunity Council (2019). Child Care Supply, Demand, and Cost in Whatcom County, Updated Oct. 18, 2019. 10 Dept. of Commerce and collaborators (2019). The Mounting Costs of Child Care: Impacts of child care affordability and access to Washington's employers and economy. 11 Whatcom County Health Dept. (2018). 2018 Whatcom County Community Health Assessment. 12 Results Leadership Group, LLC (2010). Results Based Accountability Guide. 020420 Health Board Agenda Packet Page 39 38 Supplements Letters received in support fir Child and Family Actinn Plan 020420 Health Board Agenda Packet Page 40 (#BELLINGHAM PUBLIC SCHOOLS FOUNDATION imagine the. A0A&:6ili6e.a... . BOARD OF TRUSTEES January 21, 2020 Whatcom County Council Ashley Kirriberle-v PresidenT Cc: Executive Satphal Sidhu Meredith Hayes Greetings, Vicellresidenf The Bellingham Public Schools Foundation makes a collective commitment to Bellingham's children - we will empower every child to discover and develop a passion, contribute to their Sam Gearhart community, and achieve a fulfilling and productive life. Today we honor our commitment to Secretary Bellingham's children by using our voice to advocate for a renewed focus and tangible supports at our county level. Please accept this letter as a show of support for those who envision a future in Scott Wilson which all children are safe, healthy and ready to learn, and in which families are strong, stable, Treasurer supported and welcomed by our community as a place to live, learn, work and play. We ask that you accept the recommendations put forth in the child action plan and allocate resources to Jason Alexande, implement the changes. We look forward to actively partnering to make this vision a reality. Every day we see families in crisis. Students that show up hungry, families have been Julie Batten severed, and every day educators teach through these traumas. The Bellingham Public Schools Foundation strives to equalize opportunity and to support students and families in Tony Freeland crisis, helping every student to meet their unique potential. But none of that can solve the ongoing, systemic inequities that lead to the disparities Jeff Gleaen children experience as they navigate towards graduation. A recent district -wide survey highlighted what we see in classrooms every day, that families need additional behavioral health supports for their children. That the supports aren't there to ensure they can live Chrislin Lunny up to their potential. We support the Child and Family Action Plan because Whatcom County needs a county - Jolene N1cEachran wide approach to child and family well being that includes clear strategies to address key concerns in our community and that gives all children access to those social, emotional and academic skills that are essential to success. Student success in the classroom must STAFF be a piece of a larger county -wide focus on health and wellness of children and families and we support a broad community effort to ensure: Kim Lund Executive Director 1) Availability of effective early learning within the context of full day childcare so that parents may work or pursue their education. Elixabelh Boyle Dever pmenf 2) Safe, stable and affordable housing is available for families and our workers; D;reefiar 3) Behavioral health services are available and affordable for children and their families. Kathy Dooley We support the efforts of the Health Board, the Health Department and the Executive Asslstanf Generations Forward Coalition in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, (�L Kim Lund I Executive Director I ype here] P.D. BOX 1132, BELLINGHAM, WA, 98227-1132 1 360-676-6479 1 BELLINGHAMSCHOOLSFOUNDATION.ORG 020420 Health Board Agenda Packet Page 41 /% 000 0Fmi ■ January 24, 2020 BELLINGHAM WHATCOM COUNTY HOUSING AUTHORITIES Office: 208 Unity Street — Lower Level • Bellingham Mailing Address: P.O. Box 9701 • Bellingham, \VA 98227-9701 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, The Bellingham and Whatcom County Housing Authorities fully support the Child and Family Action Plan that you will be considering at your February 4, 2020 meeting. The objectives of the Child and Family Action Plan are well aligned with our mission of offering opportunities for people to thrive by ensuring access to quality, affordable homes. We encourage you to adopt the Plan. In addition to access to quality, affordable health care, the health of our neighbors and community depends on a range of resources and services that must be available throughout our community in order to create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: safe and stable housing; safe, accessible childcare and early learning opportunities; and accessible behavioral health services for children and their families. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Since r ly, Brien Thane Executive Director/CEO Administrative Office: (360) 676-6887 • FAX (360) 676-7696 • TDD (360) 676-2140 Maintenance Office: (360) 676-6893 • FAX (360) 738-7311 020420 Health Board Agenda Packet Page 42 BELLINGHAM REGIONAL CHAMBER OF COMMERCE January 23, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically endorse the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. As the Bellingham Regional Chamber of Commerce, our mission and 2020 policy agenda are strongly aligned with the objectives of the Child and Family Action Plan. We realize that the health of the people and communities we serve depends not only on access to quality, affordable health care but also on the resources and services available throughout our community that create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families As an organization, we have been working for years to build the conversation regarding affordable and availability housing, specifically workforce housing, and childcare that is also both affordable and available. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Guy Occhiogrosso President/CEO Bellingham Regional Chamber of Commerce 119 N Commercial Street, #110 - Bellingham, WA 98225 - 360 734.1330 office bellingham.com • INTERFAITH COALITION Partners in faith. Changing lives. January 13, 2020 Whatcom County Public Health Advisory Board 311 Grand Avenue, Suite 108 Bellingham, WA 98225 Dear Public Health Advisory Board Members, I am writing to whole-heartedly endorse the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. At Interfaith Coalition, our vision of a community of many faiths working together to eliminate homelessness and poverty in Whatcom County is aligned with the objectives of the Child and Family Action Plan. We have established resources that, along with our many remarkable community partners, can help achieve the desired results of ensuring children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work and play. Whatcom County's children and families will have the opportunity to thrive when they have access to the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our many dedicated community partners to help build the resilient community set forth in the Plan. Thank you for your work, time, and thoughtful consideration. Sincerely, arxU'Ll" ga-lt&� Laura Harker, Executive Director 910 14th Street, Bellingham, WA 98225.360-734-3983 • info@interfaith-coolition.org • www.interfaith-coalition.org 020420 Health Board Agenda Packet Page 44 Lydia PLACE January 18, 2020 every family deserves a home Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members and County Executive, PO Box 28487, Bellingham, WA 98228 Phone- 360.671.76631 Fax: 360.671.7038 TTY:711 or 800.833.6384 www.lydiaplace.org Oh behalf of Lydia Place, I am writing to enthusiastically support the Child and Family Action Plan and its recommendations. Lydia Place has been serving families with children in Whatcom County for 30 years. Our mission is to disrupt the cycle of homelessness for current and future generations. We recognize that in order to address the systemic issues of poverty, we must take bold action as a community and put the health and wellbeing of children at the front and center of our work. We feel the recommendations of the Child and Family Action Plan are a great first step in doing just that. The data tells us that our children here in Whatcom County are not getting their basic needs met. Only 50% enter school ready to learn, we have 4 childcare spots for every 10 children, rates of child abuse and neglect are higher than the state average, and the mental health of our teens is steadily declining. Roughly half of those who live here cannot afford to do so and homeless continues to rise. These are just a few of the indicators that tell us we are headed in the wrong direction. At Lydia Place, we recognize that the health of a community begins with the health of the children who call it home. They are the workforce, business owners, teachers, volunteers, and neighbors of tomorrow. The future health of Whatcom County depends on the availability of critical services and basic needs. As such, Lydia Place strongly supports the Plan's focus on: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Emily O'Connor Executive Director Ryan Thramer Board President 020420 Health Board Agenda Packet Page 45 opportunity council January 17, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to extend Opportunity Council's support for the goals outlined in the Child and Family Action Plan that you will be considering for adoption at your February 4, 2020 meeting. We share the Plan's vision of a community where all children are safe, healthy, and ready to learn; families are strong, stable, and supported; and communities are welcoming and supportive places for children and families to live, learn, work, and play. Opportunity Council's mission aligns with the objectives of the Plan, and we look forward to continuing to contribute to the action areas prioritized in the Plan: • Safe and stable housing Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families Additionally, we support the Plan's commitment to invest new resources to identify gaps and innovative prevention strategies and bring to scale the current work being done across sectors providing services for families and children. We look forward to the opportunity to support this work through collaboration with you and our community. Community Action thank you for your work and consideration A Community Action Agency serving Whatcom, Island and San Juan Counties since1965 Sincerely, i' Whatcom County 1 111 Cornwall Ave., Suite C Bellingham, WA 98225 (360) 734-5121 Greg Winter (800) 649-5121 Fax (360) 671-0541 Executive Director Island County 1791 N E 1 st Ave. P.O. Box 922 Oak Harbor, WA 98277 (360) 679-6577 (800) 317-5427 Fax (360) 679-2440 San Juan County (800) 649-5121 www.oppco.org 020420 Health Board Agenda Packet Page 46 January 20, 2020 Whatcom County Council acting as Health Board Cc: County Executive Satpal Sidhu Dear Health Board, Few things are as important as building family resilience and investing in early childhood development. As pediatricians, we see the ramifications when this doesn't happen, and we see the difference it makes in healthy child and youth development when these supports exist in community. We share in the vision for a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We applaud your commitment to placing child and family well-being as a top priority county concern and urge you to carefully consider the recommendations put forward in the Whatcom Working on Well - Being: Child and Family Action Plan. We support a broad community effort to ensure that Whatcom County children and families can thrive with the services and resources prioritized for action in the Child and Family Action Plan, including: • Safe and stable housing • Safe and accessible child care and early learning opportunities ■ Accessible behavioral health services for children and their families We support the efforts of the Health Board, the Health Department and Generations Forward in their creation of the Child and Family Action plan and its adoption by our local governments. We look forward to the opportunity to support this work and collaborate with you and other community partners to bring this vision to reality. Sincerely, Dr. Lessli Putney Clinical Section LeajPIatr & Children's Therapy On behalf of PeaceHealth Pediatrics Clinic PeaceHealth Medical Group Pediatrics 4545 Cordata Parkway Bellingham, WA 98225 020420 Health Board Agenda Packet Page 47 MEDICAL CLINICS Aberdeen ��3r ar Battle Ground lA W--Community Bellevue Bellingham Health Centers Myers Burien Clinica de la Comunidad Concrete Exceptional se rvice. Every person -Every time Proudly serving the community since 1978 Des Moines Elma ADMINISTRATION 1040 S. HENDERSON ST. I SEATTLEMA 198108 1206.763.5277 Everett Everson Federal Way Kent Lacey Lakewood January 16, 2020 Marysville Monroe Mt.Vernon Ocean Shores Whateom County Board of Health Olympia Puyallup 311 Grand Ave, Suite 105 Seattle Tacoma Bellingham, WA 98225 Vancouver Yelm DENTAL CLINICS RE: CHILD AND FAMILY ACTION PLAN Aberdeen Bellevue Bellingham Burien Dear Board of Health Members, Des Moines Federal Way Everett Lacey I am writing to express Sea Mar Community Health Center's the Child Marysville endorsement of Mt -Vernon and Family Action Plan that is being considered for adoption at the February 4, 2020 Monroe Oak Harbor meeting. Ocean Shores Olympia Port Angeles Puallu Seattlep Sea Mar, founded in 1978, is a community -based organization committed to providing Tacoma quality, comprehensive health, human, housing, to Vancouver educational and cultural services Yelm diverse communities, specializing in service to Latinos in Washington state. We realize INPATIENT BEHAVIORAL HEALTH that the health of the people and communities we serve depend not only on access to Bellingham Seattle quality, affordable health care but also on the resources and services available throughout Tacoma our community that create the conditions for health. We serve the vision of a community OUTPATIENT BEHAVIORAL HEALTH where all children are safe, healthy and ready to learn, families are strong, stable and Aberdeen Anacortes supported from the start, and communities are welcoming and supportive for children and le Bellevue eround families to live, learn, work and play. Bellingham Des Moines Everett Whatcom County's children and families cannot thrive without the services and resources Federal Way prioritized in the Child and Family Action Plan: IGjig,OHarbor 1��Wood - Safe and stable housing Move - Safe, accessible learning non child care and early opportunities Oak Harbor - Accessible behavioral health services for children and their families Puyallup Seattle Tacoma Tu er Vancouver Vancou We look forward to the opportunity to support this work and to collaborate with you and Yelm our community partners to make the vision set forth in the Plan a reality. PHARMACY Bellevue Concrete Sincerely Des Moines , Federal Way Everett Mt. Vernon Ocean Shores ?Deputy Olympia art Seattle Tacoma Vancouver Di � for OTHER Administration Cannon House Care Management Child Dev. Center Comm. Care Center Community Services Educational Services Home Care Home Health Homeless Services Housing KDNA & KKMO Radio Managed Care MSS & WIC Promotores/as Program www.seamar.org 1 020420 Health Board Agenda Packet Page 48 LIVE UNITED United Way of Whatcom County 1500 Cornwall Ave Ste 203 Bellingham WA 98225-4522 tel 360.733.8670 fax 360.733.8674 un itedwaywhatcom.org January 23, 2020 Whatcom County Council Cc: Executive Satphal Sidhu Greetings, United Way of Whatcom County fights for the financial stability of every person in our community. No matter the obstacles. No matter the odds. We surround Whatcom County's most critical problems. And we fight. According to the latest ALICE Report, 35% of households with children do not have the financial resources to meet their basic needs. We are using our voices to advocate that our county government increase efforts to make our community more resilient and our families more financially stable. Since 2017, the United Way of Whatcom County has been uniting partners behind a single -issue focus to combine resources to make a more significant impact on financial stability. Based on the evidence identifying the lack of child care as a significant barrier, we launched a child care initiative that has brought together local leaders within the youth serving community to forge a pathway towards a more sustainable child care landscape in which all children have easy access to affordable, high -quality child care and early learning options. More than 30 individuals from around 20 businesses and organizations have collaborated to draft a childcare action plan that aligns with state efforts to incentivize employer -supported childcare and improve childcare access and affordability for employees. In recent months, urgent needs have arisen to address a potential loss of 500+ childcare slots in our county. While these needs are now urgent, they are not new, nor are they specific to circumstances related to Kids World. We know that the childcare industry across the state is not stable, that the childcare business is precarious and leaves families and individuals in a vulnerable position. In fact, the current system at times disincentivizes parents and caregivers to access education or join the workforce, furthering disparities in opportunities. It will take a collaborative and proactive approach to addressing this significant community need. Many other communities have modeled this for us. It is our turn to transform this into a reality. Representatives from the childcare initiative have worked alongside county leaders to inform and develop a child action plan, presented herein. We ask that you adopt these changes and allocate resources to work alongside community leaders actively pursuing a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We support the efforts of the Health Board, the Health Department and the Generations Forward Coalition in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, e Theisen President/CEO 020420 Health Board Agenda Packet Page 49 Unity Care NW f leu�tl� Core fa�Eti'e �uc January 6, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically endorse the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. As a community health center, our mission is strongly aligned with the objectives of the Child and Family Action Plan. Prevention and early intervention are at the core of our work. We realize that the health of the people and communities we serve depends not only on access to quality, affordable health care but also on the resources and services available throughout our community that create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Desmond Skubi Chief Executive Officer 1616 Cornwall Avenue, Bellingham, WA 98225 360.676.6177 • 877.235.6850 • UnityCareNW.org MEDICAL • DENTAL • PHARMACY • BEHA)ORf ,ILA.eM,661MAgendaPacketPage50 Whatcom County Coalition to End Homelssness January 22nd, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members and County Executive, As the Chair of the Whatcom County Coalition to End Homelessness, I am writing to express the Coalition Steering Committee's support of the Child and Family Action Plan. The Coalition is dedication to combatting homelessness in Whatcom County through action and advocacy. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. As a Steering Committee, we are particularly supportive of the Plans emphasis on targeted action to increase housing access and reduce homelessness. As a homeless response system, we continue to see an increasing need for rental subsidy, case management, affordable housing units, childcare, and behavioral health supports. We welcome a focus on identifying new sources of revenue to address the gaps in services. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Mike Parker, Coalition Chair 020420 Health Board Agenda Packet Page 51 • Family& Community building community together so youth and families thrive January 23, 2020 Whatcom County Council Cc: Executive Satpal Sidhu Dear Executive Satpal and County Council: Whatcom Family and Community Network recognizes the importance of our communities joining together to raise family and child hope and resilience across all stages, but especially during the years of early childhood development. The earlier we act, the more prevention happens. We envision a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We imagine Whatcom youth and families thriving despite facing adversity —social, environmental or otherwise. We support a broad community effort to ensure: 1) Availability of effective early learning within the context of full day childcare so that parents may work or pursue their education. 2) Safe, stable and affordable housing is available for families and our workers; 3) Behavioral health and prevention services are available and affordable for children and their families. We support our local governments to integrate consideration for children and families in strategic planning, and to have all relevant departments view initiatives and decisions through a lens of the same, while supporting neighborhoods in building community connections and resilience. We support the efforts of the Whatcom County Health Board, the Health Department and Generations Forward in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, Shane Steger, President On behalf of Whatcom Family & Community Network Kristi Slette, Executive Director 1231 N. Garden St., Ste. 210, Bellingham, WA 98225 1360.738.1196 1 wwwfcn.org 020420 Health Board Agenda Packet Page 52 January 9, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members and County Executive, On behalf of the Whatcom County Housing Advisory Committee (WCHAC), I am writing to express our Committee's support of the Child and Family Action Plan. The WCHAC is committed to advancing County strategies that address the shortage of affordable homes in our community and to identifying priorities for County action that reduce homelessness. We share the vision of a community where all children are safe, healthy, and ready to learn, where families are strong, stable, and supported from the start, and where communities are welcoming and supportive places for children and families to live, learn, work, and play. We would like to emphasize the following: - WCHAC recognizes that safe, stable, affordable homes are critical to the health and wellbeing of children and families, and we strongly support the Plan's recommendations for expanded support for vulnerable families with children and those of us experiencing homelessness. - WCHAC recognizes that the Plan embraces a shift in strategy from crisis response to add more efforts around prevention, and from a public health perspective, we strongly support this approach. - WCHAC recognizes that Whatcom County's children and families cannot thrive without the services and resources described in the Child and Family Action Plan, and we support the Plan's prioritization of safe and stable housing, accessible child care and early learning opportunities, and accessible behavioral health services for children and their families. - WCHAC supports the identification of new revenue sources to expand services to address child and family wellbeing and to expand the supply of homes people can afford. - WCHAC wants to emphasize that reducing or eliminating existing programs and funding would be counterproductive and not supported by the WCHAC. - WCHAC stands ready to advise and support the implementation of the Plan as it pertains to safe, stable, affordable homes, and we ask that you utilize the WCHAC as a resource in the next phase of Plan implementation. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the Plan's vision a reality. Thank you for your work and consideration. Sincerel Brien Thane, Chair 020420 Health Board Agenda Packet Page 53 WHATCOM HOUSING ALLIANCE January 8, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. At Whatcom Housing Alliance, we realize that the health of the people and communities we live and work in depends on the resources and services available throughout our community that create the conditions for health. For the Whatcom Housing Alliance, this begins with safe, stable housing that is affordable to all and available in all neighborhoods. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Whatcom Housing Alliance 020420 Health Board Agenda Packet Page 54 January 8, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to express support for the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. At Whatcom Women in Business, we realize that the health of the people and communities we live and work in depends on the resources and services available throughout our community that create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Shu-Ling Hergenhahn Zhao President, WWIB 020420 Health Board Agenda Packet Page 55 Whatcom Working on Well-being ChiLd and Famity Action Plan We all 00 Wa a future where: COMMUNITIES are welcoming & supportive places for children FAMILIES & families are strong, to live, stable, & learn, supported work, & from the play. CHILDREN Start. are safe, healthy, & ready to learn. WWa Packet Page 5 Ir S� ve need to build a solid foundation of •*!v v 7' to support famiLi.es. A - L- !Ac I Stable housing Affordable childcare & preschool Behavioral health care for families e need to build a solid foundation of to support families. 020420 Health Board Agenda Packet Page 57 Put children and families first in policy decisions Affordable childcare & preschool + Adopt trauma- BehaWioraL health' informed & equity care for families practices IN & F • 'e need to build _ olid foundation of to support families. 9MV-q The W • a F�rwar�. 5t�w Adopt Child and Family Action Plan as a guiding - y document for county action Formally commit to the 4 Proposed Next Steps 1, Request Office of the County Executive assess infrastructure and budget needs required to realize commitment 2 Ordinance to create a county task force, or other official county committee 3. Support and actively participate in fiscal analysis in early 2020 to identify existing and potential funding streams 4. Fulfill prior commitments to resource and fund two critical efforts • All County services are trauma informed and culturally and linguistically appropriate • Health Navigation System 020420 Health Board Agenda Packet Page 58 1 4 %4.96^, JIM You can I?ad! Your action in adopting these recommendations "Will support kids and families today_ tomorrow' and the 114 � r I. 1 ` 1 1A ; �' . tions of wmftt 020420 Health Board Agenda Packet Page 59 Whatcom County Agenda Bill Report File Number: AB2020-070 COUNTY COURTHOUSE 311 Grand Avenue, Ste #105 Bellingham, WA 98225-4038 (360)778-5010 File ID: AB2020-070 Version: 1 Status: Presented File Created: 01/28/2020 Entered by: TAxlund@co.whatcom.wa.us Department: Health Department File Type: Presentation Assigned to: Council as the Health Board Final Action: 02/04/2020 Agenda Date: 02/04/2020 Enactment M Primary Contact Email: taxlund@co.whatcom.wa.us TITLE FOR AGENDA ITEM: Presentation Regarding Child and Family Action Plan SUMMARY STATEMENT OR LEGAL NOTICE LANGUAGE: Pursuant to Resolution 2019-020, the purpose of the Child and Family Action Plan is to provide recommendations to the Health Board about steps County Government can take to support young children and families in Whatcom County. HISTORY OF LEGISLATIVE FILE Date: Acting Body: Action: Sent To: 02/04/2020 Council as the Health Board PRESENTED AND DISCUSSED Attachments: Discussion Form for Child and Family Action Plan, Whatcom Working Toward Well -Being - An Action Plan for County Government, PowerPoint Presentation Slides, Letters of Support for Child and Family Action Plan, Letter of Support -Rachel Lucy -Health Board 2.4.2020 Whatcom County Page 1 Printed on 2/5/2024 HEALTH BOARD Discussion Form February 4, 2020 AGENDA ITEM #2: Child and Family Action Plan PRESENTERS: Rachel Lucy, Emily O'Connor, Debbie Ahl, Heather Flaherty, Meredith Hayes, Sterling Chick, Chi-Na Stoane, Regina Delahunt, Astrid Newell, Mardi Solomon BOARD ACTION: Q Action Item Discussion FYI - Only In April 2019, the County Health Board adopted a resolution affirming commitment to Whatcom County's young children and families. As part of this resolution, the Health Board tasked the Public Health Advisory Board (PHAB), working in collaboration with Health Department (WCHD) staff and Generations Forward partners, to create a Whatcom County Child and Family Action Plan by January 31, 2020. The purpose of this plan is to provide recommendations to the Health Board about steps County Government can take to support young children and families in Whatcom County. Since April, PHAB members, WCHD staff, community partners, and family representatives have been actively working to develop the Child and Family Action Plan. The plan includes a series of recommendations that have been brought forward through a collaborative community process, along with background information and resources. Members of the Public Health Advisory Board, Health Department staff, and several community partners who were part of the planning process will present the plan and answer Health Board questions. BOARD ROLE/ACTION REQUESTED o Adopt Child and Family Action Plan as a guiding document for county action o Formally commit to the four "Proposed Next Steps" outlined in the plan ATTACHMENT(S) o Whatcom Working Towards Well-being: An Action Plan for County Government, January 2020 o Letters of Support o PowerPoint Presentation Whatcom County f HEALTH Department _M I WHATCOM WORKING WARDWELL-BEING JANUARY 2020 • iIFr �. • - Develop1jin a Collaboration between Whatcom County 14 Public Health Advisory Board, Whatcom County Health Department, Generations Forward, and Healthy Whatcom TABLE OF CONTENTS Acknowledgements ........................................ 3 1. Executive Summary ................................. 4 2. Introduction .............................................. 6 3. Challenges & Opportunities ...................... 8 4. Action Plan ............................................. 19 Appendix A: History..................................23 Appendix B: Resolution ............................25 Appendix C: Planning Participants ...........28 Appendix D: Generations Forward ...........31 Appendix E: Theory of Change ................32 Appendix F: Proposed Indicators .............33 Resources .................................................... 37 Notes............................................................ 38 Whatcom Working Towards Well-being An Action Plan for County Government ACKNOWLEDGEMENTS Key Groups and Organizations informing Whatcom Working Towards Well-being: An Action Plan for County Government (Action Plan) Generations Forward Family Council Policy, Advocacy, and Funding Action Team Honoring Equity and Culture Team Healthy Whatcom Perinatal Mental Health Task Force Whatcom County Public Health Advisory Board United Way — Child Care Initiative Whatcom County Health Department Whatcom County Housing Advisory Committee Whatcom Taking Action Special thanks to the following people for their time, thoughtful input, passion, support, and dedication to this planning process and commitment to making our community a place where all children and families can thrive: • Debbie AN • Julie Mauermann • Hilde Alden • Keith Montoya • April Barker • Jennifer Moon • Monica Burke • Melissa Morin • Sterling Chick • Astrid Newell, M.D. • Chris D'Onofrio • Emily O'Connor • Heather Flaherty • Mike Parker • Carol Frazey Amy Rydel • Ken Gass, M.D. Jessica Sankey • Daniel Hammill • Paul Schissler • Meredith Hayes • Chi-Na Stoane, M.D. • Galen Herz Michele Waltz • Monica Koller • David Webster • Rachel Lucy • Allison Williams • Samya Lutz • Judy Ziels Prepared with the support of Fel CROSSROADS CONSULTING 3 Whatcom Working Towards Well-being An Action Plan for County Government 1. EXECUTIVE SUMMARY VISION Community members from across Whatcom County have come together to envision a "Beloved Community" in which every child in every family flourishes. Achieving this vision will require the time, talents, and resources of change agents across the community working together for the well-being of children and families. COUNTY GOVERNMENT'S ROLE Whatcom County government has an important role to play in realizing the community's vision, which begins with making a commitment to promote the health and well-being of all children and families in Whatcom County, with a special focus on the critical first years of life, and families that experience disproportionate challenges due to social and economic factors, discrimination, and health issues. Since the passage of County Health Board Resolution 2019-020 in April 2019, the Public Health Advisory Board has worked in collaboration with Whatcom County Health Department staff, partners from the Generations Forward Children's Collaborative, and representatives from many related organizations and initiatives to develop this Child and Family Action Plan as a guiding document for County action to create tangible, positive results. RECOMMENDATIONS FOR COUNTY ACTION This participatory community process resulted in a proposed Action Plan, and four next steps that the County can take to demonstrate ongoing commitment to children and families. 1. Establish new structures and processes to elevate the well-being of all children and families as a county priority 2. Leverage existing county resources and public -private partnerships to address immediate child and family needs • Build county infrastructure to embed a focus on child and family well-being across county government. • Adopt a "children and families first" approach for county policy and funding decisions. • Pursue new funding mechanisms to significantly increase local resources for well-being promotion and crisis prevention. • Promote family -friendly employment policies and practices within the County and serve as a model employer. • Support community initiatives to eliminate family homelessness and improve family housing stability. • Contribute to community efforts to stabilize and expand access to child care and early learning opportunities. • Provide resources to improve access to and navigation of family services and supports, including behavioral health services. 4 Whatcom Working Towards Well-being An Action Plan for County Government Proposed Next Steps for the County to Implement These Recommendations The Public Health Advisory Board and community partners identified the following specific next steps the County can take to make progress toward these high-level recommendations: Request the Office of the County Executive assess infrastructure and budget needs required to realize commitment to an integrated focus on child and family well-being across county government departments. a. Receive from the County Executive a proposed infrastructure model to implement, aiming toward establishment of an "Office of Child and Family Well-being" or other structure that will embed a focus on children and families across county government. b. Request that biennial budget proposals be submitted to support actions contained in this Action Plan, with a focus on housing, child care, and behavioral health care. 2. Develop an ordinance to create a county task force, or other official county committee, with high-level staffing and resources to ensure that diverse community partners are informed, coordinated, and included in the implementation of this Action Plan, make additional recommendations, and regularly report progress to the County Council. a. Using the highly effective Incarceration Prevention and Reduction Task Force as a model, the task force will include representatives from government, community organizations, and families. The task force will focus on tracking and furthering progress of community efforts to achieve the desired results for children and families. 3. Support and actively participate in fiscal analysis in early 2020 to identify existing and potential funding streams for child and family programs. Potential new funding streams may include a future bond, levy, taxes, federal funding, etc. 4. Fulfill prior commitments to resource and fund two critical efforts, including: a) adoption of culturally and linguistically appropriate services and trauma -informed approaches in all County departments; and b) development of a culturally and linguistically responsive health navigation system for families seeking information and assistance with health and social services. Whatcom Working Towards Well-being An Action Plan for County Government 2. INTRODUCTION Over the last two decades, evidence for the importance of the early childhood period has been growing. A child's early experiences have the power to create a trajectory toward health and well-being throughout the lifespan or, conversely, to set-up profound challenges that need to be overcome.' Communities and leaders are being called upon to invest more resources and attention to ensure that all children have a healthy start. Indeed, the call is urgent. Each year over 2,200 babies are born in Whatcom County. The environments into which these babies are born and the care that they receive in their first few years will lay the foundation for their lifetimes and will impact the entire community. Vision for Whatcom County Organizations, community leaders and individuals in Whatcom County have heard the call to action and are responding. Community members have prioritized a focus on young children and families as part of the Whatcom County Community Health Improvement Plan, the Generations Forward Children's Collaborative, the County Health Board's policy focus on children and families, and other initiatives. The Generations Forward Children's Collaborative has embraced the concept of a "Beloved Community" — a term popularized by Dr. Martin Luther King Jr. `Dr. King's Beloved Community is a global vision in which all people can share in the wealth of the earth. In the Beloved Community, poverty, hunger and homelessness will not be tolerated because international standards of human decency will not allow it. Racism and all forms of discrimination, bigotry and prejudice will be replaced by an all-inclusive spirit of sisterhood and brotherhood. ,2 "Our goal is to create a beloved community and this will require a qualitative change in our souls as well as a quantitative change in our lives. " - Martin Luther King Jr. In describing how a Beloved Community may be manifested in Whatcom County, community members are uniting around a shared vision for the future in which all children are safe, healthy, and ready to learn; families are strong, stable, and supported from the start; and communities are welcoming and supportive places for children and families to live, learn, work, and play. A key to becoming a Beloved Community is to prioritize equity, particularly racial equity. This will require a richer understanding of who in our community has access to opportunities and what structural barriers are in place preventing certain children and families from having full access. Whatcom Working Towards Well-being An Action Plan for County Government When we make investments that support young children and families early on, we can build more RESILIENT COMMUNITIES and we can create a future where EVERYONE THRIVES N%6 COMMUNITIES FAMILIES are strong, stable, & supported from the HILDREN start. are safe, healthy, & ready to learn. are welcoming & supportive places for children & families to live, Learn, work, & play. In order to achieve these results, action is needed at all levels of the community, from families and community members, to program and service providers, to system partners and policymakers. County Government's Role Whatcom County government has an important role to play in realizing the community's vision, which began by making an ongoing commitment to promote the health and well-being of all children and families in Whatcom County, with a special focus on the critical first years of life. Over the past ten years, the County Health Board has shown leadership and resolve to address the issues that are impacting families with young children in our county (for recent history see Appendix A). In April 2019, the County Health Board passed a resolution in which the Health Board tasked the Public Health Advisory Board "to collaborate with Generations Forward partners and Health Department staff to create a Whatcom County Child and Family Action Plan, building on Generations Forward commitments and using a public health approach" (see Resolution, Appendix B). This work has involved reviewing the data and conclusions from the Community Health Improvement processes to date, and reports and recommendations from many relevant community advisory groups and initiatives (e.g., Generations Forward, Housing Advisory Committee, Health Protection for Immigrant Families Task Force). Significant progress has been made towards implementing supports needed by families of young children, and yet there are many ways in which the system remains intractable and in need of restructuring. Whatcom Working Towards Well-being An Action Plan for County Government 3. CHALLENGES & OPPORTUNITIES Challenges & Opportunities Faced by Young Children and Families in Whatcom County In October 2017, over 74 community partners and families gathered for three days to explore issues facing young children and families in Whatcom County as part of the Generations Forward Future Search Conference: Envisioning a Future where All Whatcom County Children Thrive. Participants identified the most significant trends shaping the future of families with young children in Whatcom County. These trends were: • Decrease in child care availability • Growing mental health needs and inadequate mental health services • Increased demands on school districts, including demand for social and emotional supports • Increase in housing need and decrease in affordable housing • Increase in cultural diversity • Increase in opioid abuse, disrupting families The 2018 Whatcom County Community Health Assessment reinforced the theme that many young children and families in Whatcom County are experiencing a high level of stress which is negatively impacting their development in a variety of ways including their physical and mental health, social and emotional development, and learning ability.4 Families in Whatcom County, especially those with low/no incomes, racial/ethnic minorities, and those with members who have special health or behavioral healthcare needs, face significant challenges in finding safe and stable housing, and affordable child care so they can attend school and work. The time and effort involved in navigating complex social and health care service systems is a job in itself and presents additional challenges. Inability to find or access timely behavioral health services and supports impact daily quality of life. For immigrant families and those living in rural areas, the challenges for meeting children's and families' needs are even greater. Stories and statistics shed light on the issues. Local case managers, health care providers, educators, and families themselves share accounts of some of the challenges and the kinds of choices families feel they must make to provide for their children. The good news is that there are effective approaches to addressing these issues that can make an enormous difference in the lives of children, families, and the community as a whole. Whatcom Working Towards Well-being An Action Plan for County Government Child Development and School Readiness School readiness at kindergarten entry (typically age 5) is a common measure of healthy child development, and is a reflection of nurturing relationships and environments in the first years of a child's life. In 2017-18, less than half (46%) of children in Whatcom County were developmentally ready for kindergarten in all domains (social -emotional, physical, cognitive, language, literacy, mathematics). Children of color, English -language learners, and children from low-income families are less likely to meet the developmental milestones for kindergarten. Percent of children entering kindergarten ready for school, by various factors Whatcom County, 2017-2018 Source: Office of Superintendent of Public Instruction 100% 90% ■ Whatcom avg = 46% 80% 70% 60% 50% 47% 44% 40% 30% 23% 27% 20% 10% 0% 54% WA avg = 47% (#) = total count of students in category 59% 52% 51% 46% 41% ■ -w-r i ti• ■ tier r •■• IMF ■ •■• 26% 19% p\ UN K.`bb11 ��r `l, 0 �`o�e eeyy lea eat Without adequate support, children who aren't ready for school may have trouble catching up and may experience emotional and behavioral issues that set them on a difficult path and increase risk of academic underachievement, relationship problems, and involvement with the criminal justice system. One local child mental health care provider describes it like this: Many kids that parents bring in for counseling are coming because of problems at school. We see underlying depression and/or anxiety; the school sees misbehavior. We might see a 10- year old with multiple school suspensions for aggressive behavior toward peers, or a 12-year old who refuses to go to school, or maybe a 15-year old who brought a knife to school. When families give a history of the problem, almost every time we see struggles that began in kindergarten and first grade. Small things at first such as not meeting standard for math or struggles with sitting still. By third grade, there are reports of in -school suspension for rough play at recess. By the fourth grade the kid reports he/she has no friends and is starting to not like school anymore. It is often complicated when it comes to root causes, but rather simple about what happened — those kids were not ready for school. Whatcom Working Towards Well-being An Action Plan for County Government For families experiencing social and economic challenges, family financial assistance and other concrete supports, home visiting and other parenting programs, and high -quality early care and education experiences are among the proven strategies that improve child outcomes and school readiness. Childhood Adversity and Family Functioning The rate of referrals for child abuse and neglect that are accepted for further action by Child Protective Services is one indicator of the scope of child adversity, family functioning, and toxic stress6 in a community. In Whatcom County, the rate of accepted referrals has remained higher (worse) than the state average for over 10 years and is trending in the wrong direction. Over 2,000 children are identified as victims of abuse or neglect each year. Young children under age 5 are most likely to be identified as victims of maltreatment, particularly neglect. Victims of child abuse and neglect, 2006-2018 Rate of accepted referrals per 1,000 persons aged 0-17 Whatcom County vs Washington State Source: Community Risk Profiles, Washington State Department of Social and Health Services Victims of Child Abuse and Negect in Accepted Referrals 60 Rate Per 30 - - - - 1' 20 10 0 Whatcom County f CUunties Like Us - -W - State ---A--- National 2011 2012Mia 2014i i National 47.2 49.4 48.1 44.5 41_9 52.1 52.6 51.1 State 34.0 31.6 32.0 31.8 33_g 34.3 34.4 32.4 31.9 34.0 37.8 39.2 Counties Like Us 33.9 31.1 32.7 29.8 31.6 32.6 32.5 31.1 112 33.6 37.9 40.2 Whatoom County 43.6 37.2 39.9 37.7 46.2 50.5 43.0 42.4 41.1 45.8 50.9 50.6 Accepted Victims 1,Sd8 1,579 1,6BA U92 1.967 2,1114 L926 1,9D5 L760 1.991 2,227 Z235 Persons, birth-17 42,179 42,377 4ZZ56 42,2 5 AZ614 42.475 42,511 47,5% 42,S12 43,247 43.750 44,201 Parental or caregiver substance abuse remains a leading contributor to child abuse and neglect. Opioids along with alcohol, methamphetamines, and other substances have significant ramifications for children and families in Whatcom County, as parents struggling with drug addiction have difficulty meeting children's basic needs. Exposure to family economic hardship, housing instability, social isolation, parental incarceration or criminal history, and parental mental illness can also impact family functioning and put children at risk for maltreatment and toxic stress. 10 Whatcom Working Towards Well-being An Action Plan for County Government One local case manager tells this heartbreaking story: Two parents came into my office one day quite a while ago asking for help finding housing. They both worked but he had a criminal record from his late teens and their income wasn't high enough to afford Bellingham rents. They were sleeping in their car while they had left each of their three daughters with different people in different places in the County to give them a roof over their heads. One of their daughters was sexually assaulted in the home and the parents were devastated that, while doing the best they could to keep their kids safe and housed, the result was this trauma. Many of the strategies that work to improve school readiness (family financial assistance, evidence - based home visiting, connecting families to community resources) also work to reduce child maltreatment. In addition, interventions that address parental mental health and substance use, support parents who are incarcerated or involved in the criminal justice system and their children, and those that promote trauma -informed healing for children and adults who have experienced maltreatment or other forms of childhood adversity, can help mitigate the harmful impacts of adversity on health and well-being. Child & Family Economic Insecurity The proportion of families with young children under age 5 living at or below 100% of the Federal Poverty Level is one indicator of child and family economic insecurity. In Whatcom County, approximately 12% of families with young children meet this criterion. Households headed by single females are significantly more likely to experience poverty than married couple households. Families below the poverty level with children under 5 years Whatcom County vs Washington State Source: US Census Bureau, American Community Survey (Table DP03), 2014-2018 5-year estimate 5R� 40 30% 20% 10% 0% All families Married couple families Families with female householder, no husband present 11 Whatcom Working Towards Well-being An Action Plan for County Government According to the 2016 Whatcom County ALICE Report', one out of three (35%) of all families are at or below the ALICE threshold. ALICE refers to households that are asset -limited, income -constrained, and employed. These families may struggle to meet their basic needs. In Whatcom County, the 2016 Household Survival Budget for a family of four was $66,480 which is nearly three times the Federal Poverty Level for a family of four ($24,300). Children who grow up in families without adequate financial resources are at higher risk of housing instability, food insecurity, school challenges, and health problems such as asthma and obesity. The two biggest expenses for families with young children are housing and child care. In Whatcom County, skyrocketing housing costs combined with high child care costs make it increasingly difficult for families to get by. Housing is very expensive, and over 50% of renters in Whatcom County are cost - burdened (the Washington State Affordable Housing Board defines affordability as "when a household pays no more than 30% of its income for all housing costs.,,)8 Even if families have resources, housing inventory is low, making any housing very hard to find. We (Lydia Place) are working with a single mother of two who works full-time making $16 per hour. She simply can't afford any housing in Whatcom County. She has cut her budget down to bare bones and is still nearly $1000 short every month. There are simply no affordable housing options for her. My friend's rent increased suddenly by $1400 and they were forced to move out of Bellingham. They are still commuting in, with over $3000 owed to collections. Child and Family Housing Stability The number of families with children who are literally homeless and the number and percent of school age students who experienced a housing crisis during the school year are two indicators of child and family housing stability. In Whatcom County, concentrated community efforts over the past several years have led to a 29% reduction in the number of families who were literally homeless between 2008-2019, but limited resources for housing assistance services have resulted in a recent uptick in homeless families. Families with children experiencing homelessness (sheltered or unsheltered) Whatcom County, 2008-2019 Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports 129 Whatcom County Annual Homeless Census Homeless Families with Children 2009-2019 114 92 9d 89 _ 82 70 -' i . 7Z 200S 2009 2010 2011 2012 2013 2014 2015 Zo16 Z017 Zo18 2019 12 Whatcom Working Towards Well-being An Action Plan for County Government Data from schools show an increasing number of children and youth in unstable housing situations, from doubled up with other families, to couch surfing, to living in a vehicle or unsheltered. Nearly 1,000 children and youth experience a housing crisis each school year, and this number likely underestimates actual need. Students who experienced a housing crisis during the school year Whatcom County Public School Districts, 2007-2018 Source: Office of Superintendent of Public Instruction cited in A Home for Everyone: Strategic Plan to End Homelessness in Whatcom County, "2019 Local Plan Update, Whatcom County Health Department 1200 3.7% 3.6% 4.0% 3.5/° ° 1000 3.1 °I° 0°/° 3.1 °I°3.2°/° 3.30%, 3.5°I°2 �'%/& 2.6°/° 2.6°/° 981 gsi9 966 3.0% 800 847 821 823 846 854 2.5% 771 600 699 705 2.0% 1. 5% 400 1.0% 200 Number of students Percent of enrollment 0.5% 0 0. 0% -� 1°0 o° IV 1 o° o° oo` oo` oo` oZ ti T While housing is a basic need for everyone, a safe, stable home environment is especially important during the critical first years of life. Children who are homeless are less likely to be developmentally ready for and succeed in school and are more likely to experience social and emotional distress. In addition to strategies that address lack of affordable housing (a primary driver of family housing instability), effective programs and services such as case management, rental assistance, and Rapid Re -housing make a significant difference in improving housing stability for families. 13 Whatcom Working Towards Well-being An Action Plan for County Government Child Care Availability and Affordability The number of slots in licensed child care facilities per eligible child is a common measure of child care access in a community. In Whatcom County, there are only about half as many child care slots as are needed for children with parents who work full-time,9 qualifying the county for distinction as a "Child Care Desert" and one of the counties in Washington State with the least access to child care. Child care slots available to meet needs of working families Whatcom County 2019 Source: Child Care Supply, Demand, and Cost in Whatcom County, Updated Oct. 2019 Indicator Number Children < 5 years 13,308 • Children < 5 years whose parents work full-time 8,070 Licensed Child Care Slots 3,608 • Slots that Accept State Child Care Subsidy 3,199 Additional Slots Needed to Meet Demand 4,462 For families with young children struggling to make ends meet, economic security often depends on parents being able to get some type of safe, dependable child care for their children so that they can work. While some families qualify for state child care subsidies, the rules to qualify for these benefits are based on income cut-offs which create barriers to access and barriers to employment success as well. Many local families have stories related to their challenges with child care: A single mother of three is navigating multiple systems while working as a small business owner. Her kids span in age from a first -generation college student (age 19) to a 4-year old son. Her youngest is enrolled in developmental preschool as well as a child care center to allow her to work full-time. Four days a week, she must leave work to pick up her son from preschool near Ferndale and drive him to child care in Bellingham. With the potential closure of Kid's World, she is faced with the challenge of finding another center that would accommodate part-time, subsidized care for her son. She has found one other child care center closer to home that is intending to increase their slots and eventually will have the ability to accept her son, but the center's expansion has been delayed for a long time as it awaits licensing approval. Another single mom of three kids reports that "My children need child care so I can work. Family court ordered the father to pay that cost, but there is no accountability when he doesn't pay because 1 don't have money for a lawyer. After school care is nearly $1000 per month upfront and 1 can't gather this to start them [in a program] without that financial help. 1 don't qualify for supported child care. " 14 Whatcom Working Towards Well-being An Action Plan for County Government "Casey, " who is a local social service housing client and is employed, recently experienced the "benefits ledge. " She received a notice that due to her increased income in November earned from working overtime to meet the demand of her company, she would no longer be eligible for child care benefits. With the high cost of child care, she wouldn't be able to afford the cost to send her daughter to attend the day care. In order to take care of her child without day care, Casey might have to quit a job she has worked hard in for almost two years and this would force her back into unemployment. As many clients of supportive housing programs and throughout the community gain financial independence, they approach this benefits' ledge. While it is possible to overcome, more often than not, it inhibits progress. Even for families with greater economic means, lack of child care availability has significant implications for work productivity and quality of life. For businesses, reliable access to child care for employees is critical for success including ability to recruit needed talent. One local employer described it like this: We have been working to recruit for a specialized position. We found the perfect candidate who was excited to come to the community with her family. The lack of child care options was a deal -breaker. A 2019 Washington State report10 on the cost and availability of child care found that 27% of workers quit their jobs or left school or training due to child care issues, and 27% went from full-time to part- time. The same study showed that turnover due to child care issues cost employers over $2 billion in 2017. Employees who missed work due to child care issues cost employers $53 million in 2017. The study calculated that Washington's economy lost about $6.5 billion dollars in combined direct costs to employers and missed consumer spending due to child care issues. Effective strategies to support families in meeting child care needs include policy changes that increase state child care subsidy amounts and expand eligibility to more families, increased public and private investment in child care facility development and operations, and family friendly workplace policies such as paid family leave and flexible work schedules that allow families to work and also meet their children's needs. 15 Whatcom Working Towards Well-being An Action Plan for County Government Behavioral Health Services and Supports Qualitative data from families, educators, health care and social services providers reveal concerns about increasing numbers of young children and parents who are experiencing social, emotional and behavioral health issues, and a lack of available services and supports to help address these needs. Limited quantitative data about young children makes it difficult to quantify the extent of need in this population, but local data from older youth show increasing rates of depression, anxiety, and suicidality." My sister had to wait for three months to get my 14 year -old niece into mental health counseling. My sister was excluded from any therapy sessions and felt left out and was concerned about what they were teaching my niece. A joint therapy session with both mother and child should also be included in the treatment. Effective strategies to support child and family behavioral health needs include expanding access to perinatal mental health services, increasing infant mental health consultation in child care and other settings, locating child mental health services in schools and other community settings, and ensuring services use a dual generation (family -child) approach. Developing the Child & Family Action Plan With these challenges and opportunities in mind, the Child and Family Action Plan (CFAP) development process began. There is significant work to build on. The Health Board's commitment has been an inspiration and set the direction for this planning process. Declaring "children and families" as a focus area of the Health Board for two consecutive years (2017 and 2018) laid the groundwork that was followed up by the passage of resolution 2019-020 in April 2019. Other foundational work done by the Health Board and County Council includes addressing the issues of immigrant families, responding to the potential closure of local child care facilities, and dedicating resources to the Incarceration Prevention Task Force. The CFAP is a guide for how the County can build on the strong foundation it has laid and continue to move toward prevention and upstream thinking and away from a perpetual crisis response system. Meetings and work sessions since April have brought together community organizations along with representatives from many advisory groups, committees, and action teams focused on child and family well-being (for list of participants see Appendix C). Everyone on the list of participants was invited to review and comment on each draft of the CFAP, and the voices of families and service providers have shaped this plan in an iterative way. While participation has been quite broad and has included many families and community members, engagement of families and community members will need to continue during the next phase of planning and implementation with a particular focus on engaging our tribal neighbors and families furthest from opportunity. Community partners stressed that it is necessary to address systemic inequities first and foremost for all children and families to thrive. This will require embedding a focus on equity, and particularly racial equity, to guide and influence all areas of work. An essential action for building equity is to have authentic family involvement in efforts to develop policies and practices that meet the needs of all children and families. Generations Forward fully embraces this orientation and their approach to promoting the well-being of children and families and addressing systemic inequities resonates through the CFAP (see Generations Forward 2020 Priority diagram in Appendix D). 16 Whatcom Working Towards Well-being An Action Plan for County Government Supporting the recommendations made in this CFAP requires adequate infrastructure and resources to increase cross -agency and cross -sector coordination between the various organizations and initiatives working to improve services and create conditions that help families flourish. In addition to these systems -level changes, the CFAP planning process built off of the Community Health Improvement planning and implementation work, the direction of Generations Forward, and the Health Protection for Immigrant Families planning process, as well as the focus of the Whatcom County Business and Commerce Committee and other community efforts, all of which have identified three priority issues requiring immediate attention: 1. Family homelessness and housing instability. 2. Shortage of safe, accessible child care and early learning opportunities. 3. Challenges for families to access health and social service information and resources, including behavioral health services for children and their families. The recommendations in this CFAP are based on a theory of change in which key stakeholders work together to establish new structures and processes to help "turn the curve"12 on key indicators of child, family and community well-being (see Theory of Change diagram below and Appendix E). A prevention -oriented approach will cost our county less over time by reducing the number of families in crisis. It also will be necessary to leverage existing non -dedicated funds and existing public -private partnerships, and pursue new funding mechanisms to achieve the desired results. Theory of Change Families & Community • Peer & community support • Advocacy & leadership Program & Service Providers • Evidence -based programs • High quality service delivery System Partners & Policymakers • Policy & funding support • System coordination & improvement Safe, healthy children • Child maltreatment • School readiness Strong, stable families • Economic stability • Housing stability Supportive, welcoming communities • Affordable housing • Affordable child care • Access to behavioral health 17 Whatcom Working Towards Well-being An Action Plan for County Government Child & Family Action Plan Recommendations The extensive CFAP planning process will help inform the work of many groups addressing the needs of children and families. The types of results that these groups are working toward, and some indicators for measuring progress toward achieving these results are presented in Appendix F. These results are beyond the scope of county government's role, but the County has an essential role to play in making this important work possible. The architects of this CFAP have focused specifically on the recommendations that are within the purview of county government, and these are presented in the following chart. The two core recommendations are: 1) Establish new structures and processes to elevate the well-being of all children and families as a county priority. 2) Leverage existing county resources and public -private partnerships to address immediate child and family needs. 18 Whatcom Working Towards Well-being An Action Plan for County Government 4. ACTION PLAN Establish new structures and processes to elevate the well - Recommendation #1 being of all children and families as a county priority Action Recommended steps Build county Commit resources to facilitate the adoption of equity and trauma - infrastructure to informed policies and practices across county government. embed a focus on child and Support countywide training for County staff to promote culturally and family well-being linguistically appropriate services and trauma -informed approaches in all across county County departments. government • Conduct policy reviews using equity tools and processes to assess existing policies and programs. Explore changes to existing County policies and practices, and create new ones, to support equity broadly and race equity specifically. • Become a member of the Government Alliance on Race and Equity (GARE), a national network that offers resources and strategies for government agencies working to change policies and practices to achieve racial equity. Dedicate high-level staffing and resources to lead cross -agency and cross -sector efforts on behalf of children and families. • Develop an ordinance to create a county task force or other official county committee, with governmental, family, and community representation to focus on child and family well-being results. • Request a proposal from the County Executive for an infrastructure model to embed a focus on children and families across county government. • Ensure new structures add capacity versus replacing existing resources. • Request biennial budget proposals to support actions contained in this Action Plan with focus on housing, child care, and behavioral health. • Include data, evaluation, and communication capacity within new resources. • Disaggregate data to more fully understand which populations are most likely to be negatively impacted by current conditions and inform the design of new resources with this knowledge. *Shaded items are tagged for immediate recommended action 19 Whatcom Working Towards Well-being An Action Plan for County Government Establish new structures and processes to elevate the well - Recommendation #1 being of all children and families as a county priority (cont....) Action Recommended steps Adopt a "children Develop and use policy and program review tools to ensure that local and families first" governmental services and programs consistently consider and approach for prioritize child and family needs. policy and funding Engage leadership and staff from all departments and programs including decisions health, human services, criminal justice, law enforcement, planning, public works, and parks and recreation to use appropriate review tools. Fully integrate parents, caregivers and child -serving providers into all committees, task forces and workgroups where policy strategies that impact young children and their families are considered. • Require county departments and committees to have strategies in place to gather input from parents, caregivers and community members around issues/policies impacting children and families, ensuring culturally responsive outreach to underrepresented community members. • Include stakeholders who are from underserved populations (e.g., indigenous community members, people of color, immigrants, people with disabilities, low-income), and provide compensation for their time and language translation/ interpretation as needed. Develop processes to ensure that county funding decisions prioritize maintaining and increasing funding for children and families, and protect existing programs and services from harmful cuts. • Request that departments and committees that develop budget or funding recommendations include child and family impact assessments in their processes. Pursue new Support and actively participate in a 2020 fiscal analysis to identify funding existing and potential new funding streams for child and family mechanisms to programs. significantly Learn from other communities that have successfully pursued innovative increase resources for approaches including new tax revenue, use of federal block grants, levies, well-being etc. (e.g., "Best Starts for Kids Levy" in King County). promotion and Generate new and sustainable revenue for evidence -based and crisis prevention innovative child and family programs and services based on recommendations from fiscal analysis. *Shaded items are tagged for immediate recommended action 20 Whatcom Working Towards Well-being An Action Plan for County Government Establish new structures and processes to elevate the well - Recommendation #1 being of all children and families as a county priority (cont....) Action Recommended steps Promote family- Institutionalize family -friendly employment policies and practices. friendly employment Identify opportunities to expand or adopt infant at work policy, policies and breastfeeding support, child care benefits, and flexible work scheduling practices within across all departments. the County and Promote family -friendly employment practices to other community serve as a model employers. employer Consider partnering with other governmental agencies such as the City of Bellingham and small cities on a coordinated effort. Leverage existing county resources and public -private Recommendation #2 partnerships to meet immediate family needs Action Recommended steps Support Allocate resources to scale up effective prevention and intervention community systems for family homelessness. initiatives to eliminate family Include crisis response, rental assistance, case management, linkage to homelessness financial and other supports and resources for families with young children and improve experiencing homelessness or unstable housing. family housing Work with partners to expand availability of affordable family housing stability options and accompanying services throughout the County. • Establish a Whatcom County Affordable Housing Investment Fund. • Improve zoning for modestly -priced housing. • Offer surplus and underutilized public land for affordable housing. 21 Whatcom Working Towards Well-being An Action Plan for County Government Leverage existing county resources and public -private Recommendation #2 partnerships to meet immediate family needs (cont....) Action Recommended steps Contribute to Join with businesses, community partners, and state government to community advocate for strategies to address urgent child care shortages. efforts to stabilize and Coordinate with Whatcom County Business and Commerce Committee expand access to and other efforts focused on this issue. child care and • Provide cities with technical assistance to improve policy and code early learning changes. opportunities Provide access to land, grants and/or loans to support the start- up/expansion of child care and early learning programs. • Leverage private sector funding with local and non -local public funding. Provide Support funding for a culturally and linguistically responsive health resources to navigation system for families seeking information and assistance with improve access health and social services. to family services and supports, Set aside county funds for system planning, building on effective including existing community models such as the Single Entry Access to behavioral health Services program. services Prioritize preservation and expansion of behavioral health funds to increase availability of child and family mental health programs and services integrated within child care, school, healthcare and other community settings. *Shaded items are tagged for immediate recommended action Proposed Next Steps for the County to Implement these Recommendations As we all work together to create a beloved community in which all children are safe, healthy, and ready to learn; families are strong, stable, and supported from the start; and communities are welcoming and supportive places for children and families to live, learn, work and play, there are specific steps that county government can take to make progress on the above recommendations. See page 5 for listing. 22 Whatcom Working Towards Well-being An Action Plan for County Government Appendix A: History Recent History of Efforts Addressing Child & Family Well -Being ❑ = Community Health Improvement (CHIP) ❑ = Health Board Resolutions ❑ = Generations Forward (GF) When Activities What happened 2010-11 First cycle of Community Health • Community Health Improvement Plan 2012-16 developed. Improvement — Joint project between Peace Health and Health Dept.: Did community • Decided to focus on Adverse Childhood visioning process, had a leadership council (all Experiences and drivers of ACES the foundation leaders, hospital, WCHD, OC, • Continue ongoing community activities re health City of Bellingham), did assessments, had care access, food access, etc. retreats • Unclear ownership and metrics 2013 "Compassionate Communities Resolution" called for compassionate, trauma -informed approaches to health and human services, recognizing impacts of childhood adversity on lifelong health and well- being. 2015 The "Healthy Planning Resolution" affirmed the County's commitment to incorporating a health perspective in all County planning processes and calls out consideration of children and families. Nov. The CHIP Leadership Council decided • Whatcom Community Foundation funded a 2016 Opportunity Council and WCHD would lead consultant to do an assessment of child & family the development of an "Even Start" initiative. needs (prenatal to age 5) "Even Start" was later renamed Generations • Initiated planning for a robust community Forward. engagement process to address two key priorities: equity and early childhood health and well-being. 2017 -18 In 2017 and again in 2018, the Health Board adopted an annual focus on early childhood. Oct. Opportunity Council and Health Dept. Launched the Generations Forward initiative, a 2017 organized the Future Search Conference multi -sector collaborative working to promote "Generations Forward: Envisioning a Future well-being of young children and their families and where all Whatcom County Children Thrive" — close opportunity gaps associated with race, 3 day retreat, 74 people ethnicity, income, and family adversity. Generations Forward (GF) began meeting Sustainable Financing group was led by Center for quarterly. Established action teams Philanthropy and focused on what is needed to put corresponding with GF Commitments: levy in place. Hired consultant to do fiscal analysis of where funding comes from and future funding. 1. Equity and honoring cultures Equity group was very active under leadership of 2. Community building Shirley Williams from Lummi Nation. Focused on 3. Family support and parent education historical trauma, reconciliation and healing. 4. Child care 5. Housing Groups have morphed and dwindled over time. 6. Economic mobility Hard to do self -organized action. Conclusion: Need 7. Integrated -coordinated care more coordination and infrastructure to support 8. Sustainable financing action. • Generations Forward Report 3/19 23 Whatcom Working Towards Well-being An Action Plan for County Government When Activities What happened 2018 Conduct Community Health Assessment • Community Health Assessment report identified determinants of health • Healthy Whatcom formed to work on Community Health Improvement process 2018 Health Dept. applied for Project HOPE grant • Hired Family Champion and Program Coordinator. and got it. That money funded Project NOW . Project NOW has a core team that is very focused on (Networks of Opportunity for Child Well- family stories and infrastructure that will move us being). toward equity (main focus of GF quarterly meetings) Transitioned Sustainable Funding Action • Proposed Resolution No. 2019-020 and included Team (Whatcom Center for Philanthropy) to Child & Family Action Plan in it. new GF Policy Advocacy & Funding Action Team. 2019 • The Health Board adopted Resolution No. 2019-020 "Affirming Commitment to Whatcom County's Young Children and their Families." Tasked the Public Health Advisory Board to collaborate with Generations Forward partners and Health Department staff to create this CFAP, building on the Generations Forward commitments and using a public health approach. • The Resolution also stated that the CFAP shall include an accountability process that outlines desired results and key indicators of success, an approach to ongoing monitoring and evaluation of progress, and transparent mechanisms for sharing progress with the community. • Additionally, the Resolution affirmed that the Health Board shall ensure that the needs of young children and families are included and prioritized in County plans and policies addressing: Housing, Behavioral Health, Incarceration Prevention, Economic Development, and Land Use. April Healthy Whatcom conducts Community • Selected housing, child care, and youth behavioral 2019 Health Improvement prioritization data health as top priorities. carousel to choose top CHIP priorities. • Fall 2019 — decided to focus on youth behavioral health needs first. They will develop an action plan, and also provide Results Based Accountability training to all partners. 2019 Two GF action teams, Coordinated Services • A NextGen action plan is in development. Strategies and Economic Stability, were approached by for making services more accessible will be aligned DSHS to participate in a state poverty with this CFAP's recommendations for developing a reduction initiative regarding how families culturally and linguistically responsive information access services. They are going through a and navigation system to facilitate access to child human-centered/user-centered design and family health and social services. process. The project is called NextGen. 24 Whatcom Working Towards Well-being An Action Plan for County Government Appendix B: Resolution PROPOSED BY: Health INTRODUCED: RESOLUTION NO. 21119-020 Resolution Affirming Commitment to Whatcom County's Young Children and their Families WHEREAS, mounting scientific evidence points to the first years of life as a critical time period for the healthy development of the brain and other body systems; and WHEREAS, the Center on the Developing Child -Harvard University, a national center of excellence focused on the science of child development, identifies three necessary ingredients for healthy development in the first years of life —stable nurturing relationships; sound nutrition; and safe, supportive environments; and WHEREAS, family adversity, such as financial hardship, homelessness, parental incarceration, substance use, or mental illness, can interfere with parent and caregiver ability to provide stable nurturing care, sound nutrition, and safe environments for young children; and WHEREAS, a toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity such as physical, sexual or emotional abuse; chronic neglect; caregiver substance abuse or mental illness; exposure to violence; and/or the accumulated burdens of family economic hardship —without adequate adult support; and WHEREAS, toxic stress and emotional trauma in the first years of life impact brain development and contribute to physical and behavioral health concerns, and future social and academic challenges; and WHEREAS, Indigenous children, children of color, children with disabilities, and children and families living in poverty are more likely to experience adversity due to historical and persistent patterns of discrimination, oppression and lack of equitable opportunities; and WHEREAS, disproportionate levels of adversity contribute to health and social disparities and inequities; and WHEREAS, investment in healthy development for young children is a promising cross- cutting strategy to promote lifelong physical and mental health, academic success, and future employment; to reduce criminal justice involvement and other social challenges; and to advance equity; and WHEREAS, return -on -investment for evidence -based programs focused on young children and families is as high as 9:1; and WHEREAS, families, community members, and organizational partners from many sectors working together in a coordinated and systematic way can create the environments and opportunities children and families need to thrive; and 25 Whatcom Working Towards Well-being An Action Plan for County Government WHEREAS, community leaders in Whatcom County have recognized the importance of and have come together as part of the Generations Forward initiative to envision a future where all Whatcom County children thrive; and WHEREAS, the Whatcom County Health Department and Opportunity Council co-sponsor the Generations Forward initiative; and WHEREAS, the Generations Forward initiative involves more than 100 families and stakeholders representing diverse sectors throughout Whatcom County; and WHEREAS, the Generations Forward initiative focuses on young children and families, emphasizing the prenatal and early childhood periods to age 8 years; and WHEREAS, while young children are the primary focus of Generations Forward, participants and community partners acknowledge that trauma and hardship can show up in a family at any stage and will consider that while proposing and creating solutions for young children and their families; and WHEREAS, Generations Forward is working to achieve the following results in Whatcom County: • Children are safe, healthy, and ready to learn, Families are strong, stable, and supported from the start, • Communities are supportive and welcoming places for children and families to live, learn, work and play; and WHEREAS, participants in the Generations Forward initiative have adopted a series of collective commitments focused on: • Equity: honoring all families and the diversity therein • Parenting Education and Family Support: expanding family support, mentoring, and education + Family Economic Stability: removing barriers to upward economic mobility Child Care and Early Learning: increasing access to quality, affordable child care and early learning opportunities • Housing: increasing access to safe, affordable family housing throughout the county • Health and Social Services: improving access to coordinated family -centered services and integrated health care, including behavioral health services and supports • Neighborhoods and Communities: building community connections and resilience • Funding: developing reliable financing for child and family programs and services; and WHEREAS, the Health Board adopted an annual focus on early childhood in 2017 and again in 2018; and WHEREAS, the Health Board adopted a Healthy Planning Resolution in 2015 that affirms the county's commitment to incorporating a health perspective in all county planning processes and calls out consideration of children and families; and WHEREAS, the Health Board adopted a Compassionate Communities Resolution in 2013 calling for compassionate, trauma -informed approaches to health and human services, recognizing the impacts of childhood adversity on lifelong health and well-being; 26 Whatcom Working Towards Well-being An Action Plan for County Government THEREFORE BE IT RESOLVED that the Health Board shall affirm the Generations Forward collective commitments and take steps to support policy and funding that align with these commitments; and THEREFORE BE IT FURTHER RESOLVED that the Health Board shall appoint one member to participate in the Generations Forward initiative to recommend policy options and explore development of a sustainable public financing mechanism for child and family programs and services; and THEREFORE BE IT FURTHER RESOLVED that the Health Board shall task the Public Health Advisory Board to collaborate with Generations Forward partners and Health Department staff to create a Whatcom County Child and Family Action Plan, building on Generations Forward commitments and using a public health approach; and THEREFORE BE IT FURTHER RESOLVED that the Child and Family Action Plan shall include an accountability process that outlines desired results and key indicators of success, an approach to ongoing monitoring and evaluation of progress, and transparent mechanisms for sharing progress with the community; and THEREFORE BE IT FURTHER RESOLVED that the Child and Family Action Plan shall be presented to the Health Board no later than January 31, 2020; and THEREFORE BE IT FURTHER RESOLVED that the Health Board shall ensure that the needs of young children and families are included and prioritized in county plans and policies addressing: Housing, Behavioral Health, Incarceration Prevention, Economic Development, and Land Use; and BE IT FINALLY RESOLVED that the Health Board will review this resolution on an annual basis. APPROVED�4t�hj , 21 d day of April ou t e y Darla Brown �is' Clerl,bf the Council APPROVED AS TO FORM: a ivil Deputy Prosecutor 19. WHAT COUNTY HEALTH BOARD WHA C M CO N , WASHINGTON Rud rowne, Health Board Chair 27 Whatcom Working Towards Well-being An Action Plan for County Government Appendix Q Planning Participants *Key to Organizations GF FC = Generations Forward (GF) Family Council GF PAF = GF Policy, Advocacy, & Funding Action Team GF HEC = GF Honoring Equity & Culture Team HW = Healthy Whatcom TA = Whatcom Taking Action Child Care = United Way Child Care Initiative Housing = Whatcom County. Housing Advisory Committee Name Organization* Committees/ Action Groups Attended 1 or more meetings about CFAP Participated Workrou 9 ps Reviewed draft plans Generations Forward Family Council Crystal Bevis GF FC Hilde Alden GF FC x Monica Burke The Arc of W.C. GF FC, TA x x x Michelle Burkhart GF FC Brian Dewey GF FC Monica Koller GF FC x x Susan Marks GF FC Julie Mauermann GF HEC x Keith Montoya GF FC x Barbara Roxas GF FC x Kevin Roxas GF FC Olivia Rutherford GF FC Michael Sidwell GF FC x Brittany Sullateskee GF FC Other Committees Debbie AN Mt. Baker Foundation GF PAF x x x April Barker Bellingham City Council GF PAF x x Kate Bartholomew City of Bellingham Sterling Chick Catholic Community Services PHAB, TA x x x Kyle Davidson Unity Care Northwest GF PAF x 28 Whatcom Working Towards Well-being An Action Plan for County Government Attended Participated Committees/ 1 or more Reviewed Action Groups meetings Work rou s 9 p draft plans Name Organization* about CFAP Whatcom County Health Kathryn DeFilippo Dept. TA x Derek Delvalle Unity Care Northwest HW x Western Washington Christine Espina University (WWU) W.C. Health Dept. - Housing & Homeless Chris D'Onofrio Services Program Housing x Chuckanut Health Heather Flaherty Foundation HW, GF PAF x x x Javier Flores Opportunity Council HW Carol Frazey Whatcom County Council GF PAF x x Katherine Freimund Whatcom Literacy Council HW x Ken Gass, MD TA, GF PAF x x Housing Authority Board of Stephen Gockley Commissioners HW Cathy Halka W.C. Health Dept. Daniel Hammill Bellingham City Council PHAB x x Child Care, Meredith Hayes GF PAF x x x Kulshan Community Land Housing, Galen Herz Trust PHAB x David Jefferson John Korsmo WWU HW Rose Lathrop Sustainable Connections GF PAF, Rachel Lucy PeaceHealth PHAB x x x City of Bellingham Housing Samya Lutz & Services Program Housing, HW x x Whatcom Transportation Janet Malley Authority Whatcom Community Sam Martinez Foundation HW 29 Whatcom Working Towards Well-being An Action Plan for County Government Name Organization* Committees/ Action Groups Attended 1 or more meetings about CFAP Participated Work rou s 9 p Reviewed draft plans April McMurry WWU HW x Jennifer Moon Unity Care Northwest TA x Melissa Morin W.C. Health Dept. x Astrid Newell, MD W.C. Health Dept. TA, GF PAF x x x Emily O'Connor Lydia Place Housing, GF PAF x x x Wilanne 011ila-Perry Opportunity Council Child Care x Mike Parker Opportunity Council Homeless Service Center Housing, PHAB x x Kim Perry Bellingham Technical College x Gretchen Pfleuger Bellingham Public Schools HW Brian Rick Bellingham Public Schools Amy Rydel W.C. Health Dept. HW x x x Jessica Sankey Bellingham Public Schools HW x x x Paul Schissler Housing x x Katie Stanford W.C. Health Dept. HW x Chi-Na Stoane, MD PHAB PHAB, GF PAF x x x Travis Tennessen WWU Michele Waltz Bellingham Technical College HW x x David Webster Opportunity Council GF PAF, Child Care x x Emily West W.C. Health Dept. Chris Wiebe W.C. Health Dept. Bellingham Schools GF PAF x x Allison Williams W.C. Health Dept. TA, GF PAF x x x Judy Ziels W.C. Health Dept. TA, GF PAF x x x 30 Whatcom Working Towards Well-being An Action Plan for County Government Appendix D: Generations Forward .0 R PI 31 Whatcom Working Towards Well-being An Action Plan for County Government Appendix E: Theory of Change Health Determinants Social/Physical Barriers: Homelessness/ Equity Issues: Health Issues: Housing Instability Racism � Illness Social Isolation Immigrant Status Disabilities Transportation'C Language Barriers Addiction 1 Economic Barriers: Poverty Unemployment Lack Education Lack Health Care/Insurance Current Priorities Accessible, culturally -responsive, trauma - informed health & social service info & resources, including behavioral health services for children & families Safe and stable housing Safe, accessible child care & early learning opportunities Child & Adult Education/Training Mental Health r� & Employment Implement recommended system -level and targeted actions • Establish new structures and processes to elevate the well-being of all children and families as a county priority (see action plan for targeted actions) • Leverage existing county resources and public -private partnerships to address immediate child and family needs (see action plan for targeted actions) Indicators t Child School Availability of Homelessness Cost - Availability of Affordable Families i burdened I 1 1 Maltreatment Readiness HousingRe Child Care Results • Children are safe, healthy & ready to learn • Families are strong, stable & supported from the start • Communities are welcoming & supportive places for children & families to live, learn, work, & play 32 Whatcom Working Towards Well-being An Action Plan for County Government Appendix F: Proposed Indicators Result 1: Children are safe, healthy and ready to learn Indicator 1.1: Child maltreatment Victims of child abuse and neglect, 2006-2017 Rate of accepted referrals per 1,000 persons aged 0-17 Source: Community Risk Profiles, Washington State Department of Social and Health Services 80 70 60 Washington —0—Whatcom County 50 —Bellingham 40 tBlaine tFerndale 30 t Lynden 20 Mount Baker Nooksack Valley 10 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 33 Whatcom Working Towards Well-being An Action Plan for County Government Indicator 1.2: School readiness Percent of children entering kindergarten ready for school, by various factors Whatcom County, 2017-2018 Source: Office of Superintendent of Public Instruction 100% 90% 80% 70% ■ ■ Whatcom avg = 46% - • • • WA avg = 47% (#) = total count of students in category 60% 54% 52% 50% 47% 44% a•. riti•iti•. •rr•AR'41%.1ti•riti• 40% 30% 23% 27% 19% 20% 10% 0% 51% 59% ■ 46% \b\ 1\ ` �\ •�� `b11\ `b°`s, `b` 1b\ y, 4b1\ b 1`Cb'\ q`�\ Q`Qe1 Qy`oo Off`` lQJ`� �``�e d`e A` `e r o�°de ��r` ` o` `e0 � �°tee �o Result 2: Families are strong, stable and supported from the start Indicator 2.1: Family Economic Security Families below the poverty level with children under 5 years Whatcom County vs Washington State Source: US Census Bureau, American Community Survey (Table DP03), 2014-2018 5-year estimate 6M 50ro 40% 3 Mro 2Dro All families Married couple families Famflfes with female householder, no husband present 34 Whatcom Working Towards Well-being An Action Plan for County Government Indicator 2.2: Family Homelessness Families with children experiencing homelessness Whatcom County, 2008-2019 Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports Whatcom County Annual Homeless Census Homeless Families with Children 2NO-2019 123 114 1a 00 94 92 89 3 72 70 68 Number of Homeless Families with children decreased 29%since 2008 2008 2009 2010 2021 2012 2013 2014 2015 2016 2017 2028 2019 Students who experienced a housing crisis during the school year Whatcom County Public School Districts, 2007-2018 Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports 1200 3.7% 3.6% 3.5/o ° 4.0% 0�31 3.2%3.3% 3.5% 1000 3.1 /o ° 3.0% 2.9 /o 2.6% 2.60 981 959 �966 3.0% 800 847 771 821 823 846 854 2.5% 600 699 705 2.0% 400 1.5% Number of students Percent of enrollment 1.0% 200 0.5% 0 0.0% O� oo ,ZO �N N`1' -3 �� ,�h NO ^O, �0 NN �� I 35 Whatcom Working Towards Well-being An Action Plan for County Government Result 3: Communities are welcoming and supportive places for children and families to live, learn, work and play Indicator 3.1: Housing Affordability Percentage of cost -burdened households paying 30% or more of monthly income toward housing Whatcom County, 2010-2017, 5-year estimates Source: Whatcom County Coalition to End Homelessness, Annual Point in Time Reports 100% +Renters --*--Owners 90% 80% 70% 57% 57% 57% 57% 60% Ah 50% 40% 44% 30% 20% 29% 27% 26% 10% 0% 2010-2014 2011-2015 2012-2016 2013-2017 Indicator 3.2: Child Care Availability Child care slots available to meet needs of working families Whatcom County 2019 Source: Child Care Supply, Demand, and Cost in Whatcom County, Updated Oct. 2019 Indicator Number of Children < 5 years 13,308 • Number of Children < 5 years whose parents work full-time 8,070 Number of Licensed Child Care Slots 3,608 • Slots that Accept State Child Care Subsidy 3,199 Number of Additional Slots Needed to Meet Demand 4,462 Indicator 3.3: Behavioral Health Service Availability Anecdotally, families and providers describe very limited availability of behavioral health services for children and youth. Quantitative data is not available currently and is needed. 36 Whatcom Working Towards Well-being An Action Plan for County Government RESOURCES Frameworks Strengthening Families: Increasing Positive Outcomes for Children and Families. Center for the Study of Social Policy. Working Toward Well-being: Community Approaches to Toxic Stress. Cailin O'Connor, Center for the Study of Social Policy. Early Learning Community Action Guide and Progress Rating Tool. Center for the Study of Social Policy, May 2018. Results -Based Accountability. Clear Impact. Reports 2018 Whatcom County Community Health Assessment. Whatcom County Health Dept., 2018. A Home for Everyone: Strategic Plan to End Homelessness in Whatcom County. Whatcom County Health Dept., 2019 Local Plan Update, Phase 5. Child Care Supply, Demand, and Cost in Whatcom County, Updated October 18, 2019. Child Care Aware and Opportunity Council, 2019. Generations Forward Progress Report. (March 2019). The Mounting Costs of Child Care: Impacts of child care affordability and access to Washington's employers and economy, Dept. of Commerce and collaborators, 2019. Whatcom Working Toward Well-being: Select indicators of child, family and community well-being in Whatcom County. Whatcom County Health Dept., Oct. 2017. 37 Whatcom Working Towards Well-being An Action Plan for County Government NOTES Whatcom County Health Dept. (Oct. 2017). Whatcom Working Toward Well-being: Select indicators of child, family and community well-being in Whatcom County. 2 The King Center, The King Philosophy. 3 Center for the Study of Social Policy & National League of Cities (2018). Early Learning Community Action Guide and Progress Rating Tool. 4 Whatcom County Health Dept. (2018). 2018 Whatcom County Community Health Assessment. 5 Dept. of Commerce and collaborators (2019). The Mounting Costs of Child Care: Impacts of child care affordability and access to Washington's employers and economy. 6 Center on the Developing Child, Harvard University (online). Key Concepts: Toxic Stress. 7 The United Ways of Washington (2018). ALICE in Whatcom County: 2016 Point -in -Time Data 8 Whatcom County Health Dept. (2019). A Home for Everyone: Strategic Plan to End Homelessness in Whatcom County, Local Plan Update, Phase 5. 9 Child Care Aware and Opportunity Council (2019). Child Care Supply, Demand, and Cost in Whatcom County, Updated Oct. 18, 2019. 10 Dept. of Commerce and collaborators (2019). The Mounting Costs of Child Care: Impacts of child care affordability and access to Washington's employers and economy. 11 Whatcom County Health Dept. (2018). 2018 Whatcom County Community Health Assessment. 12 Results Leadership Group, LLC (2010). Results Based Accountability Guide. 38 Whatcom Working on Well-being ChiLd and Famity Action Plan We all vcia a future Where: COMMUNITIES are welcoming & supportive places for children FAMILIES & families are strong, to live, stable, & learn, supported work, & from the play. I LDREN start. Safe, healthy, & ready to learn. Ir S� ve need to build a solid foundation of •*!v v 7' to support famiLi.es. A - L- !Ac I Stable housing Affordable childcare & preschool Behavioral health care for families L ,e need to build a solid foundation of to support families. Put children and families first in policy decisions Affordable childcare & preschool + Adopt trauma- BehaWioraL health' informed & equity care for families practices IN & F • 'e need to build _ olid foundation of to support families. 9MW"'q The W • a F�rwar�. 5t�w x. Adopt Child and Family Action Plan as a guiding document for county action Formally commit to the 4 Proposed Next Steps 1, Request Office of the County Executive assess infrastructure and budget needs required to realize commitment 2 Ordinance to create a county task force, or other official county committee 3. Support and actively participate in fiscal analysis in early 2020 to identify existing and potential funding streams 4. Fulfill prior commitments to resource and fund two critical efforts • All County services are trauma informed and culturally and linguistically appropriate • Health Navigation System 4 %4.96^, I JIM 1 1 You can I ad! Your action in adopting these recommendations Will support Kids and families today and the j,rations of tomorrow' 4 I 41� Supplements Letters received in support fir Child and Family Actin Plan (#BELLINGHAM PUBLIC SCHOOLS FOUNDATION imagine the. A0A&:6ili6e&.. . BOARD OF-RUSTEES January 21, 2020 Whatcom County Council Ashley Kimberle-, PresidenT Cc: Executive Satphal Sidhu Mered'ith Hayes Greetings, Vice f residenf The Bellingham Public Schools Foundation makes a collective commitment to Bellingham's children - we will empower every child to discover and develop a passion, contribute to their Sam Gearhart community, and achieve a fulfilling and productive life. Today we honor our commitment to Secretary Bellingham's children by using our voice to advocate for a renewed focus and tangible supports at our county level. Please accept this letter as a show of support for those who envision a future in Scott Wilson which all children are safe, healthy and ready to learn, and in which families are strong, stable, Treasurer supported and welcomed by our community as a place to live, learn, work and play. We ask that you accept the recommendations put forth in the child action plan and allocate resources to Jason Alexande, implement the changes. We look forward to actively partnering to make this vision a reality. Every day we see families in crisis. Students that show up hungry, families have been Julie Batten severed, and every day educators teach through these traumas. The Bellingham Public Schools Foundation strives to equalize opportunity and to support students and families in Tony Freeland crisis, helping every student to meet their unique potential. But none of that can solve the ongoing, systemic inequities that lead to the disparities Jeff Giesen children experience as they navigate towards graduation. A recent district -wide survey highlighted what we see in classrooms every day, that families need additional behavioral health supports for their children. That the supports aren't there to ensure they can live Chrislin Lunny up to their potential. We support the Child and Family Action Plan because Whatcom County needs a county - Jolene McEachran wide approach to child and family well being that includes clear strategies to address key concerns in our community and that gives all children access to those social, emotional and academic skills that are essential to success. Student success in the classroom must STAFF be a piece of a larger county -wide focus on health and wellness of children and families and we support a broad community effort to ensure: Kim Lund Executive Director 1) Availability of effective early learning within the context of full day childcare so that parents may work or pursue their education. Elixabelh Boyle Dever pmenf 2) Safe, stable and affordable housing is available for families and our workers; D;reefiar 3) Behavioral health services are available and affordable for children and their families. Kathy Dooley We support the efforts of the Health Board, the Health Department and the Executive Asslstanf Generations Forward Coalition in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, ('L Kim Lund I Executive Director I ype here] P.D. BOX 1132, BELLINGHAM, WA, 98227-1132 1 360-676-6479 1 BELLINGHAMSCHOOLSFOUNDATION.ORG /% 000 0Fmi ■ January 24, 2020 BELLINGHAM WHATCOM COUNTY HOUSING AUTHORITIES Office: 208 Unity Street — Lower Level • Bellingham Mailing Address: P.O. Box 9701 • Bellingham, \VA 98227-9701 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, The Bellingham and Whatcom County Housing Authorities fully support the Child and Family Action Plan that you will be considering at your February 4, 2020 meeting. The objectives of the Child and Family Action Plan are well aligned with our mission of offering opportunities for people to thrive by ensuring access to quality, affordable homes. We encourage you to adopt the Plan. In addition to access to quality, affordable health care, the health of our neighbors and community depends on a range of resources and services that must be available throughout our community in order to create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: safe and stable housing; safe, accessible childcare and early learning opportunities; and accessible behavioral health services for children and their families. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Since r ly, Brien Thane Executive Director/CEO Administrative Office: (360) 676-6887 • FAX (360) 676-7696 • TDD (360) 676-2140 Maintenance Office: (360) 676-6893 • FAX (360) /38-/311 BELLINGHAM REGIONAL CHAMBER OF COMMERCE January 23, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically endorse the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. As the Bellingham Regional Chamber of Commerce, our mission and 2020 policy agenda are strongly aligned with the objectives of the Child and Family Action Plan. We realize that the health of the people and communities we serve depends not only on access to quality, affordable health care but also on the resources and services available throughout our community that create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families As an organization, we have been working for years to build the conversation regarding affordable and availability housing, specifically workforce housing, and childcare that is also both affordable and available. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Guy Occhiogrosso President/CEO Bellingham Regional Chamber of Commerce 119 N Commercial Street, #110 - Bellingham, WA 98225 - 360 734.1330 office bellingham.com • INTERFAITH COALITION Partners in faith. Changing lives. January 13, 2020 Whatcom County Public Health Advisory Board 311 Grand Avenue, Suite 108 Bellingham, WA 98225 Dear Public Health Advisory Board Members, I am writing to whole-heartedly endorse the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. At Interfaith Coalition, our vision of a community of many faiths working together to eliminate homelessness and poverty in Whatcom County is aligned with the objectives of the Child and Family Action Plan. We have established resources that, along with our many remarkable community partners, can help achieve the desired results of ensuring children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work and play. Whatcom County's children and families will have the opportunity to thrive when they have access to the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our many dedicated community partners to help build the resilient community set forth in the Plan. Thank you for your work, time, and thoughtful consideration. Sincerely, arXU,L1--1 g� Laura Harker, Executive Director 910 14th Street, Bellingham, WA 98225.360-734-3983 • info@interfaith-coolition.org • www.interfaith-coalition.org Lydia PLACE January 18, 2020 every family deserves a home Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members and County Executive, PO Box 28487, Bellingham, WA 98228 Phone- 360.671.76631 Fax: 360.671.7038 TTY:711 or 800.833.6384 www.lydiaplace.org Oh behalf of Lydia Place, I am writing to enthusiastically support the Child and Family Action Plan and its recommendations. Lydia Place has been serving families with children in Whatcom County for 30 years. Our mission is to disrupt the cycle of homelessness for current and future generations. We recognize that in order to address the systemic issues of poverty, we must take bold action as a community and put the health and wellbeing of children at the front and center of our work. We feel the recommendations of the Child and Family Action Plan are a great first step in doing just that. The data tells us that our children here in Whatcom County are not getting their basic needs met. Only 50% enter school ready to learn, we have 4 childcare spots for every 10 children, rates of child abuse and neglect are higher than the state average, and the mental health of our teens is steadily declining. Roughly half of those who live here cannot afford to do so and homeless continues to rise. These are just a few of the indicators that tell us we are headed in the wrong direction. At Lydia Place, we recognize that the health of a community begins with the health of the children who call it home. They are the workforce, business owners, teachers, volunteers, and neighbors of tomorrow. The future health of Whatcom County depends on the availability of critical services and basic needs. As such, Lydia Place strongly supports the Plan's focus on: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Emily O'Connor Executive Director Ryan Thramer Board President Community Action A Community Action Agency erving Whaicom, Island and San Juan Counties since 1965 Whatcom County 1111 Cornwall Ave., Suite C Bellingham, WA 98225 (360)734-5121 (800) 649-5121 Fax (360) 671-0541 Island County 7791 HE 1st Ave. P.O. Box 922 Oak Harbor, WA 98277 (360)679-6577 (800)317-5427 Fax (MC) 679-2440 San Juan County (800) 649-5121 opportunity council AO January 17, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to extend Opportunity Council's support forthe goals outlined in the Child and Family Action Plan that you will be considering for adoption at your February 4, 2020 meeting. We share the Plan's vision of a community where all children are safe, healthy, and ready to learn; families are strong, stable, and supported; and communities are welcoming and supportive places for children aInd families to live, learn, work, and play. Opportunity Council's mission aligns with the objectives of the Plan, and we look forward to continuing to contribute to the action areas prioritized in the Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families Additionally, we support the Plan's commitment to invest new resources to identify gaps and innovative prevention strategies and bring to scale the current work being done across sectors providing services for families and children. We look forward to the opportunity to support this work through collaboration with you and our community. Thank you for your work and consideration. Sincerely, {j Greg Winter Executive Director www.oppco.arg January 20, 2020 Whatcom County Council acting as Health Board Cc: County Executive Satpal Sidhu Dear Health Board, Few things are as important as building family resilience and investing in early childhood development. As pediatricians, we see the ramifications when this doesn't happen, and we see the difference it makes in healthy child and youth development when these supports exist in community. We share in the vision for a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We applaud your commitment to placing child and family well-being as a top priority county concern and urge you to carefully consider the recommendations put forward in the Whatcom Working on Well - Being: Child and Family Action Plan. We support a broad community effort to ensure that Whatcom County children and families can thrive with the services and resources prioritized for action in the Child and Family Action Plan, including: • Safe and stable housing • Safe and accessible child care and early learning opportunities ■ Accessible behavioral health services for children and their families We support the efforts of the Health Board, the Health Department and Generations Forward in their creation of the Child and Family Action plan and its adoption by our local governments. We look forward to the opportunity to support this work and collaborate with you and other community partners to bring this vision to reality. Sinc rely, ' ✓Vv� Dr. Lessli Putney Clinical Section Lead — P ctiatr cs & Children's Therapy On behalf of PeaceHealth Pediatrics Clinic PeaceHealth Medical Group Pediatrics 4545 Cordata Parkway Bellingham, WA 98225 MEDICAL CLINICS Aberdeen Battle Ground Bellevue Bellingham Burien Concrete Des Moines El ma Everett Everson Federal Way Kent Lacey Lakewood Marysville Monroe Mt.Vernon Ocean Shores Olympia Puyallup Seattle Tacoma Vancouver Yelm DENTAL CLINICS Aberdeen Bellevue Bellingham Burien Des Moines Federal Way Everett Lacey Marysvillc Mt.Vernon Monroe Oak Harbor Ocean Shores Olympia Port Angeles Puyallup Seattle Tacoma Vancouver Yelm INPATIENT BEHAVIORAL HEALTH Bellingham Seattle Tacoma OUTPATIENT BEHAVIORAL HEALTH Aberdeen Anacortes Battle Ground Bellevue Bellingham Des Moines Everett Federal Way Gig Harbor Ke sa Kent Lynnwood Monroe Mt.Vernon Oak Harbor Puyallup Seattle Tacoma Tumwater Vancouver Yelm PHARMACY Bellevue Concrete Des Moines Federal Way Everett Mt.Vernon Ocean Shores Olympia Seattle Tacoma Vancouver OTHER Administration Cannon House Care Management Child Dev. Center Comm. Care Center Community Services Educational Services Home Care Home Health Homeless Services Housing KDNA & KKMO Radio Managed Care MSS & WIC Sea Mar Community Health Centers ��• Clinica de la Comunidad Exceptional service. Every person. Every time ADMINISTRATION 1 1040 S. HENDERSON ST. I SEATTLE,WA 198108 1206.763.5277 January 16, 2020 Whatcom County Board of Health 311 Grand Ave, Suite 105 Bellingham, WA 98225 Proudly serving the community since 1978 RE: CHILD AND FAMILY ACTION PLAN Dear Board of Health Members, I am writing to express Sea Mar Community Health Center's endorsement of the Child and Family Action Plan that is being considered for adoption at the February 4, 2020 meeting. Sea Mar, founded in 1978, is a community -based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington state. We realize that the health of the people and communities we serve depend not only on access to quality, affordable health care but also on the resources and services available throughout our community that create the conditions for health. We serve the vision of a community where all children are safe, healthy and ready to learn, families are strong, stable and supported from the start, and communities are welcoming and supportive for children and families to live, learn, work and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: Safe and stable housing Safe, accessible child care and early learning opportunities Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Sincerely, Mary Bart Deputy Di - for Promotores/as Program www.seamar.org LIVE UNITED United Way of Whatcom County 1500 Cornwall Ave Ste 203 Bellingham WA 98225-4522 tel 360.733.8670 fax 360.733.8674 un itedwaywhatcom.org January 23, 2020 Whatcom County Council Cc: Executive Satphal Sidhu Greetings, United Way of Whatcom County fights for the financial stability of every person in our community. No matter the obstacles. No matter the odds. We surround Whatcom County's most critical problems. And we fight. According to the latest ALICE Report, 35% of households with children do not have the financial resources to meet their basic needs. We are using our voices to advocate that our county government increase efforts to make our community more resilient and our families more financially stable. Since 2017, the United Way of Whatcom County has been uniting partners behind a single -issue focus to combine resources to make a more significant impact on financial stability. Based on the evidence identifying the lack of child care as a significant barrier, we launched a child care initiative that has brought together local leaders within the youth serving community to forge a pathway towards a more sustainable child care landscape in which all children have easy access to affordable, high -quality child care and early learning options. More than 30 individuals from around 20 businesses and organizations have collaborated to draft a childcare action plan that aligns with state efforts to incentivize employer -supported childcare and improve childcare access and affordability for employees. In recent months, urgent needs have arisen to address a potential loss of 500+ childcare slots in our county. While these needs are now urgent, they are not new, nor are they specific to circumstances related to Kids World. We know that the childcare industry across the state is not stable, that the childcare business is precarious and leaves families and individuals in a vulnerable position. In fact, the current system at times disincentivizes parents and caregivers to access education or join the workforce, furthering disparities in opportunities. It will take a collaborative and proactive approach to addressing this significant community need. Many other communities have modeled this for us. It is our turn to transform this into a reality. Representatives from the childcare initiative have worked alongside county leaders to inform and develop a child action plan, presented herein. We ask that you adopt these changes and allocate resources to work alongside community leaders actively pursuing a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We support the efforts of the Health Board, the Health Department and the Generations Forward Coalition in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, /e'o r Theisen President/CEO �unity care NW f,'euPtk CGt��ar' �ic�ne January 6, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically endorse the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. As a community health center, our mission is strongly aligned with the objectives of the Child and Family Action Plan. Prevention and early intervention are at the core of our work. We realize that the health of the people and communities we serve depends not only on access to quality, affordable health care but also on the resources and services available throughout our community that create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County�s children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, I Desmond Skubi Chief Executive Officer 1616 Cornwall Avenue, Bellingham, WA 98225 360.676.6177 • 877.235.6850 • Unit}jCareNW.org MEDICAL • DENTAL • PHARMACY • BEHAVIORAL HEALTH Whatcom County Coalition to End Homelssness January 22nd, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members and County Executive, As the Chair of the Whatcom County Coalition to End Homelessness, I am writing to express the Coalition Steering Committee's support of the Child and Family Action Plan. The Coalition is dedication to combatting homelessness in Whatcom County through action and advocacy. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, (earn, work, and play. As a Steering Committee, we are particularly supportive of the Plans emphasis on targeted action to increase housing access and reduce homelessness. As a homeless response system, we continue to see an increasing need for rental subsidy, case management, affordable housing units, childcare, and behavioral health supports. We welcome a focus on identifying new sources of revenue to address the gaps in services. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, I/" �� Mike Parker, Coalition Chair a � • Family � Community building community together so youth and families thrive January 23, 2020 Whatcom County Council Cc: Executive Satpal Sidhu Dear Executive Satpal and County Council: Whatcom Family and Community Network recognizes the importance of our communities joining together to raise family and child hope and resilience across all stages, but especially during the years of early childhood development. The earlier we act, the more prevention happens. We envision a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We imagine Whatcom youth and families thriving despite facing adversity —social, environmental or otherwise. We support a broad community effort to ensure: 1) Availability of effective early learning within the context of full day childcare so that parents may work or pursue their education. 2) Safe, stable and affordable housing is available for families and our workers; 3) Behavioral health and prevention services are available and affordable for children and their families. We support our local governments to integrate consideration for children and families in strategic planning, and to have all relevant departments view initiatives and decisions through a lens of the same, while supporting neighborhoods in building community connections and resilience. We support the efforts of the Whatcom County Health Board, the Health Department and Generations Forward in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, Shane Steger, President On behalf of Whatcom Family & Community Network Kristi Slette, Executive Director 1231 N. Garden St., Ste. 210, Bellingham, WA 98225 1360.738.1196 1 wwwfcn.org January 9, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members and County Executive, On behalf of the Whatcom County Housing Advisory Committee (WCHAC), I am writing to express our Committee's support of the Child and Family Action Plan. The WCHAC is committed to advancing County strategies that address the shortage of affordable homes in our community and to identifying priorities for County action that reduce homelessness. We share the vision of a community where all children are safe, healthy, and ready to learn, where families are strong, stable, and supported from the start, and where communities are welcoming and supportive places for children and families to live, learn, work, and play. We would like to emphasize the following: - WCHAC recognizes that safe, stable, affordable homes are critical to the health and wellbeing of children and families, and we strongly support the Plan's recommendations for expanded support for vulnerable families with children and those of us experiencing homelessness. - WCHAC recognizes that the Plan embraces a shift in strategy from crisis response to add more efforts around prevention, and from a public health perspective, we strongly support this approach. - WCHAC recognizes that Whatcom County's children and families cannot thrive without the services and resources described in the Child and Family Action Plan, and we support the Plan's prioritization of safe and stable housing, accessible child care and early learning opportunities, and accessible behavioral health services for children and their families. - WCHAC supports the identification of new revenue sources to expand services to address child and family wellbeing and to expand the supply of homes people can afford. - WCHAC wants to emphasize that reducing or eliminating existing programs and funding would be counterproductive and not supported by the WCHAC. - WCHAC stands ready to advise and support the implementation of the Plan as it pertains to safe, stable, affordable homes, and we ask that you utilize the WCHAC as a resource in the next phase of Plan implementation. We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the Plan's vision a reality. Thank you for your work and consideration. Sincerel Brien Thane, Chair WHATCOM HOUSING ALLIANCE January 8, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. At Whatcom Housing Alliance, we realize that the health of the people and communities we live and work in depends on the resources and services available throughout our community that create the conditions for health. For the Whatcom Housing Alliance, this begins with safe, stable housing that is affordable to all and available in all neighborhoods. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Whatcom Housing Alliance January 8, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to express support for the Child and Family Action Plan you will be considering for adoption at your February 4, 2020 meeting. At Whatcom Women in Business, we realize that the health of the people and communities we live and work in depends on the resources and services available throughout our community that create the conditions for health. We share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families We look forward to the opportunity to support this work and to collaborate with you and our community partners to make the vision set forth in the Plan a reality. Thank you for your work and consideration. Sincerely, Shu-Ling Hergenhahn Zhao President, WWIB ff i fll UNDER Ali . oo j-th I )w r(l Satpal Singh Sidhu, County Executive 311 Grand Avenue. Suite 108 Bellingham, WA 98225 January 30, 2020 Greetings Mr. Sidhu, The Downtown Bellingham Partnership recognizes the importance of our communities in joining together to focus on family resilience and early childhood development. We envision a future in which all children are safe, healthy and ready to learn, and in which families are strong, stable, supported and welcomed by our community as a place to live, learn, work and play. We support a broad community effort to ensure: 1) Availability of effective early learning within the context of full day childcare so that parents may work or pursue their education. 2) Safe, stable and affordable housing is available for families and our workers; 3) Behavioral health services are available and affordable for children and their families. We ask our local governments to integrate consideration for children and families in strategic planning, and to have all relevant departments view initiatives and decisions through a lens of the same, while supporting neighborhoods in building community connections and resilience. We support the efforts of the Whatcom Health Board, the Whatcom Health Department and the Generations Forward Coalition in their creation of the Child and Family Action plan, and its adoption by our local governments. Sincerely, Alice Clark Executive Director On behalf of the Downtown Bellingham Partnership DOWNTOWN BELLINGHAM PARTNERSHIP 114 W. Magnolia Street, Suite 503, Bellingham, WA 98225 1 360.527.8710 1 downtownbellingham.com CMB Consulting Thinking Partners I Business Advisors ( Leadership Mentors January 8, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan. As a local business owner and experienced senior leader, I see every day the impact of the housing and childcare shortages here in Whatcom County. As the cost of living here continues to rise, I see the impact on local businesses and on members of our community. At CMB Consulting, we share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families I support the Child and Family Action Plan and I applaud the work of the Health Board in taking necessary steps to ensure the health and vitality of Whatcom County for generations to come. Sincerely. Constance Bentley Founder and President CMB Consulting LLC. cmbconsultina@conniebentley.corn Thinking Partners I Mentors I Business Advisors 360.355.91 16 IR�vr9 tope ad Self E.�tnm inYacy Fkattrs ad Miodv January 29, 2020 Whatcom County Board of Health, 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan. As an organizational Executive Director, I see every day the impact of the housing and childcare shortages here in Whatcom County. As the cost of living here continues to rise, I see the impact on local businesses and on members of our community. At Blue Skies for Children, we share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: Safe and stable housing Safe, accessible child care and early learning opportunities Accessible behavioral health services for children and their families I support the Child and Family Action Plan and I applaud the work of the Health Board in taking necessary steps to ensure the health and vitality of Whatcom County for generations to come. With Gratitude, Executive Director '''��'"' Home Attendant Care Home Attendant Nursing January 29, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan. As a business owner and manager, I see every day the impact of the housing and childcare shortages here in Whatcom County. As the cost of living here continues to rise, I see the impact on local businesses, our employees and others in our community. At Home Attendant Care and Nursing, we share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families I support the Child and Family Action Plan and I applaud the work of the Health Board in taking necessary steps to ensure the health and vitality of Whatcom County for generations to come. Thank you, Director February 3, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan. As a business owner and manager, I see every day the impact of the housing and childcare shortages here in Whatcom County. As the cost of living here continues to rise, I see the impact on local businesses and on members of our community. At Pozie by Natalie, I have a vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: Safe and stable housing Safe, accessible child care and early learning opportunities Accessible behavioral health services for children and their families I support the Child and Family Action Plan and I applaud the work of the Health Board in taking necessary steps to ensure the health and vitality of Whatcom County for generations to come. Thank you, Natalie Ransom, Owner, Pozie by Natalie W i�� .L,Vht`nirg` Tree Des#ns January 28, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, I am writing to enthusiastically support the Child and Family Action Plan. As a business owner and manager, I see every day the impact of the housing and childcare shortages here in Whatcom County. As the cost of living here continues to rise, I see the impact on local businesses and on members of our community. At Lightning Tree Designs, we share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families I support the Child and Family Action Plan and I applaud the work of the Health Board in taking necessary steps to ensure the health and vitality of Whatcom County for generations to come. Thank you, Suzannah Gusukuma Christine Coder Interior Design 310 Palm Street unit 1 Bellingham Wa 98225 36o-927 4662 January 8, 2020 Whatcom County Board of Health 311 Grand Avenue, Suite 105 Bellingham, WA 98225 Dear Board of Health Members, am writing to enthusiastically support the Child and Family Action Plan. As a business owner and manager, I see every day the impact of the housing and childcare shortages here in Whatcom County. As the cost of living here continues to rise, I see the impact on local businesses and on members of our community. At Christine Coder Interior Design, we share the vision of a community where all children are safe, healthy, and ready to learn, families are strong, stable, and supported from the start, and communities are welcoming and supportive places for children and families to live, learn, work, and play. Whatcom County's children and families cannot thrive without the services and resources prioritized in the Child and Family Action Plan: • Safe and stable housing • Safe, accessible child care and early learning opportunities • Accessible behavioral health services for children and their families I support the Child and Family Action Plan and I applaud the work of the Health Board in taking necessary steps to ensure the health and vitality of Whatcom County for generations to come. Thank you, Christine Coder