HomeMy WebLinkAboutclosed_caption14:28:52 Hello. Hey, hi, can you folks hear us or are we on?
14:28:59 Yeah, we can hear you.
14:29:04 Good afternoon, everyone. Is there somebody who we know will not be here that There's no one I'm aware of.
14:29:14 Okay. Okay. So, I will call to order this meeting of the Jefferson County Board of Health for October, 19.
14:29:31 2023. Yeah, and I believe we have the forum present. Hello, Ray and Amanda.
14:29:40 We do have to wait 1Â min for the official beginning. Oh, we do. Yeah, we can start before they announced hour.
14:29:55 Okay.
14:30:02 Okay. And now we're good. Good. Alright, well we'll start again.
14:30:11 To call urban this meeting of the Jackson County Board of Health. Thursday October nineteenth. 2023.
14:30:18 So we'll start as usual with public comment. And when is the anyone virtually? There is no one with their hands raised.
14:30:33 Okay. And I see no one here in knowing you're present in the chamber. So.
14:30:43 No, just go ahead and get started. Let's have an approval of the agenda. By late.
14:30:59 So people can look at the agenda and see if there are any recommendations before we approve the agenda and see if there are any recommendations before we approve the agenda.
14:31:05 I was just saying they could briefly respond.
14:31:10 Thank you, Dr. Barry. I was just gonna ask that question.
14:31:13 Yeah, so there was some written public promise and I think the one that I wanted to make sure that there was some written public comments and I think the one that I wanted to
make sure we took a moment to respond to was about.
14:31:24 Access to bathrooms for transgender individuals. There's some team to connect access to appropriate bathroom facilities.
14:31:37 With sexual violence, and I think it is, important to respond to that. Naturally, the National Sex for Violence Resource Center notes that 96% of the perpetrators like sexual
violence against children are system.
14:31:53 And so the attempts to equate transpose with violence against children is not only an accurate, it is.
14:32:02 It's important and critical. Perfect children from that. The non minority folks have access to the bathroom that is consistent with their vendor identity and that poses notice
the program.
14:32:21 We are actually today going to be talking a bit about, secular. You can talk services that will be authored.
14:32:34 We'll be honored through the Department of Public Health, particularly around school in the book centers. And one, and for a critical way that we protect children from.
14:32:39 And one, and for a critical way that we protect children from sexual violence is teaching them a conference of central education.
14:32:43 So we can understand our bodies, the appropriate names for the person. And understand and, and their absolute rights to, you know, any touch stuff.
14:32:49 So well, I think it's really critical that we protect children, there are ways to do that and that allows compressive education and education about sexual violence not.
14:33:11 Thank you. Thank you very much. Any other comments about the public written public comments? Alright, let's look at the agenda and.
14:33:25 Take a look at that and see if there are any modifications we need to make.
14:33:34 I'll move to approve the agenda as presented. Alright, I'll second. Any discussion? All in favor signify by saying aye or raise your hand.
14:33:47 Hi.
14:33:48 Hi.
14:33:51 Thank you very much. Let's go on to old business and we'll start with.
14:34:00 Oh, good. Good thing you gave me a copy here. I shouldn't read it. Alright, I'm not the approval of the minutes from September 21.
14:34:10 I'm happy to. Move that we approve the minutes from September 20 first.
14:34:15 All second.
14:34:17 Thank you. Any discussion? All in favor, signify by saying I or raise your hand.
14:34:28 Bye.
14:34:26 Hi.
14:34:26 Bye.
14:34:26 Bye. Anonymous. Now let's go ahead to Jefferson County.
14:34:37 See, Let's see. Yeah.
14:34:45 I know.
14:35:06 Thank you for the technology accommodation. I appreciate it. It's like, to help me. Good afternoon.
14:35:16 I'm saying, happy fall. What a little day outside. Hello, important things. We have some new staff joining us at Jackson County for the help and I'm going to, remind you all
and, and just highlight the fact that we are.
14:35:32 Always working on recruitment, retention, workforce development and and bring our. But we have family sort of more inclusively of technical.
14:35:49 So I want to make a non to, Andrew, to hold up, to, Andrew, to hold up, which I've announced.
14:35:58 Properly, they, they started 2 days ago, and they're our. So welcome to Andrew.
14:36:02 The communicable disease team will ultimately finish or complete their their team as of next Monday with a new help nurse that's joining us.
14:36:14 . And then we currently are seeking to fill the communication specialist position in the. And we are doing those interviews right now.
14:36:24 And then we currently are seeking to fill the communication specialists position in the columns team and we are doing those interviews right now but, still open for applications.
14:36:27 Yeah, can I just ask what is the environment? What does the tech do? All kinds of things.
14:36:36 It's a very bad range. Is there anybody online from who like that? Is that more specific?
14:36:38 Hi. Yeah, the environmental health tech is playing a role key role in the intake of septic permit applications, making sure that they're complete and that they include everything
they need to include.
14:36:52 And routing them to the appropriate reviewers and shepherding them through the process. Letting the applicant know when they're ready to issue and when other steps are.
14:37:04 Are ready to inspections, things like that.
14:37:14 Yeah. Yeah.
14:37:08 It just helps if I ask that question when people are hired. So I know where to send people. Also, wanna welcome 2, 3, and, to our family.
14:37:22 Very new, 6 weeks and under additions to our, Definitely a ray of joy.
14:37:34 Running through our office recently. We are venturing out this fall to attend more trainings and conferences.
14:37:45 Statewide and also across the United States, which is inspiring and exciting for us to be able to get back out into the world after the pandemic and continue to do our first
development and.
14:38:02 That's the matter expertise building. I'm on our staff. So, I had the great fortune last week to go into, annual, Whisper Conference as Washington State Public Health Association,
a 3 day conference and.
14:38:14 Wow, it was very, very impressed with. The number of initiatives and programs that are highlighted in breakout sessions as well as a massive amount of academic posters that
were presented.
14:38:27 This is very enriching and dynamic, group of 600 folks, which is the biggest attendance.
14:38:33 We've had enough marrying there a long time. I also want to make mention to the fact that the title of the compass was Time for Reflection, Health and Hope for the future with
regards to public health.
14:38:43 Workforce and the things we do for communities all over the state. One thing that just really, was It's been throughout the entire 3 days.
14:38:55 We're keynote speeches and large group conversations that we're tying the commerce together by indigenous leaders from across the state who are really speaking to this theme
about reflection, health and hope with the idea of resiliency and connection to the natural world and having gratitude for the work we do and having balance with our work.
14:39:15 Like our personal lives for mental health and our, when we show up to work and we're going to do this in the cold work.
14:39:24 So really a great opportunity. And I will suggest that more of our local stock go. So I want to just do a little bit of updating about our various, divisional work and then.
14:39:38 So I want to just do a little bit of updating about our various, divisional work and I do this every time that every time there's so many things to say and I'll try to keep
it short.
14:39:41 Let me do a little bit about environmental public health. So just kudos to everybody who was part of the tire recycling event that happened on September thirtieth.
14:39:50 And everybody else who chipped in to make that work really well. It's great success.
14:39:56 700 tires for recycling. Yeah, excellent. I also wanted to update you all that our health is doing updates to their fees.
14:40:05 And so they will be coming forth with that information to the board like the next month to the board here as well as for PSC.
14:40:14 So look out for that in our next agenda. On the inter-front we're working with sharing one who's the contract with project manager.
14:40:25 The next steps, this phase in terms of, work and, the team is working really closely with her with the special.
14:40:34 And this is on documenting their workload, which is really the interest of, internet will be successful.
14:40:46 And last but not least for environmental health for now, our co compliance manual updates that are that were needed when thanks to Ken Duddy, are progressing toward final graphs.
That's good news.
14:41:01 That's the name of John. It's along with the rules of procedures relative to COVID bias.
14:41:05 Will be coming to the VOCC early next year where the rules specifically will need to be officially adopted by the V.
14:41:17 So look out for that in the start of 2024. In community health community. You will be hearing from our section your health team as well as, outcomes from reports as well as
the work we do in the school centers and Just wanna make a mention that it really is a model program that in the conference I was at last week as well every other sort of statewide.
14:41:41 Convening I go to as a health director, the school is health center way that we've manifested that that type of service and the inclusion of so many people's access and access
to those clinics across 4 school distances really.
14:41:55 Identified statewide as a model. People in other counties are, have been and are still definitely looking to Jackson County to learn how to do, really successfully.
14:42:09 So. We'll hear more about that soon. Quite a number of this in the community family health division this fall.
14:42:17 Very busy. The mom's tea continues to happen every Monday. Control 30 to 1 30, which is a situation in our office next year, see where we hold conversation and support around
parenting and we provide expertise on into feeding and much much more.
14:42:37 So, participation in that is growing and we always encourage people to talk in the door and sit with us.
14:42:43 That's the snacks and make us work here earlier. That's really, vile. Another thing that I think hasn't been highlighted in quite some time about our community health.
14:42:52 Services is the number of the palette. Services that are their support parent. You are aware of, several organs we have in our health.
14:43:05 I mean, you understand in partnership and essentially but we have actually masterminded and really tended to the nurturing of a partnership regionally with our friends at.
14:43:18 First step family support center, And, I really want to make it on to Denise, our director of community health as well as Alicia who was who's meeting the person, we've been
able to make for Jefferson and follow residents the availability of much more support programming for families in parents, including parents as teachers, which is another nationwide.
14:43:43 Evidence-based program, focusing on childhood development and educational support, and we now are able to talk to that.
14:43:55 Also important is a program called Parent Child Assistance Program or Pcap. Which we have not Classic we had available.
14:44:06 And now we are able to serve Jefferson residents with this program through support from the, first, support center and that program really emphasizes, substance use disorder
and helping mothers during pregnancy and parenting in the first few years.
14:44:22 And additionally, attorney support services are often offered to folks in Jefferson and Clown as well as the case management, which are 2 programs that we have formerly injection
count proper.
14:44:34 We have to let that go, but we are able to now receive that support for projection residence through the MSS and ICM team out of Plows.
14:44:48 So thank you so much for all the brilliant work that people have done to me. That programming. Available across each other.
14:44:55 And in prevention work, last but not least, very busy as well. There's the buy annual medication take back event.
14:45:04 We have one in April and one in October. The next one is October 20 eighth. From 10 am to t pm and we have it in 3 locations on the same day.
14:45:11 So that's in Port Townsend and Shinnecom at both PSCs and that's down at the firehouse in Brennan.
14:45:18 So bring your medications that you don't want or are expired and. We just wasn't done properly that way and keep a lot of things safe.
14:45:28 And finally there is an opportunity again to sign up for and attend the next guiding and choices class series for parents that talk about quite quickly and they are happening
again in November and December.
14:45:44 And one last thing that I forgot. We are having a great partnership with the. Talk about quite frequently in this forum. They are happening again in November and December. And
one last thing that I forgot.
14:45:49 We are having out of the State Department of Health who have come to the region through October and I think Twenty- is the last one which will be in. We'll see.
14:46:06 The 20 first is the last one, which will be in. We'll see. That's right.
14:46:07 So we've had 2 so far, and, and, and, and, yeah, first and foremost. And attendance has been good.
14:46:11 This isn't availability for. To get vaccinations, any vaccination, Thank you. Any quick questions?
14:46:22 Okay. And then, I noticed that you did come in before 15Â min was fast. I'd be happy to give you a few minutes. You know, you can comment.
14:46:34 That'd be great. Shall I do it over here? Yes. That'd be great.
14:46:43 Shall I do it over here? Yes, that's, well, Stephen gets situated. Can I just ask, what do we do with those 700 tires?
14:46:46 Do they
14:46:46 Yeah, they get picked up by a company called Liberty tire recycling and they get processed into new products like playground mats and even recycled wire.
14:46:54 Okay.
14:46:57 They pulled the wire out of the tires and Okay.
14:46:57 Wow, okay. I was imagining that was what happened with him, but I just wanted to confirm and thank you, Alyssa.
14:47:05 Yeah.
14:47:05 Nice. Okay. Thank you very much. Well, first of all, I just want to talk about the meeting packet for this meeting and the website.
14:47:19 I just wanted to talk about the meeting packet for this meeting and the website around 1215. I was trying to access this stuff and I totally wasn't able to talk about the meeting
packet for this meeting and the website.
14:47:25 Around 1215 I was trying to access this stuff and I totally wasn't able to access it on the website.
14:47:26 And generally I would get to if I would click links slide. Agenda meetings and stuff it would take me to a place that would eventually say log in to Jefferson you know public
password and stuff which seemed like that wasn't going anywhere.
14:47:40 The only place where I was able to find this stuff was in the sort of AV capture where it has all the video.
14:47:47 So 10, but at 1230 they didn't have any of that information. We see now that it is here.
14:47:51 So I'm just sort of important. About that situation. Another thing is that, I guess I just like to put a request and I really appreciate this opportunity for public comment
at this time.
14:48:03 But there will be reports from the health officer about infectious disease and things like that. And sometimes their things come up on there that I know that I personally can
talk to ask a question about or make comment about.
14:48:19 And you know, I know you don't want to turn this into a zoom or anything, but But I had no opportunity to comment after that.
14:48:26 You always have to wait a month or something to make a comment about so that really does know so I just wonder if you least consider if there was some way to have Hi, the public
comment period.
14:48:36 After the infections disease report or have a second. Maybe abbreviated public comment or. Whatever.
14:48:44 Okay, another thing I wanted to mention is that last time around I expressed concern that the children were being urged.
14:48:54 To be vaccinated with the COVID vaccine as early as 6 months. And I felt that not only was this a situation for them personally, their risk benefit was way out of line for infants.
14:49:08 But I also felt like our What we're doing in the United States is how to step with the rest of the world.
14:49:13 Yeah, I mentioned that the EU. You know, also was not recommending that and then officer the help officer corrected me and said that just last week that had changed and I was
trying to find out the truth of this and it was a little hard to me to find out but I was eventually able to reach an expert from Germany.
14:49:30 Who told me this. He said that what's what you went officer Barry said was kind of true that it didn't really matter that much the EU regulatory agency the EMA has indeed recommended
to boosters should be had for everybody from 6 months of age.
14:49:46 Following CDC guidance. But As far as you know, the European Commission has not yet approved that recommendation.
14:49:54 Meanwhile, the EU member states are generally taking much more restricted recommendations. Australia is a major outlier who is Austria is recommending it to 12 years and But
almost all other countries can find them to just be old and vulnerable.
14:50:10 So I kind of stand by what I'm saying that we are sort of out of step by trying to get people that are.
14:50:15 So super young. I have like 30Â s more on my own time. That was it. Okay.
14:50:23 Thank you for your comment. Good. I think we covered the kid part pretty well last time, but just said.
14:50:32 Just to reiterate, there's a, but a primary reason is that there is a.
14:50:50 As we have done, as we have done a previous meeting, The highest rate of COVID.
14:50:53 19 hospitalization is 70 and over and the second highest hospitalization rate is their children 6 months enough.
14:51:00 I'm sorry, children, children under 6 months, they, for now, that I would go for the vaccine.
14:51:04 So kids. Kids are high west for COVID-19. That is 6 months to 5 years or or also at the risk.
14:51:12 The vaccine is very, very safe. Not too much safer, I think. No, they're able to have that conversation with their positions and if they have any concerns, they're able to have
that conversation with their positions and if they have any concerns, they strongly recommend that they do talk that through.
14:51:30 And in those visits we are well situated to have that conversation. I have a father myself and I also know the stress of trying to convince your father to get a vaccine.
14:51:46 And so, on every side of this conversation and I think if you are worried if you're not sure the best thing to do this conversation and I think if you are worried if you're
not sure the best thing to do is to talk to you about and we are always happy to walk you through that answer your questions listen to any concerns you might have and make sure that
your kid has their best shot at
14:52:09 home. This. Thank you very much. Alright, I'll move on to the Jefferson Healthcare Report.
14:52:19 I'll keep it very brief. First of all, things are going as planned in terms of our replacement and.
14:52:28 Building project. Thank you for some health care. Of the MRI, has been taken out of the building because that's part of the, 65 building that is being removed and we now have
a mobile MRI so that we'll be able to continue that service even during.
14:52:50 And that has just been moved into place and I think it will be operational within about a week. The other thing is that She'll be over and I feel also on the board at Jefferson
Healthcare.
14:53:05 We took a visit to James Town Ealing Clinic in Squin. And this is the first time that I've been there.
14:53:15 Apparently they've been operational for. About 15 months and we were absolutely blown away by this facility.
14:53:22 They're remarkable staff. And the services that they provide. And, you have to be a addicted to an opioid in order to begin to get care of there but once you are there They
have everything from family, complete family medicine services to dental care, to childcare when you're there to get your medication.
14:53:50 They currently have about a hundred 50. Patients enrolled in their program. 100 and 20 I believe are a methadone and all of them come from within 15 miles of swim.
14:54:05 So very few are coming from Jefferson County. But Jefferson County. Residents are.
14:54:14 Certainly welcome to go into those programs there. So I urge, anyone who's interested to figure out how to visit that center.
14:54:25 They have grand visions for the 16 bed inpatient mental health facility there. And they have commitments from the legislature for.
14:54:36 13 million dollars this round and another 13 in the next legislative round and when we were there, Dr.
14:54:46 Barry walked in and said, oh, she's one of the musicians who happens to provide some of the care there.
14:54:53 Do you want to say anything more about, that program? I really like working there, mainly because, the people who work there, I'm just really dedicated to the people.
14:55:07 So that's a really positive. It's all these, click start since.
14:55:12 And so whenever I get up at 4 45. But then when I got there, it's very obvious.
14:55:25 Just to be surrounded by so many people who are in here. And then as far as, you know, there is a, you don't have to have to, to swim.
14:55:39 And there is talk, in consideration. But they have a global van that they're gonna try it out.
14:55:47 And, anyway, so I think it's something that we should try to promote here, information about it.
14:55:55 Alright, let's, unless there are any questions. I do have a question. Is there a more demand than the healing center can meet.
14:56:07 Not right now. There's, so they'll take a new, new it takes every day.
14:56:15 And there is, with SAFTA to meet them. So, if you have someone, one of the things that is nice to see.
14:56:23 So, if you have someone one of the things that is nice. So, if you have someone, one of the things that is nice to see you and that there's time.
14:56:28 So, if you have someone, one of the things that is nice to see you and, open to 6.
14:56:30 So 6, 8, 1235. And then you can get those things.
14:56:34 So 6, 35, and then you can get those thing. Okay. So 6, so 6, I think, 35. And then you can get those things.
14:56:38 And so And is that true of the inpatient as well? Those 16 beds or did those are those?
14:56:47 16 beds or do those are those? Yeah. They're just getting the permanent. Well, and I forgot to.
14:56:52 Yes.
14:56:50 May I ask? Sorry, I'm getting to interrupt. I just had a follow up question.
14:56:57 So it is the intention that those bed spaces for inpatient are there primarily going to be focused on.
14:57:05 On addictive recovery services or are they for all modalities of mental health need when one might need in patient care for mental health.
14:57:16 Related reasons.
14:57:19 Sure, I we ask, first of all, I should say that our tool is given by Brent, first of all I should say that our tool is given by Brent.
14:57:29 Hmm.
14:57:28 The director of health or. And Bally Barton, phenomenal, nurse practitioner, I believe, who, is the executive director there.
14:57:41 And they did mention that it will be open. It's primarily for mental health, but there are no restrictions.
14:57:48 Or, specific, requirements related to addiction or, drug use or anything.
14:57:56 . One, IS. The services are only for tile. Citizens.
14:58:04 They are not. They are open for anyone. And, there are, a specific kind of program.
14:58:15 And there are, a specific kind of, system, they are not, they are open for anyone who's rather than, but there are, a specific kind of
14:58:17 Thank you.
14:58:16 Alright, good. Thank you. Thank you, Dr. Barry for helping provide that valuable service.
14:58:23 8. I think we've got the state board of health. Great, thanks case.
14:58:31 So, while, Apple was at her conference, I was just down the road, the state board, in conjunction with the state public health association and we did one joint event which was
nice.
14:58:47 But few things I want to call out from the state board of health meeting. One was in hearing.
14:58:53 From the local health jurisdiction there, which is, Douglas and Chalan County, I believe.
14:59:01 Do I have a joint? Jurisdiction. They, discuss a program that they have, which I had not heard about before, funded through Department of Health, which provides capacity for
nursing service public health nursing services in childcare centers and just got me thinking that with the new childcare center being built up at the high school which will serve a
number of families probably Wik and medicate eligible families that it's something I'd
14:59:28 love for us to be able to look into. We talked last time about the lead testing challenges. That would be a great opportunity to do things like that would be a great opportunity
to do things like that.
14:59:36 So just wanted to plant that seed while I have all of you here, that would be a great opportunity to do things like that.
14:59:42 So just wanted to plant that seed while I have all of you here to hear that. So just wanted to plant that seed while I have all of you here to hear that.
14:59:46 And that, you know, now is the time, I'm glad to plant that seed while I have all of you here to hear that.
14:59:50 And that, you know, now is the time, you know, as we're starting to build out that, you know, finalize the design for that facility, where we should probably be talking about,
you know, is that a good opportunity for Whip to have a presence or, you know, what partnership opportunities exist.
14:59:58 So let's, follow up on that sometime. We did pass, a 2 new newborn screenings, which will become newly part of the screening panel statewide.
15:00:12 Very rare hereditary conditions that Interestingly, expect to only catch where by testing every child in the state of Washington they expect to catch a case of each of those
every 7 to 10 years that the the cost benefit analysis that the cost benefit analysis that they do still points to it being worthwhile.
15:00:33 Each of those every 7 to 10 years, but the cost benefit analysis that they do still points to it being worthwhile.
15:00:35 So that will start happening probably next year. We discussed the, as I mentioned here before the, for State Board of Health did complete role writing for the school environmental
health role, which was not has never been adopted.
15:00:50 It is kind of embargoed by the legislature and sounds like there might be some activity on that.
15:00:55 The environmental justice council, which has actually significant funding to the climate commitment act. They have included implementation of the new rule.
15:01:10 In the, recommended it to the governor's budget this year. And in many cases it is public health departments that do the inspection and planning and recommendations for improving.
15:01:23 Environmental health in schools. So, that might be funded. Might be coming down the pipe in the next couple of years.
15:01:30 And those, the board of health is. Recommending that that gets funded and that the embargo on implementing the new will be lifted.
15:01:38 So something we'll be working on. In legislative session next year. And lastly, we, finally got a look at the draft, say, septic code, which, Glenn sent out to you a little
bit of information on.
15:01:54 And if, Go ahead, I got to share my screen. If that's okay, I have the ability to do so.
15:02:06 Wanted to just share with you what I did. Bye. Provide a link to this, but I think it's wanna call attention to it.
15:02:14 A very handy. Summary of the changes that. Are being proposed.
15:02:23 One, yeah to the new subject code. I don't know if it's, we should quickly go through these or folks have had a chance to look at them.
15:02:34 The hearing has been moved until January of 24 so we have some time. There has been years of work with a diverse set of stakeholders coming up with this draft role and I have
heard generally support from number of the stakeholders who have been involved that they feel the right balance was struck here.
15:02:56 I'm trying to. Both provide more flexibility, especially on constrained sites where septic is very challenging.
15:03:05 And but also provide more protection for the environment. I do notice in here. Many of the changes rely on the local health officer to implement.
15:03:18 I wonder about capacity for doing that. Especially in counties like ours where we share a health officer I imagine there's a an appointment or signing so I guess.
15:03:35 I'm curious if and how we wish to dig further into this if we want to do a more in depth.
15:03:41 Look at the draft roll next month. Yes. Maybe we could take that up in our planning for, you know, for the next meeting and see what other issues and see where you're going
for the next meeting and see what other issues and see where it falls. Great.
15:04:03 And maybe with some environmental health staff also, we can do that at the end of this meeting. Yeah.
15:04:07 That sounds good. Okay, good. And in the meantime, if anyone's interested, I had Glenn send out, the links to the draft rules, summaries, etc.
15:04:15 I think that's all. I mean, I better hand that. Thank you. Amanda, go ahead.
15:04:19 I just have a quick question, Kate, in Glen's, you know, and I see Pinky has a hand up too.
15:04:25 I'm sorry. And in Glenn's email, he indicated that, the state board of health was looking for, I'm gonna use the wrong word. It's not testimony.
15:04:35 Yeah. Okay.
15:04:35 Does it call? Public basically, before, January ninth or January tenth. And so.
15:04:45 Do does that need to be in written form? How is it best to submit that if one was interested in doing so?
15:04:53 Yeah, good points. There, there is a public comment email, specific to the state board of health that I can send out.
15:05:02 Okay.
15:05:03 It would also be found on that website, the State Word of website link that I sent out. Okay.
15:05:08 Okay, great. I, I just wanted, I didn't know if it was a live show up to this event sort of thing or if we could do that via, email somehow. Okay, great.
15:05:18 Thank you.
15:05:18 Okay, you have some questions.
15:05:23 You're muted. You're muted.
15:05:27 Okay.
15:05:26 Sorry, Kate, I would just like some, clarification in the sense of what you might be expecting from us.
15:05:35 I know Stuart was part of the rule writing and we don't I mean we might not have a lot to add so I don't want to you know have this expectation that we're going to be able to
explain everything because I cannot explain everything in the new state code.
15:05:52 So I just need a little bit more clarification in terms of your expectations.
15:05:58 Okay. Perhaps a high level overview of key points that might be worth considering or anything about. That's what I would look for.
15:06:06 Hi, I would agree that, you know, even using that summary of the key changes and then if you were just in calling out things that you thought might be problematic or points
that would be helpful to to call out, you know, this is something that I know Christian Brotherton has been.
15:06:26 Very interested in, and I've both been waiting for this draft for a long time. And so, you know, there's a question too, is does the Board of Health wish to provide testimony?
15:06:39 To. Do individuals, obviously, Amanda, important stakeholder and, affected by this and.
15:06:52 Hey, would it be helpful if there were, potentially Oh, am I. Am I not hearing your sound?
15:07:02 Yeah, I think the chambers got muted.
15:07:03 I can hear you, Amanda. Yeah, I think that chamber is muted.
15:07:02 I can't. Okay. Okay. Yeah, okay.
15:07:09 I'll wait a second.
15:07:12 Yes.
15:07:11 Is that better? Can you hear us? Okay.
15:07:11 There I can hear you. Yeah. And I just wonder, would it be appropriate to maybe share this out with, with some of our other local stakeholders.
15:07:31 Bye.
15:07:21 I mean, is that? It might garner. I mean, I hear Pinky point. I know I know Stuart was deeply involved in this process.
15:07:36 I know that some former staff who have since left environmental public health. We're also deeply involved in this process.
15:07:40 And so I just, And I know I have not had an opportunity to read through it all.
15:07:51 I'm sorry, I was out of town and didn't get the email until just an hour ago.
15:07:56 When I popped it up and went, oh, Glenn sent this too. So I'm just wondering if, there isn't, Are we looking for additional input?
15:07:59 I certainly the state is, and so it is, you know, the, it is a statewide public hearing.
15:08:07 And so yeah, I think the more the better, you know, things like the realtors, didn't have representation, environmental groups.
15:08:17 So it is, and I assume they are also getting it up to their folks. But yeah, feel free to distribute.
15:08:26 Okay.
15:08:24 Okay, well I know that I know that I'll just say just logistically from to give you guys just a snapshot if there's something in the state code.
15:08:34 That is not in the county code that sometimes creates issues for pinky staff when they're trying to help us navigate how to address the situation.
15:08:44 And I imagine that we're not the only entity that kind of bumps up against these things. I think sometimes from.
15:08:51 My experience I think staff might feel like their hands are a little bit tied to, to make recommendations given that the state code maybe doesn't have as much, explanation or
there are local municipal code, has interpreted previously the state code really in a very specific and narrow scope.
15:09:11 And so, I think Just without having read all of this, I've read a few drafts of this over time that potentially it would be good.
15:09:19 To make sure that down the path that our county code is aligned in such a way that it doesn't leave too much room for Pinky to have to make a lot of assumptions interpretation
about things.
15:09:34 Oh, that seems that seems grand. And that's, I mean, that's.
15:09:32 Does that seem fair, Pinky? Am I giving a good assessment of the situation? Yeah.
15:09:38 Partly the way that the state codes are, they are codified in a way that they, the state purposely tries to leave things up to the local health officer.
15:09:52 That so that's that's not new in the codification of the state rules. They want to leave that discretion.
15:09:59 As fuzzy as possible at times. And you know, when we go and ask them for clarifications, it really always comes down to does the local health officer allow?
15:10:12 I mean, and so there is a little bit of push pull there. And I guess what I'm interested from the all the commissioners on Are there things that you're hearing about this new
code?
15:10:23 Because a lot of the controversial stuff, we've already, we've already done, we already have the O and M program, the point of sales.
15:10:31 So some of that stuff, the real controversial stuff we've already done and we've already crossed that bridge.
15:10:42 And so I'm wondering if there's anything else that you're hearing and the community just so that I can be better prepared because as it is now, I mean, I have, I have just as
much,
15:10:53 Probably as everybody here in the sense of maybe a little bit more. I got a little bit more because I'm digging down into the nitrogen because of our minimum landary policy,
but for the most part I might not be able to add anything more other than where we're at in the role.
15:11:12 We're gonna have to cut off the discussion on this topic. So what I would recommend is if anybody does have any of the information that Pinki's requesting that we send that
to you.
15:11:24 And, and then, when we do the agenda planning for next session, let's see, let's see how much time we can find, what the priorities are.
15:11:37 Okay. Yeah, and have a discussion about what, how points we wanna cover. I do think that kind of.
15:11:43 Not just the real but also the implementability is a good point. So that's, we're going to have a discussion in the next meeting inviting community partners to be present for
that meeting too. We're going to have a discussion in the next meeting inviting community partners to be present for that meeting too.
15:11:57 Yeah, we can scope it let's move on. We've got a pretty tight agenda from here on out.
15:12:02 So, Dr. Barry. Alright, I will try to keep things free. Okay.
15:12:09 So on the phone hanging press unfortunately, we're still experiencing relatively good rates of COVID-19 transmission in our community much like the rest of them.
15:12:18 We are also seeing higher rates of hospitalization than we have in the recent. We are also seeing higher rates of hospitalization than we have in the recent past.
15:12:26 We've seen about 4 to 5 hospitalization than we have in the recent past. We've seen about 4 to 5 hospitalizations for COVID.
15:12:27 19 those hospitalizations have been majority, over the age of 70 that some is in their twenties and disproportionately close to our Unfortunately, do you have one news app to
announce we lost one of our citizens this week to go to 19?
15:12:48 And they were on vaccine. And then what we are definitely seeing is, higher rate hospitalization, in folks who are under or unmaccinated, and, so that you've not gotten your,
your most recent We do have more about COVID.
15:13:13 19 vaccine availability than we did. It is a lot easier to access so it's not infinitely easy.
15:13:22 I am still hearing some critics, not getting their shipments on time and having to take this around.
15:13:26 So I want to acknowledge that if you try and get your vaccine. I'm still hearing the, on time and having make us around.
15:13:35 So I want to acknowledge that if you try and get your vaccine We are recommended for everyone 6 months then up.
15:13:37 The most critical The main reason there is that folks in that group, have their, their, also close to our, and that one of the big reasons is the rest of us get vaccinated.
15:14:13 And then one of the big reasons the rest of us get vaccinated. And then one of the big reasons, the rest of us, get vaccinated besides themselves.
15:14:19 And it's reduce our risk of sending 2 books in those groups. So, when you are update on your vaccines, you're less likely to share.
15:14:24 Less likely to shed high massive virus before you love symptoms. And that makes you less likely to have some people.
15:14:25 And it also, of course, makes you less likely. And, also, of course, makes you less likely to get.
15:14:30 Oh, the current vaccine is a very good. And also, of course, makes us like, we could get COVID at all.
15:14:34 The current vaccine, that is a very good. I'm sure for example, to go out and get back.
15:14:36 As far as the other respiratory viruses, we are starting to see an update in our SN.
15:14:42 So the RSC season is starting. Particularly, it's led by the South, and is experiencing a surge in our, right now.
15:14:51 And it's just, there's, on the West Coast. So they're, to see RSD cases taking up in the Seattle area.
15:14:57 We've not yet seen significant RSV activity here, but we usually are about 2 weeks events. Yeah.
15:15:02 So it is likely. That is a good reminder for all of us. We're gonna update on our.
15:15:09 Vaccines. That now would be a good time to get it. Actually vaccines are recommended for everybody over the 8 60.
15:15:15 They're also. That's the. Vaccines are recommended for everybody over the age of 60.
15:15:16 They're also recommended for everybody over the 8 60. They're also recommended for everybody over the 8 60.
15:15:18 They're also recommended for everybody over the 8 60. They're also, recommended for pregnant individuals, between the, the station age of 32 and 36 weeks around the same time
you get your TFX in pregnancy as well. And the purpose there is the same.
15:15:30 That's the key that fax need is to protect your child. There's 7 app, which is the modal antibody to protect infants from RC is not increasingly available.
15:15:43 And that is recommended for infants up to the age of 8 months of age. And that is recommended for infants up to the age of 8 months of age.
15:15:47 And older, and that is recommended for for infants up to the age of 8 months of age.
15:15:55 And older, the toddlers of the age of 8 months of age. And older, the toddlers, up to the age of 8 months, in a particular high risk conditions.
15:16:01 And generally that would be in conversation. 19 months, would have particular high risk conditions.
15:16:05 And generally that would be in conversation. And generally, that would be in conversation. Make your, that's, it's with, lung disease of prem and for the rest of us, if we don't
follow any of those groups, remember that RSC is a rustic.
15:16:18 And it's very well. And it's very well connected. And it's very well.
15:16:23 So particularly if that if you have very funny, in your life. So particularly if that if you have very tiny, in your life, newborn, so particularly if you have, if you have
very, so particularly if that if you have very funny, in your life, new board, you see, you want to spend, make sure you are well, when you see them.
15:16:33 I'm like, make sure you are well, when you see them and consider asking. But when you're meeting, you want to spend time with make sure you are well when you see them and consider
asking.
15:16:36 But when you're meeting up with them, last but not least is influenza. Thank you.
15:16:41 We are not seeing much influence at activity, nationally or locally. So, influence activity, or, is middle.
15:16:50 And so we don't know yet. And so we don't know yet. And so we don't know yet, and so we don't know.
15:17:00 No, and so we don't know, yes, when it's said in our community, but it is not that we Yes, all I have to take any questions from.
15:17:03 Okay. And you have to ask your question as quickly. Thank you very much. Alright, well, you put us back a little ahead of.
15:17:32 So that is the appointment of backup representative from Board of Health for the behavioral health advisory committee. And I think Heidi, Eisenhower, you're on that one, Canada.
15:17:46 Oh, there she is. Great. Yeah, I think Anne is gonna kick this one off. Okay.
15:17:50 Welcome. Greetings. Go ahead.
15:17:51 I'll kick it off, sure. Thank you. Hello. Oh, thank you so much.
15:17:56 Anna Mac Henry, DD behavioral health coordinator work out of public health.
15:18:02 The behavioral health advisory committee that I staff that oversees the one tenth of 1% funds has decided to request a backup representative for each committee member and I
did a touch.
15:18:17 A two-page overview of the behavioral health, one tenth of 1% program with a list of the representatives.
15:18:23 The names and and who they represent. And, we're requesting a backup representative from the board of health.
15:18:31 And the reason is, according to the Open Public Meeting Act, the OPMA, if a border or committee meets and there is no quorum, they can't go through the agenda items like normal
because discussion equals action.
15:18:46 So in the past we would continue to have a meeting without a quorum, but we wouldn't take any final action on items like.
15:18:55 Approving the agenda or the minutes. But now, according to our, prosecutor's office, a border committee has taken action just by discussing.
15:19:06 And unfortunately, we had to cancel. A special BHAC meeting a short time after it begun due to a lack of quorum.
15:19:16 And we just want to avoid that situation. We don't want it to occur again if we can help it.
15:19:22 So that's it and maybe, Commissioner Eisenhower can add something to it.
15:19:28 Yeah, it would just say that we. You know, we set a special and we went to all the work of setting a special meeting and then we had to cancel the special meeting.
15:19:36 So We really don't wanna be put in that situation when we set it a regular meeting, let alone a special meeting when there's information and discussion that needs to happen.
15:19:45 So. It was our solution to develop alternates for each of the seats on the behavioral health advisory committee and.
15:19:53 For just to remind folks what that committee is. It's the committee that distributes the one tenth of 1% grant funding for mental health services in our community.
15:20:04 So it's a really important function to keep functioning and keep our, the trains on the track and our meetings happening and the grants getting up to the community.
15:20:13 So. We divvied up the behavioral health advisory committee and have started to reach out to all of the primary.
15:20:23 Seat holders. And, there is a seat for the Board of Health that Amanda holds the primary seat for, but we're just wanting to appoint a someone in the alternate position who
can step in when, Amanda's not able to make it.
15:20:41 If she's not unable to make it. Which hasn't been a problem thus far. So.
15:20:47 And we've been getting good responses from other, the other states. On the behavioral advisory committee are the county commissioner and then a city council member.
15:20:59 Somebody from the courts. A school representative. A hospital commissioner. Somebody from the Sailors Behavioral Health Administrative Services Organization.
15:21:12 Somebody from law enforcement, community at large number and a board of health member. So those are the folks.
15:21:18 . It's like 9 folks to make up the.
15:21:24 They're well the busy. That's like great. Greg got his hand up.
15:21:30 Yeah, I just had a clarifying question. That's a great idea.
15:21:30 Thank you. Maybe we should. That's fine. Go ahead.
15:21:36 Yeah.
15:21:40 Okay.
15:21:35 Sorry. I'll wait to be recognized by the chair next time. I guess I'm just asking, is this, we, I, I've seen alternates work in 2 different ways.
15:21:48 One, the alternates go to all the meetings and only vote if the primary members not there and another is if the primary member is not going to be there, they proactively reach
out to the alternate and say, hey, can you sit in for me?
15:21:58 And I'm just wondering what is this?
15:22:02 And do you remember what we discussed?
15:22:06 We discuss the second, that if the primary wasn't there, the alternate, would be requested to attend in their steed.
15:22:16 But we also, I think it's important for the alternates to have an orientation. About this committee.
15:22:23 And we would welcome them to attend.
15:22:29 Right.
15:22:29 I don't know if that answers, but thank you for that. That's a Clarifying question.
15:22:36 So I guess the question is, is there a member who's currently on the board? Like to or agree to be the backup and self Amanda, you're currently.
15:22:52 The representative, how long have you been in that position?
15:22:57 Just I think this year and since I've been on the Board of Health, it's kind of been a concurrent.
15:23:03 Position for me. And I enjoy it. We only meet. We only meet quarterly, so it's not a huge, commitment of time.
15:23:13 It's once a quarter. And to be honest, I would challenge anybody to attend one of those meetings when we have.
15:23:21 Our folks who are the recipients of the funds come every every session and do a review of how kind of impact they make in the community and I would challenge anyone to sit through
one and not get a little missy- because we have a community full of people who are doing really incredible work in our behavioral health world.
15:23:41 So it's an honor to serve. Just logistically, I bumped up against and missed one meeting.
15:23:49 I think I was I was pulled away and had to go stand in for an employee here at work. So I just can't always anticipate when that's gonna happen, but it would be great if I had
someone to call because I really don't I don't want to put us in a bad position because those folks are depending on those funds.
15:24:05 Great. Do you have a question? Okay.
15:24:10 Yeah, I was wondering if this is also meetings that are our hybrid is is it possibly to join via zoom.
15:24:21 Yes, yes.
15:24:22 Yes, they're hybrid meetings.
15:24:25 Okay, then I'll go ahead and and offer to be an alternate
15:24:31 That sounds well. Perfect. And did you have another comment or question before we?
15:24:37 I did, thank you. Thank you. It actually isn't quarterly. It's every other month.
15:24:43 So we do meet 6 times a year. Sorry about that. I know there's so many meetings.
15:24:50 Okay.
15:24:48 It's hard to keep track, but just, Grace, so you know, we, do meet every other month.
15:24:53 Thanks.
15:24:54 The second it's the second Tuesday of every other month from 2 45 to 4 30. Alright.
15:24:59 It's pre-programmed into my calendar so I don't have to think I'm sorry.
15:25:06 And does that still work for you, right? I saw 2 thumbs up when you got that information.
15:25:12 Yeah, that still works for me. Yes.
15:25:13 Alright. Yeah. Is there any competition for this? Is there anybody anyone who would like to run against you, for this?
15:25:24 Opportunity. I'd like to quickly make a motion before I. I move that the Board of Health points at grey as the alternate to the behavioral of.
15:25:35 Second. 1Â s.
15:25:36 Grey as the alternate to the behavioral advisory committee. Okay. And want to make public comment before voting on this.
15:25:43 Thank you very much. Is there anyone who would like to make public comment? Hello. You're in non for either online or in the room.
15:25:52 Will proceed. Any further discussion? Okay, thank you, Greg. All in favor?
15:26:04 Hi.
15:26:02 I. Bye.
15:26:01 Any second by saying, I, do we have a second? Thank you. All in favor, take that off by saying I or raising your phone.
15:26:13 Alright.
15:26:11 Hi.
15:26:11 Aye.
15:26:13 Thank you very much, for jumping in and getting involved. Really, really appreciate that. Alright. And, next we have, Dr.
15:26:29 Ian Miller and Michael Dawson. And the topic is sea level rise in Washington. Bye.
15:26:37 So yeah, I will do a brief introduction here. How are we doing on time? Are we on schedule?
15:26:44 We're actually right on time. We're doing just great. So if you could keep it to 30Â min, we'll do great.
15:26:52 Okay.
15:26:56 Yeah. That's great. So this topic of sea level rise is one that the climate subcommittee wanted to see brought to the board.
15:27:10 At some point and so We were very lucky to be able to get, Dr.
15:27:19 Ian Miller, who is the coastal hazard specialist at Washington C Grant. And, he's also, he teaches at, Peninsula College there in Portangelis.
15:27:33 He does. Work on all kinds of coastal hazards, tsunamis, coastal erosion.
15:27:40 Flooding, sea level rise. He, In addition to research. Is, he really prioritizes communication.
15:27:53 In fact, I just got off another Zoom Meeting earlier at lunch where he had a lunchtime talk on one of his recent studies on sea level rise, which I think there's a link in the
in the package to to that.
15:28:12 But I also shared a recent study that our Department of Community Development. A sea level rise study that came out a few months ago.
15:28:28 And shared that with Dr. Miller just to get some. You know, quick impressions. There's more work I think that DCD is planning to do.
15:28:39 It's a preliminary study. And of course there's been. Other local studies that I think.
15:28:44 Many people are aware of Port Townsend commissioned a study recently. And also, you know, another thing very relevant for our department.
15:28:54 Sea level rise has, you know, potential impacts on septic systems and drinking water wells.
15:29:04 The proposed, septic rule revision that Kate mentioned earlier. There's something in there that, mentioned sea level rise as a potential future thing that we might have to incorporate
into our are septic management plan so We haven't, you know, done a lot yet.
15:29:29 With sea level rise in our. Departmental climate and health program, but it's time that, you know, we would like to start thinking more about that issue and the potential future
impacts to our our work here.
15:29:42 In public health. But anyway, Dr. Miller has a presentation, sea level rise in Washington state and do you wanna?
15:29:55 Go ahead and bring that up.
15:29:56 I certainly can, yes. And hopefully everyone will be able to see okay.
15:30:06 Okay. How does that look on your end?
15:30:10 Alright, should I take it away, Michael?
15:30:13 That's good. Yep.
15:30:14 Okay, thank you so much. And I did change the title a little bit just because I just jumped at the opportunity.
15:30:25 To be able to talk to you all. Both, well, some of you I know and it's delightful to see you either in person or by reputation.
15:30:34 And I'm just also I've never had the opportunity to really sort of think about this nexus between sea level rise and public health in detail and so having the opportunity to
think about it a bit with Michael before sort of this.
15:30:47 Presentation for me was really fantastic and I'm just excited for whatever I can glean from this interaction with you all.
15:30:56 Also just take the opportunity to say thank you for the work you do and the, you know, the thought that you put into serving our communities.
15:31:03 So I'm Ian Miller, as Michael said, with Washington Sea Grant. I am though based on one of our field staff, so I'm based in Portangelis.
15:31:12 And as you mentioned, I'm sitting at Peninsula College where I also teach. In this role as a coastal hazard specialist, we, at you know, serve this extension role for the university
and for federal science.
15:31:28 And I've focused on sea level rise over the last couple of years. Simply because you know presumably as largely coastal counties in Washington it's going to be an issue that's
of importance to us.
15:31:42 And grappling with it's very various impacts. I do want to start with a couple of key takeaways.
15:31:49 Perhaps things that some of you have never sort of thought about before but sea level is already rising in Washington.
15:31:57 And by the way, I've got about 15. I anticipate taking about that many minutes. So hopefully we'll allow a good amount of time.
15:32:04 I do have a tendency though to blabber so I apologize. If I get excited about something and go on.
15:32:09 Okay.
15:32:12 Maybe Michael can just give me the hook signal or something like that. But see, level rises, sea level is already rising in Washington.
15:32:18 I'm hoping to demonstrate that and we already have identifiable impacts. I think that's one thing that I feel like I can newly say with confidence.
15:32:27 Rates of silver rise are very likely to accelerate so the impacts that we see now are likely to get worse with time.
15:32:37 And I think the final one is the most important one for you all or at least my excitement to sort of talk with you all, which is the vulnerabilities associated with public health.
15:32:48 Or just starting to be understood and the example that Jeff that Michael mentioned the assessment from Jefferson County is one of the examples of really just starting to grapple
with the potential public health implications.
15:33:03 Of sea level rise impacts. So Just to back up and say, what is, what do we mean when we use that term?
15:33:10 I'm going to try to sort of define it with this visualization of data from the It's just a small Indus script device that you've probably sat next to. It sits on the ferry terminal
in Seattle.
15:33:24 It's been collecting water level in Elliot Bay since 1898 so it's by far our longest record of coastal water level.
15:33:29 What I'm showing you here, in, Washington. What I'm gonna show you here is average monthly water level data going back to that extent so, 130 years or close to 130 years in
this sawtooth pattern shows you the annual variation, summer lows, winter, average water levels a little bit higher. So that's what that sawtooth is.
15:33:55 But the key thing to note here is this upward trend. That you can see in these data. And this is sea level rise.
15:33:59 It's the long term sort of over years and decades change in average sea level. And One of the reasons this is important is because all of the other water level processes that
we tend to be really familiar with living in coastal communities.
15:34:13 Things like tides, things like storm driven extra elevation of water that sometimes pushes water ashore.
15:34:22 Are all operating on top of this. Increasing average. Now in this case, this is data from a tide gauge.
15:34:30 And so we would refer to this as relative sea level. This is water level measured relative to the land.
15:34:36 And in Washington, we have some very complicated dynamics associated with land movement. And so it begs the question, is sea level actually rising in Washington?
15:34:46 I showed you that. Data from Seattle and it surely clearly shows an upward trend. But, if we go out to Sort of whatever it has 50 miles in the opposite direction 60 or 70 maybe.
15:34:59 And look at the tide gauge there. Hopefully you can see this. This is what we see.
15:35:03 It's a downward trend and water level. And this is because of these tide gauges are attached to the land and the land is also moving over these same kind of time frames.
15:35:14 So interestingly enough, despite the fact that I'm, I'm trained as an oceanographer and, you know, I'm focused on sea level rise.
15:35:22 We've put a lot of attention in the last couple of years into what the land is doing. And this is a representation of some of those results for those of you that haven't seen
this.
15:35:31 It's mostly just for interest. But to illustrate we've got a whole bunch of dots on here that represent places where we can estimate the rate that the land is going up or down.
15:35:40 Hot colors are uplift. Cool colors are subsidence. These are low rates. They're measured in millimeters per year.
15:35:47 So about as you know roughly as fast as a fingernail grows but over years and decades they start to matter.
15:35:53 They matter for the communities and which these patterns are occurring. Places like Nea that are rising up.
15:36:01 Enjoy somewhat of a benefit from that in the sense that sea level is falling. Whereas, you know, a lot of communities in Puget Sound where the land is subsiding.
15:36:12 Patterns of sea level are exacerbated by that. And so the impacts occur sooner and they tend to be higher magnitude.
15:36:20 And indeed, When we account for that vertical land movement, when we remove it from the tide gauges.
15:36:26 This is the pattern we see. It's a little messy because this is just sort of my own.
15:36:31 Kind of back in the envelope sort of work. But what you're seeing here in the light lines is annual water level.
15:36:38 Average water level from our tied gauges in Washington with the land movement removed and then the dark black line is just a long-term average.
15:36:46 It's a 20 year rolling average with a clear upward trend. Right? So this allows us to sort of with confidence say, okay, we are seeing sea level rise occurring here.
15:36:53 In Washington, this is not necessarily unexpected because it's consistent with what we see globally, but it is nice to be able to point to this and say it is happening here,
especially given the variation that we see when we look at Tygia just because of that land movement.
15:37:10 The rates here are on the order of 5 inches or so over this 70 year time period, something along those lines.
15:37:17 So we're not talking about enormous amounts, but interestingly enough, even this small amount of sea level rise does have impacts.
15:37:25 That first photo that I showed you you may recognize as the Boat Haven in Port Townsend being flooded.
15:37:32 It was during this same event, December, the 20 seventh of last year. 2022 in which much of Puget Sound was impacted by a coastal flooding event that was impacted by a coastal
flooding event that was both, that was unique both because of its geographic extent, areas across almost the entirety of Puget Sound were flooded and also the magnitude.
15:37:52 It set water level records in many locations including in Seattle where we that record goes back almost 130 years.
15:37:59 So a really significant event this photo is from gig harbor but some work some sort of analysis that I've done suggests.
15:38:06 That even the small amount of cereal that we have seen in Puget Sound over the last 60 or 70 years made this event the the the peak that it reached.
15:38:17 About 8 times more likely to have occurred than if that sea level rise had not happened. So there is a sort of a measurable impact of that sea level rise in terms of making
events like this more likely to impact our communities, which is exactly what we would expect.
15:38:35 From something like sea level rise. We also see it in other ways. If you look at again, we can leverage that long record from Seattle and ask questions like how many hours has
the coastal water level in Seattle exceeded.
15:38:50 Flooding threshold and the National Weather Service established these flooding thresholds that they sort of use the community to get sense for how high does the water level
have to get before we start to see things like minor flooding of roads, minor impacts.
15:39:04 So it's called a minor high tight flooding threshold. And these are the number of hours in Seattle that that threshold has been exceeded.
15:39:12 Going back a hundred and close to 130 years and hopefully what you can make out there is just as we as we sort of move further in time.
15:39:19 That number of hours is succeeded more on average every year. So we see these impacts in 2 ways. Some of the impacts are less visible.
15:39:29 And so this is an example from that starting to get towards the public health impacts. This is from the Central East Coast where rates of sea level rise are about 2 to 3 times
as fast as they are here.
15:39:43 And impacts that are a little less visible. Associated with things like compromising septic tanks are starting to become more and more apparent.
15:39:55 As far as I know, I haven't heard definitively that we can document impacts like this here in Washington.
15:40:02 But the expectation is that we will. Because projections suggest that it is very likely that sea level will continue to rise.
15:40:13 Accelerating rates into the future and this is just driven by climate change and these are. Projections for Washington that I won't dwell on except to note that the sort of
upward bend to those lines, these are sea level rise projections looking out to 2,100.
15:40:34 And the sort of upward curve is an acceleration. And these all have that upward curve to them with sort of a range in magnitudes by the end of the century anywhere from a foot
to, you know, 6 plus feet.
15:40:51 There would be dramatically different impacts associated with those magnitudes. Our current best estimate is in that 2 to 3 foot range by 2,100 but again the key thing is an
acceleration of a trend that's already driving impacts in Washington now.
15:41:06 Okay.
15:41:05 So that begs the question. What, you know, is vulnerable in Washington state. What is there that we care about that can be in impacted?
15:41:15 And this is kind of the question that I'm focused on currently. Trying to come up with ways to evaluate this.
15:41:22 We have a local record of evaluating this as well. I'm trying to sort of paint that picture with the assessments that I have on the screen, some of which some of you have been
involved with.
15:41:32 But the earliest one that I'm aware of is from the James Tons Colin tribe who did a sort of a comprehensive climate change planning process in 2,013.
15:41:41 And that was followed shortly by a North Olympic Peninsula wide process. Both of these were kind of an early generation of vulnerability assessment.
15:41:49 They were more focused generally on climate change. And really the results were sectoral scale. Assessments of vulnerability.
15:41:58 What for our region are the big drivers of risk? Things like water supply emerges important, maybe places that are particularly vulnerable like the dunginess river Delta are
highlighted in these kinds of assessments.
15:42:09 More recently, we have seen some local scale and very spatially driven vulnerability assessments that much are much more sort of detailed in terms of where and what assets may
be impacted by flooding.
15:42:25 Now or in the future. So the city of Port Townsend published an assessment in 2,022 and then the one that Michael mentioned from Jefferson County.
15:42:33 Published just a few months ago. These tend to be more detailed asset mapping. So the products of those tend to be things that look like this.
15:42:42 This is from the Jefferson County Report for those of you that haven't seen it. They have a series of maps in here.
15:42:47 And they use these kind of colored polygons to represent risk zones. And then map things like structures and in this case the orange dots are septic system components I think
more so than septic systems themselves.
15:43:01 But allow us to intersect. Those 2 features to at least say you know, hey, there's a possibility that these bits of infrastructure are sort of vulnerable.
15:43:13 This particular assessment counted 520 septic systems within in Jefferson County. Within the contemporary hundred-year flood zone.
15:43:21 And found that another 276 are added to that list after 2 feet of sea level rise, which is something.
15:43:28 That we have sort of every expectation of reaching by 2,100. Now where these, so this is kind of like the phase we're currently in and tell us something about that public health
vulnerability, but they don't come anywhere near to telling us everything.
15:43:46 Generally, what these kinds of assessments sort of assume is that if there's an intersection between that, say septic system.
15:43:54 Or maybe stormwater infrastructure that there is a negative outcome. Whereas in fact, you know, you all probably know, certainly no, far better than I do about variabilities
in those systems, how sensitive they may be individually.
15:44:10 To something like groundwater flooding or groundwater exposure. That need to be incorporated to really evaluate, you know, which ones might fail first and what are the consequences
of that to public health.
15:44:26 Those are all things that really are not. Being incorporated yet because they're thornier questions that are difficult to get at.
15:44:33 So that hopefully sort of communicates the limit. Currently to where we're at in terms of trying to evaluate sort of bigger public health implications of sea level rise.
15:44:44 And then of course that doesn't even get us to the key question, which is, you know, what do we do with that information once we have it?
15:44:49 What are the possibilities? You know, I think that the the septic rules that you all were talking about earlier Sound like they may be difficult enough to implement without
even heading towards this question of like how do we think about and address these septic systems that are problematic from this standpoint.
15:45:09 But it's worth noting that the way that we typically frame the answer to this question, what do we do with this kind of information?
15:45:17 Is we pose 3 general options. That are sort of illustrated here on the screen. We can try to protect what we care about on the shoreline, you know, keep sort of flooding back.
15:45:31 We can retreat it away from the risk zone. Or we can accommodate that flooding. We can try to use designs, for example.
15:45:38 That sort of allow for flooding to occur without with minimal damage. It's worth noting that all 3 of these you know, these are generally configured around.
15:45:48 Fixed infrastructure things on the surface of the land, you know the home here is the sort of classic sort of use or case that we think about this with but there's a lot of
reasons to think that these may not be applicable for the sorts of impacts that we are concerned about in relation to things like septic systems buried in the ground.
15:46:06 So anyway, I'll end there with those questions and just invite any sort of insider discussion and I'm just so thrilled that I have the chance to talk to you all.
15:46:15 My emails at the bottom and would love to follow up in detail with anything if you all wanted to carry the conversation further.
15:46:22 But thank you.
15:46:24 Thank you, we have great overview presentation there and I know that Dr. Perry has at least one question.
15:46:39 I just wanted to, you're mentioning some local impact that we have had at the same.
15:46:41 Local impact that we have had at the same. Local impact that we have had at the same.
15:46:42 County local. Septics compromised by, by high tide events. So particularly in the business area.
15:46:49 And we're having a huge challenge finding new acceptable soil to put a septic in there because the water table is so high.
15:46:57 Oh, thank you, yeah.
15:46:59 And so that can then, and then actually unfortunately exacerbate housing challenges, but you're a related public health issue that we're dealing with.
15:47:07 And then in, in credentials, we had a couple of the agents, which is, I suspect, a combination of sea level rise and erosion, which are of course connected, where we had a septic
fall into the sea, because the hillside went away.
15:47:23 So that was also. No, good, good.
15:47:30 Yeah.
15:47:25 Thank you. Yeah, that's fantastic. And I may follow up by email, Dr. Barry to sort of try to get some more detail about those cases.
15:47:34 Amanda, I know you've got some thoughts and comments on this. Go ahead.
15:47:40 Thank you. Yeah, I, I know of, I know of cases I, work in that area where she's describing the, the, rise being an issue and infiltration into drain fields and subject systems.
15:47:55 The question I have is actually not related to my industry at all. I think it's this information is really valuable and I can definitely see how it applies to to flooding of
septic systems and that being a potential health factor.
15:48:11 Have you given any thought to how this applies to the number of people who have well water? Because I because what is I think obvious but maybe not stated is that.
15:48:21 That you know salt water from the sea mixed with affluent from people's drain fields and septic tanks also can flow into people's well water.
15:48:30 And you know groundwater infiltration is a big enough issue but We can find we can come up with creative ways to divert human waste.
15:48:44 Hmm
15:48:41 It is less easy, I think, to come up with creative ways to create new freshwater resources. Access them and the infrastructure for that.
15:48:49 And so just as the Board of Health and as a community that that is always top of mind for me, even though it might not be obvious that it's top of mind for me in my industry,
but what my industry allows is that we protect freshwater resources.
15:49:03 That's how I think of it. So.
15:49:04 That's that's really great insight. I mean, I didn't I sort of did focus this on septics noting that there are a variety of other public health.
15:49:14 Points of sort of intersection. And I think the point about freshwater wells is, a really good one.
15:49:25 I've never looked at, I don't think those well, I, I'll have to look again at this Jefferson County report to see if they had data on wells incorporated.
15:49:32 I do know that that was a real point of concern for the Jamestown Stalm Tribe.
15:49:38 For the assessment that they did back in 2013 one of the vulnerabilities that was revealed through that process was drinking water for their tribal members.
15:49:50 That live down near Jamestown, Lane. And I'll have to check with my colleagues at a try, but I do believe that one of the outcomes of that was that I know they were trying to
fund.
15:50:04 Moving that well. I guess establishing a new well and I don't know if they pulled that off but they identified that as a key sort of.
15:50:14 You know, adaptation action. There.
15:50:20 Isn't the concern also not so much the specific well at the aquifer that the that the well is tapping into.
15:50:29 I mean, if you're still tapping into the same collection of water that has been infiltrated.
15:50:35 With seawater, you know, we may have to move the world quite far. Yeah, that's, that's.
15:50:43 Conceivably, yeah. I don't know enough about how those systems work to know. To be able to address that question.
15:51:00 Right.
15:50:53 And other questions.
15:51:07 I just put my hand up, you didn't miss.
15:51:10 Okay.
15:51:12 And it's been a great, Great presentation and it kind of segue with or not Segways, but on the heels of a earlier conversation with the board.
15:51:24 I'm the director of environmental health and water quality and one of the things that's coming up in the state code is looking at our local management plans for septic systems
that are in these areas.
15:51:37 And I'm wondering since it's already rapidly happening in the southeast and other places, what policies are people putting in place in other places, what policies are people
putting in place in terms of what policies are people putting in place in terms of these and what what's the other thinking out there?
15:51:55 I mean, in terms of these and what's the other thinking out there? I mean, it's great to be able to, you know, in terms of these and what's the other thinking out there?
15:52:02 I mean, it's great to be able to, you know, protect, retreat, and accommodate.
15:52:10 But there's also a sense of, you know, property rights and people really want to build on these pieces of property.
15:52:12 And we have a lot of those properties down in our South County that are small. They can't even hardly accommodate a septic system now and people still want to develop them.
15:52:15 So I'm just wondering what you've seen out there in terms of policies and where you can direct us because we're gonna have to be looking at these issues over the next 2 years
as soon as the state code is adopted.
15:52:20 Yeah. Yeah, it's okay
15:52:23 And before you answer. One, hold on 1Â s before you answer that question. Is that you who are sharing your screen or is that Michael?
15:52:32 Sorry, that's me.
15:52:35 Yes, absolutely. Thank you.
15:52:35 If you could stop sharing your screen, then we could. Thank you very much.
15:52:40 Yeah. So it's a It's it's a great question and one that I spent about an hour.
15:52:50 Which was all the time that I could afford and the lead up to this kind of Trying to dive into especially the central east coast And unfortunately, I have a very unsatisfying
answer and that I couldn't in that time at least I didn't find any clear.
15:53:05 Sort of like, I guess policy. Indications of directions that that jurisdictions are going to regulate.
15:53:20 Septic systems differently or newly. In light of this kind of. You know, hazard or stressor.
15:53:30 I did find a few, Good to documentation. One was a sort of report that came out of a Virginia.
15:53:40 County. The other was a published paper that really were more oriented towards how do you identify those systems to.
15:53:50 Focus on and there also was you know some talk about different types of systems that might be better able to to deal with.
15:54:01 Flooding at least and sort of rising groundwater. Relative to other types of systems. I know very little about how septic systems work or engineered and so I don't wanna try
to sort of characterize what they were talking about but I'd be happy to pass on the limited bit of documentation I found, but my overall conclusion was I'm actually feeling a little
like I should be finding more than I am.
15:54:30 So I think there's a lot of room for innovation. I guess is one way to characterize that.
15:54:34 Maybe optimistically.
15:54:38 Yeah.
15:54:43 Yeah.
15:54:34 And if you, if you do find any. Throw more away because we're gonna be we're gonna be looking at that at this over the next 2 years so super appreciate this in advance.
15:54:52 Yeah, 2 quick one kind of follow up on Pinky's question. I'm just wondering, you know, we've gotten a little bit more liberal in Jefferson County about.
15:55:02 Holding tanks recently and I'm wondering if especially in some of these kind of land encumbered properties, a closed system like a holding tank which we've I think.
15:55:11 But conservative about because of, you know, it just, it's more maintenance. You know, they gotta get it pumped or, you know, the affluence gonna go somewhere.
15:55:19 I'm wondering if they might be more secure. So for some of those. Shoreline properties it might be worth something to consider that's really more of a question for staff then
also thinking about the, and this is maybe more from Michael to the, the Brennan, you know, we're trying to come up with an argument to make about the connecting to the argument to
make about the connecting to
15:55:39 the suit state park sewer to the flood way. And, and I'm wondering, to make about the connecting to the State Park, to the floodway in Brandon.
15:55:54 I'm wondering, are deltas, you know, it's the basically the Dengineers Delta there, is where the Brennan community is.
15:55:58 We're trying to connect to the sewer and get people and what businesses especially and maybe residences as well off of septics and I'm wondering if this work contributes to
a white paper that we might present to aology saying it's more resilient.
15:56:04 To sea level rise to connect it to the sewer and I guess what both Ian and Michael's thoughts are.
15:56:11 In that regard.
15:56:14 Sorry, that's a lot.
15:56:14 I mean, I, you know, on the second point, I would note that,
15:56:25 I have I'm in this position where I get to say things without thinking fully about you know the policy implications and all this sort of political implications.
15:56:31 Okay.
15:56:35 Okay.
15:56:34 So I just want to point that out. But generally, Generally, I think it's fair to assume that a connection to a central, sewage treatment system is considered more resilient
at least in regards to the impacts associated with sea level rise.
15:56:51 I mean I think this is something that came up on. Some in some conversations that I've been involved with associated with the Dungeness River Delta, you know, again, you have
a bunch of sort of single.
15:57:03 Family homes. All on individual septic systems, you know, in a very low-lying Deltaic environment and those you know the assumption is that
15:57:13 Better off managing 1 point of failure than you are managing multiple points of failure. However, you know, there are it's it's very difficult to do that right it's expensive
and so it obviously has not happened there.
15:57:27 But it is, I think it's definitely an argument to be made in favor of resilience to this stress or at least.
15:57:34 Yeah, Graham, did you have a follow up comment or question?
15:57:37 Yeah.
15:57:41 Right.
15:57:40 No, I'd love to hear from Michael too if he's got anything to add.
15:57:45 Oh, I was just gonna add in Brennan in particular, I mean, so there was a, you know, a map focused on Brennan in this sea level rise study and also Amanda looks like she has
a question about.
15:57:59 Where to find it is that the study that Jefferson County study. I'm not sure if DCD has put that on their website yet or not.
15:58:08 I will look and if I can find it all, I'll email it out.
15:58:15 And I had a similar question for Ian in the last presentation. You know, when you have got a riverine system and coastal flooding.
15:58:27 You know, especially you get a combination of effects of, you know, high sea level at the same time that you've got.
15:58:35 A lot of. River flow, then you've really exacerbated the flooding problem potentially.
15:58:42 And you know, that that kind of thing was not. Modeled in the Jefferson County sea level rise, but.
15:58:51 I think it. Would be a really interesting thing to look at in more detail. If possible, because I think the the impacts could be a lot worse in those kind of those kind of areas.
15:59:09 We're going to have to wrap this up in the back 2Â min. So, Ian, if you want to add the final word, that would be great.
15:59:16 Well, yeah, well, I'll take the opportunity well again to say thank you for just having the chance to meet in here.
15:59:23 Here your questions. It's very informative for me. To follow up on on Commissioner Brotherton's comment, I think that you know the other thing about trying to transfer to those
to those community systems.
15:59:38 That is advantageous is I ended with that framing of these kind of 3 options, you know, protect.
15:59:45 Retreat or adapt and or sorry accommodate and those accommodation sort of options typically involve things like raising homes, maybe floodproofing first floors.
15:59:56 They're kind of well known options that you know tend to be embedded in building codes for new places.
16:00:03 One of the things that we've noted repeatedly and that is kind of well known is that, you know, you can do all these things to a home to make a more flooded adaptable, but you
may be ignoring or forgetting about their septic system.
16:00:16 And that's sort of leaving a big bit of potentially quite important infrastructure. Expose to these hazards even if you've flood adapted the home.
16:00:25 And so moving on to the sort of. Central system is a way to be able to utilize some of those accommodation strategies, leave homes in place with all the benefits that accrues
in terms of, you know, tax base and maintaining community.
16:00:39 Cohesion and all these things while, sort of removing the sort of potentially remaining risk associated with doing that, which is having infrastructure on the ground that can
fail.
16:00:54 Okay.
16:00:51 We're gonna have to cut this off because we have another very important presentation. You wanna make a 30Â s comment or because.
16:00:59 Wait, just 30Â s comment to be the devil's advocate in the room is that my one argument about centralizing waste is that the potential for.
16:01:11 When there is a catastrophe, it is on a large scale versus a handful of neighborhoods.
16:01:19 You know, you might have 10 houses in a neighborhood and 10,000 gallons of waste versus 50,000 or more that can flood into the sea.
16:01:27 So just things to consider. It's always a it's a it's a wing.
16:01:27 Yep. These are all cost benefits, yeah.
16:01:31 Great. Well, I'm glad we gave you an opportunity to comment. Thank you so much for taking the time.
16:01:38 Thank you for having me.
16:01:39 It's been wonderful and continue good work and we hope to hear more from you in the near future.
16:01:44 Okay, thank you.
16:01:44 Okay, so they're getting, well they're getting set up again, I think it just to grab for 1Â s.
16:01:49 If I can have 15Â s to say. I've had the, good fortune to both have a lot of fun with Ian and undergrad and known for a long time, but also worked very closely together on the
2015, sea level rice or excuse me, preparing for climate change report.
16:02:05 And it was like pulling teeth to get anyone from, to represent health. In that process and I just want to say how great it is that we are all here thinking and talking about
this because Obviously it's important.
16:02:16 Yeah. Yeah.
16:02:20 Okay, thank you. Thanks.
16:02:18 Okay, yeah, good luck. Thanks and continue. Right. Well, we actually did save enough time for, so now, let's see, sexual reproductive health, school-based health clinic report,
and this is going to be Denise Baker, and Susan O'brien, it's all yours. Thank you. I'm like right next to you.
16:02:54 So I, Lindsey, Scale, should have the slides. She should be made a panelist.
16:02:59 I tried that. She, declined. So I wanna, I'm Susan O'brien, nurse practitioner at the School Base.
16:03:08 . Okay And, I. I've been with the health department for. More than 25 years.
16:03:17 So it initially I want to just make sure I thank Lensey because she actually did our slides. Thank you, Lindsey.
16:03:23 And thanks for hopefully you're gonna. Advance them too. There's a few people that are new on the board.
16:03:34 I hope we're gonna do is do a little bit of an overview of our 2 main clinic services that we're new on the boarding of what we're going to do is do a little bit of an overview
of our 2 main clinic services that we do.
16:03:40 And do updates. And I'm gonna, pass over Dr. Melinda. Hi, my nation's Dr.
16:03:50 Melinda Bauer. I am an atrophic position. And I'm going to talk a little bit about our main clinics.
16:03:58 Our main clinic in Port Townsend, which is right next to QSC. We've been providing medical services for 35 years, which is very impressive.
16:04:10 And we're still doing that. Lots of other local partners are not. We also have a South County clinic in.
16:04:21 And we also have a South County clinic in Philippines or not. We also have a South County living in Philippines.
16:04:27 And you can see all of the logistical locations hours on the slide. And you can see all of the logistical locations hours on the slide.
16:04:34 Our policy clinic started when I started here about 2 and a half years ago and the intent.
16:04:35 Was to offer more access to that South County. And we haven't really had a provider there per se.
16:04:43 In the past, we previously we would do WIC and Our nurses will do birth control with standing orders, but now, now that I'm there, we're pretty much able to do most things and
I'll get to the services and.
16:04:56 Most things that you could do at your primary care doctor. Please let people know that. Living in South County because I feel like this clinic is severely under utilized right
now.
16:05:07 And it's every week. Yeah, it is every week. Yeah, it's hard for me to read that. Wednesday. Every Wednesday. I'm there.
16:05:15 Could you advance the side please?
16:05:16 So these are the services that we do. I'm gonna change the order here. We are doing preventative healthcare for all genders so that means your annual exam for some of us if
you're had, depending on who you are, depends on what that means.
16:05:35 We are also doing, who you are, depends on what that means. We are also doing, depending on who you are, depends on what that means.
16:05:38 We are also doing SPI screening, evaluation and treatment, all kinds of birth control services.
16:05:41 Both. If you're pregnant. And you need support or if you don't want to be pregnant and you need support, those options, we, we are here to help you.
16:05:57 We also offer prep, which is, I'm not sure how long they've been doing correct, but for a couple of years and that's for our HIV positive or.
16:06:04 Preventing HIV in our community primarily. And then I just want to say that these are the main services that we do, but kinda like I said already, you know, Traditionally, we
say that we do women's health and now we're trying to be more all inclusive of what we do, but we, you know, we support people when they have needs.
16:06:27 We have a lot of patients who have a lot of patients who, you know, we support people when they have needs.
16:06:31 We have a lot of patients who are primary care providers that judge in health care and they can't get in to those providers very easily.
16:06:37 We're really easy to get into those providers very easily. We are really easy to get into so a lot of people will come to us for We also like to be a bridge to different healthcare
if people are new to the community and they can't get in for a year and I've heard this.
16:06:45 Okay, unfortunately a lot. People can come to us and we can help to support them getting into the direction healthcare system and we can get them started on medication refills
or if they have whatever it means they have.
16:06:59 We really try to serve the community as much as we can within our scope. And you know Susan and I have a lot of scope so yes the other thing I just wanted to say that I think
all of you know is we are the Planned Parenthood of Jackson County, the other planned parents in this region are in Riverton and Los Angeles.
16:07:24 So a lot of people will come to us for those services and we are happy to provide that.
16:07:31 Oh, right. So, Beata is our medical assistant and when she came to us she had some medical background that she was not technically an MA so she is going through this training
process to be to have a certification.
16:07:49 Predible system, which has been amazing and includes, learning. And, learning.
16:07:57 And, and, learning. And, and, Learn, H to Blood Draws.
16:07:59 And while I love doing Ledros, and while I love doing Ledros, it is very nice that, I have somebody else to support me with Bl, because I don't always have time to do blood
draws.
16:08:08 It's very helpful for, to all of our clinics. She, helps us money. And say Friday at the main.
16:08:15 And she is with Susan, at Port Townsend for one day. And, this training has been.
16:08:20 Instrumental to us doing the work that we're doing and being able to be efficient and seeing as many patients as possible.
16:08:22 Next slide. Was she on staff doing something else before? This training or she was hired specifically for. She was hired specifically for this.
16:08:33 Yeah, she she was a caregiver. You know, that was her background and was really willing to take develop and they were really excited to help her develop because That's been
a good thing.
16:08:50 So I'm going to start to talk about a little bit about the school based health centers, which, in 2,007 we got a, brand from Department of Health to do a planning grant to do
that and had a whole year and got everything in place or she might come in for towns and to have open these clinics and in 2,008 there was supposed to be an operating brand that was
to follow for
16:09:15 those 2 agencies over for this along which we would have been one of those 2. But of course we kind of, and we did not get that.
16:09:27 One of those 2. But of course, we kind of, and we did not get that funding.
16:09:30 And we did not get that. And we did not get that funding. And our director at the time, to, and we did not get that funding and our director at the time, she, decided to open
any.
16:09:35 And our director at the time, she, one, decided to open any manner in a fair because she really believes in the value of school based off centers.
16:09:38 So that, open, we opened our school based health centers. So that, open, we opened our school based health centers.
16:09:41 So that, open, we opened our school based health centers. So that, open, we opened our school based health centers in, in, in, in, 2,008, school year, 2,008, 2,009.
16:09:44 So we're now in our and then in spring of 2021, we were able to open full scene had also expressed interest as we did that whole planning.
16:09:53 For a year and a half or so. And we were able with. Hiring of Dr. Melinda, we were able to open the whole scene in spring in 2021.
16:10:04 And for those of you who may not know about the school based health centers, we, do medical services there as well as mental health.
16:10:10 With national counselors, so we cover both of those areas. Next slide, please. Oh wait, I forgot.
16:10:17 It's really important to say, in the last slide, we are partners with Geoffrey as a public health.
16:10:24 Jefferson Health Care and of course the school districts. With partnership between those 3. Agencies. Very important.
16:10:33 Okay, next slide, please.
16:10:36 These are the services that are provided and all the different school districts. So, for Townsend High School, Chemeca, junior, senior high school.
16:10:46 We'll see in high school and then Brendan does not have school-based clinic, but there is a mental health person.
16:10:54 And also, yeah, and I was gonna say, and, and also has a. Now, but not yet.
16:11:07 And I just want to iterate the partnership aspect of this because this is definitely. And I just want to iterate the partnership aspect of this because this is definitely partnership
between Jefferson Healthcare, Jefferson County, the partnership aspect of this because this is definitely partnership between Jefferson Healthcare, Jefferson County Public Health, the
school districts and the state through the community prevention and wellness initiative because we use money from our community prevention and lawless
16:11:25 initiative to fund the mental health. Supports in the school based health centers. And so each one of our entire team coalition.
16:11:31 . 1, one mental health center thing in each one of the school districts. And then we also partner with the EFD through the one tenth 1% that also pays for days of mental health
services in school-based health centers.
16:11:48 So this is a huge undertaking that Susan and Melinda and I are involved in and involved in keeping going.
16:11:56 Every single year to make sure that there is plenty of mental health services. That there is plenty of mental health services.
16:12:14 There's no one entity, to make sure that there is plenty of mental health services. That's the one entity, fully funds any of this.
16:12:16 And so she has yeah, for mental health loan. Each mental health person has 3 different contracts.
16:12:22 That they are working on. Next slide, please.
16:12:35 And these are just some of the statistics from last year. And the different schools are in different colors but this just shows who are the users by rate and percentage of usage.
16:12:48 And I will just add that the, some younger grades is because they are K 12 and I am there and I do see those kids for sports physicals and musicians. I don't feel well.
16:13:01 I hurt my leg, etc. So it is actually kind of exciting to have that K 12 piece to close.
16:13:12 And then just is there a correlation to like the total number of students that you see?
16:13:20 I'm sorry. I'm with with this bar chart. How many? Folks does the green will see mine represents.
16:13:31 Or is that another slide? Yeah, what you're saying is only a version of a percentage. Yeah, that we have.
16:13:37 And I just pulled out a few things. But yeah, so of all the people in full seeing who were seeing that clinic, 20% were in twelfth grade for example, but those numbers are not
on this slide. 20% were in twelfth grade, for example, but those numbers are not on this slide.
16:13:54 But do you have a sense of like, of people who come see. Yeah. Boy. In close.
16:14:09 And it's actually really large because they have a large percentage of kids that are involved in sports. I would say most like 75 plus percent. But I can't remember that number
either. Okay.
16:14:11 So in terms of percentage of how many kids are enrolled, I think she might come up. 35%.
16:14:15 Okay. Thank you.
16:14:20 So next slide, please.
16:14:30 So these are just some of the talk. This is medical services, by the way. We have the data we collect in the clinic is the medical is one, mental health is separate.
16:14:43 So this is just the medical, but these are the top. Yes, concerns that we see as conditions for students coming in.
16:14:50 And as you can see, there's a lot of mental health stuff that we see as well. Because you know, one person, you know, they have lots of things going on.
16:14:59 And, what I'd like to say to these 2 slides and the number of students who use these, school-based health centers.
16:15:07 Is that what this is illustrating is how important is for young people and students to take agency over their own health care.
16:15:16 And so what this program provides is this opportunity for students to be able to take agency over their own health care as younger ages, which in turn is going to impact.
16:15:30 Long term health care come in chronic disease in internal child family health. All of these life force issues that are really prominent in our public health.
16:15:44 Foundational services. And so, I also want to say that depth and healthcare now has a program at the high schools.
16:15:52 That is promoting Studying health. Related academics in order to try to Good kids to choose health care in their college years and then for their professional careers.
16:16:08 And I think this duck helps really nicely with what we're doing for student agency in their own health care and then the depths of health care's work in promoting healthcare
field as a career.
16:16:23 So this one to mention that. Could I ask a question? Can you describe the difference between reproductive health and pregnancy STI prevention education?
16:16:32 So reproductive health is actually if anybody comes in for anything. Pregnancy test, birth control. Thank you.
16:16:43 Pregnancy SDI prevention education is actually under the education piece and what are the things that we are what are we doing to do for education?
16:16:56 So usually when we see somebody who really like help, we're also keeping that education as well. And so the reproductive health is actually the way we check what is more of
what we're actually seeing the person their clinic visit and then we have a whole another section of education so that's the education around that.
16:17:13 Next slide, please. Craig's got his hand up too. Go ahead.
16:17:23 Yeah, thanks. Great, program, of course, huge supporter. I'm just curious if you can talk a little bit about that.
16:17:29 Eating weight. It just seems like that kind of healthy habits there, you know, tie into depression and so many other things too.
16:17:38 And I'm wondering if that's part of practice in the schools at all. How is that practice in schools?
16:17:42 We have 2 different, forms that we get this information from. So any student comes to us for sports physical part of that history form ask the student a question of are you
concerned or has anyone mentioned any concern about your weight?
16:17:59 So if anybody marks that, then we ask, we're curious, we ask, what does that mean?
16:18:05 And do you want to talk about that? We also have another form. We call it our health. Profile that every student who comes in to the school based health center fills out once
a year.
16:18:16 In this form is a really lovely screening farm that includes all kinds of questions. I'm that gives us information about things that we may not know about that student that
we may want to talk about like violence.
16:18:30 Self harm, eating issues with eating, do eat in private. Do you naughty?
16:18:38 Do you have concerns about reading, etc.? There's questions about drug use. Substance abuse.
16:18:46 Being sexually active, being worried about. Something you're curious or wondering about STIs, there's there's 2 pages of questions on this profile.
16:18:56 So if anybody marks that particular piece, there's questions on that form, that particular, piece, there's questions on that form, then there's questions on that form, then
we talk about it and we've talked about it.
16:19:08 We market on our form that we talked about Just a quick heads up. We've got about 10Â min, so just to your your presentation.
16:19:13 Okay, next line.
16:19:17 So.
16:19:20 In 2022 we got a new Department of Health School based health center grant that Susan and I put together.
16:19:32 Just 14 years later they didn't do it in 2,009. They finally offered it. And it was lovely that gave us a hundred $50,000 and it was lovely they gave us $150,000 and that money
went directly toward it. And it was lovely.
16:19:46 They gave us a hundred $50,000 and that money went directly toward increasing our mental health counselor one day at each school and increasing time at Fort Townsend because
at the time for some reason shouldn't have had more time than for time.
16:20:01 Fair compared to the number of students. So that was 2022 this year. They continued to give us this brand.
16:20:11 It is now a two-year grant for 110,000 each year. And it is continuing to support those same things.
16:20:18 We weren't didn't give any more money so we weren't able to do anything extra but that money has been really important.
16:20:24 Post COVID, mental health issues are real. We see it every day with our teams. We wanna do everything we can to support them.
16:20:32 And this grant has been really. Absolutely critical for that. And the fourth day is the coalition money.
16:20:41 Denise has been working her magic on for the additional day. And how secure is that funding going into the future?
16:20:51 It's a great question that we do not have an entity because it is a department. That we have this for this year next year and when we talk to when we ask that question of person
felt they think that it is good, but of course you never know.
16:21:05 There seems to be a lot of support. Yeah, the school based clinics in general. So, there's still some funding coming through the paper health advisory committee through the
one tenth funds as well. Yes.
16:21:16 Next slide.
16:21:18 So this is, but just a slide, DSM 5 if you're not familiar with that's the, the source that we use to make medical diagnosis.
16:21:31 Or mental disorders, why we do this work, you can see based off of the ages for 10 to 20 the challenges with all of these different, like actual diagnosis.
16:21:42 Like I said, we see this every day in our clinic on the medical side and on the health side that our teenagers are really struggling and I.
16:21:52 I actually think it's worse post COVID and it's very real. We also ask. We do have screens on suicide with every patient at least once a year.
16:22:04 As well as anxiety and depression and, and it's hard. These, our kids are really struggling.
16:22:10 So. This is one of the many, many reasons why we do this. Next slide.
16:22:19 And this is just, more information based off of each school. We actually asked the kids to fill this out.
16:22:28 We give them a piece of paper and all these things are listed in anxiety, stress, families of standing center and if they are concerned about anything today they market and
then we ask curious questions.
16:22:38 Oh, tell me more about your anxiety. What does it mean when you say grief, etc.? And so this is just a little bit of information.
16:22:46 The darker, I think it's the darker number is what the client said. And then if we actually talk about it, we market as the, but it shows a little bit about each school district
and, you can see there are some trends, a little bit about each school district and, you can see there are some trends, but there are also some different. Also, this is mental health,
not us.
16:23:07 So mental health. OUt us. So mental health. Okay.
16:23:11 Next slide.
16:23:13 So the other thing I wanted to say that's really kind of an update is we recently had a student who has graduated like 3 or 4 years ago who got involved in our advisory committee
and, was doing some health equity.
16:23:29 Presentation there and I ask that if they are willing to work with this more because we want to make sure we are serving as many people in it.
16:23:41 We want to make sure we are serving as many people in an FBI and they were willing and this is all the Abilina who did some amazing work last January.
16:23:47 And they were, really, and this is all the Abilina who did some amazing work last January through June and their vision was to do a survey for all the students.
16:23:53 And, their vision was to do a survey for all the students, who did some amazing work last, January through June.
16:23:56 And, their vision was to do a survey for all the students in, high school to see what is going well, school this clinic, whatever the gaps that we, where we are.
16:23:57 Thinking or finding out needs that the students need. So they were. Sort of working on student engagement and did this incredible job.
16:24:11 The, the student engagement was really amazing and some of the students were helping with the survey and figuring all that out and got gathered a lot of really interesting information.
16:24:19 So the survey has been done. We're working on getting that into a report and we found some kind of interesting things there.
16:24:27 And one of the things that, kept coming up from the students is that the high school students is that this needs to happen.
16:24:33 So we actually can start as a result of that we have started that process. We've talked to administration.
16:24:38 Our administration and then administration school and there very supportive next week we're having a. Meeting with the community and the families and the week after that we're
having a school board meeting.
16:24:52 And the school board has always been really supportive of the schools. For school-based health centers, I don't think that'll be an issue.
16:24:59 So we're kind of moving forward and the hope the goal is that maybe by next August. Blue parent school based center will be open so that's very exciting so those were the 2
things there I ask Susan how you anticipate funding that significant expansion.
16:25:17 So, that's Denise's answer. Well, the male health person is already on or 2 and a half days.
16:25:27 So there's that. A health person is already on war 2 and a half days. So there's that. And I see Apple grabbing. And again, we're partnership.
16:25:51 We have a really strong partnership with Jefferson Healthcare. And we're hoping to talk to that partner.
16:25:54 We also have foundational public health services money. And we also will be able to leverage some of this operational.
16:26:13 And then I have other ideas operational costs of, you know. Staffing clinic in the next days. So we already had 2, 3 byters.
16:26:19 In fact, actually, you were. Phone phone, So shuffling that around and find any there actually this is just talking about in addition there's gonna be quite a you know, there's
going to be quite, you know, in addition, there's gonna be quite, you know, in addition, there's gonna be quite, you know, facilities and construction costs, which looks like we're
gonna
16:26:44 be quite, you know, and facilities and construction costs, which you looks like we're going to be really, really creative about the.
16:26:51 Costs, which looks like we're going to be really, really creative about the schools are not necessarily in the position to that bill.
16:26:52 So that's, this is why we're building a plan. We do want to This is one of our.
16:26:55 Largest threat facing programs that Jefferson County Public Health. Has been supporting over the last . And, I really want to emphasize what a popular program this is and how
incredibly beneficial this program is.
16:27:17 To Jefferson County. And so I really am sort of making a picture. To say that Jefferson County.
16:27:28 Really needs to support this. But now at the county level. Yeah. Let's see. That the covered bike shelter.
16:27:44 That is constructed with over $10,000 worth of donated labor and materials from the. That was constructed with over $10,000 worth of donated labor and materials.
16:27:55 Hi. Thank you. I just, I wanted to tell, Susan and your, the whole crew, as a parent of 3 adolescents who have all benefited from the resources available through student based
health programs.
16:28:11 I deeply, deeply value the work that you do, for my children and their peers who I know robustly use your services.
16:28:20 I also want to just ask is part of your funding model taking private insurance because I made sure my daughter took her insurance card to with her so that you guys could have
it so that you could bill it.
16:27:53 Yeah, I said, you notice that Amanda has had her hand up. You're Thank you.
16:28:34 And I just want to make sure that that's part of the funding model.
16:28:38 That's an excellent question. That was one of the ways that, you know, when we're going on a, a lot of this, the clinics in Seattle weren't doing the billing.
16:28:48 So we did that right off the, the clinics in Seattle weren't doing the billing. So we did that right off the, private insurance and also so yes, and that is one because by building
insurance when it's available.
16:29:02 Our clinicians often pay their own.
16:29:04 I think there could be some community benefit and us promoting that idea to families because I don't know about you all and you're raising teenagers but they're not it's not
the kind of thing even if you guys ask them they might not remember to come home and ask a parent, but if parents knew that their children could utilize those services, it might be.
16:29:24 Another way we could help.
16:29:29 And when the first 2 clinics were built, it was also through a lot of community like the flooring people donated the vinyl, the workshop kids ripped out the old carpet and the
other carpet place donated half the, you know, the labor and the.
16:29:52 And then Boeing blew the, I mean it was a whole thing. So it's our community. And then Boeing, I mean, it was a whole thing.
16:29:54 So with our community, Dr. London, I've also been mentoring 3 in the last 12 months, 3 different nurse practitioner students.
16:30:11 To bring up the next generation of people. Anti-racist 6 week studies, that's kind of what's been going on for our department that's kind of what's been going on for our department
that we've been doing this long.
16:30:22 Intensive with you, Sawa, which has been really great. And we did this retreat.
16:30:28 For team building. So those were the last bits. That's all we need. So those were the last bits.
16:30:41 That's all we need. I know, Susan, you've been out of a long time.
16:30:45 Well, then it turns out.
16:30:49 Yeah, just want you to know and also the public to hear. The building of It's got to be one of those influential things you can learn as you so many impacts in terms of a person's
decision making their understanding of health thinking behaviors there.
16:31:14 Closeness and engaging around trusted adults in a system that can be very scary to young people. I think they get a very inclusive environment and a very humble and homey environment
for people to save to learn that.
16:31:31 Well, you're being with technical aspects. Hey, great. Yes.
16:31:42 Hey, just super, super quick is I just noticed I'm in the packet there was some additional slides one of them listed out SPHC users by gender and has different categories for
male, female, transgender, and non binary slash gender queer.
16:32:02 And just wanted to make a note that that's a little confusing since there are trans men and cis men and trans women and cis women and it would be really nice to see you know
2 separate breakdowns you know male female and non-binary and then separately cisgender and transgender slash non-conforming breakdown because I personally don't know how to interpret
whether or not the male category
16:32:29 is cis men only or all people who identify as men, etc.
16:32:35 Thank you very much for that addition. I think it's confusing the language for many of us and we all need more education on that.
16:32:44 So thanks very much. Alright, is there anything else? Go to the order yes. Just real quick.
16:32:55 I know, that the efforts that Jefferson Healthcare has been doing around workforce development in the high school have been crazy successful.
16:33:01 My daughter said had a hard time getting into the job show and shadowing program, the anatomy and physiology class built up instantly.
16:33:07 There's just a ton of opportunity. Kids are excited about health care careers right now. And so I hope public health is part of that conversation. Yeah.
16:33:22 I just want to take 1Â s to thank Lindsay Scalp of the entire team's, for making these slides for them.
16:33:32 My pleasure. Thanks everyone.
16:33:32 Alright, Thank you all.
16:33:38 Cool.
16:33:40 This is mean we'll discuss later the agenda planning for the next meeting. I'm sorry. I know where.
16:33:47 But.
16:33:45 Yeah. We will and we have quite a number of things that are already initially. You remember, including the addition of what we talked about earlier with regard to stable to
health and the.
16:34:04 Okay.
16:34:04 And we could do that as a special meeting too and then. Or I don't know. Getting in the way.
16:34:13 The business of the Board of Health. We can consider, I'm not sure it came out or it seems worthwhile.
16:34:26 We have maybe not. We've got some, with those, ones that are on the table then.
16:34:38 Yeah, this is about to be. I don't think it's not. We've got some, or those, those are on the table. Done.
16:34:43 Yeah, this is about to
16:34:41 Apple should I email you directly if I have specific questions about that? Are you the best point of contact for that or should I email Glenn?
16:34:45 No, and then shares everything from the. So that would be.
16:34:49 Okay, great. Thank you so much, everyone. Have a wonderful day.
16:34:53 Bye.
16:34:53 I could see if there's a lot of interest. You see, Yeah, And so, yes, you see, we've thought we should take it out here, not as a VOC.
16:35:25 And so there's what else in there. Hey, Glenn. Can I say this in front of you?
16:35:30 It would be, I think it would be great if we were all sitting around the same table and I wanted to say this in front of you it would be I think it would be great if we were
all sitting around the same table and I wanted to sit down here with you guys today, but the owl was in front of you.
16:35:40 It would be, I think it would be great if we were all sitting around the same table and I wanted to sit down here with you guys today, but the owl was, the back of my head.
Oh yeah, I know I wasn't actually very busy both of them.
16:35:46 You know, all the bit around the middle. I feel like I would be a lot more. Yeah, you have to think it's hard for people. You're doing, and you can see the speaker.
16:35:59 I know you and I We're talking. Well, we were actually off screen. So let's maybe know that setup, detail. Okay. And maybe we put the owl down here at the very least.
16:36:14 But, but it just felt like I was like, oh, now. And maybe we put the owl down here at the very least.
16:36:17 Yeah, and maybe we put the owl down here at the very least. Yeah, and maybe we put the owl down here at the very least.
16:36:22 But, but it just felt like, I was like, oh, there. And, and, that's, that, and it just felt like, I was like, oh, there, I want to know.
16:36:25 You know, you know.
16:36:38 Right.
16:36:43 How are you doing?
16:36:47 Yeah, sorry. Okay. She might do something like that. And that was about a month since then. Yeah, she might do something like that.