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Home My WebLink About2023_05_18_Packet-Revised_____________________________________________________________________________________________ AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request Regular Meeting Agenda Jefferson County Board of Health Thursday, May 18, 2023 @ 2:30 PM Jefferson County Courthouse – Commissioners’ Chambers 1820 Jefferson Street, Port Townsend, WA This is a hybrid meeting: Virtual and In-Person Attendance You can join this meeting by using these methods: In the event of technical difficulties, at least one of the methods above will be accessible to the public. Please try all methods first before calling 360-385-9100 to report any issues. Public comment will be accepted and can be emailed to: BOH@co.jefferson.wa.us until 5:00 PM the evening prior to the start of the meeting. AGENDA CALL TO ORDER – Chair Kolff I. Public Comment (15 mins.) Public Comment Periods are dedicated to listening to the public. Each person may address the Board one time during these periods. To ensure equal opportunity for the public to comment, all comments shall be limited to 2 or 3 minutes per person, depending on the volume of public in attendance. II. Approval of Agenda • Zoom Meeting: https://zoom.us/j/97862703889 This option will allow you to join the meeting live. You will need to enter an email address. If you wish to provide public comment, click on the hand icon at the bottom of the screen to “raise your hand.” Participation will be up to the Chair and/or Clerk of the meeting. • Audio-only: Dial: 1-253-215-8782 and use Webinar ID: 97862703889# This option will allow you to listen to the meeting live. If you wish to provide public comment, press *9 to “raise your hand.” Participation will be up to the Chair and/or Clerk of the meeting. • Website: www.co.jefferson.wa.us Follow the links under “Quick links,” “Videos of Meetings,” and click on “Streaming Live.” This option will allow you to see meeting documents and watch the meeting live- streaming, with no participation. • In-Person: You are welcome to join the meeting in-person. This option may be limited as we are operating at 50% room occupancy at this time. Masking is recommended. _____________________________________________________________________________________________ AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request III. Approval of Minutes of April 20, 2023 Board of Health Meeting IV. Old Business and Information Reports 1. Jefferson County Public Health Report (Apple Martine) (5 mins.) 2. Jefferson Healthcare Report (Dr. Kees Kolff) (5 mins.) 3. Infectious Diseases Update (Dr. Allison Berry) (10 mins.) V. New Business 1. Announcement – Available position: Nonelected Member of Board of Health as “Consumer of Public Health” (Apple Martine) (10 mins.) 2. Transgender and Nonbinary Health and Wellness Presentation (Beau Ohlgren, Dr. Berry) (60 mins.) 3. Climate Change – Pre-Summer Heat Summit Reflections (Willie Bence) (10 mins.) 4. Climate Change – Wildfire Smoke Safety Community Training Update (Lara Gaasland-Tatro) (5 mins.) VI. Future Potential Agenda Topics: Selection of New Board of Health Member CHIP and CHA Climate Subcommittee Community Wildfire Prevention Planning Strategic planning for the county Behavioral Health The Healthier Together Initiative The Child Development Center Sewer projects / wastewater Diversity, equity, inclusion, social justice Environmental Public Health VII. Announcements ADJOURNMENT BY: 4:30 p.m. Next Scheduled Meeting: June 15, 2023 2:30 – 4:30 PM Jefferson County Public Health Hybrid Meeting Respectfully submitted Page 1 of 3 G. Gilbert REGULAR MEETING MINUTES Jefferson County Board of Health Thursday, April 20, 2023 @ 2:30 p.m. Jefferson County Courthouse – Commissioners’ Chambers 1820 Jefferson Street, Port Townsend, WA Hybrid Meeting Board Members Greg Brotherton, County Commissioner, District #3 Kate Dean, Chair, County Commissioner District #1 Heidi Eisenhour, County Commissioner, District #2 Amanda Grace, Community Stakeholder AJ Hawkins, Consumer of Public Health Dr. Kees Kolff, Public Hospital District #2 Commissioner Libby Wennstrom, Port Townsend City Council Staff Members Denise Banker, Community Health Director Dr. Allison Berry, Health Officer Michael Dawson, Water Quality Manager Alisa Hasbrouck, Environmental Health Manager Barb Jones, CHIP Program Manager Apple Martine, Public Health Director Pinky Mingo, Environmental Public Health Director Veronica Shaw, Public Health Deputy Director Chair Kolff called the April 20, 2023 meeting of the Jefferson County Board of Health to order at 2:30 p.m. A quorum was present. Members Present: Chair Dr. Kees Kolff, Members Greg Brotherton, Kate Dean, Heidi Eisenhour, Amanda Grace, AJ Hawkins and Libby Wennstrom. Staff Present: Staff Members Denise Banker, Dr. Allison Berry, Michael Dawson, Alisa Hasbrouck, Barb Jones, Apple Martine and Pinky Mingo. PUBLIC COMMENT Chair Kolff called for public comment. The following is a summary of comments made by individuals in attendance (virtually and in person) at the meeting and reflect their personal opinions: • Commenter raised the subject of gender forming and transitioning. • Commenter suggested that Jefferson County/State of Washington might model its healthcare masking rules on the less stringent rules of other jurisdictions. Board members and staff addressed comments and concerns raised during the Public Comment Period. Respectfully submitted Page 2 of 3 G. Gilbert APPROVAL OF AGENDA Chair Kolff requested a motion to approve the agenda for April 20, 2023. Staff Member Martine proposed amending the agenda to include a new agenda item, “Climate Change,” as a new Item 3 (moving “Legislative Update” to Item 4). MOTION: Member Brotherton moved to approve the agenda, as amended. Member Eisenhour seconded the motion, which carried by a unanimous vote. APPROVAL OF MINUTES Chair Kolff requested a motion to approve the minutes for the March 16, 2023 meeting. MOTION: Member Eisenhour moved to approve the minutes. Member Dean seconded the motion which carried by a unanimous vote. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Jefferson County Public Health (JCPH) Report Staff Member Martine presented JCPH’s quarterly “Highlights Reel,” describing current Public Health programs and events. 2. Jefferson Healthcare (JH) Report Chair Kolff discussed the hospital expansion project, beginning with the demolition of the 1965 building. 3. Infectious Diseases Update Dr. Berry’s COVID update noted the decreasing case rates and COVID-related deaths at the national level and locally, the recent DCD recommendation for second bivalent boosters for those over 65 or immunosuppressed, and the disproportionate effect of COVID on black and indigenous people due to environment and other social determinants. Discussion ensued. NEW BUSINESS 1. Presentation of Public Health Heroes Awards In observance of National Public Health Week, Jefferson County Public Health presented it annual Public Health Heroes Awards (individuals and groups, nominated by the public). This year’s awardees: The Benji Project Cameron Botkin Tonia Burkett Greg Graves Charlie Johnson The JC MASH Free Clinic The JUMP Board The Jumping Mouse Children’s Center Judith Lundgren Shannon Minnihan Beau Ohlgren Mark Saran Respectfully submitted Page 3 of 3 G. Gilbert 2. CHIP Report: Youth Age Band 0 Suicide Objective & Firearm Safety Events Staff member Jones described recommended measures for youth suicide prevention, and educational/training efforts. Discussion followed. 3. Climate Change – Dangerous Waters/Cyanobacteria Staff member Dawson discussed the current situation concerning toxic, potentially deadly, algae blooms in lakes and rivers in Washington, affected by climate change/warmer temperatures. 4. Legislative Update Member Dean and staff member Martine introduced a discussion of the progress of current legislative bills that impact public health. FUTURE POTENTIAL AGENDA TOPICS [Not discussed.] ANNOUNCEMENTS [None.] AGENDA PLANNING CALENDAR The Agenda Planning Meeting for the next Board meeting will be held on May 9, 2023 at 11:30 a.m. The next Board of Health meeting will be held as a hybrid meeting on Thursday, May 18, 2023 from 2:30 p.m. – 4:30 p.m. ADJOURNMENT Chair Kolff adjourned the April 20, 2023 Jefferson County Board of Health meeting at 4:30 p.m. until the next Regular Meeting or Special Meeting as properly noticed. JEFFERSON COUNTY BOARD OF HEALTH Dr. Kees Kolff, Chair Glenn Gilbert, Public Health Assistant Gender-Affirming Care Allison Berry, MD MPH Health Officer for Jefferson and Clallam Counties Gender-Affirming Care: What is it? •A range of social, psychological, behavioral and medical interventions designed to support and affirm an individual’s gender identity •An intentional and gradual process involving extensive informed consent This individualized care can include: •Referring to patients by their self-identified name and pronouns •Mental health support •Medication (hormone therapy and/or puberty blockers) •Surgery (25-35% of cases, near exclusively adults) Gender-Affirming Care is Standard of Care Gender-Affirming Care is Life-Saving •Transgender individuals face higher rates of medical, legal, and social stigmatization than their cisgender peers. •54% of transgender youth have seriously considered suicide •Transgender youth who have access to gender-affirming care have a 60% lower risk of moderate to severe depression and and 73% lower risk of suicidality than youth who do not. Attacks on Gender-Affirming Health Care •Nationwide, >500 anti-trans bills were introduced in 2023, 119 of which have sought to ban gender-affirming care •19 states have banned gender-affirming care for youth Washington Legal Landscape •Gender-affirming care remains legal in Washington State •Washington State Law mandates insurance coverage for gender-affirming care •Multiple 2023 bills broadened protections for medical providers and individuals seeking gender-affirming care in WA Questions? References •https://www.who.int/standards/classifications/frequently-asked- questions/gender-incongruence-and-transgender-health-in-the-icd •https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626314/ •https://jamanetwork.com/journals/jamanetworkopen/fullarticle/27 89423 •https://pubmed.ncbi.nlm.nih.gov/32345113/ •https://www.cdc.gov/hiv/clinicians/transforming-health/health- care-providers/affirmative-care.html •https://www.hrc.org/resources/attacks-on-gender-affirming-care- by-state-map •https://www.insurance.wa.gov/gender-affirming-medical-coverage- rights •https://app.leg.wa.gov/billsummary?BillNumber=5599&Year=2023& Initiative=false AN OVERVIEW OF BEAU OHLGREN BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM GENDER & SEXUALITY: EDUCATION FOR INCLUSIVE CARE GOAL: BETTER HEALTHCARE EXPERIENCE 1.SO WHAT: CONTEXT TO THE TRANS COMMUNITY AND NEEDS 2.WHAT: GENDER AND SEXUALITY SPECTRUMS AND VOCABULARY 3.NOW WHAT: PRONOUNS 4.QUESTIONS BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM “When those who have the power to name and to socially construct reality choose not to see you or hear you...when someone with the authority of a teacher, say, describes the world and you are not in it, there is a moment of psychic disequilibrium, as if you looked in the mirror and saw nothing.” -Adrienne Rich SO WHAT BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM •CDC ANALYSIS, 2019 •TRANSGENDER ADULTS REPORT HIGHER RATES OF SMOKING TOBACCO SOME DAYS OR EVERY DAY COMPARED WITH CISGENDER ADULTS, AT 59 PERCENT AND 39 PERCENT, RESPECTIVELY. •22 PERCENT OF TRANSGENDER ADULTS REPORT BEING INFORMED THEY HAVE ASTHMA COMPARED WITH 14 PERCENT OF CISGENDER ADULTS. •60 PERCENT OF TRANSGENDER ADULTS REPORT HAVING POOR MENTAL HEALTH AT LEAST ONE DAY IN THE PAST MONTH COMPARED WITH 37 PERCENT OF CISGENDER ADULTS. •54 PERCENT OF TRANSGENDER ADULTS REPORT HAVING HAD POOR PHYSICAL HEALTH AT LEAST ONE DAY IN THE PAST MONTH COMPARED WITH 36 PERCENT OF CISGENDER ADULTS. SO WHAT: DISPARATIES SO WHAT: EXPERIENCE THE IMPACT OF SUPPORT • 62.1% OF TGNC YOUTH REPORT POOR HEALTH AT NEARLY DOUBLE THAT OF CISGENDER PEERS (33.1%) • 59.3% OF TGNC YOUTH REPORT LONG-TERM MENTAL HEALTH ISSUE (VERSUS 17.4% OF CISGENDER YOUTH) • GENDER NONCONFORMING PEOPLE WHO ARE GENDER-AFFIRMED IN ADOLESCENCE AND YOUNG ADULTHOOD HAVE AN OVERALL MENTAL HEALTH STATUS SIMILAR TO THAT OF THE GENERAL POPULATION AS ADULTS •FROM: AMERICAN ACADEMY OF PEDIATRICS, 2017 BEAU OHLGREN PRESENTATION 2022 TRANSJEFFCO@GMAIL.COM SO WHAT: LAWS AND PROTECTIONS 1964 CIVIL RIGHTS ACT: TITLE VII 1972 EDUCATION AMENDMENTS: TITLE IX 2006+ WASHINGTON LAW AGAINST DISCRIMINATION (WLAD) 2020: BOSTOCK V. CLAYTON COUNTY 2021: US DEPT OF JUSTICE MEMORANDUM AND EDUCATION NOTICE OF INTERPRETATION BEAU OHLGREN PRESENTATION 2022 TRANSJEFFCO@GMAIL.COM WHAT: GENDER AND SEXUALITY CONTINUUMS BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM SEX ASSIGNED AT BIRTH male (M)female (F)intersex (X) WHAT GETS MARKED ON YOUR BIRTH CERTIFICATE BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM BIOLOGICAL SEX XY XYY XXY XYYY XXXY XXYY XXXXY XXXXX XXXX XXX XX XO XXXYY XYYYY XXYYY CHROMOSOMES, HORMONES, AND GONADS male intersex female BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM GENDER IDENTITY man woman non-binary genderqueer/bigender/two-spirit/gender neutral/agender (around the world: hijra, kathoey, xanith, fa’afaﬁne, burrnesha, etc.) PSYCHOLOGICAL SENSE OF SELF BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM GENDER EXPRESSION COMMUNICATION (AND INTERPRETATION) OF GENDER masculine feminineandrogynous BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM attracted to women attracted to men attracted to multiple genders bi/pansexual SEXUAL ORIENTATION sex with women sex with mensex with people of multiple genders SEXUAL BEHAVIOR XY XYY XXY XYYY XXXY XXYY XXXYY XYYYY XXYYY XXXXY XXXXX XXXX XXX XX XO male intersex female BIOLOGICAL SEX man womannon-binary: genderqueer/bigender/two-spirit/gender neutral/agender (around the world: hijra, kathoey, xanith, fa’afaﬁne, burrnesha, etc.) GENDER IDENTITY masculine feminineandrogynous GENDER EXPRESSION SEX ASSIGNED AT BIRTH male (M)female (F)intersex (X) BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM WHAT: GENDER AND SEXUALITY TERMINOLOGY BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM WHAT: IMPORTANT TERMINOLOGY (LGBTQ) BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM L- LESBIAN (woman attracted to women) G- GAY (man attracted to men OR: an umbrella term used for any people attracted to the same gender) B- BISEXUAL (person attracted to people of two (or more) genders) T- TRANS/GENDER/SEXUAL (a person whose gender identity differs from the sex they were assigned at birth- includes non-binary identities like genderqueer, bigender, agender, gender neutral, etc. along with the binary identities of male and female) Q- QUEER (umbrella term for folks whose gender identity or sexual orientation goes beyond heterosexual or cisgender identity) CISGENDER (person whose gender identity aligns with the sex they were assigned at birth) NOW WHAT: PRONOUNS BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM NOW WHAT: PRONOUNS AND NAMES THE. MOST. IMPORTANT. WAY. TO. SUPPORT. BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM NOW WHAT: BEST PRACTICES- PRONOUNS HE/HIM I TALKED TO TAYLOR LAST WEEK AND HE SAID HE WOULD BRING HIS RESULTS WITH HIM. SHE/HER I TALKED TO TAYLOR LAST WEEK AND SHE SAID SHE WOULD BRING HER RESULTS WITH HER. THEY/THEM I TALKED TO TAYLOR LAST WEEK AND THEY SAID THEY WOULD BRING THEIR RESULTS WITH THEM. ZE/HIR I TALKED TO TAYLOR LAST WEEK AND ZE SAID ZE WOULD BRING HIR RESULTS WITH HIR. BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM NOW WHAT: THEY/THEM “A NEW PATIENT WILL FIND THAT THEY CAN FIND SERVICES EASILY HERE.” DEFER TO THEY/THEM AS DEFAULT JUST USE A NAME BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM NOW WHAT: PRONOUN MISTAKES “THANK YOU” OVER “SORRY” CORRECT AND CONTINUE PRACTICE PRACTICE PRACTICE BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM QUESTIONS BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM CONTACT BEAU OHLGREN 208-301-4100 TRANSJEFFCO@GMAIL.COM BEAU OHLGREN PRESENTATION 2023 TRANSJEFFCO@GMAIL.COM 10 am to 12 pm The Cotton Building (607 Water Street in downtown Port Townsend) WILDFIRE SMOKE C O M M U N I T Y T R A I N I N G T U E S D A Y , M A Y 1 6 Presenters: Dan Nelson from Olympic Region Clean Air Agency and Kaitlyn Kelly from WA State Department of Health FR EE TO THE P U BLIC Learn: -how to prepare before smoke events -when to limit or cancel outdoor activities for children or adults -how to create indoor safer air spaces -precautions to take when outdoors during smoke events Especially beneficial for anyone who runs events, sports, childcare, summer camps, schools as well as parents