HomeMy WebLinkAboutPacket Health Board Jul 30 2019Whatcom County
Council as the Health Board
COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
Meeting Agenda
Tuesday, July 30, 2019
10 AM
Council Chambers
SEE "MEETING DETAILS" FOR AUDIO
COUNCILMEMBERS
Barbara Brenner
Rud Browne
Barry Buchanan
Tyler Byrd
Todd Donovan
Carol Frazey
Satpal Sidhu
CLERK OF THE COUNCIL
Dana Brown -Davis, C.M.C.
Council as the Health Board Meeting Agenda July 30, 2019
Call To Order
Roll Call
Public Session
Director/Health Officer Report
Air Quality and Wildfire Smoke Planning
Public Health Advisory Board (PHAB) Update
Health Board/PHAB 2019 Joint Session Follow-up
Adjournment
Whatcom County Page 2 Printed on 113012024
09415 Food sources --Donated foods.
The PERSON IN CHARGE of a DONATED FOOD DISTRIBUTING ORGANIZATION
may receive FOODS for
charitable purposes that include:
(1) Surplus foods from a FOOD ESTABLISHMENT;
(2) Muscle MEAT of a wild GAME ANIMAL:
(a) Received from a LAW enforcement officer certified by a jurisdiction in the state
of
Washington or from a hunter licensed by the Washington State Department of Fish
and Wildlife;
(b) Processed by an APPROVED MEAT cutter; and
(c) Labeled "Uninspected wild game meat, thoroughly cook to 165°F (74°C)
internal temperature";
(3) Muscle MEAT of a domesticated livestock animal, POULTRY, .or rabbit;
(a) Donated live to the distributing organization;
(b) Raised by a member of an APPROVED youth club, such as 4H;
(c) Processed by an APPROVED MEAT cutter; and
(d) Labeled "Uninspected wild game meat, thoroughly cook to 165°F (74°C)
internal temperature";
(4) FOODS properly handled, stored, or prepared in a DONOR KITCHEN;
(5) FOOD handled, stored, or prepared in a residential kitchen in a private home and
is not
POTENTIALLY HAZARDOUS FOOD or READY -TO -EAT FOOD.
(6) Baked goods that are not POTENTIALLY HAZARDOUS FOOD handled, stored,
or prepared in
a residential kitchen in a private home;
(7) READY -TO -EAT FOODS that are not POTENTIALLY HAZARDOUS FOOD in an
intact commercial
package stored in a residential kitchen in a private home; and cx
(8) Commercially PACKAGED frozen FOOD.
FILE UNDEA AS he -,
DATE RECEIVED: O `t
SUBMITTED BY: 1�,rr� utrt
COUNCIL MEETING
0. COMMITTEE
EXHIBIT:
WHATCOM COUNTY COUNCIL
SPECIAL COUNCIL MEETING
AS THE
HEALTH BOARD
10:00 a.m. Tuesday, July 30, 2019
Council Chambers, 311 Grand Avenue
AGENDA
Meetin_p Topics
1. Public Session
2. Director/Health Officer Report
3. Air Quality and Wildfire Smoke Planning
4. Public Health Advisory Board (PHAB) Update
5. Health Board/PHAB 2019 Joint Session Follow-up
Whatcom County
HEALTH
fjh Department
Pages Time
no ppr 10:00-10:10
no ppr 10:10-10:25
1-5 10:25-11:05
6 11:05-11:20
7-15 11:20-11:40
HEALTH BOARD
Discussion Form
July 30, 2019
AGENDA ITEM #1: Air Quality and Wildfire Smoke Planning
PRESENTER: Mark Buford, Northwest Clean Air Agency
John Wolpers, Health Department
BOARD ACTION: Action Item Discussion OFYI - Only
SIGNIFICANT POINTS OR EXECUTIVE SUMMARY
As warmer weather and dry conditions approach, the potential for unhealthy air quality from wildfire smoke
increases. Northwest Clean Air Agency (NWCAA) will provide background information about air quality in
Whatcom County, potential impacts to air quality from wildfire smoke and efforts in east Whatcom County
to reduce air quality impact from wood burning stove emissions. Health Department staff will present
information about the health impacts of wildfire smoke and planning efforts to prepare for wildfire smoke
impacts.
In August of 2018, there was significant and unprecedented air quality impact in Whatcom County and
other western Washington counties from wildfire smoke originating in British Columbia and eastern
Washington. Public Health did not have coordinated messaging and plans in place to address health
impacts. In order to better address health impacts during the 2019 fire season the state convened a
statewide taskforce. The taskforce was charged with developing a uniform and consistent approach to
addressing the health impacts of wildfire smoke. The taskforce developed recommendations and reference
materials which we are using for preparedness messaging and for response planning. Staff will provide
information about our local preparedness outreach efforts to date and public health recommendations for
limiting exposure should air quality reach hazardous levels.
BOARD ROLE/ACTION REQUESTED
Information provided about preparedness and response planning efforts.
ATTACHMENT(S)
Wildfire Smoke Information
Whatcom County
ll HEALTH
Department
07/30/19 Health Board Agenda Packet Page 1
Stay informed about air quality
Check the air quality hazard level
Limit exposure
Avoid strenuous outdoor activity
Limit time outdoors
Stay indoors
Keep indoor air clean
Keep windows and doors closed
Don't contribute to poor air quality
Set AC on recirculate
Use an air cleaner with a HEPA filter
Pay attention to symptoms
Seek medical help if needed
•
�n
O-
o-
07/30/19 Health Board Agenda Packet Page 2
Target Audiences
General Public
Healthcare Providers
Facility Managers for outdoor camps and athletic activities
School K-12 Principles, superintendents & administrative staff
School nurses & school health team
Child care providers
Long-term Care and Assisted Living Facilities
Planners of Public Events
Adult Outdoor Activity Guide
Air Quality Conditions
Check your local air conditions at https://fortress.wa.gov/ecy/enviwa/
Air pollution is low,
so there is little
health risk. It's a
great day for
everyone to be
outdoors.
People with health
conditions should
limit spending any
time outdoors and
avoid vigorous
outdoor activities.
They may begin to
have worsened
symptoms.
Sensitive Groups Include
All sensitive groups
should limit spending
any time outdoors.
People with health
conditions may have
worsened symptoms.
Healthy people may
start to have
symptoms.
• People with health conditions such as:
- Asthma
- COPD
- Diabetes
- Other heart/lung diseases, respiratory illness and colds
- Stroke survivors
• Children under age 18 and adults over age 65.
• Pregnant women.
People who smoke.
Everyone, especially
sensitive groups,
should limit time
spent outdoors,
avoid vigorous
activities outdoors,
and choose light
indoor activities.
Activity Levels
Everyone should
stay indoors, avoid
all vigorous activity,
close windows and
doors if it's not too
hot, set your AC to
recirculate, and use
a HEPA air filter if
possible.
People with heart or
lung disease, or
those who have had
a stroke, should
consult their
healthcare provider
about leaving the
area and wearing a
properly -fitted
respiratory mask if
they must go
outdoors.
Follow burn bans
and evacuation
orders.
Light Activities are things that do not increase your heart rate. This may
include things like playing catch, taking in scenery at a park, leisurely walking, or
light gardening/yard work.
Moderate Activities are things that do increase your heart rate, these activities
may cause you to sweat. When doing these activities you can talk but not sing.
This might include things like walking fast, sprinting, playing Frisbee, or intense
yard work.
Vigorous Activities are things that increase heart rate and cause you to sweat.
During these activities, your breathing is so fast that you have difficulty talking.
This may include activities like running, jogging, playing sports like basketball,
football or soccer, swimming laps, jumping rope, and hiking.
07/30/19 Health Board Agenda Packet Page 4
Groups sensitive to smoke from fires
People with Pre -Existing Diseases
Especially lung and heart diseases
People with respiratory infections
Children & Infants
People 65 years and older
Pregnant women & fetus
Growing evidence for other sensitive groups
Photo credits: CDC/Dawn Arlotta 2009, www.pixabay.com
07/30/19 Health Board Agenda Packet Page 5
Whatcom County Health Board Resolution 2018-050
Health Protection for Immigrant Families
SUMMARY OF OBJECTIVES:
• Ensure that the health and social service needs of citizens and immigrants of all statuses are met.
• Increase awareness and promote the integration of a "compassionate" or "trauma sensitive"
approach to services.
• Evaluate existing systems and support services for families impacted by the threat of deportation,
and identify cultural, safety and language barriers preventing access.
•November, 2018 - In response to community concerns, PHAB (Public Health Advisory
Board) proposes a resolution to the Whatcom County Health Board for the health
protection of immigrant families.
•December, 2018 - Whatcom County Health Board Passes Resolution 2018-050
•March/April 2019 A subcommittee of PHAB begins identifying agencies and
organizations that provide health and social service supports to immigrant families, and
invites representatives from those organizations, and people who have been affected by
the threat of deportation, to a facilitated Information Gathering Session
•May/June 2019 - Information Gathering Sessions to identify needs and gaps
•July/August 2019 - Convene Task Force to review input from Information Gathering
Sessions, and prepare a recommendation to PHAB
•September 2019 - PHAB reviews recommendation from Task Force, evaluates, presents
findings and recommendation to Health Board in October, 2019
Note: On May 21s', 2019, after our first Information Gathering Session, Governor Jay Inslee signed into
Washington State Law ENGROSSED SECOND SUBSTITUTE SENATE BILL 5497. ("Sanctuary State Law")
6.13.19 —prepared by Crossroads Consulting — holly@ crossroads. pro
07/30/19 Health Board Agenda Packet Page 6
HEALTH BOARD
Discussion Form
July 30, 2019
AGENDA ITEM #5: Health Board/PHAB 2019 Joint Session Follow-up
PRESENTER:
BOARD ACTION:
Regina Delahunt
Action Item 0 Discussion FYI - Only
SIGNIFICANT POINTS OR EXECUTIVE SUMMARY
The Whatcom County Health Board, the Public Health Advisory Board (PHAB) and the Health Department
met for their 2nd annual Joint Meeting on June 11, 2019. A summary of the meeting is attached. The
meeting outcomes included:
• Ensuring that we have a solid, foundational understanding of policy
• Expanding our understanding of how policy can work, and how we could do more
• Continuing to build alignment between the PHAB and the Health Board in advancing our 2019
Health Priorities.
The policy discussion led to a list of considerations for PHAB to explore when developing and
recommending policy to the Health Board. PHAB reviewed the list at the July 16t" meeting and drafted a
Policy Toolkit (attached) to guide future policy discussions. This is an opportunity to translate discussion
into action and deepen our understanding of policy development and alignment the goals of the Health
Board and the PHAB.
BOARD ROLE/ACTION REQUESTED
• Discuss summary report from June 11th Joint Meeting
• Discuss and provide input on PHAB Policy Toolkit.
ATTACHMENT(S)
• June 11, 2019 Joint Meeting Report
• PHAB Health Policy Toolkit
Whatcom County
HEALTH
Department
07/30/19 Health Board Agenda Packet Page 7
Jrint Sessirn !4f the Whatc?m C?unty Health Bcard and PHAB
June 11, 2019
Summary Repart
Purpose:
• Ensure that we have a solid, foundational understanding of policy
• Expand our understanding of how policy can work, and how we could do more
• Continue to build alignment between the PHAB and the Health Board in advancing our 2019 Health Priorities.
Present:
Health Board Members:
Barry Buchanan (also on PHAB), Barbara Brenner, Carol Frazey,
Satpal Sidhu, Todd Donovan, Tyler Byrd
PHAB Members:
Sterling Chick, Lindsey Karas, Rachel Lucy, Chi-Na Stoane
Health Department Managers/Admin:
Regina Delahunt, Kathleen Roy, Anne Deacon, Greg Stern, Astrid
Newell, John Wolpers, Cindy Hollinsworth, Tammy Axlund
Facilitator:
Holly O'Neil, Crossroads Consulting
Panelists:
Andrea Northey, Emily O'Connor, Chris Wiebe
Guests:
Kelly Molaski, Aly Robinson, Taylor Lewis, Ali Jensen, Ann Beck,
Jennifer Johnson, and Kristen Ekstran (Skagit Public Health Dept.),
Cindy Coltee
Agenda:
1. Welcome and Introductions
2. Year in Review
3. 2019 Health Policy Agenda Priorities
4. Panel: Stories from the Community
5. Policy: Why it matters, and how we can do more
6. Policy Road Map for the year ahead
7. Closing and Public Comment
1
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 8
1. Welcome and Introductions
Council Member Barry Buchanan convened the joint session of the Health Board and PHAB at 9:00 am and opened
the floor for introductions. Each participant responded, shared a little about their professional background, and were
asked to share a health issue they are feeling passionate about today:
■ How public health and policy can merge to really do great things
■ Homelessness
■ Services for elders
■ Birth to three, and disparity in readiness for school for young children
■ Health equity and accessibility
■ Mental health — reducing stigma and increasing access to services
■ East Whatcom food access; no funding for staffing new food bank
■ Climate change — impact on future generations
■ Stigma around behavioral health, lack of adequate funding for those services
■ Prevention, prevention, prevention — as far upstream as we can
■ Countering mis-information
■ Housing for people we are trying to divert from jail (and importance to mental health). Dental health
■ Need for universal health care, need to be thinking long-term about health issues
■ Climate change impacts on environmental health, as well as wildfire smoke, vectors, algae blooms, etc.
■ Opioid epidemic, education about syringe exchange, and workforce education to alleviate poverty
■ Health equity, and the need for systems for people to get the resources they need
■ Children and families — and systems of support for families getting off to the best start
■ Data, being able to measure the impact, and listening to community to inform our work
Regina Delahunt, Director of the Whatcom County Health Department, welcomed everyone and thanked them for
sharing their thoughts about health priorities. Regina offered this quote to inspire the work of today:
"The well-being of our children is a barometer for the future. In one short generation, they
will be the parents, workers, volunteers, leaders, and changemakers determining the
social and economic vitality of Washington State (or Whatcom County). If we want a
better future for all of us, we need better results for kids now."
The Health Board and Public Health Advisory Board's focus on children and families reflects our understanding of
this reality. Today, our goal is to focus on policy, our role in making policy for the community, and how those policy
changes really do make a difference.
2. Year in Review
PHAB Member Chi-Na Stoane reflected on our accomplishments in 2018, and 2019 to date:
In 2018:
• A Food System Committee was established by ordinance and officially formed in early 2019. The Committee will
develop a Food System Plan for the county, identify and confirm with Council the actions needed to implement this
plan and oversee the implementation of programs to strengthen our food system.
• The Community Health Assessment (CHA) was completed. Priority issues included Child Care, Youth Mental
Health, and Housing for Families. The CHA will be used to develop the CHIP, and WCHD staff will seek input from
PHAB and the Health Board in developing the CHIP.
• The GRACE Project was implemented (Ground -Level Response and Coordinated Engagement). This is a
community -based effort to offer intensive, coordinated services to people who frequently interface with crisis services
and the criminal justice system. GRACE is creating a system to improve communication, care management, and
supportive services across agencies to improve the health and wellness of these vulnerable residents.
2
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 9
In 2019. to date:
• The Health Board passed resolutions in 2017 and in 2019 requesting increased state support for funding
Foundational Public Health Services (FPHS). The state budget included $22 million to be used across the state for
FPHS. Support for increased FPHS funding was one of the three focus areas agreed upon by PHAB and the Health
Board.
• The Health Board approved the 2019 Policy Agenda recommended by PHAB. In addition to securing FPHS
funding, two other policy goals were established: Child and Family Health and Housing and Homelessness.
• In 2016, the Health Board passed a Tobacco 21 resolution, and in 2019, Tobacco 21 passed at the state level.
This resolution expands the prohibition of smoking to include the use of vapor products in public places and places of
employment.
• The Health Board passed a resolution for the Health Protection of Immigrant Families, promoting compassionate
approaches to health -related services. PHAB was tasked with establishing a Task Force to evaluate systems and
support services for families impacted by the threat of deportation.
• The Health Board passed a resolution for full funding of Crisis Stabilization Facility Program Services.
• The Needle Exchange program was expanded. The Health Department has added Monday morning services in
Bellingham, in addition to Thursday afternoons, and is working to establish mobile exchange services in other parts
of the County.
• The Secure Medicine Return Site was opened. This was preceded by adoption of an ordinance in 2017 to
establish Secure Medicine Return in Whatcom County Code, to increase convenience for residents to safely dispose
of unused medicine, thus reducing risks of medicine poisonings and misuse, and reducing pollution from waste
pharmaceuticals. Financial sustainability for the program was secured through a pharmaceutical industry -financed
system.
3. 2019 Health Policy Agenda Priorities — What the Data Tells Us
The Health Board's 2019 Priorities are Child and Family Health and Housing and Homelessness. In the packet, there
were two handouts with data relevant to this conversation: Whatcom Working Towards Well -Being, and a Housing
and Homelessness Overview which was used in the recent CHA data carousel. The data shows us that many
children and their families are struggling. These struggles primarily tie back to poverty. Regina highlighted a few of
the key data points, which reaffirmed that focusing on children and families is the right thing to do, and that working
upstream on prevention is essential.
➢ 50% of births are paid for by Medicaid
➢ 30% of births are single mothers
➢ 44% of families are facing economic insecurity (below 200% of federal poverty limit)
➢ For housing - over 50% of renters are cost burdened
➢ Low income women have less pre -natal care and lower birthweight babies
➢ Low-income children have lower kindergarten readiness
➢ Child abuse and neglect in Whatcom are much higher than state levels, especially in low-income areas of the
county
Comments:
• It would be interesting to know rates of mental illness in Whatcom County.
• In working on incarceration prevention, it has become clear that working upstream on prevention is critical.
• Question about prenatal care data and Maternity Support Services (MSS). Astrid explained that around 2008,
federal changes made MSS so minimal that it wasn't worth the clients' time, or the providers' time. This
definitely has had an impact. A Councilmember would like to know more about how prenatal care impacts
long term health outcomes.
• At a recent Community Collaboration Committee meeting with PeaceHealth, there was agreement that every
woman in our community should receive follow up after birth.
3
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 10
We have a lot of gaps in care in Whatcom County. As leaders, we have a lot of work to do.
Child abuse happens in households of any income, and abuse has a major impact on the well-being of
children.
4. Panel: Stories from the Community related to Families and Children and Homelessness/Housing.
Three panelists were invited to share their experiences today:
Andrea Northey — Homeless Outreach Team of the Opportunity Council.
Emily O'Connor — Executive Director of Lydia Place
Chris Wiebe — East Whatcom County parent, currently residing in Bellingham
Panelists were asked to speak to four questions:
- What has your experience been, related to Families and Children and Homelessness/Housing?
- What do you think the Council may not know about this situation?
- What do you think is, or has been helpful?
- What do you think could be changed, to make a difference?
Andrea Northey: Homeless Outreach Team of the Opportunity Council (OC)
The OC's Outreach Team has a van that drives out early each morning to connect with people on the streets and
help them access services. It is important to understand that there are a lot of reasons people can become
homeless. Simple tasks can be challenging, so coordination of care is vital to helping people who are homeless.
An example was offered of one homeless woman who is disabled, and has been on the street for two years after
a divorce. Her health continues to deteriorate.
What could be changed to make a difference? We need more types of housing, more types of shelter, more low-
income senior housing, and more places for people to medically recover (e.g. from surgery). We need more
beds at the detox center (there are only 8 beds, and they receive an average 250 calls a month).
Emily O'Connor — Executive Director of Lydia Place
Lydia Place serves 250-300 homeless families every year. What these families experience in lack of childcare,
housing, food, transportation, documentation, disposable income, social supports, etc. was likened to "death by
1000 cuts." Everyone has hard times, but if people don't have a network of friends and family to help them out,
they can fall through the cracks.
Young mothers at Lydia Place are trying to create a new life, but in this housing climate, the only places they can
afford to live are right back in neighborhoods where they had trouble in the first place. They can have housing
there, or not have housing at all. Examples of current situations: one woman is living in her car, and raising three
kids there. She works nights, and her employer lets her park in the parking lot, where the kids sleep. She gets
her kids off to school in the morning then she sleeps while they are at school. Another family can't find housing
where they can stay together, so each child, the mom, and the dad are living in separate places. The father can't
find work because of a criminal record, and one of the daughters was abused at the place she was housed.
Emily noted that she can tell us a hundred more stories that evidence the broken system.
What could be changed to make a difference: The data tells us that when kids who are low-income grow up in a
segregated community, they will do worse than low-income kids that grow up in a mixed income community. We
currently have a lot of segregated housing, and we need more mixed income housing. We need creative, flexible
supports coming from many angles.
Chris Wiebe — mother of three
Chris shared about her struggles as a single parent with four kids, ages 3-11, in rural Whatcom County. She was
diagnosed with a serious illness, and her eldest daughter was disabled and in a wheel chair. Chris was on the
list for housing with the Housing Authority for over five years. She is now living in a home beyond her means, and
LI
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 11
her family helps pay for it. When her daughter died, just over three years ago, Chris had a hard time re-entering
the workplace. She spoke of her loss of dignity, courage, and hope.
What could be changed to make a difference: Chris shared her concern about too much time spent in meetings,
and the need for action and increased community engagement. Though the joint meeting today is open, she
suggested it could have been held in a neighborhood, more accessible for the public to attend. Chris
recommended that for long-term affordable housing, we build mixed income co -housing communities with
support services on -site. She said we have property in Bellingham that could be appropriate for creating that kind
of housing.
Comments:
• We need to create more people -to -people support, rather than assuming that agencies or non -profits can
fix this system. Societies that are poorer are actually more supportive of each other.
• We need representation from the cities to create solutions regarding housing. With the changes in the
PHAB charter, we will have more representation from the cities soon.
• Appreciated the idea about co -housing, and how childcare can be integrated into co -housing.
• Re -affirmed the importance of engaging the community in this conversation to create real change.
5. Policy: Why it matters, and how we
can do more
Rachel Lucy opened the discussion around
policy by asking, "How do we prepare
ourselves to move and act in the health
policy space in a really effective way?
What do we need to learn, and how can we
really take action?" Rachel shared that in
her work at the hospital, they are
downstream of so many kinds of health
issues and it is often overwhelming.
Making real changes in community health
requires many tools and approaches,
focusing in the preventative space as much
as possible.
Key definitions
Policy refers to decisions, plans, and
actions undertaken to achieve specific
health goals within a society (World Health
Organization (WHO))
Health Policy: national, state, or local
regulation or financial appropriation that
creates a structure, environment, system,
incentive, or penalty related to health.
Typically, the goal of health policy is to
make healthy choices easier.
Rachel asked the group, why does policy matter, in relation to the stories we just heard?
HEALTH
o,.p-t-t
- Working with farm working families, I have seen the suffering every day, for years. Having the ability to
convene community to talk about how we support these families enables a whole different level. It allows me
to rise up above the work I'm doing with families and look at the whole, otherwise we would have just stayed
huddled and siloed.
- Developing policies allows us to build a consensus — to pull people together and use our resources wisely.
- Policy is a way to bring people together to move forward to take things from an idea to an action.
- Policy allows us to determine a pathway to an end goal.
- When we work at the policy level and make a difference for many people, rather than one person at a time.
- Think about the process we use to get there — avoid working in an echo chamber and broaden our outreach.
- Policy is the one thing that public health can do that other organizations cannot do. The impact is powerful.
- It can helpful to think about policies both as guidelines (suggestions) and standards (where you set the bar).
- In creating our Child and Family Action Plan, we can think about what a menu of policy options might look
like. There can be a smorgasbord of options.
5
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 12
- Important to not get caught up in just thinking about policies as rules and regulations or forget about
individual people's needs and how we can help people.
We do not have unlimited resources, so policy helps us prioritize what we do with our limited resources.
It may be helpful to think of policies as resolutions that establish priorities, and then what we spend money
on; programs which translate intention into action.
We need both kinds of policy, and we need a blend. In the transformational domain, we want to rock the
boat enough to produce outcomes.
- Our policy about considering health in all policies is an important expression of our values, and impacts a lot
of specific actions, and how we coordinate across county government.
- Policy is the one thing that we do that is distinct, as leaders in government — that other groups cannot do to
help impact the system.
Important to clarify what the intended outcome of a policy is. It needs to be well thought-out, respect
personal freedom and honor people's rights.
- Policymaking can become political, which is why it is important to build those policy pathways together.
Rachel focused our attention on the Health Impact Pyramid - a model that PHAB uses to think about the levels of
intervention in a system. In policy, we are generally looking at how we can change the context so that people can (by
default) make healthier choices. But if you listen to the panelists, it is much more complex than just choices. The
systems we have set up in our community have made it much more difficult for people to succeed. In groups of
three, participants had a chance to discuss three questions:
What are examples where we've made
healthy choices easier as a county? (think
broadly)
Locally, what kinds of public policy
interventions are we open/closed to
pursuing?
How can we improve the way we advance
policy through formulation, implementation,
and modification?
Small groups reported out with these insights:
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- It was easier to think of achievements, but harder to think about bigger changes to make healthy choices
easier.
- How do we look into the future in our policy making, and think beyond the here and now.
- Importance of creating public trust in government, policy makers out in the community listening and including
public in the process, and showing how that input results in action. The "how" is as important as the "what".
- "Explanation drives intervention" — important to create agreement about the nature of the problem, and how
language is important, especially in diverse groups. We need to be very clear about causes and intended
results. What do we really care about?
- Making healthy choices easier — recreation, youth mentoring, and education. Don't get stuck in the way it's
been or politics — focus on shared goals.
- WCHD staff rely on policy to plan and focus our energy and attention, and to articulate the vision.
- Idea for increased engagement — hold meetings at libraries, provide childcare, etc., and be mindful of using
plain language and avoiding jargon.
Co
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 13
6. Policy Road Map for the year ahead
a. Child and Familv Resolution Action Plan January 2020
• Carol will join us as the representative from the Health Board
• Build the framework this summer, and have a full day work planning session in the fall
• Build on Generations Forward
• Bring it to the PHAB in the fall, then the Health Board in January
• Report out in the meantime
• Overlap in the Community Health Plan priorities
Health for Immigrant Families Resolution
• The purpose is to ensure that the health and social service needs of citizens and immigrants of all
statuses are met, increase awareness and promote the integration of a "compassionate" or "trauma
sensitive" approach to services, evaluate existing systems and support services for families impacted by
the threat of deportation
• We hosted an Information Gathering Session in May to identify needs and gaps. 30 people attended — a
mix of service providers and families who had been affected by deportation. We identified three main
issues:
o First responders — how to help families get help when a family member is detained (example)
o Community partners — making sure that there are adequate and accessible (trusted) service
providers to meet basic needs
o Policy — making sure that providers understand policy and changes in policy such as the
Washington State Sanctuary Law Governor Inslee just signed
We will convene the Task Force (August and September) to prepare the report for presentation to the
Health Board in October
Comments:
- Example offered of program in Bothel to enable people to come to a safe space in a temple to get all
kinds of services
- The situation is severe — families are facing extreme economic hardship when parents cannot work
or get services.
Noted that our goal is that all people are well — not some groups at the expense of others.
c. Community Health Improvement Plan Priorities: Child Care, Housing for Families, Youth Mental Health
• The CHA is complete! (we update this every five years)
• A data carousel was hosted recently — invited 100 people to help prioritize issues. Three priorities that
emerged were
o Housing and homelessness (especially how it impacts children)
o Economic security and opportunity, especially childcare availability
o Youth mental health (why are our rates of depression, suicide increasing)
• We will now look at how to focus our community planning efforts and coordinate with existing processes
• We are aiming for a completed Community Health Improvement Plan by the end of the year
Comments:
- What about seniors? Amy responded that there is an effort to gather more data on populations that
we know less about. Astrid mentioned that there is a collaborative working on healthy aging.
7. Closing and Public Comment
Jennifer Johnson from Skagit County Public Health applauded the work of the group, and the value of
community engagement
Each member of the group went around and shared their appreciation for the good work of the day!
7
Joint Session of the Whatcom County Health Board and PHAB - June 11, 2019 Prepared by Crossroads Consulting
07/30/19 Health Board Agenda Packet Page 14
Whatccm Ccunty Public Health Adviscry Pclicy Tcvc Wit
Defining Health Policy:
Policy refers to decisions, plans, and actions undertaken to achieve specific health goals within
a society (World Health Organization (WHO)). Health Policy can be a local regulation or
financial appropriation that creates a structure, environment, system, incentive, or penalty
related to health. Typically, the goal of health policy is to make healthy choices easier. (Source:
https://www.who.int/topics/health policy/en/)
The Health Impact Pyramid demonstrates that by focusing on policies that improve socio-
economic factors and on policies that make healthy choices easier, we can have the greatest
impact on improving health for the greatest numbers of people.
Establishing health policy for the community is the unique responsibility of the Health Board.
While many other partners make up the public health system, the Health Board's policy role is
critically important and distinct.
Health policy can:
❑ Define our vision for the future
❑ Establish targets and points of reference for short and midterm
❑ Outline priorities and expected roles of various groups
❑ Build consensus and inform people
Forms Health Policy can take:
• Regulate • Tax & Spend • Conduct Research
• Incentivize • Privatize • Board Resolutions
• Subsidize • Charge fees • Issue Prioritization
• Contract out • Educate
When developing policy recommendations for Health Board, the following should
be taken into consideration:
• Ensure that a clear, shared understanding of the problem has been established.
• Focus on prevention/socioeconomic policy that make healthy choices easier.
• Communicate the elements of health in all policies.
• Ensure that the intended health outcomes have been clearly defined and that change
can be measured.
• Engage in a community process to build consensus, create public trust, and foster
engagement.
• Ensure that there is political/public will for the proposed change.
• Explore ways to maximize existing resources.
• Research scale and propose use of evidence based practices to drive policy whenever
possible
07/30/19 Health Board Agenda Packet Page 15