--- ## 🏛️ **Module 1: Meeting Overview & Metadata** **Meeting Details** - **Date:** Tuesday, October 28, 2025 - **Time:** 10:05 AM - 12:04 PM - **Duration:** 1h 59m - **Type:** Joint Health Board/Public Health Advisory Board Meeting - **Format:** Hybrid (In-person at County Courthouse + Virtual) - **Chair:** Jon Scanlon, Health Board Chair **Board Composition** - **Health Board (County Council):** All 7 members present - Barry Buchanan, Tyler Byrd, Todd Donovan, Ben Elenbaas, Kaylee Galloway, Jon Scanlon, Mark Stremler - **Public Health Advisory Board (PHAB):** 13 members present (5 absent) **Agenda Items** 1. Update from the Health Director 2. Update from the Public Health Advisory Board Chair and Vice Chair 3. Update from the Health Officers on the Opioid Response Plan 4. Presentation on locally-led health initiatives **Key Announcements** - New Health Department Director Champ Thomaskutty started October 27, 2025 - Council testing new live captioning feature for accessibility - Four community presentations scheduled for locally-led health initiatives **Meeting Significance** This joint meeting represents the collaborative governance structure of Whatcom County's public health system, bringing together elected officials and community advisory board members to review department operations, policy initiatives, and innovative local health programs. --- ## 🏥 **Module 2: Health Department Leadership & Operations** **New Leadership Introduction** Charlene Ramont, Assistant Director, announced that **Champ Thomaskutty** began his role as Health Department Director on October 27, 2025. Thomaskutty, an epidemiologist with 10 years of administrative experience, expressed enthusiasm about joining the Whatcom County community and continuing the department's public health mission. **Key Staffing Updates** - **Greg Ituria** started as new Financial Services Manager one month prior - Brings extensive experience as budget director and finance manager from multiple California counties - Department successfully weathered interim leadership period under Ramont's guidance **Budget Adjustments** The department addressed mid-biennium budget requirements by: - Reducing general fund draw by $1 million as requested - Eliminating vacant positions - Reducing non-personnel operating expenditures - Maximizing restricted dollars before using unrestricted funds **Program Highlights** - **Refugee Health Navigation:** Supported 147 clients January-August 2025 with health systems navigation, immunizations, and I-693 forms for green card applications - **Data Infrastructure:** Epidemiology team activating weekly respiratory illness dashboard updates; informatics team launched electronic data collection system for Healthy Children's Fund doula project - **Mental Health Court:** Celebrated 10th anniversary, having enrolled 155 participants across Bellingham Municipal Court and Whatcom County District Court **Upcoming Initiatives** - Healthy Children's Fund 2025-2026 implementation plan feedback period open - Homeless Housing Plan for 2026-2030 released for public comment - Severe weather shelter: County managing operations again after RFP received no responses, with 30 positions already hired --- ## 👥 **Module 3: Public Health Advisory Board Activities** **Board Retreat & Strategic Planning** PHAB Chair Christine Espina reported on the October 17, 2025 annual retreat, which focused on foundational team building and identifying shared values. The diverse 21-member board discovered common commitments to integrity, community, families, and health. **Vital Conditions Framework Adoption** The board has embraced the **vital conditions for health and well-being** as their organizing framework, with civic muscle and belonging at the center. The framework encompasses: - Transportation and basic health needs - Environment and economic conditions - Humane housing and meaningful work - Lifelong learning and thriving natural world **Membership & Governance** - Current membership: 17 of 21 positions filled (4 vacancies) - Actively recruiting through networks for diverse, talented applicants - Board serves as bridge between community, public health services, and Health Board **Key Accomplishments** - Participated in Health Officer and Department Director selection processes - Led joint work groups examining Health Board expansion models - **Unanimous recommendation** (by members present - approximately 18 of 21) to expand Health Board while maintaining PHAB's Community Health Advisory Board duties under RCW 70.46.140 - Positioned to offer expertise supporting Board expansion recommendations **Priority Focus Areas** - Clear communication and community engagement - Building civic capacity - Community Health Improvement Plan oversight and implementation - Intentional recruitment aligned with vital conditions framework The board demonstrates strong volunteer engagement that has measurably increased the county's health and public health capacities through systematic community representation and professional expertise. --- ## 💊 **Module 4: Opioid Response & Settlement Funding** **Epidemiological Landscape** Dr. Meg Lelonik presented comprehensive opioid data showing encouraging trends. Nationally, drug overdose deaths decreased 25% from April 2024-2025, while Washington State saw a 7.5% decrease. Whatcom County's numbers align closer to the national average, with deaths declining from a peak of 12 per month in 2024 to approximately 7-8 per month currently. **Local Death Statistics** - **80% of deaths involve fentanyl** - **50% involve both fentanyl and methamphetamine** combination - Median age of death: 47 years old - Deaths occur across all zip codes and demographics - **25% of deaths involve unhoused individuals** - **75% involve people with housing** **Emergency Response Data** - Approximately 80 EMS responses per month for suspected overdose - Around 60 emergency department visits monthly for drug-related incidents - Community-wide impact requiring comprehensive response strategy **Program Highlights** - **Medication for Opioid Use Disorder (MOUD):** Expanding buprenorphine use in field and emergency settings - **Street Medicine Team:** Ashton Mott (public health nurse) and Amanda Leninga (behavioral health specialist) providing outreach to encampments, wound care, permanent supportive housing, and respite beds - **Overdose Response Pilot Program:** Since July 2025, achieved 230 encounters, 38 unique participants, 71 referrals with 50% grant funding **Naloxone Distribution Success** - **2,500 doses** distributed through community boxes in 2025 - **3,000 doses** through Safety and Support Program - **75 doses** used by field staff - Naloxone now included in American Heart Association CPR training - Studies show effectiveness up to 20 years beyond expiration dates **Settlement Fund Management** Kari Holley detailed Washington State's $1.1 billion recovery from opioid manufacturers, distributors, and pharmacies over 18 years. Whatcom County's allocation: **Local Distribution:** - Whatcom County: 1.3% ($5.8 million over 18 years) - Bellingham: 0.90% - Ferndale: 0.06% - Lynden: 0.08% - Annual county allocation: $350,000-$450,000 **2025 Spending Strategy** Successfully leveraged settlement funds by securing additional grants, allowing reallocation to: - Lock bags ($10,000) - Suicide prevention services ($18,500) - Communities That Care prevention model ($20,000) - Public education campaign (leveraged $150,000 DOH grant) - Community training events and overdose awareness initiatives **2026 Priorities** - Coalition prevention strategies - Substance use and mental health services ($40,000) - Continued public education and marketing - Cross-departmental collaboration with prosecutor, public defender, jail, and sheriff offices Settlement funds require transparent public process, ensuring community input drives spending decisions while maximizing impact through strategic partnerships and grant leveraging. --- ## 🏘️ **Module 5: Community Health Innovation Showcase** **Whatcom Mobile Medicine - Rural Primary Care** Dr. Gabriel Durbin presented his nonprofit addressing East County healthcare gaps following the 2021 flood destruction of Sumas Medical Clinic. Operating since 2023, the organization provides: **Service Model:** - Clinic days: First and third Mondays monthly at East Whatcom Regional Resource Center in Kendall - Free and sliding-scale care for uninsured/underinsured patients - Accepts Molina, CHP, and various insurance providers - Telemedicine follow-up via telephone and patient portal - Evidence-based medicine prioritizing lifestyle interventions **Philosophy & Approach:** Durbin emphasized that healthcare access barriers in rural areas stem less from infrastructure inadequacies than from lack of relationship and trust with community. His approach prioritizes: - Building authentic community relationships over time - Meeting people where they are with patience and commitment - Using existing public buildings transformed temporarily into clinics - Keeping logistics simple while maintaining consistent presence **Services Provided:** - Chronic disease management (hypertension, diabetes) - Mental health care (depression, anxiety) - Acute care (respiratory infections, back pain) - Non-opioid chronic pain management - Childhood vaccinations through state program **Lummi Island Health and Wellness - Community Resilience Model** Bob Anderson presented a comprehensive community-driven health initiative addressing the unique challenges of island living with a population averaging 62.2 years old (compared to county average of 38). **Community Assessment Process:** - Partnership with PeaceHealth for in-depth health and wellness survey - Western Washington University healthcare masters program assistance - 100-person community meeting at gathering place with table discussions - Community prioritization of programs and services **Strategic Priorities:** 1. **Healthcare Access:** Telehealth capabilities and virtual communications training 2. **Aging in Place:** Home safety programs, in-home care facilitation, health advocate training 3. **Community Connection:** Parish health ministry collaboration, Land Trust nature programs 4. **Preventive Services:** Tai Chi, yoga classes, foot care, blood pressure monitoring **Organizational Structure:** - Nonprofit under Congregational Church auspices (avoiding lengthy 501c3 process) - $115,000 funding from 5 foundations plus 2 island groups - Mission: Create health and wellness system helping residents be "resilient" in coping with life changes **Six-Month Accomplishments:** - Central health and wellness resource hub established - Five-day-weekly wellness classes at gathering place - Telehealth service with training support - Foot care clinic for non-medical needs - AARP Home Fit safety assessment program (1 of 30 national recipients) - Health advocate volunteer training preparation - Island caregiver information organization and dissemination **Success Strategies:** 1. **Community Listening:** Careful attention to community-identified priorities 2. **Asset Building:** Tapping existing island talent and collaborative DNA 3. **Strategic Communication:** Full social media portfolio, website, newsletter 4. **Partnership Leverage:** Collaboration with PeaceHealth, Northwest Regional Council, foundations Anderson emphasized the broader impact: "The community itself is becoming more resilient" through this work, creating stronger social fabric during challenging times. **Skagit County Public Hospital District #304 - Public Health Infrastructure** Beth Ruth shared insights from United General District #304, celebrating 60 years as a public hospital district serving northern and eastern Skagit County's 2,000+ square miles. **Governance Model:** - One of 57 public hospital districts in Washington State - Community-formed through local vote, managed by elected 5-member commission - Junior taxing district with limited property tax authority - Mission: "Improve health and quality of life for residents of communities served" **Service Evolution:** Since 2014 PeaceHealth partnership, expanded from WIC program and fitness center to **over 50 health and wellness programs** serving all life stages, organized around "pillars of health and well-being": - Active Living - Healthy Eating - Thriving Children and Families - Engaged Youth and Communities - Lifelong Learning (community and professional education) - Stewarding Community Assets and Opportunities **Prevention Focus:** Emphasis on social determinants of health and prevention-focused programming, recognizing health starts in places where people "live, work, worship, learn, play." Prevention approach aims to impact large community portions while reducing pain/suffering and achieving long-term healthcare cost savings. **Funding Strategy:** One of Washington State's lowest public hospital district tax rates, relying heavily on local, state, federal, and foundational grants plus sponsorships and donations to provide extensive programming while maintaining community-controlled governance. **East Whatcom County Health Equity Zone - Youth-Centered Democracy** Kristina Michele Martens presented one of three statewide Health Equity Zones, emphasizing community empowerment and youth engagement in health decision-making. **Governance Innovation:** - 11-member Community Advisory Board representing entire East County area - Monthly meetings building Health Equity Zone metrics for evaluating community priorities - Project proposal application process for community-submitted ideas - **Minimum age 14 for voting and participation** (aligned with Washington State health decision-making autonomy) **Community-Driven Process:** - Five meetings developing evaluation metrics for community priority pipeline - State Department of Health flexibility allowing each zone unique operation - Goal: "Empower community to speak up for themselves" - Balance between state oversight and local community self-determination This showcase demonstrated diverse models for community-led health innovation, from individual practitioner initiatives to comprehensive community organizing, all emphasizing relationship-building, local asset development, and responsive service design. --- ## 💰 **Module 6: Budget & Financial Management** **Health Department Budget Adjustments** The department successfully managed mid-biennium budget requirements, reducing general fund draw by $1 million through strategic approaches: **Cost Reduction Strategies:** - Elimination of vacant positions rather than layoffs - Reduction of non-personnel operating expenditures - Strategic use of restricted funding sources before tapping unrestricted dollars - Maintained service levels while achieving budget targets **Revenue Diversification Success** Multiple programs demonstrated effective grant-seeking and partnership strategies: **Settlement Fund Leveraging:** - Originally allocated $200,000 settlement funds for 2025 - Successfully secured additional grants reducing settlement fund dependency: - $150,000 Department of Health grant for public education campaign - $50,000 naloxone grant supporting overdose response position - Unspent settlement funds roll forward to 2026 priorities **Community Initiative Funding Models** **Lummi Island Health and Wellness:** $115,000 from diversified sources: - 5 foundation grants (PeaceHealth, Whatcom Community Foundation, Mount Baker Foundation, North Sound ACH, Chuckanut Health Foundation) - 1 national grant (AARP - 1 of 30 recipients nationwide) - 2 local island organization contributions - Volunteer labor significantly reducing operational costs **Whatcom Mobile Medicine:** Sustainable low-cost model: - Sliding-scale patient fees - Insurance reimbursement (Molina, CHP, various providers) - Partnership with East Whatcom Regional Resource Center for space - Minimal equipment investment with portable medical supplies **Skagit County Public Hospital District #304:** - One of Washington State's lowest property tax rates among public hospital districts - Heavy reliance on grants: local, state, federal, foundational - Sponsorship and donation support - Over 50 programs supported through diversified funding strategy **Financial Sustainability Principles** Across all initiatives, successful programs demonstrated: 1. **Community Investment:** Local financial contributions creating ownership 2. **Partnership Leverage:** Collaboration reducing individual organization burden 3. **Grant Strategy:** Professional pursuit of aligned funding opportunities 4. **Volunteer Engagement:** Community labor reducing operational costs 5. **Transparent Process:** Public accountability requirements (especially settlement funds) **Long-term Financial Planning** - Settlement funds provide 18-year timeline requiring sustainable program development - Foundation relationships requiring ongoing cultivation and reporting - Community fundraising capacity building for local sustainability - Integration with existing healthcare funding streams and reimbursement systems --- ## 🤝 **Module 7: Partnerships & Collaboration** **Intergovernmental Cooperation** The meeting highlighted extensive collaboration between multiple levels of government and community organizations: **State-Local Partnerships:** - Health Department participation in multiple state opioid response work groups - Washington State Department of Health collaboration on Health Equity Zones with local flexibility - Settlement fund coordination through One Washington MOU ensuring regional alignment - Naloxone distribution leveraging state Department of Health grants **Regional Health System Integration:** - PeaceHealth partnerships with both Lummi Island Health and Wellness and Skagit County Public Hospital District #304 - Street medicine team collaboration with North Sound BHO and behavioral health sales tax funding - Crisis system oversight committee coordination between detox center, crisis triage, and emergency services **Community-Based Organization Networks** **Lummi Island Model demonstrated extensive partnership:** - Northwest Regional Council collaboration - Lummi Island Heritage Trust joint programming - Health Ministries Network engagement - Various foundation relationships for sustainable funding - YMCA virtual programming partnerships **Prevention Coalition Infrastructure:** Kari Holley described robust community prevention network: - Four coalitions focused on youth aged 12-18 - 12 different sector representation within each coalition - School district attachment for targeted community engagement - Healthy Youth Survey data driving programming decisions - Multi-coalition coordination for county-wide impact **Healthcare Provider Collaboration** **East County Coordination:** - Whatcom Mobile Medicine partnerships with Ask A Nurse program, mobile dental services, Mount Baker school-based clinic - Opportunity Council support for rural health initiatives - Cross-referral systems between mobile providers and established health systems **Public-Private Partnership Models** **Settlement Fund Management:** - Regional Opioid Abatement Council requiring 10% administrative fee for spending coordination - County department head meetings (prosecutor, public defender, jail, sheriff) ensuring criminal justice system alignment - Community advisory group input ensuring public transparency - Multi-sector collaboration preventing service duplication **Foundation and Nonprofit Sector Engagement** Successful initiatives demonstrated sophisticated foundation relationship management: - **Mount Baker Foundation, North Sound ACH, Chuckanut Health Foundation** supporting multiple initiatives - **AARP national grants** bringing external resources to local priorities - **Whatcom Community Foundation** video production showcasing local innovation for broader replication **Academic Partnerships** - **Western Washington University** healthcare masters program supporting community health assessments - **University of Washington** empathy lens training reducing opioid stigma - **Student partnerships** leveraging university resources for community benefit (UW student supporting overdose response program) **Collaborative Governance Structures** The joint Health Board/PHAB meeting itself represents innovative democratic engagement: - Elected officials and appointed community representatives in shared decision-making - Professional expertise combined with grassroots community knowledge - Regular reporting ensuring accountability and transparency - Community presentation platforms elevating local innovation These partnerships demonstrate how effective public health requires coordination across sectors, with government providing infrastructure and accountability while community organizations deliver innovation, relationships, and local knowledge essential for sustainable health improvement. --- ## 📊 **Module 8: Data & Outcomes** **Opioid Crisis Metrics** Dr. Lelonik presented comprehensive data showing significant progress in addressing overdose deaths: **Trend Analysis:** - **Peak crisis:** 12 deaths per month in 2024 - **Current status:** 7-8 deaths per month (back to approximately 2022 levels) - **Historical context:** 11 total deaths county-wide in 2018 - **National comparison:** Whatcom County aligning with 25% national decrease vs. 7.5% Washington State average **Drug Involvement Patterns:** - **80% of deaths involve fentanyl** (consistent with national synthetic opioid trends) - **50% involve fentanyl-methamphetamine combination** (higher than national average) - Methamphetamine-fentanyl combination creating treatment challenges due to limited evidence-based methamphetamine interventions **Demographics and Geographic Distribution:** - **Median age at death:** 47 years old - **Housing status:** 75% housed, 25% unhoused (challenging stereotypes about overdose demographics) - **Geographic spread:** Deaths occurring across all county zip codes, not concentrated in specific areas **Emergency Response Volume:** - **80 EMS responses monthly** for suspected overdose incidents - **60 emergency department visits monthly** for drug-related cases - Sustained service demand requiring ongoing resource allocation **Naloxone Distribution Impact:** Comprehensive community distribution program showing robust uptake: - **2,500 doses** distributed through community naloxone boxes in 2025 - **3,000 doses** through Safety and Support Program - **75 doses** utilized by health department field staff - Community box program indicating significant community engagement and self-care capacity **Settlement Fund Allocation Data** Kari Holley presented detailed financial tracking across jurisdictions: **18-Year Funding Timeline:** - **Whatcom County total:** $5.8 million over 18 years - **Annual average:** $350,000-$450,000 (with variation by year) - **Regional context:** Part of Washington State's $1.1 billion total recovery - **Population-based allocation** ensuring smaller communities receive proportional support **Program Participation Metrics** **Overdose Response Pilot Program (July 2025 launch):** - **230 encounters** in initial months - **38 unique participants** demonstrating individual engagement - **71 referrals** made to treatment and support services - High engagement rate suggesting effective outreach model **Community Health Initiative Outcomes** **Lummi Island Health and Wellness (6-month results):** - **5-day weekly** wellness class availability - **Community assessment participation:** 100 residents in prioritization process - **Telehealth training:** Multiple islanders gaining technology skills - **Home safety assessments:** AARP Home Fit program implementation - **Foot care clinic:** Regular non-medical preventive services **Refugee Health Navigation Program:** - **147 clients served** January-August 2025 - **Comprehensive services:** Health systems navigation, immunization education, I-693 form assistance - **Population-specific outcomes** demonstrating culturally responsive healthcare access **Public Health Advisory Board Engagement:** - **18 of 21 members** participating in Board expansion recommendation (unanimous among those present) - **13 of 21 members present** at current meeting (good attendance rate) - **4 vacancies** currently being recruited through network engagement **Data Infrastructure Development** - **Weekly respiratory illness dashboard** providing real-time community health monitoring - **Electronic data collection system** for Healthy Children's Fund doula project - **Crisis system oversight metrics** tracking monthly referral patterns between services These metrics demonstrate both the scale of public health challenges and the measurable impact of coordinated community response, with data driving program adjustments and resource allocation decisions. --- ## 🏆 **Module 9: Key Achievements & Successes** **Leadership Transitions and Continuity** The successful onboarding of **Director Champ Thomaskutty** represents continuity in health department leadership after interim period, bringing epidemiological expertise and administrative experience to guide future strategic direction. Simultaneously, the addition of **Financial Services Manager Greg Ituria** strengthens fiscal management capacity with multi-county California experience. **Mental Health Court Milestone** The **10th anniversary celebration** of Mental Health Court represents sustained innovation in therapeutic justice, having enrolled **155 participants** across Bellingham Municipal Court and Whatcom County District Court systems. This program demonstrates long-term commitment to addressing behavioral health through collaborative court processes rather than traditional criminal justice approaches alone. **Opioid Response Progress** Significant reduction in overdose deaths from peak of **12 monthly deaths to 7-8 currently** shows coordinated prevention and treatment efforts achieving measurable impact. The **80% fentanyl involvement rate** recognition has led to targeted education about contaminated methamphetamine supplies, potentially preventing deaths among users unaware of fentanyl presence. **Community Health Innovation Recognition** Four distinct locally-led initiatives presented demonstrate remarkable community capacity for health problem-solving: **Whatcom Mobile Medicine** successfully filling East County healthcare gap with **consistent twice-monthly clinics** at East Whatcom Regional Resource Center, providing primary care where commercial healthcare withdrew after flood damage. **Lummi Island Health and Wellness** achieved rapid program development, launching **over 50 health and wellness programs** within six months of opening, including successful **AARP national grant** recognition as one of 30 recipients nationwide. **East Whatcom County Health Equity Zone** pioneering youth engagement with **minimum age 14 participation** in health decision-making, aligning with Washington State health autonomy rights while building civic engagement skills. **Settlement Fund Leveraging Success** Strategic grant-seeking allowed reallocation of settlement funds by securing **$150,000 Department of Health grant** for public education and **$50,000 naloxone grant**, demonstrating effective resource maximization rather than simply spending allocated funds. **Prevention Infrastructure Development** **Four prevention coalitions** covering different geographical areas with **12-sector representation** each creates comprehensive community engagement for youth substance abuse prevention, using **Healthy Youth Survey data** to drive evidence-based programming decisions. **Technology and Data Systems Enhancement** - **Weekly respiratory illness dashboard** providing community real-time health monitoring - **Electronic data collection system** for Healthy Children's Fund doula project - **Live captioning pilot program** increasing meeting accessibility for hearing-impaired community members **Community Engagement Success** **Public Health Advisory Board retreat** successfully identified **vital conditions framework** as organizing principle, creating alignment between elected officials and community representatives around shared health improvement approach. **Interagency Collaboration Excellence** **Crisis system oversight committee** coordination between detox center, crisis triage, and emergency services demonstrates systematic approach to behavioral health rather than fragmented service delivery. **Grant and Foundation Success** Multiple initiatives secured diverse funding demonstrating strong community credibility: - **$115,000 total** for Lummi Island Health and Wellness from 5 foundations plus national AARP grant - **Settlement fund supplementation** through strategic state grant applications - **Cross-sector foundation support** indicating broad community confidence in health initiatives **Volunteer Mobilization Achievement** **Health advocate training preparation** on Lummi Island and **extensive volunteer engagement** across initiatives demonstrates community willingness to contribute time and expertise for collective health improvement, reducing operational costs while building social capital. These achievements collectively demonstrate a public health system that combines professional expertise with grassroots innovation, data-driven decision-making with community relationship-building, and government accountability with local self-determination. --- ## 🔮 **Module 10: Future Planning & Next Steps** **Health Department Strategic Priorities** With new leadership in place, the department is positioning for enhanced service delivery and community engagement: **Healthy Children's Fund Implementation:** Final Council decisions pending on 2025-2026 plan, with community feedback period currently open for public input on priority allocations and service strategies. **Severe Weather Shelter Operations:** County managing shelter operations for upcoming winter after RFP received no responses, with 30 positions already hired and operational preparations underway for seasonal demand. **Homeless Housing Plan Development:** 2026-2030 plan released for public comment, indicating long-term strategic planning for housing stability as health foundation. **Data Infrastructure Expansion:** Weekly respiratory illness dashboard and electronic data systems demonstrating commitment to real-time community health monitoring and evidence-based service delivery. **Opioid Response Evolution** **Settlement Fund 2026 Priorities:** - **Coalition prevention strategies** expanding youth-focused programming through school district partnerships - **Substance use and mental health services** allocation of $40,000 for integrated treatment approaches - **Public education and marketing** continuation of successful stigma reduction campaign - **Employment services** renewed attempt at contract development for recovery support **Cross-departmental Integration:** Enhanced collaboration between health department, prosecutor, public defender, jail, and sheriff offices ensuring criminal justice system alignment with public health approaches to substance abuse. **Federal Policy Navigation:** Health officers monitoring vaccine policy changes and Medicaid modifications at federal level, preparing community guidance and support systems for potential coverage changes. **Community Health Innovation Scaling** **Replication Planning:** Multiple initiatives expressed willingness to share models with other communities: **Point Roberts Connection:** Lummi Island Health and Wellness model potentially adaptable to Point Roberts' similar geographic isolation challenges, with Community Advisory Committee connection planned. **East County Expansion:** Whatcom Mobile Medicine exploring increased service frequency and additional rural community locations using existing public building infrastructure. **Health Equity Zone Learning:** East Whatcom County model as one of three statewide pilots potentially informing broader community empowerment approaches across Washington State. **Public Hospital District Education:** Bellingham City Club February 2025 event with Association of Washington Public Hospital Districts representative Matt Ellsworth could inspire additional district formation discussions. **Public Health Advisory Board Development** **Membership Recruitment:** Active outreach to fill 4 vacant positions with diverse candidates representing all vital conditions framework areas, ensuring comprehensive community representation. **Community Health Assessment Planning:** Board positioning to lead Community Health Improvement Plan development with community engagement expertise and framework alignment. **Health Board Expansion Support:** PHAB prepared to offer expertise supporting recommended Board expansion while maintaining Community Health Advisory Board functions under state requirements. **Long-term Sustainability Planning** **Foundation Relationship Management:** Lummi Island Health and Wellness model demonstrating importance of ongoing cultivation with multiple funders rather than dependence on single revenue source. **Volunteer Infrastructure Development:** Health advocate training and community engagement strategies building local capacity for sustained programming beyond initial grant periods. **Partnership Network Expansion:** Strategic collaboration with organizations like PeaceHealth, Northwest Regional Council, and academic institutions ensuring resource sharing and expertise exchange. **Policy and Systems Integration** **Settlement Fund Public Process:** Ongoing community engagement requirements ensuring transparent decision-making and accountability for opioid response investments over 18-year timeline. **State-Local Coordination:** Continued participation in state opioid response work groups maintaining alignment with statewide strategies while addressing local community needs. **Data-Driven Evaluation:** Regular outcome measurement and program adjustment based on community health metrics and participant feedback ensuring effective resource utilization. **Innovation Incubation Planning** Recognition that "we don't need to do all the work in government ourselves" suggests ongoing commitment to supporting community-led initiatives while providing infrastructure, accountability, and resource connections. **Community Leadership Development:** Focus on identifying, training, and supporting local champions who can initiate and sustain health improvement efforts in their neighborhoods and populations. **Model Documentation and Sharing:** Whatcom Community Foundation video production for Lummi Island model and potential regional learning opportunities ensuring successful approaches benefit broader Pacific Northwest rural and isolated communities. The meeting concluded with clear momentum toward expanded community engagement, enhanced service coordination, and sustainable local health improvement infrastructure supporting both professional public health capacity and grassroots community innovation.

### Meeting Overview The Whatcom County Council met as the Health Board on October 28, 2025, in a joint session with the Public Health Advisory Board. The 2-hour meeting featured updates from health department leadership, discussion of opioid response efforts, and presentations from four locally-led health initiatives addressing healthcare access in rural and underserved communities. ### Key Terms and Concepts **Public Health Advisory Board (PHAB):** A 21-member volunteer board that serves as a bridge between the community, county health services, and the Board of Health. Currently has 4 vacancies and operates under the vital conditions for health framework. **Medication for Opioid Use Disorder (MOUD):** Treatment using medications like buprenorphine to reduce overdose risk by half and help people recover from opioid addiction. Being expanded in EMS, emergency departments, and hospital settings. **Naloxone (Narcan):** An opioid overdose reversal medication now included in basic CPR training. The county distributed 2,490 doses through community boxes and 2,990 through their Safety and Support Program in 2025. **Street Medicine Team:** Public health team consisting of nurse Ashton Mott and behavioral health specialist Amanda Leninga who provide outreach services at encampments, permanent supportive housing, and respite beds to connect people with treatment. **Opioid Settlement Funds:** Money recovered from litigation against pharmaceutical companies. Whatcom County will receive $5.8 million over 18 years (about $350,000-$450,000 annually) for prevention and treatment programs. **Public Hospital Districts:** Locally-controlled health entities formed by community vote with elected commissioners. There are 57 in Washington State, including Point Roberts and Skagit County's United General District #304. **Vital Conditions for Health:** Framework focusing on civic muscle, belonging, transportation, basic needs, environment, economic opportunity, humane housing, meaningful work, lifelong learning, and thriving natural world. **Health Equity Zones:** Community-driven initiatives to address health disparities. East Whatcom County is one of three pilot zones in Washington State, with a community advisory board and youth participation starting at age 14. ### Key People at This Meeting | Name | Role / Affiliation | |---|---| | Jon Scanlon | Council Member / Health Board Chair | | Champ Thomaskutty | New Health Department Director (started October 27) | | Charlene Ramont | Assistant Health Director / Former Interim Director | | Christine Espina | Public Health Advisory Board Chair | | Dr. Meg Lelonek | Co-Health Officer | | Kari Holley | Opioid Prevention Specialist | | Dr. Gabriel Durbin | Whatcom Mobile Medicine | | Bob Anderson | Lummi Island Health and Wellness | | Beth Ruth | Skagit County Public Hospital District #304 | | Kristina Michele Martens | East Whatcom County Health Equity Zone | ### Background Context This meeting occurred during a significant transition in county health leadership, with new director Champ Thomaskutty starting just one day before the meeting. The county is managing a $1 million budget reduction while continuing essential services including operating the severe weather shelter after receiving no responses to their RFP. The opioid crisis remains a major public health concern, with Whatcom County experiencing about twice the national average for overdose deaths per capita. However, deaths have decreased from a peak of 12 per month in 2024 to about 7 per month currently, following national trends. About 80% of local overdose deaths involve fentanyl, often mixed with methamphetamine. Rural healthcare access continues to be a challenge, particularly in East County after the 2021 flood destroyed the Sumas medical clinic. Community-led initiatives are emerging to fill gaps, representing a growing trend toward local solutions for health equity and access issues. ### What Happened — The Short Version The meeting began with the introduction of new Health Department Director Champ Thomaskutty, an epidemiologist with 10 years of administrative experience. Assistant Director Charlene Ramont provided updates on department activities, including hiring a new financial services manager, monitoring federal policy changes, and implementing the mid-biennium budget cuts. PHAB Chair Christine Espina reported on the board's October 17 retreat where members identified shared values and committed to using the vital conditions framework. The board has 4 vacancies and continues working on community health assessment and improvement planning. Dr. Meg Lelonek presented comprehensive opioid response data showing decreasing death rates but continued challenges. Kari Holley detailed how the county plans to spend opioid settlement funds, emphasizing prevention, treatment, and public education campaigns. The highlight was hearing from four community-led health initiatives: Whatcom Mobile Medicine providing rural primary care, Lummi Island Health and Wellness creating community resilience, Skagit County's public hospital district model, and the East Whatcom Health Equity Zone empowering community-driven solutions. ### What to Watch Next - November 5: County Council consideration of opioid settlement fund supplemental budget request - Implementation of Healthy Children's Fund 2025-26 plan coming to Council for final decisions - Public comment period for county's Homeless Housing Plan 2026-2030 - Continued hiring for severe weather shelter operations - PHAB's upcoming regular meeting to evaluate accomplishments and plan future priorities ---

**Q:** Who is the new Whatcom County Health Department Director? **A:** Champ Thomaskutty, an epidemiologist who started October 27, 2025. **Q:** What does PHAB stand for and how many members should it have? **A:** Public Health Advisory Board, which should have 21 members but currently has 4 vacancies. **Q:** What framework is PHAB using to guide their work? **A:** The vital conditions for health and well being framework, with civic muscle and belonging at the center. **Q:** How much will Whatcom County receive from opioid settlements over 18 years? **A:** $5.8 million total, or approximately $350,000 to $450,000 per year. **Q:** What percentage of Whatcom County overdose deaths involve fentanyl? **A:** About 80% of overdose deaths involve fentanyl. **Q:** How many naloxone doses did the county distribute in 2025? **A:** 2,490 doses through community boxes and 2,990 through the Safety and Support Program. **Q:** What is the average age on Lummi Island compared to Whatcom County overall? **A:** 62.2 years on Lummi Island versus 38 years countywide. **Q:** Where does Whatcom Mobile Medicine provide services? **A:** At the East Whatcom Regional Resource Center in Kendall on the first and third Mondays each month. **Q:** What happened to the county's RFP for severe weather shelter operations? **A:** They received no responses, so the county will manage the shelter again this winter. **Q:** How many public hospital districts are in Washington State? **A:** Over 57 public hospital districts, with nearly half of all Washington hospitals being public hospital districts. **Q:** What is the minimum age for participation in the East Whatcom Health Equity Zone? **A:** Age 14, because youth at that age can make their own health decisions in Washington State. **Q:** What major budget adjustment did the health department make? **A:** Cut $1 million from their general fund draw, primarily through vacant positions and reduced operating expenses. **Q:** Which Mental Health Court celebrated its 10th anniversary? **A:** The county's Mental Health Court, which has enrolled 155 participants over the decade. **Q:** What is the street medicine team's funding source? **A:** Behavioral health sales tax for the nurse position and substance abuse block grant for the behavioral health specialist. **Q:** How many EMS responses per month does Whatcom County average for suspected overdoses? **A:** About 80 EMS responses per month for suspected overdoses. **Q:** What is the median age of overdose death in Whatcom County? **A:** 47 years old. **Q:** What percentage of overdose deaths in 2024 involved both fentanyl and methamphetamine? **A:** About 50% of deaths involved both fentanyl and methamphetamine as a combination. **Q:** How much grant funding did Lummi Island Health and Wellness secure? **A:** $115,000 from five foundations and two island groups. **Q:** What destroyed the Sumas medical clinic? **A:** Flooding in 2021. **Q:** When will the November 5 supplemental budget request address opioid settlement funds? **A:** It will include a request for expenditure authority and a specialized fund for settlement dollars. ---