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HomeMy WebLinkAbout2022/03/22 - BOH Packet MASON COUNTY COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health MASON COUNTY BOARD OF HEALTH PUBLICMarch 22, 2022 " 3:00 PM Commission Chambers ® 411 North 5t' Street Shelton, WA 98584 Zoom Information Meeting ID: 834 8034 3274 Passcode: 721009 DRAFT AGENDA 1. Welcome and Introductions Peggy Van Buskirk, Chair 2. Approval of Agenda—ACTION Board Members 3. Approval of January 25,2022 Minutes—ACTION Board Members 4. Declaration of Public Health Month—ACTION Board Members 5. Community Health Assessment—ACTION Board Members 6. Health Officer Report Dr.Keri Gardner 7. Administration Report Dave Windom a. Regionalization 8. Environmental Health Report Alex Paysse 9. Community Health Report Lydia Buchheit 10. Board Composition Ordinance—ACTION Cmmr. Trask 11. Other Business and Board Discussion Board Members a. Presentation by Cmmr. Trask on House Bill 1152 12. Public Comments 13. Adjourn If special accommodations are needed,please contact McKenzie Smith at(360)427-9670 ext.589. Mason County Public Health 415 N 61h Street,Bldg.8,Shelton WA 98584, (360)427-9670 ext.400 Fax(360)427-7787 MASON COUNTY BOARD OF HEALTH PROCEEDINGS 411 North 51h Street,Shelton,WA January 25,2022 Attendance: Randy Neatherlin,County Commissioner;Kevin Shutty,County Commissioner;Sharon Trask. County Commissioner;Peggy VanBuskirk,Hospital District#2;Kathy McDowell,City of Shelton Council Member,Dr.Keri Gardner,Health Officer;Keri Davidson,Shelton School Board;McKenzie Smith,Clerk of the Board;Lydia Buchheit,Community&Family Health Manager;Dedrick Allen,Mason WebTV;Abe Gardner, Program Coordinator;Alex Paysse,Environmental Health Manager;Melissa Casey,Community Health Specialist;Adam Bernbaum,Lucky Anguelov,and Jean Bray. 1. Chair Peggy Van Buskirk called the meeting to order at 3:00 p.m. 2. Approval of Agenda—Cmmr. Shutty/Trask moved and seconded to approve the agenda as presented. Motion carried. 3. Resolution to Set Meeting Dates—Cmmr. Shutty/Trask moved and seconded to approve the Resolution setting the 2022 meeting dates. Motion carried. 4. Elect Officer Positions—Cmmr.Trask/Shutty moved and seconded to nominate Peggy Van Buskirk to remain as Chair. 5. Approval of Minutes—Cmmr. Shutty/Kathy McDowell moved and seconded to approve the November 2021 minutes. Motion carried 6. Health Officer Report by Dr.Keri Gardner Dr.Gardner discussed the composition of the Board of Health. Cmmr. Shutty had requested that she find a position to fill on the Board. There is at least one candidate to consider. The Omicron COVID variant spreads very quickly and has increased the overall numbers,however it is not as dangerous as the Delta variant. Hospitals still remain over capacity and transferring patients has still been problematic. She asked that individuals get vaccinated as well as get their booster. Omicron may be peaking or already has peaked locally. Currently the County is at a very high rate but will hopefully drop down to the triple digits instead of quadruple digits. The BA2,or"son of Omicron",variant is now the predominant form in Europe. The National Association of County and City Health Officials released an important statement with several other large Public Health organizations recommending to stop contact tracing. The State of Washington has not yet determined whether or not they will support the statement. Mason County is at the level of community spread where contract tracing really loses its value. A decision has not been made yet to recommend schools stop contact tracing. Dr.Gardner is looking forward to getting back to the basics of Public Health. Cmmr.Trask asked about Corona-Flu/Flu-Rona. Dr.Gardner shared that individuals have been co-infected with both influenza and Respiratory Syncytial Virus(RSV)which complicates the body's ability to respond immunologically as well as maintaining breathing,temperatures,and hydration. 7. Administration Report by Dave Windom Dave reiterated that the Omicron variant is spreading quickly and that they are seeing a possible peak. A total of 40,000 tests have been ordered and some have been received. Shipping has been an issue. Currently he is working on a distribution plan. Schools and tribes have their own access to tests. County priority is the most vulnerable. The second shipment will go to businesses. The distribution will include N95 masks as well. The Washington State Data Dashboard has a new look and is more user friendly. The Department of Health(DOH)will report three times a week. BOARD OF HEALTH PROCEEDINGS January 25,2022-PAGE 2 DOH received$130k to implement a regionalization program and will receive$1.8 million next year to implement the program. Local Public Health wants to continue working one-on-one with local hospitals. House Bill 1152 will be reopened which authorized this. DOH and local Public Health have a Consolidated Contract which consist of recitals and a statement of work(exhibit A financials and an exhibit B). The DOH website shows a"deconstructed contract'which only shows what has had a change made to it. Rollover items and financials will not be available until February. Money cannot be spent until a contract is approved and sign,the County cannot"back bill'to a contract that has not been received. 8. Environmental Health Report by Alex Paysse Alex shared a summary of 2021. Permits are up,food safety had staffing changes,Foundational Public Health money was received,water quality local funding support,and grant projects are being wrapped up. Updates for Chapter 6.32—Platting Standards—are being proposed to address health requirements for subdivisions and division of land. This chapter was last updated in 1980. A lot of the requirements are being addressed at the State level. Definitions are being updated,language is being added around general requirements,forms and fees that are required,and provides greater transparency. Cmmr.Trask/Keri Davidson moved and seconded to approve the updates to Chapter 6.32—Platting Standards and move that to the Board of County Commissioners. Motion carried. 9. Community Health Report by Lydia Buchheit Lydia shared the November-December Manager Report that staff put together for the Board to review. Abe Gardner gave a PowerPoint Presentation on Behavior Health Response from 2017 to present. Topics included substance use and mental health,prioritization of central resources and information,utilizing data, community stakeholder participation,community education and stigma reduction,\capacity building and system improvement,service system map,resources,and next steps and points of emphasis. Lachezar"Lucky"Anguelov gave a PowerPoint Presentation on the Comprehensive Opioid,Stimulant,and Substance Abuse Program(COSSAP). Topics included goals and objectives,data collection and analyses, participants,referrals,discharges and returns,networking and communication,conferences and presentations,and next steps. Melissa Casey presented the Community Health Assessment. Topics included an overview with conclusions and recommendations,strengths and weaknesses,recommendations,and next steps. 10. Other Business and Board Discussion Cmmr.Trask discussed House Bill 1152. Currently waiting to get more information from the tribes. Dave added that three users of Public Health will need to be added as well. The Current Health Department code in Chapter 2.14 will need to be changed as well. 11. Public Comments- Jean Bray commented that it was a productive meeting and that she is glad Dr. Gardner is here. 12. Adjourn BOARD OF HEALTH PROCEEDINGS January 25,2022-PAGE 3 ATTEST MASON COUNTY,WASHINGTON BOARD OF HEALTH MASON COUNTY,WASHINGTON Melissa Drewry,Clerk of the Board Scott Hilburn,Hospital District#1 Kathy McDowell,City Commissioner Kevin Shutty,Commissioner Randy Neatherlin,Commissioner Sharon Trask,Commissioner Peggy Van Buskirk,Hospital District#2 Gary Plews,Fire Commissioner Keri Davidson, Shelton School Board 2022 National Public Health Week Proclamation Whereas the week of April 4-10, 2022, is National Public Health Week, and the theme is "Public Health is Where You Are"; and Whereas since 1995, the American Public Health Association, through its sponsorship of National Public Health Week, has educated the public, policymakers and public health professionals about issues important to improving the public's health; and Whereas U.S. life expectancy dropped from 2014 to 2017 in the longest sustained decline since the Great Recession and only in 2018 began to increase again; U.S life expectancy then dropped again in 2020 by a full year, which is the largest drop in life expectancy since 1943. Whereas there is a significant difference in health status, such as obesity, poor mental health and drug use, among people living in rural areas compared with people living in urban areas, and this variance increases because rural residents are often more likely to face social determinants that negatively impact health, such as poverty,transportation barriers and lack of economic opportunity; and Whereas a person's health status can differ drastically by zip code due to differences in the built environment, environmental quality, community context, access to healthy food, access to education and access to health care. Whereas public health professionals help communities prevent, prepare for, withstand and recover from the impact of a full range of health threats, including disease outbreaks such as the COVID-19 pandemic, measles, natural disasters and disasters caused by human activity; and Whereas public health action, together with scientific and technological advances, has played a major role in reducing and, in some cases, eliminating the spread of infectious disease, and in establishing today's disease surveillance and control systems; and Whereas preventable risk factors such as such as physical inactivity, poor nutrition, tobacco use and excessive alcohol use are leading causes of chronic disease; and 6 in 10 U.S adults have a chronic disease and 4 in 10 have two or more; and chronic diseases cause 7 of every 10 deaths annually in the United States. Whereas the COVID-19 pandemic has illuminated and exacerbated racial inequities and a growing number of local, state governments and public health leaders have declared racism a public health crisis. NOW,THEREFORE,the Mason County Board of Health and Mason County Board of County Commissioners do hereby proclaim the week of April 4-10, 2022, as National Public Health Week 2022 in Mason County and call upon the people of Mason County to observe this week by helping our families, friends, neighbors, co-workers and leaders to better understand the value of public health and supporting great opportunities to adopt preventive lifestyle habits in light of this year's theme, "Public Health is Where You Are." Dated this 22th day of March 2022 Mason County Board of Health Mason County,Washington Mason County Board of County Commissioners Mason County,Washington Chair Chair Commissioner Commissioner Commissioner Commissioner Member Member Attest: Member Clerk of the Board Member Health Officer • MOP • MASON COUNTY COMMUNITY SERVICES Mason County CommunityHea t Assessment 2021 Mason County Public Health A Safe and Healthy Mason County http://healthymasoncounty.com/ www.masoncountVwa.gov Purpose The Community Health Assessment (CHA) is a review of various health data used to illustrate the current health status of a community and monitor its progress over time. It is a critical step in defining the vision for health in Mason County so that we can choose targeted health improvement efforts that affect policies, dismantle health disparities, and promote health in our community. The findings of this assessment will be used to identify the health priorities of focus for the 2022-2026 Mason County Community Health Improvement Plan. Background Annually, the County Health Rankings & --� Roadmaps program of the University of Leagthof Life(50%) Health Outcomes _ — Wisconsin Population Health Institute Quality OfUfe(50%) publishes the County Health Rankings. Tobacco use The local data reported in this section is Health Behaviors Diet&Exercise organized by the Health Rankings Model (30%) Alcohol&Drug Use (1). The Health Rankings Model Sexual Activity emphasizes the many factors in population ea ulati health that, improved,if im d, Clinical Care can Access to Care help make communities healthier places (20%) Quality of Care to live, learn, work, and play. In the Health Factorsf Education Health Rankings Model, the current health status of a community is Social& Employment described as health outcomes, which are 'E`onoiao%a`t I Income ). F ranked by rates of mortality (premature Family&Social Support death) and morbidity (chronic diseases). Community Safety These health outcomes are influenced by Physical Air&Water Quality health factors in a community, ranked b Environment y y •_ (10%) Housing&Transit a calculation of various health behaviors, Cmnivl -RenW­rnotlN4]14 UWPHI clinical care, social and economic, and physical environment measures. Health Factors represent what will influence the future health of a community, while health outcomes represent how healthy a community is today(1). There are evidence-based policies and programs that a community can implement to improve health factors and, ultimately, improve its health outcomes. These standard measures facilitate comparisons and benchmarking with similar communities and changes over time. Mason County is compared to two neighboring rural counties—Grays Harbor and Lewis—with similar populations, health factors, and health outcomes. Due to the COVID-19 pandemic beginning in January 2020, the data reflected in this assessment are from 2019 and earlier; 2020 data is used for few measures where available. Data will be revised in the subsequent CHA after detailed 2020 data are released. The impacts of the 1 pandemic are unknown; therefore, we can only make assumptions about the anticipated outcomes as a result of the pandemic. COVID-19 will likely have a greater impact on unemployment, children in poverty, income inequality, premature age-adjusted mortality, food insecurity, and severe housing cost burden than is currently reflected in this assessment (1). Least Healthy Healthiest 0% 25% 50% 75% 100% According to the Health Rankings, Mason County's health outcomes is ranked in the lower middle range (25%-50%) of counties in Washington. Our community's health factors are ranked among the least healthy counties (lowest 0%-25%) in the state. The 2021 estimated population of Mason County is 65,750 residents (2). Although Mason County is a predominantly white population (83%), 12% identify as Hispanic origin of any race (3). Nine percent (9%) of Mason County residents are biracial or multiracial, 5% are American Indian or Alaska Native, and 1%are Black/African American or Asian (3). Race(3) Ethnicity(3) 0 100% .Y m a 75% 0 a ° 50% c a� U 25% ■White a- ■Two or More Races 0% ■American Indian or Alaska Native Non-Hispanic Hispanic 2 Percent of More than half(53%) of Mason Age Group Female Male Total Population County residents are adults ages 0-4 1,529 1,599 3,127 5% 20-64 years (3). Twenty-six 5-19 5,216 5,561 10,776 16% percent (26%) of the community 20-64 16,341 18,419 34,119 53% are seniors over age 65 and 21% 65+ 8,794 8,293 17,087 26% are under the age of 20 (3). ' "' Health Outcomes Health Outcomes represent how healthy a county is right now, reflecting the physical and mental wellness of residents within in a community through measures representing both the length and quality of life (1). The County Health Rankings measures life expectancy, premature death, birth risk factors, and ratings of physical and mental health as key factors that influence a community's health outcomes. Mortality The life expectancy for a child born in Mason County between 2015 and 2019 is 79.7, meaning a person born in Mason County between 2015 and 2019 can be expected to live 79.7 years on 79.7 years average (4). In comparison, the life expectancy for the state of Washington for that same period is 80.4 years (4). Mason Life expectancy in County's life expectancy rate has increased steadily over the last Mason County 25 years; between 1994 and 2019, life expectancy increased by 4.3 years (4). Leading Causes of Death, 2015-2019(4) ■Mason Washington a a (U c 200 167 160 148 136 136 m a 120 °J o o a v 0 80 49 43 43 36 35 44 30 35 0 40 20 16 19 21 15 12 10 11 Q o 0 m `ec aye J� QO �y �e ae ey ye `a o° Q lac `ye �`c, LO `fie ��co �J�o` \a�e� \yea mo O a e O J GJ\at ��`oc Ptir O �\,es �Q�e Ga`a\oay Jc\�tie Cr`oc�� o`��Je�~a The top 3 leading causes of death for both males and females in Mason County are cancer, heart disease, and unintentional injury; the cancer type that results in the most deaths in Mason County is lung cancer (4). Mason County has higher mortality rates due to cancer, 3 cardiovascular disease, unintentional injury, chronic obstructive pulmonary disorder (COPD), suicide, and chronic liver disease (4). Local mortality rates associated with Alzheimer's, stroke, and diabetes are lower compared to the state's rates (4). Premature Death (1) 0 0 0 0 0 9000 v Ln 0 8000 � an 75 a 7000 Q o v a. 6000 0 r- m 5000 J a 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 r *—Mason —0—Grays Harbor --*--Lewis Washington Years of Potential Life Lost (YPLL) measures the rate and distribution of premature death, or deaths that could have been prevented (1). While statistics that include all mortality are dominated by deaths of the elderly, YPLL emphasizes deaths of younger people (1). The YPLL in Mason County has remained largely consistent over time; however, between 2015 and 2017, YPLL has begun to decline. While Mason County's YPLL remains higher than the state's, rates of premature death have declined overtime and continue to remain lower than neighboring Grays Harbor County. Morbidity Morbidity measures the burden of disease on a population and can reveal how healthy a community is as well as indicators for future health (1). Many of the leading causes of death and chronic health conditions are caused or exacerbated by unhealthy lifestyle behaviors. Diet and exercise influence one's risk for various chronic diseases including diabetes and heart disease. Many of these behaviors are established in childhood (1). Prevalence of Select Adult Health Risk Factors, 2015-2019 (6) 0 50% M 3,889 hospitalizations 4U% 0 30% Heart disease was the leading 0 20% cause of hospitalizations in Mason County between 2016 and 2019 (5) 10% An 0% __. Obesity Diabetes High blood High pressure cholesterol ■Mason Washington 4 Prevalence of Selected Unhealthy Habits Washington Among Students, 2018(7) ■Mason Less than 5 servings of fruits/vegetables daily 3+hours of screen time daily Do not meet physical activity recommendations i 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Health Factors There is a plethora of factors that influence a person's overall health.The Health Rankings Model focuses on four main health factors that influence the health of the county: Health Behaviors, Clinical Care, Social and Economic Factors, and Physical Environment (1).The remainder of this report will discuss the health indicators that make up the four Health Factors. Health Behaviors The Health Rankings Model estimates that approximately 30%of our health is influenced by an individual's health behaviors (1). These include actions that improve health such as eating well and physical activity, as well as those that increase the risk of disease such as substance use and risky sexual behavior. ComparisonIndicators Health Behaviors Mason Washington Adult Smoking(2015-2019) 23% 14% Adult Obesity(2015-2019) 41% 28% Physical Inactivity(2017) 22% 16% Excessive Drinking(2015-2019) 15% 16% Alcohol-Impaired Driving Deaths(2015-2019) 29% 33% Sexually Transmitted Infections(rate per 100,000)(2018) 381.4 465.2 Teen Births(rate per 1,000 females ages 15-19) (2013-2019) 30 16 Smoking The smoking rates of both adults and youth in Mason County have historically been higher than the state's rates. Between 2012 and 2016, 21%of Mason County residents were current smokers compared to 16%of Washington state residents (6). Since 2012, smoking rates among 5 adults in Mason County have remained around 1 in 5 residents while youth smoking rates have decreased over the last decade. Adult cigarette smoking trends in Mason County have varied over time and compared to similar counties. Due to changes in data collection methods for adult e-cigarette use, data between 2015 and 2019 are not comparable. Adult Cigarette Smoking(6) 30% c E 25% _ C 20% a 0 15% N*0000 c u 10% L a 5% 2012 2013 2014 2015 2016 2017 2018 2019 Mason 0 Grays Harbor -*--Lewis Washington In 2008, 22% of 10th graders reported they were While youth smoking current cigarette smokers, compared to 9% in 2018 rates have decreased (7). Electronic cigarette use, or vaping, has become y more popular in recent years. In 2012, only 4%of over the last decade, Mason Count 12th graders re orted va in durin youth vaping in Mason the last 30 days compared to 37% in 20p8.This g County 12th graders has increased by 37% - staggering increase in vaping reflects national trends between 2012 and 2018 for which the Surgeon General declared youth vaping at epidemic levels in December of 2018 (8). Youth Cigarette Smoking, 2015-2019 Youth Electronic Cigarette Use, 2015- (7) 2019(7) 0 14% 0 30% 12% 2 25% Q 10% Q 20% a- 8% a° 15% 6% a 4% 0 10% 2% a�i 5% ai 0% v 0% 8th Grade loth Grade 12th Grade a 8th Grade loth Grade 12th Grade ■Mason '_ Washington ■Mason Washington 6 Obesity Obesity increases the risk for chronic health conditions such as Adult obesity rates in heart disease, type 2 diabetes, cancer, hypertension, and Mason County have stroke (1). Although Mason County and Washington State exceeded those of report similar rates for adult diabetes (10%and 9% neighboring counties respectively), a larger portion of the Mason County adult and the state over the population is diagnosed as obese (6). In addition to last four years consistently exceeding statewide rates, Mason County's adult obesity rates have remained higher than Grays Harbor and Lewis counties over the last four years (6). Between 2015 and 2019, the five-year obesity rate for Mason County adults (41%) was 13% higher than the state's rate (28%) (6). Being obese prior to getting pregnant can result in negative health outcomes for both mother and baby(9). Between 2015 and 2019, over a quarter of mothers (27%) in Mason County had a BMI of 30 or greater prior to pregnancy (10). Adult Obesity(6) 50% c 0 40% a 0 a 0 30% I 20% a 10% 2012 2013 2014 2015 2016 2017 2018 2019 --*--Mason —8 Grays Harbor tLewis Washington Mason County's youth also experience higher Youth Obesity Rates, 2015-2019(7) rates of obesity compared to the state. Eighteen percent (18%) of Mason County 8tn graders are obese, compared to the state o 20% average of 12% (7). Youth obesity rates have ° 15% remained relatively consistent over time in o Mason County, with the sharpest increase o 10% occurring in 8th graders between 2016 and 5% 2018 by 50% (7)• o% 8th Grade loth Grade 12th Grade ■Mason Washington 7 Physical Activity Leisure time physical activity is defined as "physical activity or exercises such as running, calisthenics, golf, gardening, or walking for exercise" (6). The percent of adults not meeting leisure time physical activity recommendations has varied over time. In 2019, 38%of adults did not meet physical activity recommendations compared to 15% in the previous year (6). Adults Not Meeting Leisure Time Physical Activity(6) c 40% 0 35% 30% 0 25% 0 20% v v 15% . 2015 2016 2017 2018 2019 --*—Mason 0 Washington In 2018, 79%of 12th graders in Mason County did not meet the recommendations for 60 minutes of physical activity 7 days a week, compared to the state's 74% (7). The percent of Mason County 8th, 101h, and 121h graders meeting the physical activity recommendations has increased over the last decade while the rate of 61h graders meeting recommendations has decreased over time (7). Youth Not Meeting Physical Activity Recommendations, 2018(7) 0 80% ''H', f° 78% 0 76% The percent of adults not meeting o 74% physical activity recommendations 72% more than doubled between 2018 v70% and 2019, and only a quarter(25%) a 68°i - of youth meet physical activity 6th Grade 8th Grade loth 12th recommendations Grade Grade ■Mason Washington Food Insecurity The County Health Rankings measures a county's Food Environment Index based on 1) estimated percentage of low-income population who live more than 10 miles from a full-service 8 grocery store and 2) food insecurity—the percentage of a population that did not have access to a reliable source of food during the past year (1). The Food Environment Index is ranked from 0 (worst) to 10 (best). Mason County's Food Environment Index in 2018 was 7.7 compared to the state's score of 8.2 (1). Mason County is largely rural; compared to similar counties, Mason's food environment index is scored higher than Grays Harbor (6.8) and Lewis County (7.2). Food Insecurity, 2017-2019(11) Food Insecurity measures prior to COVID-19 pandemic revealed that 13% of Mason County 25% were food insecure (11).The impact of the o pandemic is projected to increase food ID 20i° insecurity to 15.8% (11). fl 15% ' 0 0 10% Households that experience income u5i° insufficiency usually supplement their budgets v by participating in various programs such as a 0% free and reduced meal programs and SNAP 2017 2018 2019 (12,13). ■Mason ae Washington Participation Rate in Food Supplement Programs(12,13) 2015 2016 2017 2018 2019 Mason County Free and Reduced Meal Programs 62% 62% 59% 60% 61% Mason County SNAP—Basic Food 25% 25% 24% - - WA Free and Reduced Meal Programs 45% 44% 43% 42% 43% WA SNAP—Basic Food 20% 19% 17% - - Substance Use Substance use and abuse is a health behavior that is harmful to the health and well-being of individuals as well as their families, friends, and communities (1). In Mason County, adult marijuana usage rates have increased rapidly since 2012, whereas heavy alcohol usage rates have fluctuated but decreased between 2018 and 2019 (6). Binge drinking is defined as having five or more drinks in a Mason County adults row in the past 2 weeks (6). Mason County youth have similar have higher usage rates binge drinking rates compared to the state, which have of marijuana and similar decreased steadily over the last decade (7). In 2008, 27%of heavy alcohol usage 10th graders reported binge drinking compared to only 10% in compared to the state 2018 (7). Youth marijuana usage rates have historically been higher than the state's. In 2019, youth marijuana use increased in 8th and 12th graders compared to the previous year. Between 2016 and 2018, marijuana use in 12th graders increased by 10% (7). 9 Alcohol-or drug-related deaths have remained consistent over the past decade (14). Mason County's death rate between 2015 and 2019 (13.9 per 100 deaths) has remained similar to both the previous five years (13.8 per 100 deaths) and alcohol- or drug-related deaths statewide (14). Binge Drinking Rates,2015-2019(6,7) Marijuana Usage Rates, 2015-2019 (6,7) 0 20% 0 35% M . 30% 2 a 15% Q 25% Q_ a- 20% 0 10% 0 15% c c 10% u 5% u 5% a 0% La 0% Adults 8th Grade loth 12th Adults 8th Grade 10th 12th Grade Grade Grade Grade ■Mason Washington ■Mason Washington Drug Overdose Deaths Drug-specific overdose deaths have Opioid Overdose Age-Adjusted Death increased in Mason County over the last Rate (4) decade. Prior to 2010, death rates due to 0 30 any drug overdose were as low as 8.2 per 100,000 population (4). In 2016, Mason a 20 ; County Community Services—Public Health o implemented new programs to reduce drug o 10 ~ overdose deaths throughout the county. In QJ the subsequent years, opioid death rates ° dropped dramatically. In 2017, the age- zo15 2016 2017 2018 2019 adjusted death rate due to opioid overdose tMason tGrays Harbor —4--Lewis Washington decreased by 65%, and the age-adjusted death rate due to any drug overdose Drug Overdose Age-Adjusted Death decreased by 18%compared to the previous Rate(4) year(4). In 2019, deaths due to any drug 2 40 — - overdose, including opioids, increased Q 0 30 ___._�. dramatically from the previous year while °- se000 rates statewide increased only slightly. The o zo age-adjusted death rate due to opioid 10 overdose increased by 14 per 100,000 a 0 compared to the previous year (4).The age- m 2015 2016 2017 2018 2019 adjusted death rate due to any drug tMason Grays Harbor overdose increased by 11.3 per 100,000 (4). —0--Lewis Washington 10 The increase in opioid and drug overdose death rates in 2019 may be an outlier in overall trends; the cause of the one-year increase cannot be immediately identified, though behavioral health professionals have inferred it may be due to the increase of fentanyl use. Between 2018 and 2019, Washington state deaths due to opioid overdose increased by 1 per 100,000 (4). In late 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) released findings from the 2020 National Survey on Drug Use and Health that suggests the COVID-19 pandemic has had a negative impact on mental health, which includes exacerbating use of alcohol or drugs (15). Sexually Transmitted Infections Sexually transmitted infection (STI) indicators are typically based upon reported Chlamydia cases, as Chlamydia is the most common bacterial sexually transmitted infection in the United States (1). In 2020, the rate of Chlamydia infection was 326 per 100,000 in Mason County, which was less than the state rate of 410.4 per 100,000 (16). Despite the overall rate being lower than the states, Chlamydia infection rates are increasing in Mason County. Since 2010, Chlamydia infection rates have increased by 44% (16). Rates of STIs are based on clinically diagnosed STI cases reported to the Washington State Department of Health (WA DOH) through public health surveillance. Therefore, the burden of disease may be greater than these data indicate as not all cases of sexually transmitted infections are diagnosed and not all diagnosed cases are laboratory confirmed (17). Chlamydia Infection Rates (16) In Mason County, Planned Parenthood was a highly utilized service for young adults 400 between ages 20 and 24, teens, a and Mason County's growing Hispanic population. In early 0 300 2021, the state closed three o Planned Parenthood centers in Q 200 Washington, including Mason County's location in Shelton 100 (29). In Mason County, Planned 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Parenthood provided services to 1,200 clients in 2020, a growing number compared to 1,100 clients in 2019. Planned Parenthood provided a safe haven for people to receive STI testing and contraception for family planning. Planned Parenthood also demonstrated an impact on maternal and child health by providing an avenue for young people to receive pregnancy testing and increasing referrals to early prenatal care. 11 Early initiation of First Trimester Prenatal Care (10) prenatal care can improve maternal 90% and infant health 0 outcomes. Women o so% = ��y who receive delayed prenatal care after 70% first 12 weeks of ZZ pregnancy or no 60% prenatal care at all 2015 2016 2017 2018 2019 2020 are at risk of undetected —*--Mason --*—Grays Harbor —Lewis Washington pregnancy complications (28). Compared to similar counties and the state, mothers have lower rates of seeking early prenatal care in Mason County (10). While the closure of Planned Parenthood is too recent to see any immediate outcomes, the anticipated impact is expected to be significant on a community that relied so heavily on the access it provided to sexual and reproductive health services. Similarly, the Shelton WIC clinic also closed its doors in late 2021, creating a new gap in services to over 3,000 families who accessed resources to healthy foods, breastfeeding support, and nutrition education. Evidence suggests teen pregnancy significantly increases the likelihood of future risky sexual behavior, STI, and other adverse health outcomes (1). Pregnant teens are more likely than older women to receive late or no prenatal care and experience increased risk of complications in pregnancy, preterm delivery, low birthweight, and severe neonatal conditions (1). Teen pregnancy is also associated with poor socioeconomic, behavioral, and mental health outcomes (1). The teen birth rate in Mason County has historically been higher than the state's (1). Between 2013 and 2019, there were 30 births per 1,000 female population ages 15-19, compared to 16 births per 1,000 for Washington State (1). The teen birth rate in Mason County varies by demographic. For instance, the teen birth rate among Hispanics is 77 births per 1,000 female population ages 15- 19, compared to 22 births per 1,000 among Whites (10). Clinical Care Clinical Care factors account for 20%of a community's health status as demonstrated in the Health Rankings Model diagram on page 1 of this report (1). Clinical Care considers both access to care and quality of care issues. Key indicators examined in clinical care include the percentage of uninsured individuals, and the ratios of population to providers for medical, dental, and mental health services. These indicators help to show how readily accessible these crucial services are in the community. 12 Comparison of Key Indicators (1) Clinical Care Mason Washington Uninsured(2018) 10% _ 7% I-Primary Care Physicians(2018) 3,850:1 �_ 1,180:1 Dentists(2019) 2,900:1 � 1,200:1 Mental Health Providers 490:1 ! 250:1 (2020) Health Insurance Status The quality of health care in a community is dependent on an individual's ability to access both health insurance coverage and health care providers (1). Between 2015 and 2019, the number of Mason County residents who are insured has remained consistent as in previous years, which is also historically lower than the number insured statewide (18). In 2019, 95.4% of children under the age of 19 in Mason County were also insured.That same year, 96.9%of children under the age of 19 were insured in Washington State (18). Access to Healthcare Mason County's Access to health care can be challenging in Mason County due shortage in primary care to barriers such as geographical distances and provider physicians exceeds other shortages. In 2018, the ratio of Mason County's population to counties and the state primary care physicians was 3,850:1, meaning there is only one primary care provider per every 3,850 residents in Mason County (1). In comparison, the ratio for Mason County Washington Washington State was 1,180:1 (1). Comparing provider rates per 100,000 population to other counties with similar populations and 3,850 1,180 geographical barriers as Mason County further illustrates our community's access to healthcare People People needs. In Mason County, there are per I Primary Care per 1 Primary Care Physician Physician approximately 26 primary care physicians per 100,000 people; there are 34 in Grays Harbor 2 �oo � �oo County, 43 in Lewis County, and a statewide rate of 84 primary care physicians per 100,000 people People People (1). As a result, many residents are forced to per IDentist per 1Dentist leave the county to access primary care or utilize urgent cares and emergency departments. 490 250 In 2019 the population o ulation to dentist ratio was People People 2,900:1, more than twice the state's ratio of per 1 Mental Health per 1 Mental Health Provider Provider 1,200:1 (1). Finally, the ratio of residents to mental health care providers—psychiatrists, social workers, counselors, marriage and family 13 therapists, and those who treat alcohol and other drug abuse—was also nearly twice the state's ratio. In 2020, Mason County's ratio was 490:1 compared to the state's ratio of 250:1 (1). Social and Economic Factors The Health Rankings Model estimates that 40% of our health is influenced by the social and economic conditions in which we live (1). Some examples of social and economic factors of interest are education, employment, income, poverty, and crime. ComparisonIndicators Social and Economic Factors Mason Washington On-time graduation rates(2015-2020) 76% 81% Adults w/some college education(2015-2019) 49% 71% Unemployment rate(2019) 6.3% 4.3% Children in poverty(2019) 21% 12% Income inequality ratio(2015-2019) 4.3 _ 4.4 Children in single-parent households(2015-2019) 23% 20% Violent crime rate(per 100,000(2014-2016) 220 294 Injury deaths rate(per 100,000)(2015-2019) 96 67 Graduation Rates In 2020, A high school degree is correlated with higher life expectancies County achieved its Mason and improved quality of life (1). Adults with high school diplomas C are more likely to be employed and earn more than their less highest time educated counterparts (1). Historically, Mason County's high graduation rate in the school graduation rates have been lower than the state rates for last decade both on-time and extended graduation (19). On-time graduation rates in Mason County have remained consistent over the last five years but have Increased steadily over the last decade; our highest rate of on-time graduation was achieved in 2020 (19). On-Time Graduation Rates(19) Extended Graduation Rates (19) L 85% 90% y � W QJ o 80% 85/a _ N N 'C: 80% v a µ o °+ 75% v v u � 75% U a C9 70% a 70% L015 L016 L01� L01a L019 LOLO 1015 V%11 10" 201a L0�9 y0�0 Mason Washington Mason Washington 14 Extended graduation rates include students who completed their high school diploma after their expected year of graduation (19). Rates for students who graduated in 5 years have remained consistent at both the local and state level with improvements seen in the last two years (19). High School Completion, 2015-2019(1) High school completion rates are similar across 3 Mason, Grays Harbor, 0 100% and Lewis counties. N+ C 95/ Although slightly lower a — fl 90% than the state, all o •� 85% o counties are similar to o N W 80% Washington high school Lao 75% ai completion rates (1). 70% Mason Grays Harbor Lewis Washington Educational Attainment Mason County's adult educational attainment levels have been consistent over the past decade and have historically been lower than the state's rates (20). Mason County has a higher percent of adults with less than a high school diploma and a lower percent of adults who have completed a college degree. Thirty-six percent of Washington State residents have a Bachelor's Degree or higher, while only 17% of Mason County residents has attained this same education level (20). Educational attainment levels are comparable to neighboring rural counties. Adult Educational Attainment, 2015-2019(20) 40% 0 >. 30% Ln Ln L 20% �+ aJ a 0% Less than High High School Some college,no Associate's Degree Bachelor's Degree or 0 School Diploma/GED degree Higher a ■Mason e Grays Harbor ■Lewis Washington Unemployment Historically, Mason County's unemployment rates have been consistently higher than the state's rate. Despite a slow recovery after the 2008 economic downturn, unemployment rates in Mason County fell by 3.7 percentage points between 2013 and 2019 (21). In March 2020, the 15 Unemployment(21) COVID-19 coronavirus pandemic profoundly impacted the Washington labor market. 12% Widespread business closures prompted a ° 10r° wave of mass unemployment that would have 8i° been uncharacteristic in a pre-pandemic o setting. Washington state's unemployment a 6% 0 rate reached an all-time high of 16.3% in April 4�° 2020 and declined to 5.1% by July 2021 (21). a) 2i Concurrently, the unemployment rate in 0% Mason County reached 17.5% at the start of 101�l y°16 ti°tip ti°1a ti°19 y°ti° the pandemic and declined to 5.7% by July ---*---Mason Washington 2021 (21). Economic recovery is ongoing as the virus continues to impact communities and the workforce worldwide; however, the outlook appears promising with the sharp decline in unemployment in the later months of the COVID- 19 pandemic. Poverty and Income Inequality The poverty rate is a ratio of the number of people whose income is at or below the Federal Poverty Mason County's poverty rates continue to decline from Guidelines. In 2019, the poverty threshold for a family of four with two children under the age of 18 was any previous years but remain high compared to the state. family making at or below $25,926 a year (22). In Mason poverty rates are similar to County, 12.8%of residents met these criteria and were neighboring rural counties living below the federal poverty level (23). Nearly a quarter (21%) of Mason County children under the age of 18 lived in poverty (23). Though Mason County's poverty rates historically exceed the state's, local rates have decreased slowly over the last half decade. Poverty Rates (23) Over the past five years, poverty rates have remained 20% similar across Mason County o 18r° and neighboring Grays Harbor and Lewis counties. While CL 16i° poverty rates have decreased 0 14% over time in all three counties, v 12% progress has been slower in Grays Harbor, which has had 10°y 2015 2016 2017 2018 2019 the highest rates of poverty over the last two years. Rates --S--Mason —*--Grays Harbor —*—Lewis Washington for all counties consistently average 33% higher than the state. 16 While poverty at any age Poverty Rates for Children Under 18(23) contributes to increased risk of more frequent and severe 35% chronic health conditions, 0 30% children in poverty may 25% experience long-term effects o 20% on academic achievement, 15°i° 0 health, and income into - 10% adulthood (1). Child poverty U 5% rates in Mason County have 0% 2015 2016 2017 2018 2019 been consistently higher than in similar counties and tMason--*sGrays Harbor tLewis Washington compared to the state. The incidence of children in poverty is not evenly spread across the county, as indicated by Free and Reduced Meal Program data (13). All but one Mason County school district reported higher or equal rates of poverty compared to the state (13). Percent of Students Eligible for Free/Reduced Meal Program by School District, 2015-2019(13) Washington Grapeview Hood Canal Pioneer Mary M.Knight North Mason Shelton Southside 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Income inequality can also be an indicator of health outcomes, Mason County's increasing risk for chronic disease and mortality (1). Income income inequality inequality is defined as the ratio of household income at the 80th ratio is consistent percentile to that at the 20th percentile. A higher inequality ratio with the state's rate indicates greater division between the lowest income and highest income earners in a community (1). Between 2015 and 2019, Mason County's income inequality ratio was 4.3, which is consistent with Washington state's ratio of 4.4 (1). 17 Household Structure Adults and children in single-parent Household Structure for Families households are at higher risk for adverse with Children Under 18 Years, 2015- health outcomes (1). In 2019, the divorce rate 2019 (24) in Mason County was 3.6 per 1,000 persons, 0 80% with a recorded 194 divorces (14). Divorce 60% rates in Mason County remained relatively the o 40% same prior to 2017 when the trend decreased 0 20% by 27%from the previous year; rates remain 0% N lower than the previous 10 years (14).The v Couple Male Female a Headed Householder, Householder, majority of families in Mason County with Households no spouse no spouse children under the age of 18 are headed by present present couples (24). However, 42%of families are ■Mason Washington single parent households (24). Family & Social Support Research shows that individuals with limited social and emotional The majority of support experience poorer health outcomes (1). Three out of 4 Mason County Mason County youth reported that they could ask their parents for youth report having help with a personal problem (7). Nearly half also reported having consistent social an adult in their lives they could turn to if they felt depressed (7). and emotional For 12th grade students in particular, the percent of youth who feel they have an adult they can turn to for help has decreased over support; however, rates have time. In 2012, 57%of 12th graders reported having a supportive decreased for 12th adult (7). By 2018, less than half(46%) reported feeling they had an graders over time adult they could turn to when they felt depressed, 20% less than in 2012 and a 15% decrease over the last decade (7). Youth Reporting They Could Ask Youth Reporting They Had an Adult Parents for Help with a Personal to Turn to When Feeling Depressed, Problem, 2018(7) 2018(7) 0 80% 2 100% } 80% 60% a a 60% 40% 0 40% a-. o u 20% u 20% a 0% a 0% 6th Grade 8th Grade loth 12th 6th Grade 8th Grade loth Grade 12th Grade Grade Grade ■Mason Washington ■Mason Washington 18 Community Safety The safety of the communities in which we live Crime Arrest Rates for Adults, and work can also be an indicator of health 2019(14) outcomes (1). In Mason County, the arrest o 8 rates for youth ages 10-17 are lower than the state's rates for all types of crime (14).The C 6 total arrests for youth in Mason County have o 4 decreased significantly over the past decade. o In 2005, there were 381 recorded arrests for W Z youth ages 10-17, compared to a mere 32 CL QJ arrests in 2019 (14). For adults, Mason County 0 Violent Crime Property Crime Drug Law arrest rates are lower than the state's rate for Violation property crime and for drug law violations; ■Mason Washington arrest rates are similar to the state for violent crime (14). Arrest rates for adults have remained relatively the same over time (14). Unintentional Injury Deaths The final indicator used to access social and Unintentional Injury Death Rate by economic health is injury death rates (1). County, 2015-2019(4) Between 2015 and 2019, deaths due to unintentional injury or accidents were the 70 60 third leading cause of death for Mason County a so residents, occurring at an age-adjusted rate of 040 49.2 per 100,000 (or 192 deaths) (4). This rate o 30 is higher than the state's rate for that same o zo 10 time period of 42.8 per 100,000 (4). The top 3 Q o causes of unintentional injury death in Mason W �o� County between 2015 and 2019 were poisoning, motor vehicle-traffic, and falls, in c,�a that order (4). Death rates due to unintentional injury have remained consistent over the past two decades (4). Physical Environment Physical Environment factors account for 10%of a community's health status as demonstrated in the Health Rankings Model. The physical environment is where individuals live, learn, work, and play (1). The air we breathe, the water we drink, the housing we live in, and the transportation we have access to are examples of the physical environment that can affect our ability to live long and healthy lives (1). 19 Housing & Homelessness Stable, affordable housing can provide a safe environment for families to live, learn, and grow. A home that is safe and free from physical hazards reduces the risks for infectious diseases, injuries, and poor childhood development. Conversely, unaffordable housing can create additional stress. Housing is often a family's largest expense and when the majority of a paycheck goes to the rent or mortgage, this housing cost burden can force people to choose among paying for other essentials such as utilities, food, transportation, or medical care (1). According to the American Community Survey, between 2015 and 2019 there were 33,503 housing units located in Mason County (26). Of that total, 24,278 units are currently occupied with 77% of units being owner-occupied and 23%of units being rentals (26). A measure used to identify housing problems Households that are Housing Cost is housing cost burden (1). The U.S. Burdened, 2014-2018(25) Department of Housing and Urban Development (HUD) considers households that o 35% pay more than 30% of their income on rent or housing costs (including utilities) as housing a cost burdened (25). Nearly a third of Mason a 30% County residents have a housing cost burden o greater than 30% of their income (25). Of v 25io those residents that are housing cost a o0 0� 011 burdened, 34% of households are renters and �a5 `a,Sza`� 66/o are owner households (25). Mason County has a lower housing cost burden compared to the State of Washington, but a higher housing cost burden compared to neighboring Grays Harbor and Lewis counties (25). HUD and Washington state require an annual statewide count, known as the Point in Time (PIT) count, of people experiencing homelessness.The PIT count includes both sheltered and unsheltered persons. "Sheltered" refers to all persons living in temporary housing programs, and "unsheltered" refers to those living in places not meant for human habitation (31). Due to the pandemic, Mason County conducted a PIT count of sheltered homeless in 2021, but did not conduct a PIT count of unsheltered homeless. LL i e Households with Households without Households with only children&adults children children Households People Households People Households People Emergency Shelter 11 33 37 37 0 0 --— Transitional Housing 7 24 I� 0 0 0 0 According to the Washington State Department of Commerce, increasing rents have been the main driver of homelessness in Washington over the last decade (31). Fair Market Rent (FMR) is 20 a statistic calculated by HUD to determine payments for various housing assistance programs (32). Payment standards can be approved up to 120% of FMR. t .. Efficiency One-Bedroom Two-Bedroom Three-Bedroom Four-Bedroom $660 $825 $949 $1,297 $1,373 Availability of rental units further impacts 2021 Mason County Rentals<120% FMR housing costs, with low vacancy rates leading to housing price inflation and e Shelton housing cost burden (31). In 2021, A count ■Union of 78 unduplicated rentals at<120% FRM were found in Mason County. Ninety ■Belfair percent (or 70 units) were located in Grapevlew Shelton. Three units were found in Union, ■Hoodsport 2 in Belfair, 2 in Grapeview, and 1 in Hoodsport. 2021 Mason County Rentals by Unit Bedrooms Nearly half(40%) of Mason County's homeless Bedrooms Count population are in a one-person household, One-Bedroom 18 demonstrating the need for efficiency, such as Two-Bedroom 34 studio apartments, and one-bedroom units, yet Three-Bedroom 23 less than a quarter (23%) of available rentals were one-bedroom units. Four-Bedroom 1 Water Quality Drinking Water Systems, 2018(27) Water contaminated with chemicals, pesticides, or other contaminants can lead to illness, infection, and increased risks of cancer (1). 302 Mason County residents receive drinking water from three different types of public water systems: Group A, Group B, and private wells (27). Group A systems are the largest type of system and are regulated by the State Department of Health Office of Drinking Water ■Group A ■Group B ■Private Wells (27). Group B systems are smaller systems and are regulated by Mason County Public Health (27). Homeowners with private wells are responsible for monitoring their own drinking water systems for quality. Between 2015 and 2019, the United States Environmental Protection Agency reported no drinking water violations in Mason County (1). 21 Open shellfish harvesting areas are an indicator of good water quality (28). Washington State monitors marine water quality to assure safe shellfish for the consumer (28). In addition to shellfish harvesting, stringent water quality requirements exist to ensure the public's health is protected for other water recreation uses. At the beginning of 2018, 350 acres in Mason County were restored to harvestable shellfish acreage. This increase in harvestable shellfish acres indicates the correction of pollution sources (28). Air Quality Poor air quality can be detrimental to a population's health outcomes such as greater incidence of asthma, chronic bronchitis, decreased lung function, and other adverse pulmonary effects (1). This is especially true for more vulnerable populations such as the elderly, the very young, and those with existing chronic health conditions (1). Particulate matter is a measure of outdoor quality; in Mason County, the main source of particulate matter is wood burning fire emissions. Forest fires are also a source of particulate matter. A key method for evaluating the quality of the air is to measure the average daily density of fine particulate matter in the air that are less than 2.5 micrometers in diameter(PM2.5) (1). Levels of particulate matter may vary geographically; more urban areas may have additional contributing factors such as vehicle or industrial emissions while heavily forested areas may have higher risk of wildfires (28). For most areas in Washington, PM2.5 levels are not considered a contribution to elevated risk of adverse health outcomes (28). The prevalence of asthma in Mason County has fluctuated over the last decade but has ultimately decreased in 2018 compared to the previous year. Rates are similar in Mason County compared to the rest of the state, suggesting that there are no major environmental conditions contributing to adverse health outcomes in the county. Percent of Population with Asthma, 2015-2019 (6,7) Levels of fine 25i particulate o Z matter have 20% generally 0 15% declined in Mason a o 10% County and statewide 5% ' since 2000 a 0% Adults 6th Grade 8th Grade loth Grade 12th Grade ■Mason Washington 22 Conclusions Strengths Mason County residents are expected to live longer lives, an improvement in life expectancy that can be linked with positive changes in other health factors: • Life expectancy has improved by over 4 years and premature death has begun to decline in recent years • Graduation rates have increased steadily over the last decade and reached its highest rate in 2020 • Adult crime rates are lower than the state's rate for property crime and drug law violations • Arrest rates for youth have decreased significantly over the last decade • Water and air quality continue to improve and suggest that there are no major physical environment factors that contribute to health outcomes in the county • Binge drinking rates for both adults and youth have decreased over time Weaknesses Ultimately, Mason County is ranked among the least healthy counties in Washington. In addition to demonstrating our strengths, this report has highlighted some areas where Mason County can improve its health factors and health outcomes: • Access to healthcare continues to be a major barrier in Mason County; local provider to population ratios are very large as many residents seek primary care or utilize urgent cares and emergency departments in larger neighboring counties • Adult obesity rates in Mason County have exceeded those of neighboring counties and the state over the last four years, increasing the risk of chronic health conditions • The percent of adults not meeting physical activity recommendations more than doubled between 2018 and 2019, and only a quarter of youth meet physical activity recommendations • Chlamydia infection rates have nearly doubled over the last decade • Teen birth rates remain higher than teen births statewide • The rate of drug overdose and opioid overdose deaths have increased significantly in Mason County, inconsistent with the state; in 2019, Mason County reached its highest rate of opioid overdose deaths in the last ten years • While poverty rates are declining compared to previous years, they remain much higher than the state's • Cigarette smoking rates remain higher than the state for both adults and youth • Electronic cigarette use or"vaping" in youth has increased by 22% across all grade levels • Mason County adults have higher marijuana usage rates compared to the state • Nearly a third of Mason County residents are housing cost burdened 23 References (1) County Health Rankings & Roadmaps. University of Wisconsin Population Health Institute. www.countVhealthrankings.org (2) Office of Financial Management. (30 November 2021).April 1 official population estimates. https://ofm.wa.gov/washington-data-research/population- demographics/population-estimates/april-l-official-population-estimates (3) Office of Financial Management. (11 January 2022). Estimates of April 1 population by ag, sex, race and Hispanic origin. https://ofm.wa.gov/washington-data- research/population-demographics/population-estimates/estimates-april-l-population- age-sex-race-and-hispanic-origin (4) Washington State Department of Health, Center for Health Statistics, Death Certificate Data, 1990-2019, Community Health Assessment Tool (CHAT),January 2021. (5) WA Hospital Discharge Data, Comprehensive Hospitalization Abstract Reporting System (CHARS) 1987-2019. Washington State Department of Health, Center for Health Statistics, Community Health Assessment Tool (CHAT), Aug 2021. (6) Behavioral Risk Factor Surveillance System (BRFSS) 2012-2019. Washington State Department of Health, Center for Health Statistics, Community Health Assessment Tool (CHAT), December 2020. (7) Washington State Department of Health. (2019). Healthy Youth Survey. https://www.askhys.net/ (8) Stein, R. (2018, December 18). Surgeon General Warns Youth Vaping is Now an Epidemic. NPR. https://www.npr.org/sections/health- shots/2018/12/18/677755266/surgeon-genera I-warns-youth-vapi ng-is-now-an- epidemic (9) Vinturache, A., Moledina, N., McDonald, S., Slater, D., &Tough, S. (2014). Pre-pregnancy Body Mass Index (BMI) and delivery outcomes in a Canadian population. BMC Pregnancy and Childbirth, 14, 422. http://doi.org/10.1186/sl2884-014-0422-y (10)Washington State Department of Health, Center for Health Statistics (CHS), Birth Certificate Data, 1990-2019, Community Health Assessment Tool (CHAT), October 2020. (11) Feeding America. (2021). Food Insecurity in Mason County Before COVID-19. https://feedingamericaaction.org/resources/state-by-state-resource-the-impact-of- coronavi rus-on-food-insecurity/ 24 (12)Client Count and Direct Services Expenditures: Washington State Department of Social and Health Services, Research and Data Analysis, Client Services Database. http://clientdata.rda.dshs.wa.gov/Home/ShowReport?reportMode=2 (13)Washington Office of Superintendent of Public Instruction Data Portal. (2015-2019). School Meals Participation Report. https://www.kl2.wa.us/policy-funding/child- nutrition/child-nutrition-program-reports (14)Washington State Department of Social & Health Services, Research and Data Analysis Division. (2021). Risk and Protection Profile for Substance Abuse Prevention in Mason County. https://www.dshs.wa.gov/data/research/research-4.47-mason.pdf (15)Substance Use and Mental Health Services Administration. (26 October 2021). SAMHSA releases 2020 National Survey on Drug Use and Health. https://www.samhsa.gov/newsroom/press- announcements/202110260320?utm campaign=386b60df3a- SAMHSA Announcement 2021 10 26 1600418&utm medium=email&utm source=S AMHSA&utm term=0 ee1c4b138c-386b60df3a-168173297 (16)Washington State Department of Health. (1 June 2021). Sexually Transmitted Infection Cases and Rates by County. https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/SexuallyTransmittedDis ease (17)Washington State Department of Health, Infectious Disease, STD Services Section, PHIMS-STD, 1992-2019, Community Health Assessment Tool (CHAT), Oct 2021. (18) U.S. Census Bureau. (2019). 2008-2019 Small Area Health Insurance Estimates (SAHIE) using the American Community Survey(ACS). https://www.census.gov/data/datasets/time-series/demo/sahie/estimates-acs.html (19)Washington Office of Superintendent of Public Instruction Data Portal. (2020). Report Card Graduation 2014-15 to Most Recent Year. https://www.kl2.wa.us/data- reporting/data-portal (20) U.S. Census Bureau. (2019). Educational Attainment for the Population 25 Years and Over, 2015-2019 American Community Survey 5-Year Estimates. https://data.census.gov/cedsci/ (21) U.S. Bureau of Labor Statistics, U.S. Department of Labor(2021). Local Area Unemployment Statistics Map. https://data.bls.gov/map/MapToolServlet?survey=la (22) U.S. Census Bureau (2021). Poverty Thresholds by Size of Family and Number of Children. https://www.census.gov/data/tables/time-series/demo/income- poverty/historical-poverty-thresholds.html 25 (23) U.S. Census Bureau. (2019). Poverty Status in the Past 12 Months, 2015-2019 American Community Survey 5-Year Estimates. https://data.census.gov/cedsci/ (24) U.S. Census Bureau. (2019). Children Characteristics, 2015-2019 American Community Survey 5-Year Estimates. https://data.census.gov/cedsci/ (25) U.S. Department of Housing and Urban Development. (2020). Comprehensive Housing Affordability Strategy(CHAS)2014-2018. https://www.huduser.gov/portal/datasets/cp.html (26) U.S. Census Bureau. (2019). Selected Housing Characteristics, 2015-2019 American Community Survey 5-Year Estimotes. .https://data.census.gov/cedsci/ (27)Washington State Department of Health. (2018 December). Water System Data. https://www.doh.wa.gov/DataandStatisticalReports/EnvironmentalHealth/DrinkingWa terSystemData/Data Download (28)Washington State Department of Health. (2018 March). 2018 Washington State Health Assessment. https://www.doh.wa.gov/Portals/1/Documents/1000/2018SHA FullReport.pdf (29)Santos, Melissa. (2021, March 15). Planned Parenthood shutters 3 clinics, including the only one in Mason County. Kitsap Sun. https://www.kitsapsun.com/story/news/2021/03/15/planned-parenthood-shutters-3- clinics-including-only-one-mason-county/4707972001/ (30)Washington State Department of Commerce. (2017-2021).Annual Point in Time Count. https://www.commerce.wa.gov/serving-communities/homelessness/annual-point- time-count/ (31)Washington State Department of Commerce. (2017 January). Why is homelessness increasing?http://www.commerce.wa.gov/wp-content/uploads/2017/01/hau-why- homelessness-increase-2017.pdf (32) U.S. Department of Housing and Urban Development. (2017-2021). Fair Market Rents. https://www.huduser.gov/portal/datasets/fmr.htmi 26 Questions about this report may be directed to: Melissa Casey, MPH Public Health Educator Mason County Community Services— Public Health mcasey@masoncountywa.gov 360-427-9670 Ext. 406 Acknowledgment: Jacob Ritter, MPH Community Health Specialist Mason County Community Services— Public Health 27 • MASON COUNTY COMMUNITY SERVICES Mason County Public Health A Safe and Healthy Mason County http://healthymasoncounty.com/ www.masoncountywa.gov 28 From the Director's Desk March 2022 - Covid and more Things have been calming down across the COVID-19 front. The characteristics for Omicron held pretty closely to early modeling reports. We had a very sharp increase and an equally sharp drop after reaching the peak. We currently have case rates approximately equal to the rates last seen in July of 2021. TREND IN 7-DAY RATE OF NEW COVID-19 CASES PER 100000 POPULATION —*7-Day Case Rate 7•Day O U-Day 1.500 1 000 500 0 Jug 2020 )ar 2,21 ! 2)21 Jar 2)22 Specimen Collection Date Over the past two months, public health has distributed over 9000 masks and around 20,000 rapid tests for COVID-19. Our nursing homes and skilled nursing facilities should be well- Publt Health ' stocked for at least the next six weeks. Demand for tests has --- __ dropped dramatically over the past two weeks as cases have =_ dropped. We continue to monitor the BA.2 and the newly identified ;ilfl- _ .2 h been identified in Washington but - Deltacron variants. BA as g I does not seem to be getting a foothold here. We will be having some management changes in the immediate future. Lydia Buchheit announced that she will be retiring on May 25th. That job notice has been published and we have a few applications in the review process at the moment. I hope to begin interviews in the next couple of weeks. Alex Paysse gave notice as well and his last day with us will be March 25th. Ian Tracy will be the interim EH manager until we fill the position permanently. Both Lydia and Alex will be very much missed. From the Directors Desk 14 As COVID hopefully winds down, we will be transitioning staff from COIVD duties to a broader use of Foundational Public Health Services (FPHS). This allows us to keep these trained team members and keeps us ready in case we have another upsurge in disease. Regionalization of public health services continues to be a concern. I have been in conversations with the Secretary of Health, Umair Shah and his chief of staff Jessica Todorovich. At this point, DOH will be standing up two regional offices as support offices for local public health jurisdictions. These will probably consist of a health officer/medical advisor and an Administrator. I will be in Spokane helping to host the NW Rural Health Conference as the incoming chair of the Washington Rural Health Association which means I will miss our BOH meeting. Two of our team members will be going along as well to start building those connections with hospitals, clinics, FQHCs, and EMS across the state and region. There was funding available from WRHA to support this conference attendance and we're excited to be able to participate. 2022 has been a wild ride so far but I hope we're getting back to the normal work of public health. David Windom, MSHS Director - * - j �4 commubityHecilth & , H' an'�,Services 9 }_ • • • • January-February 2022 Communicable Disease & Notifiable Conditions (3 programs-CD, TB, STD) Staff:Audrey O'Connor, Back-up: Elizabeth Custis& Lydia Buchheit January-February our communicable disease(CD)program nurse received 49 reports requiring data entry into the State database,and/or investigation and follow-up. * Chronic Hepatitis C cases are being directly entered into new WDRS database by DOH. This does not include their work in COVID-19 case investigations.We are no longer keeping COVID line list.Current case numbers provided by WA DOH. Disease January- Total to date February COVID-19/2022 5,025 5,025 Campylobacteriosis 1 1 Cryptosporidiosis 1 1 Giardiasis 0 0 higa Toxin 2 0 0 higellosis 0 0 Mumps 0 0 Haemaphilus Influenza 0 0 Hepatitis B-Acute 0 0 Hepatitis B-Chronic 0 0 Hepatitis C-Chronic Hepatitis C-Acute 0 0 Hepatitis D 0 0 Lyme 0 0 Pertussis 0 0 almonellosis 0 0 1 ersinia 0 0 Coccidioidomycosis 0 0 Carbapenemase-resistant 0 0 enterobacteria(CRE) Hepatitis A—Ruled out 0 0 Meningitis-Ruled out 0 0 ibrio-Ruled out 0 0 Listeriosis-Ruled out 0 0 Legionella 0 0 Suspected rabies/sample sent 0 0 Malaria 0 0 Tuberculosis-Ruled out 0 0 Tuberculosis-Latent 0 0 Tuberculosis-Active/open cases 2/WCC 2 ibriosis(non-cholera) 0 0 Listeria 0 0 Congenital Syphilis 0 0 Chlamydia 32 32 Gonorrhea 12 12 Syphilis 0 0 Herpes 1 1 HIV 0 0 Totals 49 49 Hepatitis C Screening Staff:Christina Muller-Shinn With the new foundational public health funding,we will be focusing on this program by funding staff in this position. Maternal Child Health Staff: Elizabeth Custis, RN Elizabeth assisted with support and training of the COVID staff and was the primary contact for childcare and Headstart/ECEAP agencies regarding COVID cases, response guidance,and testing. The trained and experienced COVID team has taken over all aspects of the epidemic, allowing Elizabeth to return to work in the Maternal Child Health programs. Elizabeth provides back-up RN work for CD and COVID as needed. 2 SMART Team of Mason County Elizabeth participates in the Mason County SMART(School Medical Autism Review Team)which evaluates and has the ability to diagnose children with Autism.Team members are Dr Rayos and Dr Tuladhar, Speech/Occupational Therapy/Physical Therapy from school districts and Mason General Hospital Pediatric Rehabilitation Team,Special Education teachers, and Birth to Three Early Intervention Providers.Without this team, many children wait 12 -18 months to see a specialist for diagnosis,which can delay needed services. Our local pediatricians and other providers on this team have been specially trained to evaluate children. Elizabeth's role is to assist families to get the support and resources needed during or after their child is diagnosed with Autism. Maternal Child Health Parenting Program-Incredible Years No Incredible Years parenting classes were offered due to COVID. Future work will be with DCYF for Child Protection Services. Breastfeeding Coalition of Mason County Breastfeeding Coalition meetings and support group are on hold during COVID. Elizabeth has continued to share breastfeeding COVID immunity and vaccination information with MGH OB Department and Mason Clinic Pediatricians. Early Learning Coalition of Mason County Elizabeth is part of this team,where providers work together to support early learning, identify gaps, and assist with promoting opportunities in early learning for children in Mason County. The coalition continues to update a mapping project to compile supportive early learning resources available in the county. Once complete,the data will be evaluated to see any gaps or areas that might need better support opportunities. Immunization Improvement Grant Elizabeth continues to encourage parents and newly vaccinated adults to apply for online access to their child's and their own Immunization Information System records.This is for COVID records and other vaccines. Immunization records may be provided to individuals without internet access or those having difficulty with the state system. Immunization guidance and recommendations are provided for school and college attendance. Children with Special Health Care Needs Elizabeth provides consultation, care coordination, and referrals to families with children that have special health care needs in Mason County. This RN participates in monthly Pediatric Care Coordination Meetings that include Mason Health Pediatricians, Birth to Three Early Intervention, School and Mason Health Speech, Physical, and Occupational Therapy, and Developmental Preschool and Special Services staff. The goal of these coordination meetings is to better provide services to families by reducing duplication of services, matching needs with appropriate providers, and assist families to access the medical care and services needed for their child. Social Service Programs Staff: Todd Parker, Jaime Ellertsen, Haley Foelsch Housing($5,994,321 Annually: 12 funding sources—grants,tax, local recording fees, 12 subcontracts, and 20 programs)Staff:Todd Parker, Haley Foelsch 3 Eviction Rent Assistance Program ERAP 2.0: (Effective October 1,2021-June 30,2023) The Eviction Rent Assistance Program (ERAP) 2.0 became effective in October replacing the Treasury Rent Assistance Program (TRAP) 1.0. ERAP 2.0 is intended to prevent evictions by paying past due and future rent and utilities while distributing funds equitably.Two organizations are ensuring that funds are distributed to equitably. Crossroads focuses on populations age 25+and Shelton Family Center focus on the population under the age of 25. As of February 2022, a total of$2,927,320.24 has been provided in rent and utility assistance, preventing 307 evictions. Point in Time Count With Covid cases rising in January 2022, Commerce received a waiver from HUD and postponed our Continuum of Care's PIT Count from the night of January 27 to February 24, 2022.A project connect event was held on February 25, 2022,from 10 AM to 3 PM on Second Street as a street fair style and clothing,sleeping bags, and tents bank was inside the Youth Connections. Street outreach and homeless encampments were also included in the count survey. An event also took place at the HUB in North Mason during the same times and date. Community resources came together to help the draw access to resources. Teams also went out to the encampments to get a count of people who could not attend the event. For the unsheltered counts,with raw data from the surveys, 81 households were counted, and 87 individuals were counted for both Shelton and North Mason. North Mason had 14 individuals total unsheltered with 10 individuals and 2 households of 2 people in each household unsheltered. For the sheltered counts, across ten emergency shelters and two transitional housing programs, 78 households were sheltered on the night of February 24th and 129 people were stayers in the emergency shelter and transitional housing on the night of February 24th. Community Homeless Survey-Businesses A survey was conducted asking businesses in Shelton about their experiences with the homeless population,contributing factors that they believe lead to homelessness, and suggestions for ways to improve homelessness in Mason County.The survey was completed before the Point in Time Count and was conducted since the Needs Assessment is underway. Education material was also handed out as well including the Mason County 5-year plan and booklets of behavioral health resource guide.The largest amounts of homeless person were said to be around the post office park and the largest amounts of homeless people were located between 2nd and 4th and Franklin and 1st. From the survey, several quotes were given saying that there is one person who causes issues or there is 3-5 people who we have had negative experiences with.The community believed that the leading factors that lead to homelessness were releasing prisoners to the streets from the jail,trauma, mental health issues and substance use disorder, lack of available resources for mental health and substance use disorders, violence, crime, hopelessness,judgment, poverty, living paycheck to paycheck,cost of living,felonies not getting another chance, and lack of education on life skills. Further surveys will be expanded through survey monkey in partnership with the Economic Development Council to gather more information from businesses throughout Mason County. Emergency and Transitional Housing Mason County Emergency Shelter and Transitional Housing so far this year from January 1, 2022 to February 28, 2022 has served 271 persons and 197 households. This data is unofficial deduplicated data to give an idea of how many people and households have been served in Mason County for Emergency Shelter and Transitional Housing. Agencies currently providing direct services for emergency shelters and transitional housing include Crossroads, Shelton Family Center, Community Lifeline and Turning Pointe. 4 Behavioral Health Mason County Mental Health &Substance Use Disorder(SUD) Response(7 programs) Staff:Jamie Ellertsen,Christina Muller-Shinn,Audrey O'Connor Welcome to Jaime Ellertsen who replaced Abe Gardner as the Behavioral Health coordinator of a number of programs and coordinator of Behavioral Health Services in Mason County. She comes with many years of experience as a Substance Use Disorder Professional,worked in ourjail with Olympic Health and Recovery and at Washington Corrections Center as well as other agencies in our community. She will be working on the LEAD and Behavioral Health Navigator Programs as well as the Treatment Sales Tax programs and overall coordination of Behavioral Health Overdose Data to Action (OD2A) OD2A staff provided several overdose education and naloxone administration trainings to Mason County professions during this reporting period.Agencies include Olympic Health and Recovery Services (OHRS staff also received an additional"train the trainer"workshop which teaches how to train their clients on overdose prevention, recognition, and response), Community Lifeline staff, and the Grapeview School District staff(including the principal and superintendent!). OD2A staff participated in the annual Point in Time Count with the outreach RV in partnership with peer navigators from Olympic Health and Recovery Services. Overdose prevention, recognition and response training was given to 11 new individuals, and staff was able to reconnect with 10 previous participants and provide a refill kit.7 people reported having used a naloxone kit to save a life before. In addition to naloxone,staff also distributed socks, blankets, and wound care supplies. In January,the second panel on sex trafficking and exploitation occurred at the Thurston Safety Net Council meeting (although the title is Thurston,OD2A staff co-chairs the meeting and has attendance from Mason County professionals, recognizing that our populations regularly move through both counties). Susan Kirchoff, Executive Director of the Youth Connections, presented on the panel about what they see occurring in Shelton. Although organized sex trafficking is not currently known about in Mason County like it is in Thurston (staff spoke with many organizations to understand what the breadth of this issue may be here, and no one was aware of anything going on),sexual exploitation does seem to be rampant, especially with homeless youth. Other presenters included the Executive Director of Innovations in Human Trafficking Collaborative and the co-lead for Firefly(a collaborative working group for sex trafficking victims)and the Thurston County Human Trafficking Task Force. Mason County participants included the Emergency Department,Turning Pointe, Mason County Sheriff's Office, OHRS, and Northwest Resources.There does seem to be an interest in having a Mason-specific group to discuss this issue, but Firefly is inclusive of the entire region and does partner with many Mason agencies. Substance Use Mobile Outreach of Mason County Substance Use Mobile Outreach had 59 interactions with 46 unduplicated participants during this reporting period. 29% of visits reported knowing someone who had overdosed in the past 30 days—a 11% increase from the previous reporting period. Naloxone kits were distributed in 61%of visits,and Fentanyl testing strips were requested at 56%of visits, illustrating the community's concern with wanting to know what is in the drug supply. 3 participants received overdose prevention education and response training.To date,the Mobile Outreach has served 530 unduplicated participants. 5 The University of Washington's Addictions, Drug and Alcohol Institute has finalized and published results from the 2021 WA State Syringe Service Program Health Survey which we participated in.Topics covered include substance use patterns, routes of drug administration, opioid overdose, acute consequences of methamphetamine use, health care needs and utilization,substance use treatment, and how to use these data. Key findings as well as a link to the full report can be found here: https://adai.uw.edu/syringe-survey-2021 Mason County Behavioral Health Network The Community partnerships, systematic change, program coordination (COAP/COSSAP) project completed their four-year grant at the end of October 2021.The project emphasis on system coordination is a critical discussion that public health continues to carry on. Mason County Behavioral Health Network will be undertaking the important conversations that were generated through the COAP/COSSAP project.The emphasis will begin with analyzing the behavioral health system focusing on crisis response and crisis stabilization.This would encompass individuals in the community who are experiencing a short-term mental health crisis in which they would not require hospitalization.These individuals would need crisis support in the community or interim to entering into a mental health facility. MCLEAD (Mason County Law Enforcement Assisted Diversion) Mason County Public Heath coordinated with Olympic Health and Recovery services and the LEAD contract was signed.The contract is fully executed with a contract term ranging from January 15Y, 2022- June 30th, 2023. The implementation and continued efforts of the LEAD program continue to be used by the Public Defenders Association as an example to other rural communities for how to develop, implement and coordinate an appropriate LEAD program. Referrals continue to be received through all three referral pathways: arrest,social contact, and community referrals. The beginning phase of implementing an expansion plan for LEAD are underway. The peer case management team will increase by 1.0 FTE and potentially 1.0 FTE Substance Use Disorder Professional. The LEAD team has been working diligently to provide outreach and community education on how to place referrals. • Number of active cases in January: 23 with (3) Community referrals • Number of active cases in February: 38 with (1) arrest diversion (5) social contacts and (22) Community referrals Behavioral Health Navigator Program The new program coordinator is analyzing the operations of the Behavioral health Navigator Program at the Mason County Sheriff's office and the Shelton Police Department. Law Enforcement partners have been utilizing the behavioral health navigator program with numerous success stories.The partnership between Public Health having (0.5 FTE)with the Sherriff's office and Olympic Health and Recovery Services has allowed for implementation of 1.0 FTE peer counselor stationed at the Shelton Police Department. The ability to have a full-time staff on site has increased the response time and helped law enforcement tremendously. This program is continuing to grow as staffing becomes stable and consistent. 6 Behavioral Health Transportation Support (pilot program) The Behavioral Health Transportation Program is a partnership between Mason County Community Services and two transportation providers: Patty Wagon and Gethsemane Ministry. Patty Wagon is providing transportation services within Mason County and Gethsemane ministry is providing out of County transportation. This is a no cost transportation program for individuals within Mason County navigating the behavioral health system. Individuals navigating the behavioral health system have identified lack of transportation to support their recovery and wellness as a barrier.The program was developed to bridge the gap and support recovery wellness.The service is providing transportation to substance use and mental health related medical appointments, inpatient and out outpatient substance use and mental health treatment, recovery support meetings, UAs,jail re-entry services and other needed support services for substance use and mental health recovery. Contracts with Patty Wagon and Gethsemane ministries were signed the beginning of February and the program was launched thereafter.An interview with Mason County Journal is scheduled for March 2022 to announce the launch of the Behavioral Health Transportation Program.The Patty Wagon has developed an informational flier to be distributed to community members. Gethsemane Ministries requested that Mental Health and Substance use providers refer individuals to utilize their service, whereas the Patty Wagon can be accessed by all individuals. RCORP(Rural Communities Opioid Response Program) RCORP activities are running smoothly. Peers continue to connect participants/clients/patients to behavioral health treatment, social services, and broad recovery support services through the jail, community outreach events,the emergency department, and Mason Health's Behavioral Health Department. Additionally,we have leveraged RCORP dollars to support programming in other MCPH behavioral health initiatives.These include the First Responder Peer Training(supporting LEAD) and a series of prevention parenting classes subcontracted through FESS (supporting Substance Abuse Prevention Coalition). In February we were awarded three mini-grants through our partnership with Cascade Pacific Action Alliance's RCORP Planning Grant (a separate grant than the RCORP Implementation grant that MCPH coordinates). Awarded activities include a drug user oral health education and nutrition program, development of a drug user health education curriculum to be shared with regional and state-wide partners, and the installment of full-sized lockers at Community Lifeline so guests and non-guests alike can store their belongings safely while engaging in behavioral health treatment (including inpatient), medical appointments or hospital stays, or other recovery supports like job or social services interviews. Substance Use Prevention Staff: Ben Johnson& Melissa Casey In the past two years the newly developed the Shelton and North Mason (Now) Mason Substance Abuse Prevention Coalitions has continued to meet via zoom. We have our first in hybrid in person/zoom meeting in two years scheduled for the end of March. We have developed a new All Mason County Coalition that includes sector representation from Shelton, North Mason and Mary M Knight school Districts, Public Health, Faith Based,Youth, Substance Abuse Treatment, law enforcement, parents, and local business. 7 This year the coalition will focus on providing prevention programming throughout the entire county. We are happy to announce that the Mary M. Knight School District has agreed to assist with the development of a youth prevention leadership group at the Jr. and High school levels. We are also continuing our partnership with prevention leadership groups at the North Mason and Shelton school districts. The North mason and Shelton School Choice and MMK began programming in January, 2022. The focus will be on promoting the new Rx take back boxes in Mason County and conducting a Community Substance Sale Assessment at store fronts. Cedar High School students, Gay City Pride of Seattle,Shelton Youth Connections, Youth Marijuana Prevention Education, Mason County Substance Abuse Prevention Coalition, and North Mason have been starting a process of organization of a Mason County LGBTQ youth support program that will focus on substance abuse prevention and mental health issues. Youth and community diversity training are scheduled for April 2022. Mason County Public Health and the Mason County Substance Abuse Prevention Coalition also continues to partner with Family Education Support Systems to provide Guiding Good Choices parenting training. Offering an average of three classes per year for the past 3 years.Also providing Spanish speaking parenting classes during the same time.The Coalition and Mason County Public Health has also partnered on community and parent substance abuse prevention trainings such as Hidden in plain sight, community youth forums and Prevention specialist Dr.Jason Kilmer. The course has been completed with 8 families who participated,the next series of classes are scheduled to begin this spring. Community Health Education,Assessment and Data Staff: Melissa Casey The 2021 Community Health Assessment has been finalized and is pending approval by the Board of County Commissioners for official release.The dashboard on the Mason County Health Improvement website (healthymasoncounty.com) has been updated with the latest assessment data.The Mason Matters Board has established work group meetings for the 2022-2026 Community Health Improvement Plan. We invite community members interested in joining the Mason County Health Coalition to please contact Melissa Casey at 360-427-9670 Ext 406 or mcasev@masoncountywa.gov. Staff have coordinated a Social Media Team to expand the department's reach on social media and adapt to more innovative methods of promoting health through videos and highlighting staff in the field conducting Public Health activities. All content will be available in both English and in Spanish. Emergency Preparedness Staff: Lydia Buchheit,Alex Paysee,Sunni Evans, COVID-19 Response Staff: Rebecca Shipman,Jacob Ritter,Cesar Apaez-Mendiola,Alyssa Medcalf Throughout January and part of February,COVID cases, hospitalizations, and deaths increased due to the Omicron variant.There were multiple outbreaks in Long-Term Care Facilities throughout the county. The COVID team helped these facilities navigate through difficulties. Since about the middle of February, cases throughout the county have dropped dramatically. Hospitalizations and deaths followed, after a bit of a lag, as has been seen previously. So far,cases among county employees have dropped as well. The last test done for a county employee was on Feb. 11, and the last case report was received on Mar. 8.The team has assisted schools and day-cares in understanding/interpreting new guidance as it has been made available.The team continues to help the county as new changes occur. You can check the Covid 19 data dashboard for the most up-to-date data. https://www.doh.wa.gov/Emergencies/COVID19/Data Dashboard#dashboard 8 ORDINANCE NO. An Ordinance Amending Board of Health Ordinance No. 01-21 Concerning the Composition of the Mason County Board of Health WHEREAS,RCW 70.05.030 allows the Board of Mason County Commissioners/Board of Health, at its discretion,to expand the size and composition of the Board of Health to include Elected Officials and persons other than Elected Officials as members; and WHEREAS,the Board of Mason County Commissioners believe that having officials representing other governments within Mason County will enrich the Mason County Board of Health through discussion of public health policy to ensure that the public health needs of the citizens of Mason County are being met; and WHEREAS,Engrossed Second Substitute House Bill(E2SHB) 1152 provides additional guidance for the composition of local Boards of Health,adding new representatives, and term limits;and NOW, THEREFORE, BE IT RESOLVED, that the Board of County Commissioners of Mason County as the Board of Health hereby resolve that the composition of the Mason County Board of Health shall consist of members as follows: Three(3)Elected members of the Mason County Commission One(1)Elected member of the City of Shelton Commission One(1)Representative of the Squaxin Island Tribe One(1)Representative of the Skokomish Tribe At least one(1)Representative of Public Health,healthcare facilities, and providers as defined by E2SHB 1152 At least one(1)consumer of Public Health as defined by E2SHB 1152 At least one(1)community stakeholder as defined by E2SHB 1152; and BE IT FURTHER ORDAINED,that all members of the Board of Health shall have the ability to vote on all issues pertaining to Public Health policy and priorities. However,any Board of Health supported issue requiring additional funding from the County will be forwarded as a recommendation to the Board of County Commissioners for final action;and BE IT FURTHER ORDAINED, that a quorum shall consist of at least one (1) County Commissioner and at least three other members; and BE IT FURTHER ORDAINED,that the Elected members of the Mason County Board of Health shall serve terms consistent with the terms of the entity they represent; and BE IT FURTHER ORDAINED, that all other members of the Board of Health shall serve three- year terms; and BE IT FURTHER ORDAINED, that members will serve without compensation, but may be reimbursed for travel expenses approved by the Mason County Board of Health;and BE IT FURTHER ORDAINED, that at the first annual meeting of the Board of Health, the members shall elect a Chairman for the period of one(1)year; and BE IT FURTHER ORDAINED,that non-elected Board members shall be approved by a majority vote of the Board of Mason County Commissioners. DATED this day of 32022. MASON COUNTY,WASHINGTON ATTEST: BOARD OF HEALTH MASON COUNTY,WASHINGTON McKenzie Smith,Clerk of the Board Darrin Moody,Hospital District#1 Kathy McDowell,City Commissioner Kevin Shutty,Commissioner Randy Neatherlin, Commissioner Sharon Trask,Commissioner Peggy Van Buskirk,Hospital District#2 Gary Plews,Fire Commissioner Keri Davidson, Shelton School Board