# Whatcom County Health and Human Services: A Deep Dive Into Community Care The Whatcom County Council Public Works and Health Committee convened on Tuesday, April 15, 2025, at 11:11 a.m. for what would prove to be an illuminating look into the breadth and complexity of the county's health and human services work. Committee Chair Jon Scanlon presided over the hybrid meeting, with members Mark Stremler and Ben Elenbaas present, along with several other council members attending as observers. The meeting featured two comprehensive presentations that revealed both the impressive scope of community services and the ongoing challenges of funding and coordination in an era of increasing need and uncertain federal support. ## Community Services Division: Fighting Fires on a Flying Plane Ann Beck, supervisor of the Community Services Division within Health and Community Services, opened her presentation with an unusual but telling metaphor drawn from her recent travel experience. Describing a fire that broke out on her airplane during her return from vacation, she compared the work of her division to flight attendants managing emergencies while keeping essential services running. "We are constantly flying this plane and pushing those snack carts down the aisle, trying to take care of all the things," Beck explained. "And the fires continue to jump in and we continue to address them because you've got to address the fires or else the plane goes down." This vivid analogy set the tone for what followed: a presentation that showcased both remarkable achievements and persistent challenges across multiple program areas. ### Housing and Homelessness: Planning Amid Uncertainty The housing program represents one of the county's most visible and challenging areas of work. Beck reported that staff are currently updating the five-year homeless housing plan, the first comprehensive revision since 2019. Jamie Oliphant, a program staff member, has been leading an extensive community outreach effort that included 17 separate events in a single month, from appearances at farmers markets to meetings with the small cities caucus and housing advisory committee. The plan update comes at a critical time. The severe weather shelter season, which recently concluded, served more than 300 individuals over 27 nights of operation. While generally successful, Beck noted the toll on staff who maintain day jobs while operating emergency shelters during extended cold snaps. "The hardest stretch, as it was the year before, was when we had to do kind of back to back nights. So I think it was close to two weeks of being open," she explained. Looking ahead, a subgroup of the housing advisory committee is developing recommendations for year-round shelter expansion, with multiple options and cost-benefit analyses expected to be presented to the council soon. However, funding challenges loom large. Document recording fees, a key revenue source, have underperformed due to reduced refinancing activity in the sluggish housing market. The consolidated homeless grant from the state is expected to be reduced when allocations are announced in July. Federal housing funds face uncertainty as partners express concerns about the continuity of their awards and increasingly complex requirements. "The program is operating at a deficit and must cut costs to balance that budget," Beck reported bluntly. "So some hard decisions on the line." Beck also provided an update on a housing assessment that had seemingly disappeared from view. The study, examining permanent supportive housing, experienced delays due to the complex dynamics of having the county both fund the assessment and own the resulting data while simultaneously being evaluated alongside their funded partners. "It took a little while to kind of sort that piece out," Beck explained, but results are expected by summer in time to inform the homeless housing plan. ### Capital Projects: Transforming Communities Through Development The capital projects portfolio represents one of the division's most tangible success stories. Eric, the special projects manager, has been leading efforts that have produced impressive results across multiple areas: - 100 new units of affordable rentals - 83 new units of home ownership - 30 new emergency shelter units - 50 shelter units preserved - 86 assisted living and treatment beds - 300 child care slots These numbers represent projects spanning from Ferndale to Everson, Sumas to Bellingham, including partnerships with organizations like Habitat for Humanity, Catholic Housing Services, and the YWCA. The YWCA shelter project, which received $1 million in county funding, recently held its opening ceremony, attended by Council member Kaylee Galloway. Beck emphasized the importance of having dedicated expertise for this work. "There's homeless housing work, and then there's affordable housing and development work, and those are two very different things," she explained. "For a long time, we were kind of asking the homeless housing folks to focus on those pieces, and we're missing some of the expertise there." ### Human Services: The Quiet Heroes Some of the county's most impactful work happens largely out of public view. The developmental disabilities and veterans services programs, funded through property tax millage, demonstrate remarkable effectiveness with relatively modest resources. In developmental disabilities services, the county supported 348 clients per month through employment services and provided community-based therapeutic services to 374 infants and toddlers monthly. The program has developed an innovative website called Hireability Whatcom to connect businesses with potential employees who have developmental disabilities and can receive job coaching support. "We have over 200 businesses right now that are working in the supported employment programs, and it would be great to see even more," Beck noted enthusiastically. The veterans services program filed over 1,000 claims with the VA, helping veterans access compensation they earned through their service. This approach proved so effective that veterans assistance funds could be reduced because clients were receiving more sustainable income through their VA benefits. Still, the program distributed $116,000 in direct assistance for rent, utilities, work boots, and other necessities. Beck highlighted the return on investment: "I think I pay like four dollars a year towards millage for veterans and I can tell you, it's such a wonderful return on my investment to see that happen. The same for the DD millage." Amanda Burnett, a human services supervisor, clarified the funding structure for developmental disabilities services, noting that while local millage dollars support direct services, the state's Developmental Disabilities Administration provides pass-through funding for county staff and overhead costs. ### Nurse Family Partnership: Supporting New Families The Nurse Family Partnership program exemplifies the county's commitment to prevention and early intervention. In 2024, the program served 83 clients, with 15 completing the full program that supports first-time mothers from pregnancy through their child's second birthday. The results speak to the program's effectiveness: 18 babies were born to program participants, with zero having very low birth weight. All clients initiated breastfeeding, with 70% continuing at six months. Notably, 32% of new clients were younger than 19 years old, highlighting the program's role in supporting very young mothers. However, the program faces staffing challenges that illustrate broader workforce issues in public health. Beck's nurse family partnership supervisor left in December, leaving her temporarily supervising a program outside her expertise. Two additional nurses departed for family reasons, spreading caseloads thin among remaining staff. "They need more than making do, they need somebody who's gonna be able to provide that close supervision," Beck acknowledged. The program typically operates with five nurses (including job-sharing arrangements), but is currently down to three, making it difficult to maintain the fidelity requirements for national reporting. The program's funding comes from multiple sources, some of which could be affected by federal changes, adding another layer of uncertainty to staffing decisions. ### Opioid Settlement: New Resources, Strict Rules Beck provided a brief update on opioid settlement funds, noting that a more detailed briefing would come later in the month. The county currently has approximately $2 million in settlement funds, subject to strict guidelines about allowable uses and rigorous reporting requirements. "There is a very thick packet of how we can spend this money," Beck explained. "It's not something that we can use wherever we might see fit. It's supposed to be to help remediate, to help do prevention work, to kind of go long term." The county is developing a spending plan in collaboration with the executive's office that will focus on prevention, remediation, and long-term solutions within the settlement guidelines. ### Community Health: A Wide Network of Care The division's community health work encompasses a broad range of activities, from oral health care solutions in rural areas to healthcare access initiatives focused on children with special health care needs. Beck noted ongoing work on aging services and language access training, acknowledging that time constraints prevented detailed discussion of these important programs. When Council Chair Scanlon asked about dental services, Beck confirmed that Ali Robinson, one of their healthcare access staff, has been working with Dr. Doback to expand mobile dental van services throughout the county. ## Healthy Children's Fund: Ambitious Goals Meet Implementation Challenges Sarah Simpson, child and family program supervisor, followed with an update on the Healthy Children's Fund that demonstrated both impressive progress and ongoing implementation challenges. The scope of work is staggering: over 35 active contracts totaling more than $7 million currently operating in the community. ### Drop-In Child Care: Meeting a Critical Need One of the fund's most innovative initiatives, the drop-in child care program, addresses a frequently voiced community need. Simpson explained the program's purpose: "If I have a doctor's appointment, but I typically stay home with my children, I'd love it if there was a place that I could send them that is safe and reliable, or something has come up and our regular child care is closed for the day." The early results are encouraging. With three providers currently enrolled and more in the pipeline, the program offers over 122 spaces per month across Ferndale, Deming, Nooksack, Bellingham, and Blaine. Significantly, the program has achieved 100% usage for qualifying families, meaning no eligible family has been turned away. Qualifying metrics include income requirements, foster or kinship care status, or crisis situations such as primary caregivers being hospitalized. The program represents exactly the kind of innovative approach that family surveys indicated was needed. ### Bellingham Technical College: Moving Forward at Last Simpson provided welcome news about the long-delayed Bellingham Technical College workforce development initiative contract. After what contract documents suggest has been nearly a year of delays, productive meetings involving the executive's office, county health and community services, and BTC have aligned everyone on scope, evaluation metrics, and budget. "Really looking forward to moving that forward, but had an incredibly productive meeting with everyone about a week ago," Simpson reported. ### Child Care Subsidy: Adapting to State Reality The county's planned child care subsidy program faces significant adjustments due to state budget constraints. Originally designed to complement anticipated state increases to the Working Connections subsidy from 60% to 75% of state median income, the county program aimed to extend coverage to 85% of state median income. With the state apparently abandoning those increases, Simpson acknowledged the need for difficult conversations about scaling back local ambitions. "I think we're going to have to address that and have a conversation at a further date," she said, noting that cost projections for lower income thresholds were still being finalized. Despite these challenges, the county continues moving forward with an RFP for a working connections child care campaign to increase enrollment in existing state subsidies among eligible families who aren't aware of the program. ### Family Voices: Survey Data Drives Programming Simpson shared compelling quotes from a rapid survey conducted in partnership with Stanford University's Center for Early Learning. The survey, which received responses from every school district and catchment area in the county, revealed both the impact of child care challenges and validation of the county's approach. One parent wrote: "Low cost drop in child care where families need to attend to things without their children present" – precisely what the new program addresses. More troubling responses revealed the real-world consequences of inadequate child care: "The biggest challenges families are experiencing right now [include] when our children are sick and people can't return to work." Another parent described "balancing work and personal life as our family supports are not in the county." These quotes prompted visible reactions from council members, with Simpson noting that the county received many similar responses about parents losing jobs due to child care access issues, both from children being sick and from inconsistent care arrangements. ### Looking Ahead: Food Policy and Home-Based Providers Simpson outlined upcoming presentations for May and June, focusing on food policy work and support for home-based child care providers – areas where the Healthy Children's Fund is making significant investments but which haven't received detailed public attention. ## Contract Transparency: A Familiar Frustration The meeting's most tense exchange centered on an ongoing dispute about contract transparency and reporting. Council member Tyler Byrd pressed for inclusion of detailed contract tracking information in regular presentations, referencing a resolution passed months earlier requiring such reporting. Byrd specifically requested a table showing contract timing and progress through various bureaucratic stages, noting that such information was already being provided to the Child and Family Well-being Task Force. "The whole point of that reporting was so that we could become aware of things before they blew up and came to us at a meeting, public hearing, or 100 emails that we were getting," he explained. The exchange revealed ongoing frustration with delayed information flow from the executive's office to council. Byrd pointed out that while staff had indicated only one contract was experiencing delays as of last September, the BTC contract had apparently been delayed for nearly a year without council awareness. Kayla Schott-Bresler from the executive's office expressed reluctance to commit to a specific reporting structure, asking for time to review what information was being provided to the task force and consult with her team about how to proceed. The response clearly frustrated several council members. Byrd argued that the information was already public record being shared with a public task force, making additional review unnecessary. "You can share, we can have this provided to us without creating duplicates of work and you could always bring your suggestions for how we change that in the future to us to discuss," he said. Council member Scanlon supported immediate information sharing while allowing for future modifications: "You start giving us that for the time being, and if you come up with an alternative, then you can bring it to us and we will look at that and see if we want the alternative works for us until then." ## Emergency Shelter: Preparing for Next Winter When Scanlon asked about preparations for next winter's emergency shelter operations, Beck confirmed that planning never stops. The county will again issue an RFP seeking providers who might be able to operate shelter services, hopefully relieving county staff of the dual burden of maintaining day jobs while operating emergency shelters during extended cold periods. "The hope is that we'll have a space and maybe even somebody else who's able to operate it," Beck said, acknowledging the significant operational challenges the current model creates for her team. ## A System Under Stress Throughout both presentations, themes of dedication amid constraint emerged repeatedly. Beck's airplane fire metaphor proved prescient – her division operates like a well-trained crew managing multiple simultaneous emergencies while maintaining essential services. The scope of work is impressive: from housing development to veterans services, from emergency shelter to nurse family partnerships, from opioid settlement implementation to developmental disabilities support. Yet every program area faces challenges. Funding streams remain uncertain, with federal changes threatening some programs while state budget constraints limit others. Staffing shortages plague critical services like the Nurse Family Partnership. Even successful programs like the emergency shelter system strain the capacity of staff managing multiple roles. The county's response has been systematic and professional, developing new expertise where needed (like Eric's capital projects role), seeking community input extensively (like Jamie Oliphant's 17 outreach events), and adapting to changing circumstances (like the modified child care subsidy program). But the underlying tension remains: growing community needs meeting constrained and uncertain resources, requiring increasingly sophisticated coordination and difficult priority decisions. ## What's Ahead Several key developments await in coming months. The housing assessment results will inform the five-year homeless housing plan update, due to the state by year's end. Year-round shelter options will come before council with multiple scenarios and cost analyses. Opioid settlement spending plans will detail how $2 million can best address addiction and its consequences. The BTC workforce development contract will finally move forward after extended delays. The Healthy Children's Fund will continue expanding, with upcoming presentations on food policy and home-based provider support, while the drop-in child care program establishes its presence in communities throughout the county. Perhaps most significantly, the ongoing dispute over contract transparency suggests council members' growing determination to receive timely information about program implementation – a reminder that even the most dedicated public servants operate within systems of democratic accountability. As Beck observed in closing her presentation, she feels "more optimistic than I have been in a long time about getting those resources in place and having those things on board," citing improved working relationships with legal and finance teams. For a division managing multiple emergencies while maintaining essential services, such optimism represents a valuable resource in itself. The meeting adjourned at 11:54 a.m., leaving observers with a clear sense of both the remarkable breadth of county health and human services work and the complex challenges these dedicated public servants navigate daily in service of their community's most vulnerable residents.