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Home My WebLink About081524 Packet�e�ehson Public H Board of Health Meeting August 15, 2024 Jefferson County Board of Health Agenda Minutes 02 Public H August 15, 2024 Regular Meeting Agenda Jefferson County Board of Health Thursday, August 15, 2024 @ 2:30 PM Jefferson County Courthouse — Commissioners' Chambers 1820 Jefferson Street, Port Townsend, WA This is a hybrid meeting: Virtual and In -Person Attendance You can join this meeting by using these methods: • Zoom Meeting: https://zoom.us/i/97862703889 This option will allow you to join the meeting live. You will need to enter an email address. If you wish to provide public comment, click on the hand icon at the bottom of the screen to "raise your hand." Participation will be up to the Chair and/or Clerk of the meeting. • Audio -only: Dial: 1-253-215-8782 and use Webinar ID: 97862703889# This option will allow you to listen to the meeting live. If you wish to provide public comment, press *9 to "raise your hand." Participation will be up to the Chair and/or Clerk of the meeting. ■ In -Person: You are welcome to join the meeting in -person. In the event of technical difficulties, at least one of the methods above will be accessible to the public. Please try all methods first before calling 360-385-9100 to report any issues. Public comment will be accepted and can be emailed to: BOH( )co;jefferson.wa.us until 5:00 PM the evening prior to the start of the meeting. AGENDA CALL TO ORDER — Chair Dean I. Public Comment (15 mins.) Public Comment Periods are dedicated to listening to the public. Each person may address the Board one time during these periods. To ensure equal opportunityfor the public to comment, all comments shall be limited to 2 or 3 minutes per person, depending on the volume of public in attendance. II. Approval of Agenda III. Approval of Minutes of July 18, 2024 Board of Health Meeting AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request IV. Old Business and Information Reports 1. Jefferson County Public Health Report (Apple Martine) (10 mins.) 2. State Board of Health Update (Kate Dean) (5 mins.) 3. Infectious Diseases Update (Dr. Allison Berry) (10 mins.) V. New Business 1. Overview of the Special BHAC Meeting — Opioid Settlement Funds Planning (Anna McEnery, Heidi Eisenhour, Apple Martine) (30 mins.) 2. Zoonotic Disease: Lyme Disease (Dr. Allison Berry) (20 mins.) 3. Consumer of Public Health position on Board of Health (Apple Martine) (10 mins.) VI. Future Potential Agenda Topics: ATSDR Report on Port Townsend Air Quality (Sept.) Selection of Board of Health member: Consumer of Public Health (Oct.) Emergency Fund for Public Health Strategic planning for the county The Child Development Center Sewer projects / wastewater Diversity, equity, inclusion, social justice VII. Announcements Board of Health Training in Leavenworth, October 2-3, 2024. ADJOURNMENT BY: 4:30 p.m. Next Scheduled Meeting: September 19, 2024 2:30 — 4:30 PM Jefferson County Public Health Hybrid Meeting AT A REGULAR MEETING, THE MEMBERS MAY ADD AGENDA ITEMS AND TAKE ACTION ON OTHER ITEMS NOT LISTED ON THIS AGENDA. Americans with Disabilities Act (ADA) Accommodations Provided Upon Request Public HealtFi REGULAR MEETING MINUTES Jefferson County Board of Health Thursday, July 18, 2024 @ 2:30 p.m. Jefferson County Courthouse — Commissioners' Chambers 1820 Jefferson Street, Port Townsend, WA Hybrid Meeting Board Members Greg Brotherton, County Commissioner, District #3 Kate Dean, Chair, County Commissioner District #1 Heidi Eisenhour, County Commissioner, District #2 Amanda Grace, Vice -Chair, Community Stakeholder Dr. Kees Kolff, Public Hospital District #2 Commissioner Monica MickHager, Port Townsend City Council [Vacant], Consumer of Public Health Staff Members Denise Banker, Community Health Director Dr. Allison Berry, Health Officer Michael Dawson, Water Quality Manager Alisa Hasbrouck, Environmental Health Manager Barb Jones, CHIP Program Manager Apple Martine, Public Health Director Pinky Mingo, Environmental Public Health Director Veronica Shaw, Public Health Deputy Director Chair Dean called the July 18, 2024 meeting of the Jefferson County Board of Health to order at 2:33 p.m. A quorum was present. Members Present: Chair Kate Dean, Vice -Chair Amanda Grace, Members Greg Brotherton and Monica MickHager. Member Heidi Eisenhour joined later. Staff Present: Staff Members Dr. Allison Berry, Michael Dawson, Alisa Hasbrouck, Barb Jones, Apple Martine, and Pinky Mingo. Chair Dean called for public comment. There was none. PUBLIC COMMENT APPROVAL OF AGENDA Chair Dean called for a motion to accept the agenda for July 18, 2024. MOTION: Member Brotherton moved to approve the agenda as amended. Vice -Chair Grace seconded the motion, which carried by a unanimous vote. Respectfully submitted Page 1 of 3 G. Gilbert APPROVAL OF MINUTES Chair Dean requested a motion to approve the minutes of the June 20, 2024 meeting. MOTION: Member Brotherton moved to approve the agenda as amended. Vice -Chair Grace seconded the motion, which carried by a unanimous vote. OLD BUSINESS AND INFORMATIONAL ITEMS 1. Jefferson County Public Health (JCPH) Report Staff Member Martine introduced Liz Anderson and Jordan Carter (the JCPH Communications Team), who presented a "Highlights Reel" slideshow concerning Public Health activities and accomplishments of the last quarter. 2. State Board of Health Update Chair Dean reported on topics of local interest: (a) a petition that pumping of R.V. holding tanks be approved; and (b) rewriting the rules in regard to time from harvest to cooling for shellfish. 3. Infectious Diseases Update Dr Berry reported on the spread of COVID, it being a good time to use caution when in a crowded setting. Avian flu continues to spread, but risk remains low for humans who do not consume raw milk or farm dairy or poultry. NEW BUSINESS 1. Clean Air and Cooling Center Update Staff member Lara Gaasland-Tatro provided a presentation on heat and air quality resources, including availability of public cooling/safer air spaces. Discussion ensued, particularly concerning the risks of "cold plunging" during hot weather, and the dangers to young children around water. 2. Jefferson County Climate Summit Report Staff member Gaasland-Tatro, with assistance from staff member Josh Peters, director of Community Development, described the joint meeting of representatives of a number of concerned agencies, with the goals of understanding climate -related projects and initiatives already in progress in the County, identifying opportunities for cross - departmental collaboration on climate change efforts, and starting the process of creating a Climate Resiliency Element to the County Comprehensive Plan. 3. Zoonotic Disease The term "zoonotic disease" refers to diseases that can be transmitted from animals (including bugs) to humans. Dr. Berry's presentation focused on rabies, its characteristics, risk factors, ways of contracting, prevention and treatment. FUTURE POTENTIAL AGENDA TOPICS ATSDR (Agency for Toxic Substances and Disease Registry) needs two months to schedule a presentation on its research on the potential health impacts of emissions from the Port Townsend Paper Mill. Report on the special Behavioral Health Advisory Committee meeting concerning Opioid Settlement Funds Planning, originally scheduled for this meeting, planning to present at August meeting. Respectfully submitted Page 2 of 3 G. Gilbert ANNOUNCEMENTS Staff member Martine announced that Board of Health member Grey Schad has tendered their resignation from the board, effective immediately. Planning will be initiated to find a new Consumer of Public Health member. Also noted: a member to fill the tribal position on the board is still being sought. AGENDA PLANNING CALENDAR The Agenda Planning Meeting for the next regular meeting of the Board will be held on August 8, 2024 at 10:30 a.m. The next regular Board of Health meeting will be held as a hybrid meeting on Thursday, August 15, 2024 from 2:30 p.m. — 4:30 p.m. ADJOURNMENT Chair Dean adjourned the July 18, 2024 Jefferson County Board of Health meeting at 4:01 p.m. until the next Regular Meeting or Special Meeting as properly noticed. JEFFERSON COUNTY BOARD OF HEALTH Kate Dean, Chair Glenn Gilbert, Public Health Assistant Respectfully submitted Page 3 of 3 G. Gilbert Jefferson County Board of Health w Old Business and Information Reports Item 1 Jefferson County Public Health Report [No hand-out] flason Public H August 15, 2024 Jefferson County Board of Health IV. Old Business and Information Reports Item 2 State Board of Health Update [No hand-out] Public Healt August 15, 2024 Jefferson County Board of Health IV. Old Business and Information Reports Item 3 Infectious Diseases Update [No hand-out] Cel.Sai Publ*lc Healt August 15, 2024 Jefferson County Board of Health V. New Business Item 1 Overview of the Special BHAC (Behavioral Health Advisory Committee) Meeting — Opioid Settlement Funds Planning Public H August 15, 2024 it AGENDA SPECIAL Behavioral Health Advisory Committee (BHAC) Meeting (Opioid Settlement Funds Planning) Thursday, May 30th from 11:45am to 2:30pm IN -PERSON MEETING- LOCATION: The Maritime Center- 431 Water Street Port Townsend, WA 98368 In the Oliver Meeting Room BHAC Members: Heidi Eisenhour (Chair), Libby Urner-Wennstrom (Co -Chair), Chris Ashcraft, Patricia Beathard, Jill Buhler-Rienstra, David Fortino, Amanda Grace, Patrick Johnson, (Co -Chair for this Meeting) Alternate BHAC Members: Greg Brotherton, Richard Davies, Scott Mauk, Bruce McComas, Joe Nole, Grey Schad To view the agenda, please click here: www.co.iefferson.wa.us Laserfiche Web Portal — (User Name and Password is Public.) SPECIAL Behavioral Health Advisory Committee Meeting/Agenda Month/Date of the meeting/ 5-30-2024 Individuals may rovide Public Comment ahead of the meeting using the following method: • Email: You may submit comments/correspondence to: amcenerV(dj�ca.efferson.vua.u5 up through 5:00 p.m. the day before the meeting. 12:00pm 1. CALL TO ORDER/ POTENTIAL ACTION & PUBLIC COMMENT Designating Patrick Johnson as Co -Chair to adjourn this Special MTG/ Commissioner Heidi Eisenhour 2. PUBLIC COMMENTS/ Acknowledgment of Any Written Comments/ POTENTIAL ACTION 3. PRESENTERS/ POTENTIAL ACTION & PUBLIC COMMENT a) Introductions/ Brad Banks -President of Banks Consulting Group b) Opening Remarks/ Commissioner Heidi Eisenhour c) Opioid Trends on the Olympic Peninsula/ Apple Martine- Public Health Director will read a Statement from Jefferson and Clallam County Health Officer -Dr. Allison Berry MD d) What are the priorities from the WA MOU Abatement Strategies? What does our Opioid Settlement Budget actually look like? /Apple Martine- Public Health Director e) Presentation/ Jefferson County Opioid Statistics- Public Health Epidemiologists/ Lolinthea Hinkley & Alyssa Wyrsch f) Lack of Housing & the Impacts on Addiction/ Commissioner Heidi Eisenhour will read a statement from Commissioner Greg Brotherton g) Gaps identified at the SUD Summit/The Roles of different entities that are involved Jolene Kron/Salish BH-ASO- Administrator/Clinical Director 4. BREAKOUT GROUP DISCUSSION/POTENTIAL ACTION & PUBLIC COMMENT a) How may this funding be utilized and how do we prioritize the funding? b) What are the service gaps/needs in Jefferson County? c) How do we deal with one-time funding vs. multiyear funding? d) Do we create a targeted RFP? e) Do we establish 2-year timelines for a targeted RFP, etc? 5. REPORTING OUT/ POTENTIAL ACTION & PUBLIC COMMENT a) Share key themes and preferred strategies from breakout group discussions. b) How do the groups' key themes/strategies crosswalk with known service gaps and needs? c) What timeline should the award cycle have? 6. NEXT STEPS/ POTENTIAL ACTION & PUBLIC COMMENT a) Summarize key takeaways from today's meeting. b) How do we approach future meetings? 7. PUBLIC COMMENTS/ POTENTIAL ACTION 2:30pm 8. ADJOURNMENT Opioid Abatement Strategies Opioid Abatement Strategies_ Gaps Tactics Notes PART ONE: TREATMENT 1. Expand availability of treatment for OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction, including all forms of Medication -Assisted Treatment (MAT) approved by the U.S. Food and Drug Administration. 2. Support and reimburse services that include the full American Society of Addiction Medicine (ASAM) continuum of care for OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction, including but not limited to: a. Medication -Assisted Treatment (MAT); b. Abstinence -based treatment; c. Treatment, recovery, or other services provided by states, subdivisions, community health centers; non -for -profit providers; or for -profit providers; d. Treatment by providers that focus on OUD treatment as well as treatment by providers that offer OUD treatment along with treatment for other SUD/MH conditions, co -usage, and/or co -addiction; or e. Evidence -informed residential services programs, as noted below. 3. Expand telehealth to increase access to treatment for OUD and any co-occurring SUD/MH conditions, co -usage, and/or co - addiction, including MAT, as well as counseling, psychiatric support, and other treatment and recovery support services. 4. Improve oversight of Opioid Treatment Programs (OTPs) to assure evidence -based, evidence -informed, or promising practices such as adequate methadone dosing. 5. Support mobile intervention, treatment, and recovery services, offered by qualified professionals and service providers, such as peer recovery coaches, for persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction and for persons who have experienced an opioid overdose. 6. Support treatment of mental health trauma resulting from the traumatic experiences of the opioid user (e.g., violence, sexual assault, human trafficking, or adverse childhood experiences) and family members (e.g., surviving family members after an overdose or overdose fatality), and training of health care personnel to identify and address such trauma. 7. Support detoxification (detox) and withdrawal management services for persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction, including medical detox, referral to treatment, or connections to other services or supports. 8. Support training on MAT for health care providers, students, or other supporting professionals, such as peer recovery coaches or recovery 'outreach specialists, including telementoring to assist community -based providers in rural or underserved areas. 9. Support workforce development for addiction professionals who work with persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction. 10. Provide fellowships for addiction medicine specialists for direct patient care, instructors, and clinical research for treatments. 11. Provide funding and training for clinicians to obtain a waiver under the federal Drug Addiction Treatment Act of 2000 (DATA 2000) to prescribe MAT for OUD, and provide technical assistance and professional support to clinicians who have obtained a DATA 2000 waiver. Opioid Abatement Strategies_ Gaps Tactics Notes 12. Support the dissemination of web -based training curricula, such as the American Academy of Addiction Psychiatry's Provider Clinical Support Service-Opioids web- based training curriculum and motivational interviewing. 13. Support the development and dissemination of new curricula, such as the American Academy of Addiction Psychiatry's Provider Clinical Support Service for Medication -Assisted Treatment. 1. Provide the full continuum of care of recovery services for OUD and any co-occurring SUD/MH conditions, co -usage, and/or co - addiction, including supportive housing, residential treatment, medical detox services, peer support services and counseling, community navigators, case management, and connections to community -based services. 2. Provide counseling, peer -support, recovery case management and residential treatment with access to medications for those who need it to persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction. 3. Provide access to housing for people with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction, including supportive housing, recovery housing, housing assistance programs, or training for housing providers. 4. Provide community support services, including social and legal services, to assist in deinstitutionalizing persons with OUD and any co- occurring SUD/MH conditions, co- usage, and/or co -addiction. 5. Support or expand peer -recovery centers, which may include support groups, social events, computer access; or other services for persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction. 6. Provide employment training or educational services for persons in treatment for or recovery from OUD and any co-occurring SUD/MR conditions, co -usage, and/or co- addiction. 7. Identify successful recovery programs such as physician, pilot, and college recovery programs, and provide support and technical assistance to increase the number and capacity of high -quality programs to help those in recovery. 8. Engage non -profits, faith -based communities and community coalitions to support people in treatment and recovery and to support family members in their efforts to manage the opioid user in the family. 9. Provide training and development of procedures for government staff to appropriately interact and provide social and other services to current and recovering opioid users, including reducing stigma. 10. Support stigma reduction efforts regarding treatment and support for persons with CUD, including reducing the stigma on effective treatment. Page 2 of 8 ❑c 1. Ensure that health care providers are screening for CUD and other risk factors and know how to appropriately counsel and treat (or refer if necessary) a patient for OUD treatment. 2. Support Screening, Brief Intervention and Referral to Treatment (SBIRT) programs to reduce the transition from use to disorders. 3. Provide training and long-term implementation of SBIRT in key systems (health, schools, colleges, criminal justice, and probation), with a focus on youth and young adults when transition from misuse to opioid disorder is common. 4. Purchase automated versions of SBIRT and support ongoing costs of the technology. 5. Support training for emergency room personnel treating opioid overdose patients on post -discharge planning, including community referrals for MAT, recovery case management or support services. 6. Support hospital programs that transition persons with OUD and any co-occurring SUDIMH conditions, co -usage, and/or co - addiction, or persons who have experienced an opioid overdose, into community treatment or recovery services through a bridge clinic or similar approach. 7. Support crisis stabilization centers that serve as an alternative to hospital emergency departments for persons with OUD and any co-occurring SUDIMH conditions, co- usage, and/or co -addiction or persons that have experienced an opioid overdose. 8. Support the work of Emergency Medical Systems, including peer support specialists, to connect individuals to treatment or other appropriate services following an opioid overdose or other opioid-related adverse event. 9. Provide funding for peer support specialists or recovery coaches in emergency departments, detox facilities, recovery centers, recovery housing, or similar settings; offer services, supports, or connections to care to persons with OUD and any co- occurring SUD/MH conditions, co -usage, and/or co -addiction or to persons who have experienced an opioid overdose. 10. Provide funding for peer navigators, recovery coaches, care coordinators, or care managers that offer assistance to persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction or to persons who have experienced on opioid overdose. 11. Create or support school -based contacts that parents can engage with to seek immediate treatment services for their child; and support prevention, intervention, treatment, and recovery programs focused on young people. 12. Develop and support best practices on addressing CUD in the workplace. 13. Support assistance programs for health care providers with OUD. 14. Engage non -profits and the faith community as a system to support outreach for treatment. 15. Support centralized call centers that provide information and connections to appropriate services and supports for persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction. 16. Create or support intake and call centers to facilitate education and access to treatment, prevention, and recovery services for persons with OUD and any co- occurring SUD/MH conditions, co -usage, and/or co -addiction. 17. Develop or support a National Treatment Availability Clearinghouse - a multistate/nationally accessible database whereby health care providers can list locations for currently available in -patient and out -patient OUD treatment services that are accessible on a real-time basis by persons who seek treatment. Page 3 of 8 1. Support pre -arrest or post -arrest diversion and deflection strategies for persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction, including established strategies such as: a. Self -referral strategies such as the Angel Programs or the Police Assisted Addiction Recovery Initiative (PAARI); b. Active outreach strategies such as the Drug Abuse Response Team (DART) model; c. "Naloxone Plus" strategies, which work to ensure that individuals who have received naloxone to reverse the effects of an overdose are then linked to treatment programs or other appropriate services; d. Officer prevention strategies, such as the Law Enforcement Assisted Diversion (LEAD) model; e. Officer intervention strategies such as the Leon County, Florida Adult Civil Citation Network or the Chicago Westside Narcotics Diversion to Treatment Initiative; f. Co -responder and/or alternative responder models to address OUD-related 911 calls with greater SUD expertise and to reduce perceived barriers associated with law enforcement 911 responses; or g. County prosecution diversion programs, including diversion officer salary, only for counties with a population of 50,000 or less. Any diversion services in matters involving opioids must include drug testing, monitoring, or treatment. 2. Support pre-trial services that connect individuals with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co - addiction to evidence -informed treatment, including MAT, and related services. 3. Support treatment and recovery courts for persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co - addiction, but only if these courts provide referrals to evidence -informed treatment, including MAT. 4. Provide evidence -informed treatment, including MAT, recovery support, or other appropriate services to individuals with OUD and any co-occurring SUD/MR conditions, co -usage, and/or co -addiction who are incarcerated in jailor prison. 5. Provide evidence -informed treatment, including MAT, recovery support, or other appropriate services to individuals with OUD and any co-occurring SUDIMH conditions, co -usage, and/or co -addiction who are leaving jail or prison have recently left jail or prison, are on probation or parole, are under community corrections, supervision, or are in re-entry programs or facilities. 6. Support critical time interventions (CTI), particularly for individuals living with dual- diagnosis ODD/serious mental illness, and services for individuals who face immediate risks and service needs and risks upon release from correctional settings. 7. Provide training on best practices for addressing the needs of criminal -justice- involved persons with OUD and any co- occurring SUD/MR conditions, co -usage, and/or co -addiction to law enforcement, correctional, or judicial personnel or to providers of treatment, recovery, case management, or other services offered in connection with any of the strategies described in this section. 1. Support evidence -based, evidence -informed, or promising treatment, including MAT, recovery services and supports, and prevention services for pregnant women - or women who could become pregnant - who have OUD and any co-occurring SUD/MR conditions, co - usage, and/or co -addiction, and other measures to educate and provide support to families affected by Neonatal Abstinence Syndrome. 2. Provide training for obstetricians or other healthcare personnel that work with pregnant women and their families regarding treatment of OUD and any co-occurring SUD/MR conditions, co -usage, and/or co -addiction. Page 4 of 8 Opioid Abatement Strategies_ Gaps Tactics Notes 3. Provide training to health care providers who work with pregnant or parenting women on best practices for compliance with federal requirements that children born with Neonatal Abstinence Syndrome get referred to appropriate services and receive a plan of safe care. 4. Provide enhanced support for children and family members suffering trauma as a result of addiction in the family; and offer trauma -informed behavioral health treatment for adverse childhood events. 5. Offer enhanced family supports and home -based wrap -around services to persons with OUD and any co-occurring SUD/MH conditions, co -usage, and/or co -addiction, including but not limited to parent skills training. 6. Support for Children' s Services - Fund additional positions and services, including supportive housing and other residential services, relating to children being removed from the home and/or placed in foster care due to custodial opioid use. PART TWO: PREVENTION 1. Training for health care providers regarding safe and responsible opioid prescribing, dosing, and tapering patients off opioids. 2. Academic counter -detailing to educate prescribers on appropriate opioid prescribing. 3. Continuing Medical Education (CME) on appropriate prescribing of opioids. 4. Support for non-opioid pain treatment alternatives, including training providers to offer or refer to multi -modal, evidence -informed treatment of pain. 5. Support enhancements or improvements to Prescription Drug Monitoring Programs (PDMPs), including but not limited to improvements that: a. Increase the number of prescribers using PDMPs; b. Improve point -of -care decision -making by increasing the quantity, quality, or format of data available to prescribers using PDMPs or by improving the interface that prescribers use to access PDMP data, or both; or c. Enable states to use PDMP data in support of surveillance or intervention strategies, including MAT referrals and follow-up for individuals identified within PDMP data as likely to experience OUD. 6. Development and implementation of a national PDMP - Fund development of a multistate/national PDMP that permits information sharing while providing appropriate safeguards on sharing of private health information, including but not limited to: a. Integration of PDMP data with electronic health records, overdose episodes, and decision support tools for health care providers relating to OUD. b. Ensuring PDMPs incorporate available overdose/naloxone deployment data, including the United States Department of Transportation's Emergency Medical Technician overdose database. 7. Increase electronic prescribing to prevent diversion or forgery. Page 5 of 8 Opioid Abatement Strate 8. Educate Dispensers on appropriate opioid dispensing. 1. Corrective advertising or affirmative public education campaigns based on evidence. 2. Public education relating to drug disposal. 3. Drug take -back disposal or destruction programs. 4. Fund community anti -drug coalitions that engage in drug prevention efforts. 5. Support community coalitions in implementing evidence -informed prevention, such as reduced social access and physical access, :stigma reduction - including staffing, educational campaigns, support for people in treatment or recovery, or training of coalitions in evidence -informed implementation, including the Strategic Prevention Framework developed by the U.S. Substance Abuse and 6. Engage non -profits and faith -based communities as systems to support prevention. 7. Support evidence -informed school and community education programs and campaigns for students, families, school employees, school athletic programs, parent- teacher and student associations, and others. 8. School -based or youth -focused programs or strategies that have demonstrated effectiveness in preventing drug misuse and seem likely to be effective in preventing the uptake and use of opioids. 9. Support community -based education or intervention services for families, youth, and adolescents at risk for OUD and any co- occurring SUD/MH conditions, co -usage, and/or co -addiction. 10. Support evidence -informed programs or curricula to address mental health needs of young people who may be at risk of misusing opioids or other drugs, including emotional modulation and resilience skills. ' 11. Support greater access to mental health services and supports for young people, including services and supports provided by school nurses or other school staff, to address mental health needs in young people that (when not properly addressed) increase 1. Increase availability and distribution of naloxone and other drugs that treat overdoses for first responders, overdose patients, opioid users, families and friends of opioid users, schools, community navigators and outreach workers, drug offenders upon release from jail/prison, or other members of the general public. 2. Provision by public health entities of free naloxone to anyone in the community, including but not limited to provision of intra- nasal naloxone in settings where other options are not available or allowed. 3. Training and education regarding naloxone and other drugs that treat overdoses for first responders, overdose patients, patients taking opioids, families, schools, and other members of the general public. 4. Enable school nurses and other school staff to respond to opioid overdoses, and provide them with naloxone, training, and support. 5. Expand, improve, or develop data tracking software and applications for overdoses/naloxone revivals. 6. Public education relating to emergency responses to overdoses. Gaps Tactics Notes Page 6 of 8 Opioid Abatement Strategies_ 7. Public education relating to immunity and Good Samaritan laws. Gaps Tactics Notes 8. Educate first responders regarding the existence and operation of immunity and Good Samaritan laws. 9. Expand access to testing and treatment for infectious diseases such as HIV and Hepatitis C resulting from intravenous opioid use. 10. Support mobile units that offer or provide referrals to treatment, recovery supports, health care, or other appropriate services to persons that use opioids or persons with OUD and any co-occurring SUD/MR conditions, co -usage, and/or co -addiction. 11. Provide training in treatment and recovery strategies to health care providers, students, peer recovery coaches, recovery outreach specialists, or other professionals that provide care to persons who use opioids or persons with OUD and any co- occurring SUD/MR conditions, co -usage, and/or co -addiction. 12. Support screening for fentanyl in routine clinical toxicology testing. PART THREE: OTHER STRATEGIES 1. Current and future law enforcement expenditures relating to the opioid epidemic. 2. Educate law enforcement or other first responders regarding appropriate practices and precautions when dealing with fentanyl or other drugs. 1. Community regional planning to identify goals for reducing harms related to the opioid epidemic, to identify areas and populations with the greatest needs for treatment intervention services, or to support other strategies to abate the opioid epidemic described in this opioid abatement strategy list. 2. A government dashboard to track key opioid-related indicators and supports as identified through collaborative community processes. 3. Invest in infrastructure or staffing at government or not -for -profit agencies to support collaborative, cross -system coordination with the purpose of preventing overprescribing, opioid misuse, or opioid overdoses, treating those with OUD and any co-occurring SUD/MI-I conditions, co -usage, and/or co -addiction, supporting them in treatment or recovery, connecting them to care, or implementing other strategies to abate the opioid epidemic described in this opioid abatement strategy list. 4. Provide resources to staff government oversight and management of opioid abatement programs. 1. Provide funding for staff training or networking programs and services to improve the capability of government, community, and not - for -profit entities to abate the opioid cnsls. Page 7 of 8 Opioid Abatement Strategies_ Gaps Tactics Notes 2. Invest in infrastructure and staffing for collaborative cross -system coordination to prevent opioid misuse, prevent overdoses, and treat those with OUD and any co- occurring SUD/MI-I conditions, co -usage, and/or co -addiction, or implement other strategies to abate the opioid epidemic described in this opioid abatement strategy list (e.g., health care, primary care, pharmacies, PDMPs, etc.). 1. Monitoring, surveillance, and evaluation of programs and strategies described in this opioid abatement strategy list. 2. Research non-opioid treatment of chronic pain. 3. Research on improved service delivery for modalities such as SBIRT that demonstrate promising but mixed results in populations vulnerable to opioid use disorders. 4. Research on innovative supply-side enforcement efforts such as improved detection of mail -based delivery of synthetic opioids. 5. Expanded research on swift/certain/fair models to reduce and deter opioid misuse within criminal justice populations that build upon promising approaches used to address other substances (e.g. Hawaii HOPE and Dakota 24/7). 6 . Research on expanded modalities such as prescription methadone that can expand access to MAT. Page 8 of 8 SPECIAL Behavioral Health Advisory Committee MTG - 5/30/2024 (Opioid Settlement Funds Planning) Summary of Notes from Meeting Attendees' Activity A. Tit OniUld LTse D15o der • Contingency Mgmt. ■ Wellness Education ■ Support DBH in exploring detox options- Support either in Clallam or at the Healing Center? i I l r s* - F _.L ' L c1 ! 1 • Supportive Services for supportive housing locations/Have Treatment Providers on -site • Work with Tribes on in -patient treatment facility • Strengthen services/provider and agencies that already exist • Employment options • Something to look forward to • Pets (safety)/ Care for them normally- also while doing detox • Reduce Barriers to access • Workforce support ■ Housing with support • Connect people who need help to the help they need/Navigator • Harm Reduction -Resource Center • Mental Health in Schools/Wellness Education C. Co=ecL P� e Whv �d Help to the eJp they _ - d/ (Cnnnection�to—Cam) • Transportation Hub/ (3 x's) Subsidized • Transportation -not enough stops for buses • Dial -a -Ride @ 24-7 ■ Jefferson Transit -run taxi service/ (2x's) Available on demand • Specific Transportation for medical use? • Smaller buses • Dial -a -Ride for SUD Treatment ■ Pay Piers a livable wage • Systems Navigator/Navigator to walk through the process -medical- job--DL— housing • For the Unhoused/Who does it well? Serenity House? 1 I Page NOTES FROM ATTENDEES 7/1/2024 • Vet-Standdown- (tents, etc...) • Support for ID • Basic Safety • Crisis Response • Long-term Mental Health/Medicaid • Availability of mental health counseling resources close to people across the County • Travel to Treatment for the patient in County/across the State ■ Access to BH Services nearby and community supports D. At1dr��thQ NPerls of C�-lusticy�ly�d�e • Contingency Mgmt. • Harm Reduction/Resource Center • Need for Housing First/Apply this concept to Transitional Housing; i.e., a place of shelter for those in active use, as a step towards recovery E. Address the Needs of Pregnant or Parenting Women and their Families; including Babies with Neonatal Abstinence Syndrome (NAD) • Fill this need in a non judgmental way • Doctor Erickson is AWESOME in our Community F. Prevent Over-Prescribing_and_I)ispensing_of Qpioicis ■ No Comments G. Prnk sure _"piodds • Provide Kids with better options/opportunities to prevent use • Mental Health Counseling in Schools/Wellness Education • The WISE Program is an amazing resource, but is only for Medicaid -only recipients; it would be nice to fund their work for non -Medicaid participants H. Present c7�erdvse 17t11,5ui. vthe�Har�t� • Place to Be/Drop-off--Set-aside room with trained staff • How to Engage Families • Safe Injection Site as a harm reduction emphasis -in and around services at the site, including access to healthcare 2 1 P a g e NOTES FROM ATTENDEES 7/1/2024 I. Fixst_Resp-Qaders ■ More funding for the Fire CARES Program • Regional Approach with the Fire CARES Program ■ Gateway Training/Focus on the gii Theater w/Emergency Personnel/EMT's-Fire Fighters ■ Support for all of the Navigators and Peer Support staff who serve residents living with SUD ■ Mobile Response got into South County J. Leadership Planning and Coordination • No Comments K. Training • SUD-Prevention/Early Intervention Services for younger kids • Stigma Education for Peers/Get the kids/NEST/Recovery Cafe • Lower (BH) stigma with training in people first language and trauma informed care for providers/clinicians • Lower (BH) stigma, by having adults who have been in recovery (for x number of years) mentor youth or have group discussions led by those adults L. Research • Transitional Housing/Assisted Living 3 1 P a g e NOTES FROM ATTENDEES 7/1/2024 Jefferson County Board of Health V. New Business Item 2 Zoonotic Disease: Lyme Disease [No hand-out] V � ason Public H August 15, 2024 Jefferson County Board of Health In New Business Item 3 Consumer of Public Health, available position on the Board of Health Public H August 15, 2024 Name: Mailing Address: City: Email: Employer: Date: Home Phone: State: Zip: Work Phone: Cell Phone: Occupation: ❑ Applicant understands and agrees that the information and/or materials being submitted are subject to disclosure under the Public Records Act, Chapter 42.56 RCW. [MUST be checked.] #1 I am applying to I reside in Commissioner #2 serve on: Jefferson County Board of Health District Number: #3 ❑❑ I seek appointment as a nonelected member of the Board of Health in the category(ies) below (check one or more): ❑"Consumer of Public Health," meaning the category of persons consisting of county or health district residents who have self -identified as having faced significant health inequities or as having lived experiences with public health - related programs. Explain how and why you satisfy the requirements of the category, providing as many specific examples as you think would be helpful to the Board in considering your application. Please feel free to submit additional materials if you think that will also be helpful. BOARD and COMMISSIONS VOLUNTEER APPLICATION/STATEMENT OF INTEREST Page 2 Please share why you are applying for this appointment? What community activities have you participated in during the past five years? Please describe how, in the past, you have demonstrated a commitment to or passion for public health. BOARD and COMMISSIONS VOLUNTEER APPLICATION/STATEMENT OF INTEREST Page 3 Please share and describe how and why your appointment to the Board would advance the goal of increasing the diversity of expertise and lived experience on the Board. Please tell us whether you identify with a historically underrepresented community, describing the community, and how your identification with this community would positively contribute to the Board. Please state how your joining the Board would better reflect the geographic diversity of the community. BOARD and COMMISSIONS VOLUNTEER APPLICATION/STATEMENT OF INTEREST Page 4 The Board meets for two -hours each month. A week prior to each meeting, members are sent a (sometimes substantial) "packet" of materials concerning diverse and at times complicated issues to review and prepare for the meeting. What limitations, if any, are there on the time you would be available to prepare for and attend meetings and other activities? What skills and past experience do you have that would help you prepare for these meetings? Board members should not participate in deciding any matter that might benefit them personally, or benefit someone close to them, or benefit an organization or business in which they are involved. Doing so would be a conflict of interest. Can you think of anything that might create a conflict of interest for you in the future if you were a Board member? In addition to those already described, please tell us what other special skills, knowledge, or experience you have that would contribute to the Board and its commitment to public health. BOARD and COMMISSIONS VOLUNTEER APPLICATION/STATEMENT OF INTEREST Page 5 I understand that this appointment will entail my attendance at meetings and participation in the activities of this Board. All of the information on this application is true to the best of my knowledge. Signature of Applicant Date Please return to: Jefferson County Public Health no later than 4:30 p.m., Attn: Glenn Gilbert September 20, 2024. 615 Sheridan Street Port Townsend, WA 98368 Jefferson County Board of Health m Agenda Planning Public H August 15, 2024 Jefferson County Board of Health VII. Announcements Local Board of Health Training Leavenworth, October 2-3, 2024 (see attached) l.J-�cu ut„ Public Health August 15, 2024 h4tps.//membersmsac.ory;reven llocal-board-of-health-training WASHINGTON ;'ia ik•sS2:eiCYrf:K l wCQUlITIES Event description Join us for the Local Board of Health Training in Leavenworth, WA. WHO SHOULD ATTEND • Content will be focused on public health governance and authority. Best suited for the local board of health members. LH) leadership, and other county officials. HOTEL RESERVATION PROCEDURE Hotel rooms available for the nights of 10i1, 10/2. and 10/3. WSALPHO will arrange hotel accommodation for all attendees directly with the hotel. After registration closes, the hotel will email attendees a confirmation page before the event (attendees can disregard the cost listed). • Upon check -in, attendees must provide a credit card upon arrival for incidentals. • When registering, attendees must select the check -in and check-out date on the registration form, and any additional accommodation needs. You are responsible for communicating any changes to the dates you registered for. • Attention: There are no block codes. If an attendee chooses to book a room directly with the hotel and not through this registration process, the attendee will assume responsibility for the full cost of the room at the hotels standard rate, EVENT COST • WSALPHO will cover registration and lodging and provide meals for LHJ attendees and partners. You are responsible for covering your costs for travel, additional. meals, etc. CANCELLATION POLICY • If an attendee cancels after Friday, August 30, 2024, at 4:30 PM PST, the attendee will be billed for a one-night room and any applicable taxes. Should an attendee be a no-show for the reservation, the attendee will be billed for the full reservation cost and fees. • Please note that modifications to reservations after Friday, August 30, 2024, 4:30 PM, which result in a shorter stay, are subject to a cancellation fee equal to the cost of each canceled night and fees. • According to hotel policy, arrivals after 1:00 AM PST, the day after check -in, are considered no- shows. PARKING • Complimentary parking is available for overnight guests on the property. AGENDA • The agenda will be updated with details once finalized. • The hotel provides breakfast free of charge to guests daily from 7:00 am - 10:00 a in. WSALPHO will provide lunch on October 2nd and 3rd. Details Starts. 102 Oct 2024 Ends: IV 3 Oct 2024 O All day Registration closes August 30, 2024, at 4:30 PM PST. If you are no longer able to attend, please cancel your registration by contacting Nia Watkins at nwatkinsowsac.Arg_ Public H