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i am Board of Health Vice Chair

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Cannon Daniels, and today I

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have the pleasure of serving as

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the chair for board. Chair

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Mosqueda. I

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m calling this

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meeting to order on JUNE 18th,

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2026. Chair Mosqueda

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unfortunately could not attend

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today and I will surely MISS

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The charisma and the precision

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that comes with her leadership.

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Are you warning this meeting

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today MAY be a little rough

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around the edges, as this is

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only my second tier, second

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time chairing our monthly

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meetings. So I ask for your

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grace, and we

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ll work hard to

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ensure that our time together

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today is spent as effectively

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and efficiently as possible

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with especially with so many

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things vying for our attention

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on a per second basis. I really

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want to thank everyone for

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setting aside these next couple

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of hours to learn about and

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discuss various public health

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items that are set on our

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agenda today. It

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s good to see

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you all at our meeting today.

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The board will hear a chair

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s

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report from me and a director

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s

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report from Doctor Sandra

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Valenciano, health officer and

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acting director of Public

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Health Seattle in King County.

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You can also find a written

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report from doctor v in the

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meeting Materials packet,

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beginning on page nine. Today

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we

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ll hear three briefings.

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First, we

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ll hear from board

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administrator Joy Carpenter,

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Joy Carpine-Cazzanti Canty.

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Thank you. To about board

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membership and this summer

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s

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recruitment efforts for 2027.

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Second, we

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ll hear from board

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member Tripoli and Public

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Health about innovations and

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sexual health. This briefing

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was deferred at the MAY

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meeting. So I want to ensure

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adequate time is given. And

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lastly, we

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ll hear from me and

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the Washington State Department

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of Health about findings and

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recommendations from the

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Washington

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s Maternal Mortality

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Review Panel. At the end of the

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meeting. Board members will

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have the opportunity to share

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any updates. Additionally, our

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our JULY meeting will be held

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on the usual third Thursday,

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JULY 16th, 2026, beginning at 1

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P.M.. Clerk hey, would you

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please call the roll?

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Thank you. Chair. Daniels.

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Board member Dunn. Board

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member.

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Lewis.

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Here. Board member. Mosqueda.

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Board member. Von Reichbauer.

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Here. Board member. Foster.

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Board member. Juarez. Board

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member. Rinke. Board member.

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Soca. Board member. Falcone.

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I

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m here.

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Board member. Garcia.

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Present.

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Board member. Schroth. Board

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member. Blas.

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Present.

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Board member. Core.

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Here.

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Board member. Paquette. Here.

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Board member. De Castro. Board

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member two. Board member.

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Gadgil. Present. Board member.

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Hartfield. Board member.

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Mohammad.

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Here.

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Board member. Green. Board

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member. Polly.

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Present.

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Board member. Lu.

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Yes.

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Board member. Milligan. Board

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member. Elkins. Board member.

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Thomas. Board member. Williams.

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Board member. De Los Angeles.

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Board member. Bowen. Board

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member. Lucero. Here. Thank

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you. Board member. Gilli and

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chair. Daniels.

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Thank you. Clerk.

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You have a quorum.

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We always welcome alternates to

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join board meetings. Are there

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any alternates who are serving

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in place of regular members

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today?

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Board member Green is present.

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Thank you. Partner.

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Board member. Foster.

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Just identifying. I missed roll

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call, but I

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m present. Thank

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you so much, chair Daniels.

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Thank you.

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Okay. I think that

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s all I see.

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Okay. All right. Thank you

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everyone. We will now move to

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the approval of our MAY 21st,

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2026 minutes. Board member

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Falcon, can you move to approve

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the MAY 21st, 2026 minutes?

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Yes. Thank you. Vice chair

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Daniels, I move that we approve

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the MAY 2026 meeting minutes.

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Thank you. All those in favor,

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please signify by saying I.

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I, I.

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I.

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All opposed name any

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abstentions? The ayes have it.

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The MAY minutes are approved.

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Thank you. Okay, now we will

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move on to public comments.

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Clerk. Do we have anyone in

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chambers or on the line wishing

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to provide public comment?

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We have one.

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Okay. Um, the Board of Health,

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we welcome public comment as an

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important part of the public

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process. And we truly want to

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hear your thoughts regarding

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public health matters in King

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County. With that being said,

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each commenter will have two

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minutes and I will be a bit

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stingy with that time as we do

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have a full agenda. Um, in

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addition, please keep in mind

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that all comments must be

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germane to the agenda items or

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items within the board

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s

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purview. Speakers should not

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make introductory statements,

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derogatory remarks, profanity,

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or personal attacks not germane

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to an agenda item, nor

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statements related to a

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political campaign or

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statements for or against a

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candidate or ballot measure.

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Clerk. We have.

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One in chamber.

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We do.

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Have one in chambers signed up.

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And that is Alex Zimmerman.

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Okay. Alex, you have the four.

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We

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ll take this down. Yeah.

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I

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m candidate for election 15

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times, and I

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m talking about

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agenda number eight for my

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understanding about sexual

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problem. That is, we have it

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s

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a little bit confused me

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because we have a syphilis

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epidemic. Who are you guys?

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21st century. You can count on

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PRESIDENT. Be very

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intellectual. How many

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percentage people educate? With

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college degree? 77% plus minus.

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If you have a syphilis

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epidemic. Doctor months ago

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told me it was the biggest

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blood test I took. Everybody

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needs this epidemic. I know

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last time syphilis epidemic

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came in 15th century in Europe.

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Who are you? You. I told you

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so. King country number one for

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city in America. County in

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America. Right now you Wilt

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County. You know what I mean?

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Syphilis in 21st century for

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2.5 million people. Because you

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are Baggett a killer. All

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money. What is you give, you

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give to people what is not

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deserve this like not legal

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immigrants who bring a thousand

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syphilis inside America. In

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King County you are a bandit.

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You are a killer. And I talk

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about this many times, but very

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interesting because professor,

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from you, you double present

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this of 20 year ago. And I know

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the PRESIDENT Of you double

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make a $1 million salary. I

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think why he make $1 million in

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salary in Alex Zimmerman have

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only $2,000 Social Security,

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whereas a problem when you stop

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an Arctic like a veiled stupid

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idiot. Viva Trump, viva new

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American revolutions, up slap

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and happy cow. You need stop

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and steal us money driving

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these millions and millions of

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dollars to stranger. What is

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being.

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That was the last person on the

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list. Chair Daniels.

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Thank you Claire. That

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concludes public comment. We

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will move on to the chair

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s

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report. Uh, first chair

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Mosqueda wanted to express her

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appreciation to all the board

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members for considering and

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signing the sign on letter to

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the state Department of Health

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regarding improving access to

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massage licensure, reducing

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barriers that are preventing

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many prospective and current

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massage workers, particularly

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immigrant, low income and

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non-English speaking Asian

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women, from from accessing

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Washington

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s Massage Licensure

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system. Chair. And in

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partnership with the board

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members assigned on stand ready

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to work with the Department of

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Health team to collectively

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address and reduce hurdles to

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licensure. Thanks to board

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members Foster, Lewis, Mercedes

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rink, Scruff, Muhammad, Green,

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Melanie Lucero, Lou Hartville,

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myself and chair Mosqueda for

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signing on to The letter. We

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sent a letter on JUNE 12th,

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2026 and we

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ll let the board

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know what the response is. I

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also want to say

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congratulations to Doctor

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Sandra Valenciano. Her

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appointment as Director of

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Public Health was confirmed

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this month by both the Seattle

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City Council and the

293
00:10:12,353 --> 00:10:14,353
Metropolitan King County

294
00:10:14,588 --> 00:10:16,623
Council, and her title is

295
00:10:16,623 --> 00:10:18,525
officially official. So,

296
00:10:18,525 --> 00:10:20,527
doctor, v, just unpacked those

297
00:10:20,527 --> 00:10:22,228
last few boxes, settle in

298
00:10:22,228 --> 00:10:23,897
because we want to keep you in

299
00:10:23,897 --> 00:10:24,865
your step with us now.

300
00:10:24,865 --> 00:10:26,865
Congratulations.

301
00:10:27,100 --> 00:10:29,100
Doctor v.

302
00:10:29,302 --> 00:10:31,472
All right. This brings us to

303
00:10:31,472 --> 00:10:31,738
item number seven, the

304
00:10:31,738 --> 00:10:33,674
director

305
00:10:33,674 --> 00:10:33,940
s report. A written

306
00:10:33,940 --> 00:10:35,276
director

307
00:10:35,276 --> 00:10:37,244
s report is in the

308
00:10:37,244 --> 00:10:39,213
meeting material shared by the

309
00:10:39,213 --> 00:10:41,615
clerk last week, beginning on

310
00:10:41,615 --> 00:10:43,150
page nine. And it does include

311
00:10:43,150 --> 00:10:44,785
an update on the Community

312
00:10:44,785 --> 00:10:46,586
Health Improvement Plan or

313
00:10:46,586 --> 00:10:48,421
Chip. Board members Lew

314
00:10:48,421 --> 00:10:50,190
Muhammad and I serve on the

315
00:10:50,190 --> 00:10:51,491
Chip steering committee. So

316
00:10:51,491 --> 00:10:53,927
please take a look at that

317
00:10:53,927 --> 00:10:56,327
written report. Okay. Doctor,

318
00:10:56,629 --> 00:10:59,600
ve, you have the floor.

319
00:10:59,600 --> 00:11:02,402
Thank you. Chair Daniels. And

320
00:11:02,402 --> 00:11:04,472
thank you for the kind words.

321
00:11:04,472 --> 00:11:07,274
Um, that was actually the first

322
00:11:07,274 --> 00:11:10,440
item on my list of updates. Uh,

323
00:11:10,440 --> 00:11:12,179
yes. After four confirmation

324
00:11:12,179 --> 00:11:13,714
hearings or, uh, because I had

325
00:11:13,714 --> 00:11:15,715
to do two with the King County

326
00:11:15,715 --> 00:11:18,952
Council and two with City of

327
00:11:18,952 --> 00:11:20,687
Seattle. Um, happy to inform

328
00:11:20,687 --> 00:11:22,956
everyone that I was officially

329
00:11:22,956 --> 00:11:25,458
confirmed last week, Tuesday by

330
00:11:25,458 --> 00:11:28,295
both councils. And on Friday,

331
00:11:28,295 --> 00:11:30,130
um, was happy to participate in

332
00:11:30,130 --> 00:11:31,464
a swearing in ceremony at the

333
00:11:31,464 --> 00:11:34,464
city of Seattle, along with

334
00:11:34,834 --> 00:11:36,637
other directors. Um, we can

335
00:11:36,637 --> 00:11:37,938
share the link to that,

336
00:11:37,938 --> 00:11:39,873
actually, because I took oath

337
00:11:39,873 --> 00:11:41,675
of office and I had to make

338
00:11:41,675 --> 00:11:44,711
remarks. So happy to share that

339
00:11:44,711 --> 00:11:46,280
with the board. Um, and happy

340
00:11:46,280 --> 00:11:48,140
to be here in, in this dual

341
00:11:48,140 --> 00:11:50,650
role now officially as director

342
00:11:50,650 --> 00:11:52,452
and health officer. Um, thank

343
00:11:52,452 --> 00:11:54,688
you all for your support.

344
00:11:54,688 --> 00:11:56,560
Really appreciate it. Uh, the

345
00:11:56,560 --> 00:11:57,558
other item I wanted to just

346
00:11:57,558 --> 00:11:59,226
quickly highlight is, you know,

347
00:11:59,226 --> 00:12:01,940
fifa World Cup has officially

348
00:12:01,940 --> 00:12:04,970
kicked off in the city of

349
00:12:04,970 --> 00:12:06,767
Seattle. Um, and we had our

350
00:12:06,767 --> 00:12:10,367
first game here on Monday. We

351
00:12:10,437 --> 00:12:13,740
have a game tomorrow. Um, and,

352
00:12:13,740 --> 00:12:16,409
uh, happy to report that so far

353
00:12:16,409 --> 00:12:19,646
it has been knock on wood. Uh,

354
00:12:19,646 --> 00:12:21,348
blue skies in Seattle. Uh, of

355
00:12:21,348 --> 00:12:24,348
course, you all probably saw

356
00:12:24,518 --> 00:12:26,387
and felt the heat. Um, that

357
00:12:26,387 --> 00:12:28,255
happened over the weekend and

358
00:12:28,255 --> 00:12:30,690
earlier part of this week. We

359
00:12:30,690 --> 00:12:33,861
did see a slight increase in

360
00:12:33,861 --> 00:12:35,662
heat related calls for ems and

361
00:12:35,662 --> 00:12:38,640
a slight uptick in heat related

362
00:12:38,640 --> 00:12:40,464
illness. Um, an emergency

363
00:12:40,500 --> 00:12:40,700
department visits. However,

364
00:12:40,700 --> 00:12:42,336
that

365
00:12:42,336 --> 00:12:44,400
s not surprising, right?

366
00:12:44,400 --> 00:12:46,600
Given the changes in the

367
00:12:46,600 --> 00:12:48,642
weather and did not have a

368
00:12:48,642 --> 00:12:51,512
major impact on our health care

369
00:12:51,512 --> 00:12:53,748
system. Uh, aside from that, no

370
00:12:53,748 --> 00:12:55,115
other broader trends requiring

371
00:12:55,115 --> 00:12:56,816
any additional public health

372
00:12:56,816 --> 00:12:59,520
action have been identified at

373
00:12:59,520 --> 00:13:00,920
this time. Um, our team is

374
00:13:00,920 --> 00:13:02,323
activated. We have our Mac

375
00:13:02,323 --> 00:13:04,458
Health Medical Area Command

376
00:13:04,458 --> 00:13:06,794
activated since last week.

377
00:13:06,794 --> 00:13:08,629
Actually. And our team is

378
00:13:08,629 --> 00:13:09,996
continuing to do surveillance

379
00:13:09,996 --> 00:13:12,396
throughout throughout all of

380
00:13:13,167 --> 00:13:15,690
the matches in Seattle. Um, and

381
00:13:15,690 --> 00:13:16,770
I will also add that, you know,

382
00:13:16,770 --> 00:13:18,204
various members of our team are

383
00:13:18,204 --> 00:13:19,907
on a number of different calls

384
00:13:19,907 --> 00:13:22,543
related to fifa. We have, of

385
00:13:22,543 --> 00:13:24,780
course, our internal Mac calls.

386
00:13:24,780 --> 00:13:25,612
We have our emergency

387
00:13:25,612 --> 00:13:27,113
preparedness team that are

388
00:13:27,113 --> 00:13:28,549
sitting in on the King County

389
00:13:28,549 --> 00:13:29,416
emergency operations, as well

390
00:13:29,416 --> 00:13:32,152
as the City of Seattle

391
00:13:32,152 --> 00:13:34,955
emergency operations. Um, I am

392
00:13:34,955 --> 00:13:36,489
on calls with cdc, with local

393
00:13:36,489 --> 00:13:38,125
health officials from all of

394
00:13:38,125 --> 00:13:38,281
the host cities. Uh, so that

395
00:13:38,281 --> 00:13:40,281
s

396
00:13:40,593 --> 00:13:40,761
actually really great because

397
00:13:40,761 --> 00:13:42,195
it

398
00:13:42,195 --> 00:13:44,640
s an opportunity for us to

399
00:13:44,640 --> 00:13:45,232
learn about anything that could

400
00:13:45,232 --> 00:13:46,600
happen. You know, from a public

401
00:13:46,600 --> 00:13:49,269
health standpoint and any of

402
00:13:49,269 --> 00:13:50,470
the other host cities, um, as

403
00:13:50,470 --> 00:13:51,905
well as calls with the

404
00:13:51,905 --> 00:13:53,373
Department of Health and the

405
00:13:53,373 --> 00:13:55,242
Big Cities Health Coalition.

406
00:13:55,242 --> 00:13:57,878
So, needless to say, a whole

407
00:13:57,878 --> 00:13:59,146
number of coordination calls

408
00:13:59,146 --> 00:14:00,547
with a variety of different

409
00:14:00,547 --> 00:14:02,115
partners that are all

410
00:14:02,115 --> 00:14:03,883
monitoring everything related

411
00:14:03,883 --> 00:14:06,386
to fifa World Cup and public

412
00:14:06,386 --> 00:14:08,922
health. Um, at our last board

413
00:14:08,922 --> 00:14:11,922
meeting, I provided an update

414
00:14:12,859 --> 00:14:14,661
about, uh, the hantavirus, uh,

415
00:14:14,661 --> 00:14:17,610
outbreak associated with the

416
00:14:17,230 --> 00:14:18,532
cruise ship. And, um, informed

417
00:14:18,532 --> 00:14:20,834
the board about, you know, our

418
00:14:20,834 --> 00:14:23,537
King County residents that we

419
00:14:23,537 --> 00:14:25,839
had identified as being high

420
00:14:25,839 --> 00:14:27,400
risk exposures. And we did have

421
00:14:27,400 --> 00:14:29,176
an additional low risk

422
00:14:29,176 --> 00:14:32,176
exposure. Just wanted to share

423
00:14:32,312 --> 00:14:34,140
and report that, um, our

424
00:14:34,140 --> 00:14:35,348
residents followed public

425
00:14:35,348 --> 00:14:37,348
health guidance throughout

426
00:14:37,517 --> 00:14:39,620
their entire monitoring period.

427
00:14:39,620 --> 00:14:41,155
And, uh, some have completed

428
00:14:41,155 --> 00:14:43,555
their monitoring period without

429
00:14:44,358 --> 00:14:45,993
any symptoms. Um, and a couple

430
00:14:45,993 --> 00:14:47,761
will be completing theirs, uh,

431
00:14:47,761 --> 00:14:49,730
shortly. The there is one

432
00:14:49,730 --> 00:14:51,364
resident who chose to remain at

433
00:14:51,364 --> 00:14:53,700
the Nebraska facility during

434
00:14:53,700 --> 00:14:55,340
the entire monitoring period.

435
00:14:55,340 --> 00:14:57,571
Um, but happy to report that

436
00:14:57,571 --> 00:14:59,840
also without any symptoms. Um,

437
00:14:59,840 --> 00:15:01,841
and then, of course, right

438
00:15:01,841 --> 00:15:02,510
after hantavirus, I

439
00:15:02,510 --> 00:15:04,510
m sure you

440
00:15:05,112 --> 00:15:08,480
all have seen about the ongoing

441
00:15:08,480 --> 00:15:10,830
outbreak of Ebola. Um, wanted

442
00:15:10,830 --> 00:15:13,520
to share a little bit about

443
00:15:13,520 --> 00:15:14,955
that. So on MAY 5th, uh, the

444
00:15:14,955 --> 00:15:16,955
World Health Organization

445
00:15:17,424 --> 00:15:19,759
alerted, uh, about an outbreak

446
00:15:19,759 --> 00:15:21,995
of Ebola virus occurring in the

447
00:15:21,995 --> 00:15:24,264
eastern providences of the

448
00:15:24,264 --> 00:15:26,300
Democratic Republic of Congo.

449
00:15:26,300 --> 00:15:28,568
And there are different kinds

450
00:15:28,568 --> 00:15:31,337
of Ebola viruses. And the the

451
00:15:31,337 --> 00:15:34,937
one that has been identified is

452
00:15:36,760 --> 00:15:40,276
Buju Ebola virus. Um, so far as

453
00:15:41,581 --> 00:15:42,949
of JUNE 16th. And these are

454
00:15:42,949 --> 00:15:44,517
numbers from the cdc

455
00:15:44,517 --> 00:15:46,517
s, um,

456
00:15:46,587 --> 00:15:48,587
situational update report.

457
00:15:49,423 --> 00:15:53,230
There have been a total of 875

458
00:15:53,727 --> 00:15:56,727
confirmed cases in drc and 202

459
00:15:57,163 --> 00:15:58,865
deaths in Uganda as of JUNE

460
00:15:58,865 --> 00:16:01,802
18th. There have been a total

461
00:16:01,802 --> 00:16:04,104
of 19 confirmed cases and two

462
00:16:04,104 --> 00:16:06,539
deaths. Um, there, as you can

463
00:16:06,539 --> 00:16:08,942
imagine, this is a situation

464
00:16:08,942 --> 00:16:10,177
of, uh, global importance,

465
00:16:10,177 --> 00:16:11,278
especially as we

466
00:16:11,278 --> 00:16:13,278
ve undertaken.

467
00:16:13,947 --> 00:16:15,982
Right? This, um, World Cup and

468
00:16:15,982 --> 00:16:18,218
lots of travel, summertime,

469
00:16:18,218 --> 00:16:20,860
etcetera. Um, the cdc is

470
00:16:20,860 --> 00:16:22,860
actively monitoring their

471
00:16:22,556 --> 00:16:24,956
emergency operations center is

472
00:16:25,325 --> 00:16:27,160
has been stood up and the they

473
00:16:27,160 --> 00:16:29,160
have implemented strict

474
00:16:29,729 --> 00:16:31,729
protocols, including routing

475
00:16:32,199 --> 00:16:34,599
individuals who are returning

476
00:16:34,634 --> 00:16:36,770
from any travel to drc, Uganda

477
00:16:36,770 --> 00:16:40,400
and South Sudan in the last 21

478
00:16:40,400 --> 00:16:42,175
days to specific airports where

479
00:16:42,175 --> 00:16:44,544
upon arrival they are screened

480
00:16:44,544 --> 00:16:46,346
and then state and local health

481
00:16:46,346 --> 00:16:48,148
departments are receiving

482
00:16:48,148 --> 00:16:49,783
information about any travelers

483
00:16:49,783 --> 00:16:51,885
that will then be returning to

484
00:16:51,885 --> 00:16:53,520
their states. Like other Ebola

485
00:16:53,520 --> 00:16:54,955
outbreaks in the past. Public

486
00:16:54,955 --> 00:16:56,389
health is working closely with

487
00:16:56,389 --> 00:16:58,291
the state Department of Health

488
00:16:58,291 --> 00:16:59,860
and the cdc, and will be

489
00:16:59,860 --> 00:17:01,395
conducting symptom monitoring

490
00:17:01,395 --> 00:17:03,463
on any travelers returning from

491
00:17:03,463 --> 00:17:05,298
these affected countries. Uh,

492
00:17:05,298 --> 00:17:06,466
currently, travelers that have

493
00:17:06,466 --> 00:17:08,702
returned have all been

494
00:17:08,702 --> 00:17:11,171
identified to be very low or

495
00:17:11,171 --> 00:17:13,240
low risk. Uh, the risk to the

496
00:17:13,240 --> 00:17:16,110
United States and here in King

497
00:17:16,110 --> 00:17:17,611
County remains low. We do not

498
00:17:17,611 --> 00:17:19,179
expect a bullet to be a local

499
00:17:19,179 --> 00:17:21,148
health threat during the World

500
00:17:21,148 --> 00:17:22,949
Cup. And we are, of course,

501
00:17:22,949 --> 00:17:25,118
continuing to monitor the

502
00:17:25,118 --> 00:17:26,887
situation as it continues to

503
00:17:26,887 --> 00:17:28,388
evolve. Um, and then just to

504
00:17:28,388 --> 00:17:29,823
note also on those numbers, of

505
00:17:29,823 --> 00:17:32,920
course, that, you know, numbers

506
00:17:32,920 --> 00:17:34,492
are actively changing rapidly.

507
00:17:35,695 --> 00:17:37,698
Um, and, uh, another important

508
00:17:37,698 --> 00:17:39,466
piece of information is that no

509
00:17:39,466 --> 00:17:40,833
cases of Ebola have been

510
00:17:40,833 --> 00:17:43,233
identified in the United

511
00:17:43,937 --> 00:17:46,937
States. Uh, and then lastly,

512
00:17:47,740 --> 00:17:49,609
wanted to share about, uh,

513
00:17:49,609 --> 00:17:50,844
measles. Um, so I think

514
00:17:50,844 --> 00:17:51,440
everyone has seen and I

515
00:17:51,440 --> 00:17:53,440
ve

516
00:17:53,881 --> 00:17:56,281
reported in previous board

517
00:17:56,416 --> 00:17:58,416
meetings about measles

518
00:17:59,352 --> 00:18:00,754
outbreaks and where we stand in

519
00:18:00,754 --> 00:18:03,824
the United States. So as of

520
00:18:03,824 --> 00:18:05,759
JUNE 5th, we have had a 45

521
00:18:05,759 --> 00:18:07,594
cases of measles. Measles in

522
00:18:07,594 --> 00:18:09,396
Washington state, uh, with

523
00:18:09,396 --> 00:18:12,396
three cases here in King

524
00:18:12,633 --> 00:18:15,633
County. Uh, cases in Washington

525
00:18:15,936 --> 00:18:17,637
have occurred typically in, uh,

526
00:18:17,637 --> 00:18:19,839
people who have been

527
00:18:19,839 --> 00:18:21,842
unvaccinated or not fully

528
00:18:21,842 --> 00:18:23,943
vaccinated and have either

529
00:18:23,943 --> 00:18:25,478
traveled domestically where

530
00:18:25,478 --> 00:18:27,140
active outbreaks of measles

531
00:18:27,140 --> 00:18:28,815
have been occurring, or

532
00:18:28,815 --> 00:18:30,350
internationally and have been

533
00:18:30,350 --> 00:18:31,719
exposed. Um, we

534
00:18:31,719 --> 00:18:33,719
ve also had

535
00:18:34,221 --> 00:18:36,190
introduction from travelers who

536
00:18:36,190 --> 00:18:37,791
traveled into Washington or

537
00:18:37,791 --> 00:18:39,560
traveled through Washington

538
00:18:39,560 --> 00:18:41,428
with measles and then, um,

539
00:18:41,428 --> 00:18:43,930
have, you know, exposed other

540
00:18:43,930 --> 00:18:46,133
individuals. Our team is

541
00:18:46,133 --> 00:18:48,168
actively working on measles

542
00:18:48,168 --> 00:18:50,136
surveillance at all times, uh,

543
00:18:50,136 --> 00:18:52,536
working with the state

544
00:18:52,673 --> 00:18:54,307
Department of Health and cdc.

545
00:18:54,307 --> 00:18:56,543
And I think really important,

546
00:18:56,543 --> 00:18:58,478
since, of course, we are now in

547
00:18:58,478 --> 00:19:00,514
summer travel period to make

548
00:19:00,514 --> 00:19:02,914
sure that, uh, community

549
00:19:03,160 --> 00:19:04,717
members know that it is really

550
00:19:04,717 --> 00:19:07,286
important to make sure that

551
00:19:07,286 --> 00:19:10,591
they are immune and have had

552
00:19:10,591 --> 00:19:13,591
two doses of measles vaccine.

553
00:19:14,940 --> 00:19:15,496
Um, before traveling outside of

554
00:19:15,496 --> 00:19:17,970
the United States or even

555
00:19:17,970 --> 00:19:18,310
traveling domestically in the

556
00:19:18,310 --> 00:19:20,300
United States, where there

557
00:19:20,300 --> 00:19:22,769
might be an active outbreak of

558
00:19:22,769 --> 00:19:24,705
measles. Um, and typically,

559
00:19:24,705 --> 00:19:27,740
children receive their first

560
00:19:27,740 --> 00:19:30,740
dose of the measles vaccine

561
00:19:30,677 --> 00:19:32,279
between 12 to 15 months of age.

562
00:19:32,279 --> 00:19:35,315
Uh, but I want to make sure

563
00:19:35,315 --> 00:19:38,315
that parents know that children

564
00:19:38,485 --> 00:19:40,120
that are 6 to 11 months old and

565
00:19:40,120 --> 00:19:42,322
who MAY be traveling

566
00:19:42,322 --> 00:19:43,957
internationally or to an area

567
00:19:43,957 --> 00:19:46,593
with an active outbreak, can

568
00:19:46,593 --> 00:19:48,280
get a dose prior to their

569
00:19:48,280 --> 00:19:49,996
travels, even though their

570
00:19:49,996 --> 00:19:50,297
child is not a year old yet. I

571
00:19:50,297 --> 00:19:52,265
think that

572
00:19:52,265 --> 00:19:54,265
s really important.

573
00:19:56,136 --> 00:20:00,336
Um, and so happy to conclude my

574
00:20:00,907 --> 00:20:03,307
updates at this time.

575
00:20:03,877 --> 00:20:05,178
Thank you. Doctor v board

576
00:20:05,178 --> 00:20:06,813
members, are there any

577
00:20:06,813 --> 00:20:08,813
questions or comments.

578
00:20:08,882 --> 00:20:09,583
For Doctor e.

579
00:20:09,583 --> 00:20:11,583
Or members of.

580
00:20:13,186 --> 00:20:16,289
The Sarah who have the floor?

581
00:20:16,289 --> 00:20:17,891
Hey doctor v. Congratulations.

582
00:20:17,891 --> 00:20:20,194
Uh, really happy to have you in

583
00:20:20,194 --> 00:20:20,360
this role. Um. My question.

584
00:20:20,360 --> 00:20:21,995
It

585
00:20:21,995 --> 00:20:22,863
s more of a recommendation.

586
00:20:22,863 --> 00:20:24,300
Actually, I

587
00:20:24,300 --> 00:20:25,766
m wondering if King

588
00:20:25,766 --> 00:20:28,100
County has considered putting

589
00:20:28,100 --> 00:20:30,270
forward all of the sites that

590
00:20:30,270 --> 00:20:32,380
actually provide vaccinations

591
00:20:32,380 --> 00:20:33,907
as, like a form of, you know,

592
00:20:33,907 --> 00:20:35,876
outreach to community with

593
00:20:35,876 --> 00:20:36,360
these reminders. Um, and I

594
00:20:36,360 --> 00:20:37,143
m

595
00:20:37,143 --> 00:20:37,544
particularly thinking because

596
00:20:37,544 --> 00:20:37,811
we, you know, it

597
00:20:37,811 --> 00:20:39,680
s very

598
00:20:39,680 --> 00:20:40,447
important that we contradict

599
00:20:40,447 --> 00:20:40,947
kind of the administration

600
00:20:40,947 --> 00:20:42,249
s

601
00:20:42,249 --> 00:20:42,616
position, the federal

602
00:20:42,616 --> 00:20:43,817
administration

603
00:20:43,817 --> 00:20:45,752
s position on

604
00:20:45,752 --> 00:20:47,354
vaccines. Um, and, you know,

605
00:20:47,354 --> 00:20:48,655
speaking as a leader of one of

606
00:20:48,655 --> 00:20:51,240
the federally qualified health

607
00:20:51,240 --> 00:20:53,226
centers, and I know this is a

608
00:20:53,226 --> 00:20:54,661
massive effort on our part. And

609
00:20:54,661 --> 00:20:55,962
so we could use some assistance

610
00:20:55,962 --> 00:20:58,565
from King County in getting

611
00:20:58,565 --> 00:20:59,966
that information out and having

612
00:20:59,966 --> 00:21:02,503
a broader reach. So that would

613
00:21:02,503 --> 00:21:04,503
be my request.

614
00:21:06,273 --> 00:21:09,800
Yes, absolutely. Um, our team,

615
00:21:09,800 --> 00:21:11,879
uh, we do have about 22

616
00:21:11,879 --> 00:21:13,913
community navigators who are

617
00:21:13,913 --> 00:21:15,882
actively working in community

618
00:21:15,882 --> 00:21:18,510
and with community and are

619
00:21:18,510 --> 00:21:20,510
sharing information regarding

620
00:21:20,687 --> 00:21:22,222
measles. Um, of course, at our

621
00:21:22,222 --> 00:21:23,323
public health clinics and

622
00:21:23,323 --> 00:21:25,559
through our community access

623
00:21:25,559 --> 00:21:28,461
and outreach teams as well. Um,

624
00:21:28,461 --> 00:21:30,630
and but always happy to

625
00:21:30,630 --> 00:21:32,532
collaborate in any way, shape

626
00:21:32,532 --> 00:21:34,134
or form to provide accurate

627
00:21:34,134 --> 00:21:36,403
information to the community.

628
00:21:36,403 --> 00:21:38,905
Um, actually, just yesterday I

629
00:21:38,905 --> 00:21:41,207
did a measles interview in

630
00:21:41,207 --> 00:21:42,876
Spanish, uh, as well. Uh, that

631
00:21:42,876 --> 00:21:45,110
was live Facebook live for

632
00:21:45,110 --> 00:21:47,411
community, kind of answering

633
00:21:47,547 --> 00:21:49,947
questions from community about

634
00:21:50,170 --> 00:21:52,170
misinformation related to

635
00:21:52,252 --> 00:21:53,687
measles vaccination. Um, you

636
00:21:53,687 --> 00:21:55,687
know, misinformation about

637
00:21:56,222 --> 00:21:58,225
measles and autism and just

638
00:21:58,225 --> 00:22:00,293
concerns that people have. Uh,

639
00:22:00,293 --> 00:22:01,628
so we did do that. And I have a

640
00:22:01,628 --> 00:22:02,729
one coming up in a couple of

641
00:22:02,729 --> 00:22:03,630
weeks as well that I

642
00:22:03,630 --> 00:22:05,630
ll be

643
00:22:05,198 --> 00:22:07,330
doing in Spanish for another

644
00:22:07,330 --> 00:22:08,868
outlet. Um, but our team is

645
00:22:08,868 --> 00:22:11,305
actively doing these two with

646
00:22:11,305 --> 00:22:13,705
other smaller community media.

647
00:22:14,174 --> 00:22:16,409
Um, any, you know, uh,

648
00:22:16,409 --> 00:22:18,780
recommendations or suggestions?

649
00:22:18,780 --> 00:22:19,179
Our team is happy to, to work

650
00:22:19,179 --> 00:22:20,748
on this.

651
00:22:20,748 --> 00:22:23,148
Thank you, Doctor Bee.

652
00:22:23,283 --> 00:22:24,852
Uh, board member Lucero, is is

653
00:22:24,852 --> 00:22:25,318
your hand up for additional

654
00:22:25,318 --> 00:22:25,485
follow up?

655
00:22:25,485 --> 00:22:26,419
It

656
00:22:26,419 --> 00:22:26,786
s just a follow up. Yes.

657
00:22:26,786 --> 00:22:28,222
Go ahead.

658
00:22:28,222 --> 00:22:29,923
Please. You know, I was

659
00:22:29,923 --> 00:22:31,691
speaking, um, as the co-chair

660
00:22:31,691 --> 00:22:33,993
who, um, led the Breaking the

661
00:22:33,993 --> 00:22:36,296
Cycle initiative from, um,

662
00:22:36,296 --> 00:22:38,364
executive Zahilay. And one of

663
00:22:38,364 --> 00:22:40,167
the commitments within that,

664
00:22:40,167 --> 00:22:41,501
um, committee is to make sure

665
00:22:41,501 --> 00:22:43,901
that we have meaningful

666
00:22:44,705 --> 00:22:45,372
community. Um, partnerships.

667
00:22:45,372 --> 00:22:46,573
And so I

668
00:22:46,573 --> 00:22:48,275
d like to see much

669
00:22:48,275 --> 00:22:51,275
more than just, you know,

670
00:22:51,978 --> 00:22:54,378
information. But really, um,

671
00:22:54,514 --> 00:22:56,914
advertising and marketing and

672
00:22:57,500 --> 00:22:58,985
communicating the community

673
00:22:58,985 --> 00:23:00,853
based organizations that are

674
00:23:00,853 --> 00:23:03,230
ready to assist with this and

675
00:23:03,230 --> 00:23:04,557
have capacity to be able to

676
00:23:04,557 --> 00:23:04,725
support the need. Um, so that

677
00:23:04,725 --> 00:23:06,159
s

678
00:23:06,159 --> 00:23:08,595
I want to be very clear about

679
00:23:08,595 --> 00:23:10,597
my ask. Thank you.

680
00:23:10,597 --> 00:23:12,866
And I will follow up with we

681
00:23:12,866 --> 00:23:14,334
have a within Public health,

682
00:23:14,334 --> 00:23:16,936
our Office of Equity and

683
00:23:16,936 --> 00:23:18,338
Community Partnerships because

684
00:23:18,338 --> 00:23:20,673
we work with a number of

685
00:23:20,673 --> 00:23:21,774
community based partners. Um,

686
00:23:21,774 --> 00:23:23,430
through a number of efforts,

687
00:23:23,430 --> 00:23:23,777
like Chair Daniels mentioned,

688
00:23:23,777 --> 00:23:25,445
our community health

689
00:23:25,445 --> 00:23:26,947
improvement plan work that

690
00:23:26,947 --> 00:23:28,248
includes a number of community

691
00:23:28,248 --> 00:23:30,648
partners who are constantly

692
00:23:31,150 --> 00:23:33,720
working with um, as well as our

693
00:23:33,720 --> 00:23:35,188
here tag group, which is our

694
00:23:35,188 --> 00:23:36,957
health equity and Anti-Racism

695
00:23:36,957 --> 00:23:39,357
community advisory group. Um,

696
00:23:39,926 --> 00:23:41,294
so we do constantly communicate

697
00:23:41,294 --> 00:23:42,795
with and coordinate and

698
00:23:42,795 --> 00:23:44,865
collaborate with all of those

699
00:23:44,865 --> 00:23:45,966
partners. But I will follow up

700
00:23:45,966 --> 00:23:48,468
with them just to make sure

701
00:23:48,468 --> 00:23:49,469
that, you know, there is that

702
00:23:49,469 --> 00:23:49,623
communication as you

703
00:23:49,623 --> 00:23:51,623
re

704
00:23:51,738 --> 00:23:53,140
mentioning and that, you know,

705
00:23:53,140 --> 00:23:53,316
collaboration. And if there

706
00:23:53,316 --> 00:23:53,640
s

707
00:23:53,640 --> 00:23:54,541
anything that

708
00:23:54,541 --> 00:23:54,707
s missing that

709
00:23:54,707 --> 00:23:56,707
we

710
00:23:59,279 --> 00:23:59,979
re addressing that.

711
00:23:59,979 --> 00:24:01,915
Thank you.

712
00:24:01,915 --> 00:24:03,915
Board member Lucero.

713
00:24:05,510 --> 00:24:07,387
Um, doctor v, any additional

714
00:24:07,387 --> 00:24:10,323
questions or comments from the

715
00:24:10,323 --> 00:24:12,292
board? Okay. Hearing none.

716
00:24:12,292 --> 00:24:14,610
Seeing none. Um, and thank you

717
00:24:14,610 --> 00:24:15,695
so much, board member. Lucero.

718
00:24:15,695 --> 00:24:15,929
It, um, it sounds like you

719
00:24:15,929 --> 00:24:17,397
re

720
00:24:17,397 --> 00:24:18,398
saying, hey, we don

721
00:24:18,398 --> 00:24:20,199
t want just

722
00:24:20,199 --> 00:24:22,599
information dispense. We want

723
00:24:24,771 --> 00:24:27,171
to have in-depth conversations

724
00:24:27,340 --> 00:24:29,510
and connections regarding this,

725
00:24:29,510 --> 00:24:31,745
not just information. So, um,

726
00:24:31,745 --> 00:24:34,614
so it looks like a work is

727
00:24:34,614 --> 00:24:36,483
already been, um, a been, uh,

728
00:24:36,483 --> 00:24:39,920
been done to ensure that that

729
00:24:39,920 --> 00:24:41,888
is possible. And, um, we will

730
00:24:41,888 --> 00:24:43,957
we will continue to make sure

731
00:24:43,957 --> 00:24:46,459
that our community is served.

732
00:24:46,459 --> 00:24:49,362
All right. Okay. All right.

733
00:24:49,362 --> 00:24:52,165
Thank you. Doctor v, next. This

734
00:24:52,165 --> 00:24:54,134
brings us to our. It brings us

735
00:24:54,134 --> 00:24:55,835
to item eight on the agenda

736
00:24:55,835 --> 00:24:58,370
with an update on board

737
00:24:58,370 --> 00:25:00,273
membership and recruitment for

738
00:25:00,273 --> 00:25:02,273
2027. Uh, welcome, board

739
00:25:03,110 --> 00:25:04,544
administrator Joy Joy

740
00:25:04,544 --> 00:25:06,790
Carpine-Cazzanti. I think I got

741
00:25:06,790 --> 00:25:07,881
there, Rick, to join us.

742
00:25:07,881 --> 00:25:08,315
Yes. Thank you. Um, yes, you

743
00:25:08,315 --> 00:25:09,850
got it right. I

744
00:25:09,850 --> 00:25:11,150
m Joy

745
00:25:11,150 --> 00:25:12,585
Carpine-Cazzanti your board of

746
00:25:12,585 --> 00:25:14,860
health administrator from

747
00:25:14,860 --> 00:25:14,245
public health. Uh, and today,

748
00:25:14,245 --> 00:25:15,321
I

749
00:25:15,321 --> 00:25:16,422
ll give you an update on

750
00:25:16,422 --> 00:25:18,422
recruitment for board

751
00:25:20,493 --> 00:25:22,529
membership in 2027. The board

752
00:25:22,529 --> 00:25:24,131
has three members and one

753
00:25:24,131 --> 00:25:25,599
alternate whose terms will

754
00:25:25,599 --> 00:25:28,334
conclude at the end of this

755
00:25:28,334 --> 00:25:29,802
year. Board member Butch de

756
00:25:29,802 --> 00:25:31,137
Castro, who represents public

757
00:25:31,137 --> 00:25:33,390
health facilities and

758
00:25:33,390 --> 00:25:35,375
providers. Board member Lisa

759
00:25:35,375 --> 00:25:36,209
Chu, who also represents public

760
00:25:36,209 --> 00:25:38,209
health facilities and

761
00:25:39,120 --> 00:25:40,680
providers. Board member

762
00:25:40,680 --> 00:25:41,982
Christopher Archiopoli, who

763
00:25:41,982 --> 00:25:43,982
represents community

764
00:25:44,251 --> 00:25:46,251
stakeholders. And lastly,

765
00:25:46,954 --> 00:25:48,954
alternate Francoise Milinganyo,

766
00:25:49,890 --> 00:25:51,425
who also represents community

767
00:25:51,425 --> 00:25:53,459
stakeholders. Board Member Chu

768
00:25:53,459 --> 00:25:55,495
accepted the invitation to be

769
00:25:55,495 --> 00:25:57,864
reappointed and would begin her

770
00:25:57,864 --> 00:25:59,199
third term in JANUARY. Board

771
00:25:59,199 --> 00:26:01,599
member Archie Poli, an

772
00:26:01,801 --> 00:26:03,303
alternate Telangana, have

773
00:26:03,303 --> 00:26:04,804
accepted the invitation to be

774
00:26:04,804 --> 00:26:06,740
reappointed and would also

775
00:26:06,740 --> 00:26:09,740
begin their second terms in

776
00:26:10,377 --> 00:26:11,144
JANUARY. Board member Butch de

777
00:26:11,144 --> 00:26:12,120
Castro um, who

778
00:26:12,120 --> 00:26:13,547
s not with us

779
00:26:13,547 --> 00:26:15,882
today, but he has served on the

780
00:26:15,882 --> 00:26:17,683
board for many years and he has

781
00:26:17,683 --> 00:26:19,386
indicated that he will finish

782
00:26:19,386 --> 00:26:22,221
his current term but not

783
00:26:22,221 --> 00:26:24,621
continue next year. Uh,

784
00:26:25,920 --> 00:26:27,460
alternate Karen Hartfield, who

785
00:26:27,460 --> 00:26:29,429
is his alternate um, has

786
00:26:29,429 --> 00:26:31,898
accepted the invitation to be

787
00:26:31,898 --> 00:26:32,165
appointed to fill. Board member

788
00:26:32,165 --> 00:26:34,134
de Castro

789
00:26:34,134 --> 00:26:36,134
s position. So

790
00:26:37,300 --> 00:26:38,471
therefore, we need to fill her

791
00:26:38,471 --> 00:26:38,972
position. So that

792
00:26:38,972 --> 00:26:40,972
s what we

793
00:26:41,700 --> 00:26:43,810
will be advertising for this

794
00:26:43,810 --> 00:26:45,445
summer, for the recruitment and

795
00:26:45,445 --> 00:26:47,380
appointment process, the state

796
00:26:47,380 --> 00:26:49,582
Board of Health Code outlines

797
00:26:49,582 --> 00:26:51,217
requirements including posting

798
00:26:51,217 --> 00:26:52,919
vacancy announcements in public

799
00:26:52,919 --> 00:26:55,319
places, including the newspaper

800
00:26:55,355 --> 00:26:56,989
of record making, available

801
00:26:56,989 --> 00:26:59,389
vacancy announcements in any

802
00:26:59,659 --> 00:27:01,395
language upon request. Um,

803
00:27:01,395 --> 00:27:03,163
posting vacancy announcements

804
00:27:03,163 --> 00:27:04,965
in all geographic regions

805
00:27:04,965 --> 00:27:07,000
represented by the King County

806
00:27:07,000 --> 00:27:09,202
Board of Health. Working with

807
00:27:09,202 --> 00:27:11,202
local community organizations

808
00:27:11,371 --> 00:27:13,206
to distribute vacancy notices

809
00:27:13,206 --> 00:27:14,941
and complying with applicable

810
00:27:14,941 --> 00:27:16,943
provisions of the Americans

811
00:27:16,943 --> 00:27:18,178
with Disabilities Act. State

812
00:27:18,178 --> 00:27:19,812
requirements place

813
00:27:19,812 --> 00:27:21,314
responsibility for recruitment,

814
00:27:21,314 --> 00:27:23,249
selection, and recommendation

815
00:27:23,249 --> 00:27:24,551
with the Board of Health and

816
00:27:24,551 --> 00:27:26,951
the official appointment with

817
00:27:27,854 --> 00:27:29,188
the King County Council. So we

818
00:27:29,188 --> 00:27:31,358
hope to have board

819
00:27:31,358 --> 00:27:33,260
recommendations in the form of

820
00:27:33,260 --> 00:27:35,660
resolutions approved by the

821
00:27:35,895 --> 00:27:37,664
board this OCTOBER to allow

822
00:27:37,664 --> 00:27:39,332
time for final action by the

823
00:27:39,332 --> 00:27:41,835
King County Council before the

824
00:27:41,835 --> 00:27:43,402
end of the year. So the

825
00:27:43,402 --> 00:27:45,105
recruitment announcement is

826
00:27:45,105 --> 00:27:45,338
available now on the Board of

827
00:27:45,338 --> 00:27:47,173
Health

828
00:27:47,173 --> 00:27:48,641
s web page. Um, if you

829
00:27:48,641 --> 00:27:49,842
look for the Join the Board of

830
00:27:49,842 --> 00:27:50,509
Health link, and I

831
00:27:50,509 --> 00:27:52,509
ll send this

832
00:27:52,646 --> 00:27:55,515
out after the the meeting as

833
00:27:55,515 --> 00:27:56,349
well. And over the next month,

834
00:27:56,349 --> 00:27:57,517
we will announce the

835
00:27:57,517 --> 00:27:57,717
opportunity on Public Health

836
00:27:57,717 --> 00:27:59,717
s

837
00:27:59,953 --> 00:28:02,522
blog and social media channels

838
00:28:02,522 --> 00:28:03,790
and in paid ads in newspapers

839
00:28:03,790 --> 00:28:04,457
across the county. We

840
00:28:04,457 --> 00:28:06,259
ll also

841
00:28:06,259 --> 00:28:06,626
share it with public health in

842
00:28:06,626 --> 00:28:08,261
Public Health

843
00:28:08,261 --> 00:28:10,130
s newsletters,

844
00:28:10,130 --> 00:28:12,198
with community partners, and we

845
00:28:12,198 --> 00:28:15,680
will ask them and you to spread

846
00:28:15,680 --> 00:28:16,870
the word. So today, I would

847
00:28:16,870 --> 00:28:18,638
kindly request that our current

848
00:28:18,638 --> 00:28:20,307
board members and alternates

849
00:28:20,307 --> 00:28:22,707
share the announcements with

850
00:28:22,842 --> 00:28:23,576
your networks as well. And um,

851
00:28:23,576 --> 00:28:24,770
as I mentioned, I

852
00:28:24,770 --> 00:28:26,450
ll send an

853
00:28:26,450 --> 00:28:29,316
email in the next week with

854
00:28:29,316 --> 00:28:32,118
that information to share. Once

855
00:28:32,118 --> 00:28:33,453
we receive applications, I will

856
00:28:33,453 --> 00:28:35,588
share them with all the board

857
00:28:35,588 --> 00:28:36,189
members for your review. And

858
00:28:36,189 --> 00:28:38,189
while we don

859
00:28:38,658 --> 00:28:40,126
t expect a super

860
00:28:40,126 --> 00:28:41,361
intensive process this year,

861
00:28:41,361 --> 00:28:44,163
given that we are recruiting

862
00:28:44,163 --> 00:28:45,932
for only one seat, we will need

863
00:28:45,932 --> 00:28:47,367
1 to 3 board members or

864
00:28:47,367 --> 00:28:49,402
alternates to volunteer to

865
00:28:49,402 --> 00:28:50,637
review applications and serve

866
00:28:50,637 --> 00:28:53,637
on the interview panel. This

867
00:28:53,773 --> 00:28:55,609
summer. Um, I will thank in

868
00:28:55,609 --> 00:28:57,100
advance. Uh, board members are

869
00:28:57,100 --> 00:28:58,979
Chipotle and alternate

870
00:28:58,979 --> 00:29:01,379
Hartfield, who have volunteered

871
00:29:02,849 --> 00:29:05,685
to serve on that committee. Um,

872
00:29:05,685 --> 00:29:07,687
and the commitment for serving

873
00:29:07,687 --> 00:29:09,289
in the committee would require

874
00:29:09,289 --> 00:29:11,224
time for 2 to 3 meetings

875
00:29:11,224 --> 00:29:13,659
outside of the board meetings,

876
00:29:13,659 --> 00:29:15,528
first to review applications,

877
00:29:15,528 --> 00:29:17,630
probably in late JULY, and then

878
00:29:17,630 --> 00:29:19,320
to interview candidates in

879
00:29:19,320 --> 00:29:20,567
AUGUST or SEPTEMBER and discuss

880
00:29:20,567 --> 00:29:21,768
the results in order to make a

881
00:29:21,768 --> 00:29:24,168
recommendation to the full

882
00:29:24,671 --> 00:29:26,573
board at the SEPTEMBER meeting.

883
00:29:26,573 --> 00:29:27,974
So if one or more members or

884
00:29:27,974 --> 00:29:29,442
alternates are willing to

885
00:29:29,442 --> 00:29:31,311
participate on the interview

886
00:29:31,311 --> 00:29:31,944
panel, um, if you

887
00:29:31,944 --> 00:29:33,747
d like to

888
00:29:33,747 --> 00:29:36,983
raise your hands now or let me

889
00:29:36,983 --> 00:29:40,653
know via email, I will sign you

890
00:29:40,653 --> 00:29:41,320
up. Thank you. That

891
00:29:41,320 --> 00:29:43,320
s it for

892
00:29:43,656 --> 00:29:45,592
me. Unless you have questions.

893
00:29:45,592 --> 00:29:46,626
And I see board member

894
00:29:46,626 --> 00:29:48,626
Muhammad.

895
00:29:49,562 --> 00:29:52,432
Board member Muhammad, are you

896
00:29:52,432 --> 00:29:54,832
volunteering to for the

897
00:29:55,301 --> 00:29:57,301
recruitment committee?

898
00:29:58,400 --> 00:29:59,272
Uh, yeah, if I have time. Yes,

899
00:29:59,272 --> 00:30:01,272
maybe. Yeah.

900
00:30:02,175 --> 00:30:04,310
Okay. Thank you. Yeah. I will

901
00:30:04,310 --> 00:30:06,710
follow up with you.

902
00:30:07,947 --> 00:30:09,516
Any any additional board

903
00:30:09,516 --> 00:30:11,151
members? Board member

904
00:30:11,151 --> 00:30:14,151
alternates who would like to

905
00:30:16,589 --> 00:30:19,158
serve? Well, we know that every

906
00:30:19,158 --> 00:30:20,894
that that board members, you

907
00:30:20,894 --> 00:30:23,195
have 20 million things on your

908
00:30:23,195 --> 00:30:25,932
schedule. So, um, take a look

909
00:30:25,932 --> 00:30:28,134
at that and see what your

910
00:30:28,134 --> 00:30:30,837
availability is for the summer

911
00:30:30,837 --> 00:30:32,806
and reach out to Joi if you

912
00:30:32,806 --> 00:30:33,506
have availability. That will be

913
00:30:33,506 --> 00:30:35,506
awesome.

914
00:30:35,775 --> 00:30:37,577
Thank you. And if you are an

915
00:30:37,577 --> 00:30:38,978
elected member, you could also

916
00:30:38,978 --> 00:30:41,714
send a staff member in your

917
00:30:41,714 --> 00:30:43,714
stead. Thank you.

918
00:30:45,585 --> 00:30:47,286
Thank you Joey. Okay. All

919
00:30:47,286 --> 00:30:50,560
right. This brings us to item

920
00:30:50,560 --> 00:30:51,992
number nine on the agenda, an

921
00:30:51,992 --> 00:30:53,693
update on innovations in sexual

922
00:30:53,693 --> 00:30:55,940
health in King County,

923
00:30:55,940 --> 00:30:57,940
including progress and

924
00:30:57,230 --> 00:31:00,200
innovation in hiv and sti

925
00:31:00,200 --> 00:31:02,769
control. This item was deferred

926
00:31:02,769 --> 00:31:04,971
at our main meeting. So thank

927
00:31:04,971 --> 00:31:06,773
you so much, presenters, for

928
00:31:06,773 --> 00:31:08,750
returning today. We thank

929
00:31:08,750 --> 00:31:09,109
Doctor Cannon for his

930
00:31:09,109 --> 00:31:09,910
flexibility. We

931
00:31:09,910 --> 00:31:11,477
ll hear from

932
00:31:11,477 --> 00:31:13,412
board member Archie Epperly and

933
00:31:13,412 --> 00:31:15,782
Doctor Chase cannon from Public

934
00:31:15,782 --> 00:31:17,417
Health. Just a quick reminder.

935
00:31:17,417 --> 00:31:19,180
We have about 30 minutes for

936
00:31:19,180 --> 00:31:21,418
this agenda item, including

937
00:31:21,488 --> 00:31:23,289
discussion. And welcome Doctor

938
00:31:23,289 --> 00:31:25,625
Cannon and board member Archer

939
00:31:25,625 --> 00:31:27,260
Poli. Please kick us off.

940
00:31:27,260 --> 00:31:28,595
Thank you, Vice Chair Daniels.

941
00:31:28,595 --> 00:31:29,662
And thank you, fellow board

942
00:31:29,662 --> 00:31:30,530
members. Uh, I

943
00:31:30,530 --> 00:31:31,131
m Christopher

944
00:31:31,131 --> 00:31:31,831
Archiopoli I

945
00:31:31,831 --> 00:31:32,965
m a community

946
00:31:32,965 --> 00:31:34,767
stakeholder on the Board of

947
00:31:34,767 --> 00:31:36,200
Health. I also identify as a

948
00:31:36,200 --> 00:31:37,638
person in long term recovery

949
00:31:37,638 --> 00:31:39,171
from substance use disorder.

950
00:31:39,171 --> 00:31:41,341
And a person living with hiv

951
00:31:41,341 --> 00:31:43,900
since 2008, and a member of the

952
00:31:43,900 --> 00:31:43,443
queer community. I

953
00:31:43,443 --> 00:31:44,777
ll make sure

954
00:31:44,777 --> 00:31:45,978
that Doctor Cannon has the

955
00:31:45,978 --> 00:31:47,314
majority of our time to talk

956
00:31:47,314 --> 00:31:49,480
about what public health is

957
00:31:49,480 --> 00:31:51,418
doing. My portion has less to

958
00:31:51,418 --> 00:31:52,318
do with innovations. Before

959
00:31:52,318 --> 00:31:52,489
handing things over, I

960
00:31:52,489 --> 00:31:53,586
ll

961
00:31:53,586 --> 00:31:55,755
address what is happening with

962
00:31:55,755 --> 00:31:56,889
community based initiatives, as

963
00:31:56,889 --> 00:31:58,191
well as how sexual health

964
00:31:58,191 --> 00:32:00,591
marketing reaches those most

965
00:32:03,863 --> 00:32:05,640
impacted. Next slide. So a lot

966
00:32:05,640 --> 00:32:07,534
has changed since the height of

967
00:32:07,534 --> 00:32:07,834
the Aids crisis and post-Covid,

968
00:32:07,834 --> 00:32:08,601
but there

969
00:32:08,601 --> 00:32:10,103
s still a robust

970
00:32:10,103 --> 00:32:11,771
community of people looking to

971
00:32:11,771 --> 00:32:14,674
engage with each other and with

972
00:32:14,674 --> 00:32:16,760
research. I facilitate a weekly

973
00:32:16,760 --> 00:32:18,177
support group, a support group

974
00:32:18,177 --> 00:32:20,346
for people living with iv on

975
00:32:20,346 --> 00:32:21,314
Mondays from 6 to 7 P.M. At

976
00:32:21,314 --> 00:32:22,248
Pier Seattle. I

977
00:32:22,248 --> 00:32:24,150
m co-chair of

978
00:32:24,150 --> 00:32:25,418
the University of Washington

979
00:32:25,418 --> 00:32:27,860
Positive Research Community

980
00:32:27,860 --> 00:32:28,488
Advisory Board, focused on

981
00:32:28,488 --> 00:32:29,755
connecting, communicating to

982
00:32:29,755 --> 00:32:31,458
people most impacted about

983
00:32:31,458 --> 00:32:32,659
research efforts being made

984
00:32:32,659 --> 00:32:35,590
towards ending the hiv

985
00:32:35,195 --> 00:32:36,363
epidemic. As vice chair of the

986
00:32:36,363 --> 00:32:38,431
King County Health Care for the

987
00:32:38,431 --> 00:32:38,638
Homeless Governance Council,

988
00:32:38,638 --> 00:32:39,465
I

989
00:32:39,465 --> 00:32:40,733
m always focused on

990
00:32:40,733 --> 00:32:41,767
highlighting the disparities

991
00:32:41,767 --> 00:32:43,103
marginalized communities

992
00:32:43,103 --> 00:32:44,971
experience regarding public

993
00:32:44,971 --> 00:32:47,507
health issues. I also sit on

994
00:32:47,507 --> 00:32:49,309
the communication subcommittee

995
00:32:49,309 --> 00:32:50,977
community for Advancing

996
00:32:50,977 --> 00:32:52,345
Clinical Therapeutics globally,

997
00:32:52,345 --> 00:32:53,947
an international organization

998
00:32:53,947 --> 00:32:56,449
focused on hiv and sti

999
00:32:56,449 --> 00:32:58,517
research. One of my favorite

1000
00:32:58,517 --> 00:32:59,419
local organizations is Bailey

1001
00:32:59,419 --> 00:33:00,119
Bush House in Seattle

1002
00:33:00,119 --> 00:33:01,520
s Madison

1003
00:33:01,520 --> 00:33:01,821
Valley neighborhood. They

1004
00:33:01,821 --> 00:33:03,821
ve

1005
00:33:04,624 --> 00:33:06,192
operated since 1992, providing

1006
00:33:06,192 --> 00:33:07,861
hospice care as well as shelter

1007
00:33:07,861 --> 00:33:09,296
services to people living with

1008
00:33:09,296 --> 00:33:11,164
hiv who are unhoused or on

1009
00:33:11,164 --> 00:33:12,632
stably housed. They provide

1010
00:33:12,632 --> 00:33:14,667
meals, make connection to

1011
00:33:14,667 --> 00:33:16,200
housing services, as well as

1012
00:33:16,200 --> 00:33:17,403
ensuring individuals have

1013
00:33:17,403 --> 00:33:19,205
access to lifesaving, saving

1014
00:33:19,205 --> 00:33:21,605
medications and basic medical

1015
00:33:21,641 --> 00:33:23,420
care. I provide haircuts to the

1016
00:33:23,420 --> 00:33:23,944
residents once a month and have

1017
00:33:23,944 --> 00:33:25,845
been doing qualitative

1018
00:33:25,845 --> 00:33:27,514
interviews for a research study

1019
00:33:27,514 --> 00:33:29,182
aimed at determining how to how

1020
00:33:29,182 --> 00:33:30,984
to best communicate with this

1021
00:33:30,984 --> 00:33:31,851
population. In my

1022
00:33:31,851 --> 00:33:32,251
conversations, I

1023
00:33:32,251 --> 00:33:33,419
ve heard

1024
00:33:33,419 --> 00:33:34,487
growing concerns about the

1025
00:33:34,487 --> 00:33:36,489
stability of this vital

1026
00:33:36,489 --> 00:33:38,358
community resource. As weekend

1027
00:33:38,358 --> 00:33:39,692
nursing services have been cut

1028
00:33:39,692 --> 00:33:41,270
and quality of care has

1029
00:33:41,270 --> 00:33:42,128
decreased since Common Spirit

1030
00:33:42,128 --> 00:33:44,164
took over management of the

1031
00:33:44,164 --> 00:33:45,731
facility, many shelters will

1032
00:33:45,731 --> 00:33:47,501
not serve people living with

1033
00:33:47,501 --> 00:33:49,602
hiv. And Bailey Boucher House

1034
00:33:49,602 --> 00:33:52,238
is a unique resource that saved

1035
00:33:52,238 --> 00:33:54,373
countless lives over 34 years.

1036
00:33:54,373 --> 00:33:55,342
This is not an exhaustive,

1037
00:33:55,342 --> 00:33:55,494
exhaustive list of what

1038
00:33:55,494 --> 00:33:56,843
s

1039
00:33:56,843 --> 00:33:57,143
happening in the community, but

1040
00:33:57,143 --> 00:33:57,643
there aren

1041
00:33:57,643 --> 00:33:59,112
t as many

1042
00:33:59,112 --> 00:33:59,946
opportunities to be as engaged

1043
00:33:59,946 --> 00:34:02,482
as there were at the height of

1044
00:34:02,482 --> 00:34:04,183
the crisis. As hiv research and

1045
00:34:04,183 --> 00:34:05,485
treatment have advanced, many

1046
00:34:05,485 --> 00:34:08,210
have taken for granted that we

1047
00:34:08,210 --> 00:34:11,210
have not solved this challenge.

1048
00:34:11,924 --> 00:34:13,526
Next slide. So shifting to a

1049
00:34:13,526 --> 00:34:15,628
kind of what what marketing

1050
00:34:15,628 --> 00:34:17,196
looks like. I wanted to state

1051
00:34:17,196 --> 00:34:18,498
first, I stand in awe of the

1052
00:34:18,498 --> 00:34:19,899
talents of physicians and

1053
00:34:19,899 --> 00:34:21,835
scientists who devoted their

1054
00:34:21,835 --> 00:34:23,169
careers to improving the health

1055
00:34:23,169 --> 00:34:24,637
and saving the lives of people

1056
00:34:24,637 --> 00:34:26,939
in my community, including

1057
00:34:26,939 --> 00:34:28,275
myself. I would not be alive

1058
00:34:28,275 --> 00:34:28,741
without the advances in

1059
00:34:28,741 --> 00:34:29,342
research that we

1060
00:34:29,342 --> 00:34:31,342
ve seen over

1061
00:34:32,178 --> 00:34:33,480
the last 30, 40 years. As

1062
00:34:33,480 --> 00:34:34,747
someone with a background in

1063
00:34:34,747 --> 00:34:36,883
marketing, I often view

1064
00:34:36,883 --> 00:34:38,451
challenges through that lens.

1065
00:34:38,451 --> 00:34:39,819
These images are examples of

1066
00:34:39,819 --> 00:34:41,988
the kind of marketing targeted

1067
00:34:41,988 --> 00:34:43,523
at our community. It is often

1068
00:34:43,523 --> 00:34:45,825
so generic and sanitized that

1069
00:34:45,825 --> 00:34:47,260
it can seem patronizing. I know

1070
00:34:47,260 --> 00:34:48,928
from conversations within my

1071
00:34:48,928 --> 00:34:49,929
social and professional circles

1072
00:34:49,929 --> 00:34:50,863
that this type of marketing

1073
00:34:50,863 --> 00:34:52,650
does not give people the

1074
00:34:52,650 --> 00:34:54,134
information they need to make

1075
00:34:54,134 --> 00:34:56,134
healthcare decisions. Next

1076
00:34:56,435 --> 00:34:58,505
slide. So where are people

1077
00:34:58,505 --> 00:34:59,505
getting their information? A

1078
00:34:59,505 --> 00:35:00,973
quarter of Americans are

1079
00:35:00,973 --> 00:35:02,808
getting their information from

1080
00:35:02,808 --> 00:35:04,244
influencers. The majority of

1081
00:35:04,244 --> 00:35:06,644
influencers are not healthcare

1082
00:35:06,946 --> 00:35:08,881
professionals. Leo Herrera and

1083
00:35:08,881 --> 00:35:11,517
Bobby Box are two influencers

1084
00:35:11,517 --> 00:35:12,819
creating quality content, but

1085
00:35:12,819 --> 00:35:15,388
there are many more spreading

1086
00:35:15,388 --> 00:35:16,556
myths or disinformation. This

1087
00:35:16,556 --> 00:35:17,890
challenge is a broader problem

1088
00:35:17,890 --> 00:35:19,459
than just the topic at hand in

1089
00:35:19,459 --> 00:35:21,160
this briefing. I think a lot

1090
00:35:21,160 --> 00:35:22,261
about the American Revolution,

1091
00:35:22,261 --> 00:35:23,296
when the British famously

1092
00:35:23,296 --> 00:35:25,165
objected to the guerrilla

1093
00:35:25,165 --> 00:35:26,566
tactics of the colonial rebels.

1094
00:35:26,566 --> 00:35:28,340
Rather than adjust their

1095
00:35:28,340 --> 00:35:29,602
tactics, they dug their heels

1096
00:35:29,602 --> 00:35:31,971
in, expecting conformity to

1097
00:35:31,971 --> 00:35:34,107
establish norms. We all know

1098
00:35:34,107 --> 00:35:35,741
how that battle ended.

1099
00:35:35,741 --> 00:35:37,410
Sanitizing our message leads to

1100
00:35:37,410 --> 00:35:39,212
death by community committee.

1101
00:35:39,212 --> 00:35:41,681
What offends? What offends? No

1102
00:35:41,681 --> 00:35:41,881
one reaches no one. If we

1103
00:35:41,881 --> 00:35:42,848
aren

1104
00:35:42,848 --> 00:35:43,817
t willing to communicate

1105
00:35:43,817 --> 00:35:45,385
with people the way that they

1106
00:35:45,385 --> 00:35:46,585
receive messages, public trust

1107
00:35:46,585 --> 00:35:48,888
will continue to migrate to

1108
00:35:48,888 --> 00:35:50,490
online influencers rather than

1109
00:35:50,490 --> 00:35:51,857
healthcare professionals. The

1110
00:35:51,857 --> 00:35:52,580
information is out there. It

1111
00:35:52,580 --> 00:35:53,359
s

1112
00:35:53,359 --> 00:35:55,829
our choice if we want to be the

1113
00:35:55,829 --> 00:35:56,930
source of that information. So

1114
00:35:56,930 --> 00:35:58,597
with that, I want to hand

1115
00:35:58,597 --> 00:35:59,266
everything over to Chase

1116
00:35:59,266 --> 00:36:00,000
cannon. He

1117
00:36:00,000 --> 00:36:01,801
s an assistant

1118
00:36:01,801 --> 00:36:03,469
professor in the Department of

1119
00:36:03,469 --> 00:36:05,404
Medicine at the University of

1120
00:36:05,404 --> 00:36:06,572
Washington, medical director of

1121
00:36:06,572 --> 00:36:07,540
the Public Health Seattle and

1122
00:36:07,540 --> 00:36:09,509
King County Sexual Health

1123
00:36:09,509 --> 00:36:10,576
Clinic, and medical officer on

1124
00:36:10,576 --> 00:36:13,576
the Public Health Seattle and

1125
00:36:14,981 --> 00:36:16,816
King County Prevention Division.

1126
00:36:16,816 --> 00:36:18,840
Thank you very much. Board

1127
00:36:18,840 --> 00:36:21,840
member Archer Pulley I will

1128
00:36:22,688 --> 00:36:25,191
pull out my slides here.

1129
00:36:25,191 --> 00:36:27,591
Hopefully everyone can see

1130
00:36:29,962 --> 00:36:32,650
that. Okay. Um, so good

1131
00:36:32,650 --> 00:36:34,465
afternoon everyone. Um, thank

1132
00:36:34,600 --> 00:36:36,736
you for the opportunity to

1133
00:36:36,736 --> 00:36:38,171
present, uh, about this

1134
00:36:38,171 --> 00:36:38,771
important topic. Uh, so in the

1135
00:36:38,771 --> 00:36:39,380
next few minutes, I

1136
00:36:39,380 --> 00:36:40,873
m just

1137
00:36:40,873 --> 00:36:42,408
going to review some of the

1138
00:36:42,408 --> 00:36:43,410
highlights of the innovation

1139
00:36:43,410 --> 00:36:43,676
and the progress that we

1140
00:36:43,676 --> 00:36:45,676
ve

1141
00:36:46,812 --> 00:36:48,982
made in the control for hiv and

1142
00:36:48,982 --> 00:36:50,650
STIs. Uh, here in King County.

1143
00:36:50,650 --> 00:36:50,884
So this is a brief overview of

1144
00:36:50,884 --> 00:36:52,151
what I

1145
00:36:52,151 --> 00:36:53,953
ll discuss. The state of

1146
00:36:53,953 --> 00:36:55,855
hiv in Seattle, King County.

1147
00:36:55,855 --> 00:36:56,700
Uh, the progress on what

1148
00:36:56,700 --> 00:36:57,690
s

1149
00:36:57,690 --> 00:36:59,893
called e or ending the hiv

1150
00:36:59,893 --> 00:37:01,961
epidemic. And the four pillars

1151
00:37:01,961 --> 00:37:02,128
that comprise that. And then

1152
00:37:02,128 --> 00:37:03,396
we

1153
00:37:03,396 --> 00:37:05,131
ll end with some trends on

1154
00:37:05,131 --> 00:37:06,432
STIs, including for syphilis

1155
00:37:06,432 --> 00:37:09,680
and something called Doxy Pep,

1156
00:37:09,680 --> 00:37:10,803
which I will discuss. So I

1157
00:37:10,803 --> 00:37:12,405
wanted to first start by

1158
00:37:12,405 --> 00:37:13,306
discussing the status of hiv in

1159
00:37:13,306 --> 00:37:14,340
King County. We

1160
00:37:14,340 --> 00:37:15,575
ve made really

1161
00:37:15,575 --> 00:37:15,775
extraordinary progress, I

1162
00:37:15,775 --> 00:37:17,775
d

1163
00:37:17,777 --> 00:37:20,246
say, over the past 20 years. So

1164
00:37:20,246 --> 00:37:23,246
in the population overall, new

1165
00:37:23,549 --> 00:37:26,519
hiv diagnoses have fallen by

1166
00:37:26,519 --> 00:37:28,200
65% among men who have sex with

1167
00:37:28,200 --> 00:37:29,355
men who historically are a

1168
00:37:29,355 --> 00:37:30,823
priority population that is

1169
00:37:30,823 --> 00:37:32,592
disproportionately impacted by

1170
00:37:32,592 --> 00:37:34,992
hiv. New diagnoses have

1171
00:37:35,610 --> 00:37:37,610
dramatically decreased by 75%

1172
00:37:37,430 --> 00:37:39,632
since 2010. And the reason that

1173
00:37:39,632 --> 00:37:39,965
this is important is because,

1174
00:37:39,965 --> 00:37:40,867
you know, we

1175
00:37:40,867 --> 00:37:42,869
ve only had about

1176
00:37:42,869 --> 00:37:45,400
100 new diagnoses of hiv in

1177
00:37:45,400 --> 00:37:47,600
this group in 2025, and that

1178
00:37:47,600 --> 00:37:49,750
represents the lowest number

1179
00:37:49,750 --> 00:37:50,677
that we have seen since the hiv

1180
00:37:50,677 --> 00:37:53,112
epidemic began in King County

1181
00:37:53,112 --> 00:37:55,248
in the 1980s. So extraordinary

1182
00:37:55,248 --> 00:37:56,783
progress in much of that in

1183
00:37:56,783 --> 00:37:58,170
recent years has occurred due

1184
00:37:58,170 --> 00:38:00,253
to the success of something

1185
00:38:00,253 --> 00:38:01,787
called e, or ending the hiv

1186
00:38:01,787 --> 00:38:03,123
epidemic. Um, this is an

1187
00:38:03,123 --> 00:38:05,523
initiative that was announced

1188
00:38:05,825 --> 00:38:07,527
in 2019 that aims to

1189
00:38:07,527 --> 00:38:08,794
substantially reduce hiv

1190
00:38:08,794 --> 00:38:11,163
infections in the United States

1191
00:38:11,163 --> 00:38:12,198
by focusing resources in 57

1192
00:38:12,198 --> 00:38:14,133
jurisdictions that have the

1193
00:38:14,133 --> 00:38:15,167
greatest need. So King County

1194
00:38:15,167 --> 00:38:18,471
was selected as one of those

1195
00:38:18,471 --> 00:38:20,390
jurisdictions, and in 2025, we

1196
00:38:20,390 --> 00:38:21,507
received our sixth year of

1197
00:38:21,507 --> 00:38:22,909
funding. And there are four

1198
00:38:22,909 --> 00:38:24,778
pillars of e that you can see

1199
00:38:24,778 --> 00:38:26,713
listed here. Diagnose, treat,

1200
00:38:26,713 --> 00:38:28,748
prevent and respond. In the

1201
00:38:28,748 --> 00:38:30,116
next few slides, I will just

1202
00:38:30,116 --> 00:38:30,616
give a high level summary of

1203
00:38:30,616 --> 00:38:32,616
public health

1204
00:38:32,619 --> 00:38:33,953
s activities and

1205
00:38:33,953 --> 00:38:35,188
successes within each of these

1206
00:38:35,188 --> 00:38:36,356
pillars. But for those of you

1207
00:38:36,356 --> 00:38:38,925
who are interested in more

1208
00:38:38,925 --> 00:38:40,960
detail, I welcome you to access

1209
00:38:40,960 --> 00:38:42,595
the county and State hiv

1210
00:38:42,595 --> 00:38:44,995
epidemiology report that is

1211
00:38:46,366 --> 00:38:47,800
linked here on the slide. So

1212
00:38:47,800 --> 00:38:50,200
for the first pillar,

1213
00:38:50,670 --> 00:38:52,872
diagnosing hiv, um, overall,

1214
00:38:52,872 --> 00:38:54,874
23% of all the new diagnoses in

1215
00:38:54,874 --> 00:38:56,643
2025 that we saw in King County

1216
00:38:56,643 --> 00:38:57,677
were made as a direct result of

1217
00:38:57,677 --> 00:38:59,450
public health. Seattle King

1218
00:38:59,450 --> 00:39:00,747
County funding. And that

1219
00:39:00,747 --> 00:39:02,182
includes activities ranging

1220
00:39:02,182 --> 00:39:03,816
from our staff, you know,

1221
00:39:03,816 --> 00:39:05,840
conducting testing at school or

1222
00:39:05,840 --> 00:39:06,886
the South County Correctional

1223
00:39:06,886 --> 00:39:08,287
Facility to promotion of

1224
00:39:08,287 --> 00:39:10,687
testing and low barrier

1225
00:39:10,790 --> 00:39:12,625
clinics. We closely followed

1226
00:39:12,625 --> 00:39:13,659
diagnosis rates for several key

1227
00:39:13,659 --> 00:39:15,228
populations that are

1228
00:39:15,228 --> 00:39:17,290
disproportionately impacted by

1229
00:39:17,290 --> 00:39:19,866
hiv, or who have been involved

1230
00:39:19,866 --> 00:39:21,534
in historic outbreaks. So for

1231
00:39:21,534 --> 00:39:24,534
women, we saw slight increase

1232
00:39:25,710 --> 00:39:26,405
in diagnoses in 2024. Although

1233
00:39:26,405 --> 00:39:28,174
this seems to have declined

1234
00:39:28,174 --> 00:39:31,174
more recently. Women still made

1235
00:39:31,711 --> 00:39:33,980
up 21% of all new diagnoses in

1236
00:39:33,980 --> 00:39:35,281
2025. We continue to see

1237
00:39:35,281 --> 00:39:36,849
disproportionately high rates

1238
00:39:36,849 --> 00:39:38,551
of hiv being diagnosed among

1239
00:39:38,551 --> 00:39:40,753
black residents, and they

1240
00:39:40,753 --> 00:39:42,655
comprised 36% of all new

1241
00:39:42,655 --> 00:39:44,590
diagnoses, despite only making

1242
00:39:44,590 --> 00:39:46,426
up 11% of the population in the

1243
00:39:46,426 --> 00:39:48,600
county. And we see similar

1244
00:39:48,600 --> 00:39:51,184
trends in men who have sex with

1245
00:39:51,184 --> 00:39:51,497
men or msm, where both black

1246
00:39:51,497 --> 00:39:52,965
and Latino men are

1247
00:39:52,965 --> 00:39:54,367
disproportionately impacted

1248
00:39:54,367 --> 00:39:56,536
compared to their makeup in the

1249
00:39:56,536 --> 00:39:58,380
population. For people

1250
00:39:58,380 --> 00:40:00,380
experiencing unstable housing

1251
00:40:00,139 --> 00:40:03,800
or houseless, uh, we have

1252
00:40:03,800 --> 00:40:05,408
observed decrease in new

1253
00:40:06,646 --> 00:40:07,547
diagnoses since the 2018

1254
00:40:07,547 --> 00:40:09,415
outbreak that people MAY

1255
00:40:09,415 --> 00:40:11,617
remember, um, but still over

1256
00:40:11,617 --> 00:40:13,152
20% of heterosexual people who

1257
00:40:13,152 --> 00:40:15,210
are diagnosed with hiv are

1258
00:40:15,210 --> 00:40:16,522
unstable, housed. And then on

1259
00:40:16,522 --> 00:40:18,491
the right side, you can see a

1260
00:40:18,491 --> 00:40:20,930
figure here that outlines the

1261
00:40:20,930 --> 00:40:21,600
fact that new diagnoses are not

1262
00:40:21,600 --> 00:40:22,828
equally distributed

1263
00:40:22,828 --> 00:40:24,300
geographically. So most of the

1264
00:40:24,300 --> 00:40:25,298
new diagnoses that we see,

1265
00:40:25,298 --> 00:40:27,330
actually over a third of them

1266
00:40:27,330 --> 00:40:30,330
were in people residing in

1267
00:40:30,403 --> 00:40:32,905
South King County. The second

1268
00:40:32,905 --> 00:40:33,907
pillar is treatment. So since

1269
00:40:33,907 --> 00:40:35,574
2020, we

1270
00:40:35,574 --> 00:40:37,210
ve had a real focus on

1271
00:40:37,210 --> 00:40:38,678
building up differentiated care

1272
00:40:38,678 --> 00:40:40,780
models. And so that is the

1273
00:40:40,780 --> 00:40:43,480
strategy of tailoring our

1274
00:40:43,480 --> 00:40:44,417
system of services to what we

1275
00:40:44,417 --> 00:40:46,686
offer for people with hiv to

1276
00:40:46,686 --> 00:40:47,821
really meet their needs. So

1277
00:40:47,821 --> 00:40:48,788
increasing access to low

1278
00:40:48,788 --> 00:40:51,457
barrier care has been a

1279
00:40:51,457 --> 00:40:53,893
priority. And over the past

1280
00:40:53,893 --> 00:40:55,662
year, 10% of all people living

1281
00:40:55,662 --> 00:40:57,330
with hiv in the county received

1282
00:40:57,330 --> 00:41:00,330
hiv primary care and low

1283
00:41:00,633 --> 00:41:02,134
barrier clinics. In addition to

1284
00:41:02,134 --> 00:41:04,700
expanding those brick and

1285
00:41:04,700 --> 00:41:05,338
mortar low barrier services.

1286
00:41:05,338 --> 00:41:06,806
Beyond the clinics that you see

1287
00:41:06,806 --> 00:41:08,708
listed there in the table at

1288
00:41:08,708 --> 00:41:11,760
the bottom left, um each

1289
00:41:11,760 --> 00:41:12,911
supported a new, uh, hiv mobile

1290
00:41:12,911 --> 00:41:14,314
Outreach team, or Mott uh,

1291
00:41:14,314 --> 00:41:16,249
which aims to reach people with

1292
00:41:16,249 --> 00:41:18,484
hiv who are virally suppressed

1293
00:41:18,484 --> 00:41:20,119
and who are not engaged in care

1294
00:41:20,119 --> 00:41:21,855
and face complex barriers to

1295
00:41:21,855 --> 00:41:23,723
care, such as behavioral health

1296
00:41:23,723 --> 00:41:25,723
disorders, housing instability,

1297
00:41:26,125 --> 00:41:27,427
and justice system involvement.

1298
00:41:27,427 --> 00:41:29,595
And out of those who were

1299
00:41:29,595 --> 00:41:31,197
referred to the Mott who were

1300
00:41:31,197 --> 00:41:34,233
still in county and agreed to

1301
00:41:34,233 --> 00:41:37,233
engage with the team, 69% of

1302
00:41:38,104 --> 00:41:39,538
people connected to care, 63%

1303
00:41:39,538 --> 00:41:41,607
started or restarted hiv

1304
00:41:41,607 --> 00:41:43,576
treatment, and then 46% reached

1305
00:41:43,576 --> 00:41:45,345
viral suppression. So part of

1306
00:41:45,345 --> 00:41:46,546
the success of reaching these

1307
00:41:46,546 --> 00:41:47,647
levels of viral suppression,

1308
00:41:47,647 --> 00:41:49,182
which is our end goal for

1309
00:41:49,182 --> 00:41:50,650
people with hiv, especially

1310
00:41:50,650 --> 00:41:52,952
those with the highest needs,

1311
00:41:52,952 --> 00:41:54,853
um, is a direct result of the

1312
00:41:54,853 --> 00:41:57,156
efforts to expand access to

1313
00:41:57,156 --> 00:41:58,624
newer injectable hiv

1314
00:41:58,624 --> 00:41:59,825
medications, both in low

1315
00:41:59,825 --> 00:42:02,225
barrier clinics and also

1316
00:42:02,895 --> 00:42:04,263
through the mobile team. So

1317
00:42:04,263 --> 00:42:05,999
moving to pillar number three,

1318
00:42:05,999 --> 00:42:06,265
which is prevention. We

1319
00:42:06,265 --> 00:42:07,667
ve

1320
00:42:07,667 --> 00:42:10,103
worked to increase access to

1321
00:42:10,103 --> 00:42:12,500
Prep or hiv pre-exposure

1322
00:42:12,500 --> 00:42:13,172
prophylaxis through new low

1323
00:42:13,172 --> 00:42:14,774
barrier sites at community

1324
00:42:14,774 --> 00:42:16,676
health centers, community based

1325
00:42:16,676 --> 00:42:17,544
organizations and public

1326
00:42:17,544 --> 00:42:18,177
health. Seattle King County

1327
00:42:18,177 --> 00:42:19,512
s

1328
00:42:19,512 --> 00:42:20,813
sexual and reproductive health

1329
00:42:20,813 --> 00:42:22,415
clinics that are serving

1330
00:42:22,415 --> 00:42:22,715
communities in South County.

1331
00:42:22,715 --> 00:42:24,715
Um, we

1332
00:42:24,717 --> 00:42:26,385
ve also made headway

1333
00:42:26,385 --> 00:42:28,755
with promoting Prep through our

1334
00:42:28,755 --> 00:42:29,956
e health care collaborative

1335
00:42:29,956 --> 00:42:31,825
that brings together leaders

1336
00:42:31,825 --> 00:42:33,250
and stakeholders within several

1337
00:42:33,250 --> 00:42:34,526
major health systems in the

1338
00:42:34,526 --> 00:42:36,610
community that provide care to

1339
00:42:36,610 --> 00:42:38,198
over half of all adults in the

1340
00:42:38,198 --> 00:42:40,165
county. And then our community

1341
00:42:40,165 --> 00:42:41,467
education team has condom cubes

1342
00:42:41,467 --> 00:42:43,436
that are set up around the

1343
00:42:43,436 --> 00:42:45,138
county, including in some

1344
00:42:45,138 --> 00:42:47,773
access spots for the World Cup.

1345
00:42:47,773 --> 00:42:49,709
And they distributed nearly 1.3

1346
00:42:49,709 --> 00:42:51,644
million external condoms in

1347
00:42:51,644 --> 00:42:52,111
2025. But then I

1348
00:42:52,111 --> 00:42:53,880
d say the

1349
00:42:53,880 --> 00:42:54,981
major innovation in prevention

1350
00:42:54,981 --> 00:42:56,582
is the recent advent of

1351
00:42:56,582 --> 00:42:57,883
injectable Prep. I mean, you

1352
00:42:57,883 --> 00:42:59,786
saw a couple of advertisements

1353
00:42:59,786 --> 00:43:01,554
for those that Boardmember

1354
00:43:01,554 --> 00:43:03,256
showed, um, including an option

1355
00:43:03,256 --> 00:43:05,425
that can be given every two or

1356
00:43:05,425 --> 00:43:06,960
even every six months. And, you

1357
00:43:06,960 --> 00:43:08,610
know, these are exciting. And

1358
00:43:08,610 --> 00:43:10,129
there does seem to be a lot of

1359
00:43:10,129 --> 00:43:11,731
demand for the community for

1360
00:43:11,731 --> 00:43:13,199
these agents, but they are very

1361
00:43:13,199 --> 00:43:13,566
expensive medications. And

1362
00:43:13,566 --> 00:43:14,266
currently we

1363
00:43:14,266 --> 00:43:15,668
re navigating

1364
00:43:15,668 --> 00:43:17,236
financial challenges that are

1365
00:43:17,236 --> 00:43:18,137
associated with the Washington

1366
00:43:18,137 --> 00:43:18,437
State Department of Health

1367
00:43:18,437 --> 00:43:20,437
s

1368
00:43:20,740 --> 00:43:22,107
Prep assistance program. And so

1369
00:43:22,107 --> 00:43:23,877
we, as public health, have

1370
00:43:23,877 --> 00:43:25,378
issued guidance specifically on

1371
00:43:25,378 --> 00:43:27,120
how to prioritize this

1372
00:43:27,120 --> 00:43:28,715
resource. Um, and currently at

1373
00:43:28,715 --> 00:43:30,383
the sexual health clinic, uh,

1374
00:43:30,383 --> 00:43:31,550
we are limiting access to

1375
00:43:31,550 --> 00:43:32,985
populations who have the

1376
00:43:32,985 --> 00:43:34,721
greatest need, but the lowest

1377
00:43:34,721 --> 00:43:36,355
uptake of Prep. So those

1378
00:43:36,355 --> 00:43:37,923
include black and Latino men

1379
00:43:37,923 --> 00:43:39,525
who have sex with men,

1380
00:43:39,525 --> 00:43:41,270
transgender two, spirit and

1381
00:43:41,270 --> 00:43:42,628
other gender diverse people,

1382
00:43:42,628 --> 00:43:43,729
people who use drugs, and then

1383
00:43:43,729 --> 00:43:45,531
others who have not found

1384
00:43:45,531 --> 00:43:47,931
success using standard oral

1385
00:43:48,401 --> 00:43:49,835
prep medications. And then the

1386
00:43:49,835 --> 00:43:51,637
fourth and final pillar is

1387
00:43:51,637 --> 00:43:53,406
respond. This has focused

1388
00:43:53,406 --> 00:43:55,208
primarily on boosting our

1389
00:43:55,208 --> 00:43:57,309
capacity to respond to hiv

1390
00:43:57,309 --> 00:43:58,878
outbreaks. So one of our public

1391
00:43:58,878 --> 00:44:00,212
health epidemiologists

1392
00:44:00,212 --> 00:44:02,810
conducted focus groups with

1393
00:44:02,810 --> 00:44:03,449
community members to learn what

1394
00:44:03,449 --> 00:44:05,510
people know about cluster

1395
00:44:05,510 --> 00:44:06,752
detection and response, and to

1396
00:44:06,752 --> 00:44:06,986
explain how it can benefit the

1397
00:44:06,986 --> 00:44:08,986
public

1398
00:44:09,188 --> 00:44:10,723
s health. Staff capacity

1399
00:44:10,723 --> 00:44:11,824
has expanded to conduct

1400
00:44:11,824 --> 00:44:13,125
outreach to people within

1401
00:44:13,125 --> 00:44:15,394
clusters and get them tested

1402
00:44:15,394 --> 00:44:18,498
for hiv in either link to care

1403
00:44:18,498 --> 00:44:20,320
or to prep for prevention. And

1404
00:44:20,320 --> 00:44:21,434
over the last several years,

1405
00:44:21,434 --> 00:44:23,569
you can see that a significant

1406
00:44:23,569 --> 00:44:25,438
proportion of new diagnoses

1407
00:44:25,438 --> 00:44:27,239
with available genetic

1408
00:44:27,239 --> 00:44:29,141
information were found to be

1409
00:44:29,141 --> 00:44:31,244
linked to clusters like this.

1410
00:44:31,244 --> 00:44:33,879
So when public health can

1411
00:44:33,879 --> 00:44:35,715
identify, um, these clusters

1412
00:44:35,715 --> 00:44:37,349
and using systems that we have

1413
00:44:37,349 --> 00:44:39,685
at hand, we can also sort of

1414
00:44:39,685 --> 00:44:40,954
put in place activities and

1415
00:44:40,954 --> 00:44:43,954
work to intervene to prevent

1416
00:44:45,257 --> 00:44:46,725
new hiv transmission events. So

1417
00:44:46,725 --> 00:44:47,994
transitioning away from hiv.

1418
00:44:47,994 --> 00:44:50,362
Next, I wanted to talk a bit

1419
00:44:50,362 --> 00:44:52,165
about syphilis. Um, so this is

1420
00:44:52,165 --> 00:44:53,499
a type of bacterial sexually

1421
00:44:53,499 --> 00:44:55,568
transmitted infection that I

1422
00:44:55,568 --> 00:44:56,435
think people feel is antiquated

1423
00:44:56,435 --> 00:44:57,270
and maybe isn

1424
00:44:57,270 --> 00:44:58,270
t around anymore,

1425
00:44:58,270 --> 00:44:59,338
but it very much is still

1426
00:44:59,338 --> 00:45:01,740
present and circulating in the

1427
00:45:01,740 --> 00:45:02,175
United States. Um, for many

1428
00:45:02,175 --> 00:45:03,710
years, we were seeing

1429
00:45:03,710 --> 00:45:05,578
consistent increases in

1430
00:45:05,578 --> 00:45:06,946
syphilis cases. But the

1431
00:45:06,946 --> 00:45:09,382
epidemic in King County has

1432
00:45:09,382 --> 00:45:12,382
recently evolved in two main

1433
00:45:12,618 --> 00:45:12,785
ways. So first, since 2023,

1434
00:45:12,785 --> 00:45:14,190
we

1435
00:45:14,190 --> 00:45:15,388
ve seen a decline in

1436
00:45:15,388 --> 00:45:17,423
syphilis cases among all

1437
00:45:17,423 --> 00:45:19,125
populations except for

1438
00:45:19,125 --> 00:45:20,693
congenital syphilis. So

1439
00:45:20,693 --> 00:45:21,728
congenital syphilis is when

1440
00:45:21,728 --> 00:45:22,862
syphilis occurs during

1441
00:45:22,862 --> 00:45:24,497
pregnancy, which can have

1442
00:45:24,497 --> 00:45:25,698
really devastating effects on

1443
00:45:25,698 --> 00:45:27,633
babies, including to their

1444
00:45:27,633 --> 00:45:30,300
bones, internal organs, and can

1445
00:45:30,300 --> 00:45:31,404
even cause stillbirth. So

1446
00:45:31,404 --> 00:45:33,639
congenital syphilis is a major

1447
00:45:33,639 --> 00:45:35,341
health public health issue that

1448
00:45:35,341 --> 00:45:35,508
is completely preventable. So

1449
00:45:35,508 --> 00:45:36,408
we

1450
00:45:36,408 --> 00:45:38,177
ve put a lot of effort

1451
00:45:38,177 --> 00:45:39,979
toward awareness testing and

1452
00:45:39,979 --> 00:45:41,781
treatment. And thankfully, we

1453
00:45:41,781 --> 00:45:43,820
MAY be seeing a little bit of a

1454
00:45:43,820 --> 00:45:44,550
light at the end of the tunnel.

1455
00:45:44,550 --> 00:45:46,118
Um, congenital syphilis cases

1456
00:45:46,118 --> 00:45:48,487
seem to have kind of peaked in

1457
00:45:48,487 --> 00:45:48,854
2024. Um, and maybe coming

1458
00:45:48,854 --> 00:45:49,521
down, but we

1459
00:45:49,521 --> 00:45:51,521
re waiting for

1460
00:45:52,250 --> 00:45:53,560
finalization of those 2025

1461
00:45:53,560 --> 00:45:53,793
numbers. Uh, the second way

1462
00:45:53,793 --> 00:45:54,860
that we

1463
00:45:54,860 --> 00:45:56,328
ve seen the epidemic

1464
00:45:56,328 --> 00:45:56,762
evolve is that we

1465
00:45:56,762 --> 00:45:57,997
re seeing

1466
00:45:57,997 --> 00:45:59,432
increasing proportions of

1467
00:45:59,432 --> 00:46:00,967
people who are diagnosed with

1468
00:46:00,967 --> 00:46:02,368
syphilis, who are living

1469
00:46:02,368 --> 00:46:04,737
homeless and and or using

1470
00:46:04,737 --> 00:46:04,970
substances. And like the trends

1471
00:46:04,970 --> 00:46:05,872
that we

1472
00:46:05,872 --> 00:46:07,873
re seeing with hiv, I

1473
00:46:07,873 --> 00:46:09,375
think almost 70% of new cases

1474
00:46:09,375 --> 00:46:10,643
among people and that our

1475
00:46:10,643 --> 00:46:11,911
public health staff interview

1476
00:46:11,911 --> 00:46:14,514
with syphilis are residents of

1477
00:46:14,514 --> 00:46:16,115
South County. And then the most

1478
00:46:16,115 --> 00:46:17,116
important recent innovation

1479
00:46:17,116 --> 00:46:18,651
within the field of sexual

1480
00:46:18,651 --> 00:46:19,952
health is Doxy Pep, which

1481
00:46:19,952 --> 00:46:21,952
stands for doxycycline

1482
00:46:22,388 --> 00:46:24,388
post-exposure prophylaxis. This

1483
00:46:25,258 --> 00:46:26,558
is the strategy of taking 200mg

1484
00:46:26,558 --> 00:46:28,600
of a common antibiotic,

1485
00:46:28,600 --> 00:46:30,230
doxycycline, after sex, to

1486
00:46:30,230 --> 00:46:31,564
prevent STIs. So multiple

1487
00:46:31,564 --> 00:46:32,564
studies, including a major one

1488
00:46:32,564 --> 00:46:34,334
that was conducted here in

1489
00:46:34,334 --> 00:46:35,968
Seattle, were done in msm and

1490
00:46:35,968 --> 00:46:37,270
transgender women and showed

1491
00:46:37,270 --> 00:46:38,872
that doxy Pep can reduce the

1492
00:46:38,872 --> 00:46:41,540
risk of getting committee on

1493
00:46:41,540 --> 00:46:43,242
syphilis by more than 80%. So

1494
00:46:43,242 --> 00:46:44,444
Doxy Pep is something that an

1495
00:46:44,444 --> 00:46:45,778
individual can do for

1496
00:46:45,778 --> 00:46:46,745
themselves that allows them to

1497
00:46:46,745 --> 00:46:48,948
take control of their own

1498
00:46:48,948 --> 00:46:50,830
sexual health, and based on the

1499
00:46:50,830 --> 00:46:51,784
strong evidence from these

1500
00:46:51,784 --> 00:46:52,885
clinical studies, cdc released

1501
00:46:52,885 --> 00:46:53,453
guidelines that you see they

1502
00:46:53,453 --> 00:46:55,453
re

1503
00:46:57,423 --> 00:46:59,325
endorsing doxy Pep use in 2024.

1504
00:46:59,325 --> 00:47:00,259
And here in Seattle, because we

1505
00:47:00,259 --> 00:47:01,794
were involved in some of the

1506
00:47:01,794 --> 00:47:03,762
initial studies, we were early

1507
00:47:03,762 --> 00:47:06,466
adopters of Doxy Pep, uh, back

1508
00:47:06,466 --> 00:47:07,733
in 2023, even before cdc

1509
00:47:07,733 --> 00:47:09,702
released their guidelines to

1510
00:47:09,702 --> 00:47:10,670
endorse it, we released our own

1511
00:47:10,670 --> 00:47:12,371
for public health, Seattle,

1512
00:47:12,371 --> 00:47:13,506
King County, and we started to

1513
00:47:13,506 --> 00:47:15,906
see increasing numbers of

1514
00:47:16,142 --> 00:47:17,810
people who used it after that.

1515
00:47:17,810 --> 00:47:18,944
Um, given that we sort of know

1516
00:47:18,944 --> 00:47:20,145
that it works very well for

1517
00:47:20,145 --> 00:47:21,580
syphilis, we wanted to study

1518
00:47:21,580 --> 00:47:23,716
what impact, if any, it had on

1519
00:47:23,716 --> 00:47:24,351
syphilis locally. And so these

1520
00:47:24,351 --> 00:47:24,717
are the data that you

1521
00:47:24,717 --> 00:47:26,452
re seeing

1522
00:47:26,452 --> 00:47:27,653
here in the graphs. We used,

1523
00:47:27,653 --> 00:47:29,653
uh, county surveillance

1524
00:47:29,788 --> 00:47:31,991
information. And we found that

1525
00:47:31,991 --> 00:47:34,560
since the rollout began in

1526
00:47:34,560 --> 00:47:36,228
2023, Doxy Pep has really had a

1527
00:47:36,228 --> 00:47:38,970
dramatic impact on syphilis

1528
00:47:38,970 --> 00:47:39,832
diagnoses overall. Um, so

1529
00:47:39,832 --> 00:47:41,334
specifically on the left side,

1530
00:47:41,334 --> 00:47:43,702
you see that, uh, diagnoses

1531
00:47:43,702 --> 00:47:46,305
went down over 50% in cisgender

1532
00:47:46,305 --> 00:47:48,274
men and almost 50% in cisgender

1533
00:47:48,274 --> 00:47:50,142
women. Um, but because numbers

1534
00:47:50,142 --> 00:47:51,344
were so small, we did not see

1535
00:47:51,344 --> 00:47:52,912
this type of change in

1536
00:47:52,912 --> 00:47:54,313
transgender and nonbinary folks

1537
00:47:54,313 --> 00:47:55,915
and other gender diverse

1538
00:47:55,915 --> 00:47:57,717
people. But I think overall,

1539
00:47:57,717 --> 00:47:58,585
this is an exciting, uh,

1540
00:47:58,585 --> 00:47:59,118
finding. And it

1541
00:47:59,118 --> 00:47:59,685
s it

1542
00:47:59,685 --> 00:48:00,787
s nice to

1543
00:48:00,787 --> 00:48:02,870
see that we finally basically

1544
00:48:02,870 --> 00:48:03,222
have a low cost and easy to

1545
00:48:03,222 --> 00:48:04,723
implement intervention that

1546
00:48:04,723 --> 00:48:06,158
seems to to really be changing

1547
00:48:06,158 --> 00:48:09,395
the tides for syphilis in King

1548
00:48:09,395 --> 00:48:09,562
County. So to summarize, we

1549
00:48:09,562 --> 00:48:10,729
ve

1550
00:48:10,729 --> 00:48:12,698
seen tremendous progress in

1551
00:48:12,698 --> 00:48:14,133
reducing hiv diagnoses in King

1552
00:48:14,133 --> 00:48:15,534
County, but we still see groups

1553
00:48:15,534 --> 00:48:17,369
who are disproportionately

1554
00:48:17,369 --> 00:48:18,738
impacted, um, including all of

1555
00:48:18,738 --> 00:48:20,372
the people that you see listed

1556
00:48:20,372 --> 00:48:22,341
there. We have many ongoing

1557
00:48:22,341 --> 00:48:24,176
activities to address the hiv

1558
00:48:24,176 --> 00:48:26,176
epidemic. Overall, syphilis

1559
00:48:26,312 --> 00:48:27,813
rates are decreasing, but cases

1560
00:48:27,813 --> 00:48:30,249
remain high in pregnancy and in

1561
00:48:30,249 --> 00:48:31,384
babies. And Doxy prep, sort of.

1562
00:48:31,384 --> 00:48:32,751
Our newest intervention

1563
00:48:32,751 --> 00:48:33,686
prevents chlamydia and syphilis

1564
00:48:33,686 --> 00:48:35,488
and has contributed to

1565
00:48:35,488 --> 00:48:38,488
declining syphilis cases at the

1566
00:48:38,924 --> 00:48:41,527
population level in King County.

1567
00:48:41,527 --> 00:48:42,161
So in there and again, thanks

1568
00:48:42,161 --> 00:48:42,861
for the time. And we

1569
00:48:42,861 --> 00:48:44,861
ll take

1570
00:48:55,740 --> 00:48:57,343
questions. Let me stop sharing.

1571
00:48:57,343 --> 00:49:00,146
Thank you. Board member Archer,

1572
00:49:00,146 --> 00:49:01,714
Polly and Doctor Cannon. Looks

1573
00:49:01,714 --> 00:49:02,748
like we do have some hands up.

1574
00:49:02,748 --> 00:49:04,317
I think. I

1575
00:49:04,317 --> 00:49:05,952
m not sure who had

1576
00:49:05,952 --> 00:49:09,488
their hand up first, but board

1577
00:49:09,488 --> 00:49:11,357
member foster.

1578
00:49:11,357 --> 00:49:13,192
Thank you so much. Vice Chair

1579
00:49:13,192 --> 00:49:15,295
Daniels. Um, and thank you so

1580
00:49:15,295 --> 00:49:17,396
much to our presenters for that

1581
00:49:17,396 --> 00:49:18,797
fantastic information. Doctor

1582
00:49:18,797 --> 00:49:20,565
Cannon and board member Archie.

1583
00:49:20,565 --> 00:49:21,734
Polly, I really appreciate it

1584
00:49:21,734 --> 00:49:22,968
and I apologize, I did not

1585
00:49:22,968 --> 00:49:24,737
write down the slide number for

1586
00:49:24,737 --> 00:49:26,639
my question, but, um, it was

1587
00:49:26,639 --> 00:49:29,750
during your presentation of the

1588
00:49:29,750 --> 00:49:31,243
decline in hiv rates, and you

1589
00:49:31,243 --> 00:49:33,243
highlighted the ongoing

1590
00:49:33,779 --> 00:49:35,779
disproportionate outcomes for

1591
00:49:35,781 --> 00:49:36,782
black folks. And I was curious

1592
00:49:36,782 --> 00:49:38,782
if, um, we

1593
00:49:39,180 --> 00:49:41,180
re seeing that

1594
00:49:41,420 --> 00:49:42,855
disproportionate, um, number

1595
00:49:42,855 --> 00:49:43,389
change or if that

1596
00:49:43,389 --> 00:49:45,389
s been

1597
00:49:46,225 --> 00:49:47,360
consistent in the decline. So,

1598
00:49:47,360 --> 00:49:48,761
um, can you speak to that a

1599
00:49:48,761 --> 00:49:50,761
little bit?

1600
00:49:51,997 --> 00:49:53,999
Uh, yes. Sure. So, uh, the

1601
00:49:53,999 --> 00:49:54,233
proportion of new diagnoses

1602
00:49:54,233 --> 00:49:54,834
that we

1603
00:49:54,834 --> 00:49:56,535
re seeing in King

1604
00:49:56,535 --> 00:49:58,103
County for black people has

1605
00:49:58,103 --> 00:49:58,971
sort of increased over time.

1606
00:49:58,971 --> 00:50:00,173
Um, but it doesn

1607
00:50:00,173 --> 00:50:00,873
t exactly sort

1608
00:50:00,873 --> 00:50:02,174
of, uh, it

1609
00:50:02,174 --> 00:50:03,375
s not the way that

1610
00:50:03,375 --> 00:50:06,412
it looks, I will say. So it

1611
00:50:06,412 --> 00:50:08,140
ranged from around 30 to 35%

1612
00:50:08,140 --> 00:50:09,582
for the past couple of years,

1613
00:50:09,582 --> 00:50:11,984
after it had been stable for

1614
00:50:11,984 --> 00:50:13,519
about two decades, around 10 to

1615
00:50:13,519 --> 00:50:13,986
20%. But I think the main

1616
00:50:13,986 --> 00:50:14,853
reason that we

1617
00:50:14,853 --> 00:50:16,853
re seeing what

1618
00:50:16,956 --> 00:50:18,824
looks to be like an increase is

1619
00:50:18,824 --> 00:50:20,590
that, uh, the hiv diagnosis

1620
00:50:20,590 --> 00:50:21,494
rate has risen over time,

1621
00:50:21,494 --> 00:50:22,561
primarily in people who are

1622
00:50:22,561 --> 00:50:24,463
black, who are born outside of

1623
00:50:24,463 --> 00:50:24,730
the United States. So that

1624
00:50:24,730 --> 00:50:25,898
s

1625
00:50:25,898 --> 00:50:26,865
partly why public health,

1626
00:50:26,865 --> 00:50:29,769
Seattle, King County, we sort

1627
00:50:29,769 --> 00:50:31,360
of look at new hiv diagnoses,

1628
00:50:31,360 --> 00:50:33,406
uh, by country of birth. So

1629
00:50:33,406 --> 00:50:34,874
when we separate those out, um,

1630
00:50:34,874 --> 00:50:36,800
we see that actually the

1631
00:50:36,800 --> 00:50:37,243
numbers have remained fairly

1632
00:50:37,243 --> 00:50:38,277
stable among people who were

1633
00:50:38,277 --> 00:50:39,812
born in the United States who

1634
00:50:39,812 --> 00:50:41,790
are black. But it is increasing

1635
00:50:41,790 --> 00:50:43,583
among people who were born

1636
00:50:43,583 --> 00:50:44,317
outside the United States. And

1637
00:50:44,317 --> 00:50:44,483
I think, you know, there

1638
00:50:44,483 --> 00:50:45,818
s a

1639
00:50:45,818 --> 00:50:46,986
lot of reasons for that. But I

1640
00:50:46,986 --> 00:50:48,200
think people who immigrate to

1641
00:50:48,200 --> 00:50:50,323
the us MAY not be aware of

1642
00:50:50,323 --> 00:50:52,424
their status. And so a new

1643
00:50:52,424 --> 00:50:52,625
diagnoses when they move here

1644
00:50:52,625 --> 00:50:53,693
doesn

1645
00:50:53,693 --> 00:50:55,528
t necessarily mean that

1646
00:50:55,528 --> 00:50:56,562
they got hiv here. And it MAY

1647
00:50:56,562 --> 00:50:57,162
not represent local

1648
00:50:57,162 --> 00:50:57,596
transmission that

1649
00:50:57,596 --> 00:50:59,596
s happening

1650
00:51:00,660 --> 00:51:01,601
in our area.

1651
00:51:01,601 --> 00:51:02,968
Thank you so much for that. And

1652
00:51:02,968 --> 00:51:03,129
then, um, just to make sure

1653
00:51:03,129 --> 00:51:04,360
I

1654
00:51:04,360 --> 00:51:06,339
ve got this right. So it

1655
00:51:06,339 --> 00:51:07,740
would be uh, based on that, it

1656
00:51:07,740 --> 00:51:10,476
would be, would it be accurate

1657
00:51:10,476 --> 00:51:12,876
to say that the

1658
00:51:13,880 --> 00:51:15,681
disproportionality for us born

1659
00:51:15,681 --> 00:51:17,816
black residents has remained

1660
00:51:17,816 --> 00:51:18,250
fairly consistent over time?

1661
00:51:18,250 --> 00:51:18,851
And then we

1662
00:51:18,851 --> 00:51:20,486
re seeing an

1663
00:51:20,486 --> 00:51:22,388
increase in that overall number

1664
00:51:22,388 --> 00:51:24,290
because it does not represent a

1665
00:51:24,290 --> 00:51:26,626
disaggregation of the data

1666
00:51:26,626 --> 00:51:27,660
based on, um, nationality or

1667
00:51:27,660 --> 00:51:27,860
country of birth.

1668
00:51:27,860 --> 00:51:28,528
That

1669
00:51:28,528 --> 00:51:29,695
s correct.

1670
00:51:29,695 --> 00:51:32,640
Okay. Thank you so much. I

1671
00:51:32,640 --> 00:51:34,640
appreciate that.

1672
00:51:34,266 --> 00:51:36,736
Thank you. Vice Chair foster.

1673
00:51:36,736 --> 00:51:38,237
Uh, I think board member

1674
00:51:38,237 --> 00:51:40,673
Google, did you have your hand

1675
00:51:40,673 --> 00:51:41,240
up next?

1676
00:51:41,240 --> 00:51:42,775
Um, I.

1677
00:51:42,775 --> 00:51:44,110
Was willing to go last. If

1678
00:51:44,110 --> 00:51:45,978
board member Hartfield wants to

1679
00:51:45,978 --> 00:51:47,790
go and ask her question first.

1680
00:51:47,790 --> 00:51:48,614
Okay. Thank you. Baughman,

1681
00:51:48,614 --> 00:51:50,950
board member. Hartfield. You

1682
00:51:50,950 --> 00:51:52,217
have the floor? Sure. Um,

1683
00:51:52,217 --> 00:51:54,617
thanks for that. Really

1684
00:51:56,355 --> 00:51:58,123
informative presentation. Um, I

1685
00:51:58,123 --> 00:52:00,523
have questions about about

1686
00:52:00,859 --> 00:52:02,628
funding. Um, doctor v mentioned

1687
00:52:02,628 --> 00:52:03,762
the Medicaid changes that are

1688
00:52:03,762 --> 00:52:05,198
going to be coming into place.

1689
00:52:05,198 --> 00:52:08,434
And then in your slides, you

1690
00:52:08,434 --> 00:52:11,434
mentioned the, um, doe, um,

1691
00:52:12,705 --> 00:52:14,941
prep dep issue. And I wonder

1692
00:52:14,941 --> 00:52:17,941
what kinds of, um, contingency

1693
00:52:18,844 --> 00:52:20,446
plans are, how these two, um,

1694
00:52:20,446 --> 00:52:22,448
difficult things that are going

1695
00:52:22,448 --> 00:52:24,483
to happen are going to impact

1696
00:52:24,483 --> 00:52:26,819
the patients that we have who

1697
00:52:26,819 --> 00:52:27,190
are on Prep and whether or not

1698
00:52:27,190 --> 00:52:28,820
there

1699
00:52:28,820 --> 00:52:29,955
s something that you all

1700
00:52:29,955 --> 00:52:33,192
are hoping that the Board of

1701
00:52:33,192 --> 00:52:35,694
Health can, can do, so that the

1702
00:52:35,694 --> 00:52:37,129
funding is prioritized toward,

1703
00:52:37,129 --> 00:52:38,230
um, the the highest impact

1704
00:52:38,230 --> 00:52:40,980
interventions, which sounds

1705
00:52:40,980 --> 00:52:43,200
like Prep and oxy prep at the

1706
00:52:43,200 --> 00:52:43,770
Oxy prep at this point.

1707
00:52:43,770 --> 00:52:44,937
Yeah. Thank you. That

1708
00:52:44,937 --> 00:52:46,937
s a big

1709
00:52:47,440 --> 00:52:48,174
concern for our program. Um,

1710
00:52:48,174 --> 00:52:49,108
and it

1711
00:52:49,108 --> 00:52:50,275
s something that we just

1712
00:52:50,275 --> 00:52:51,978
discussed actually this week in

1713
00:52:51,978 --> 00:52:53,178
our policy planning meeting.

1714
00:52:53,178 --> 00:52:53,545
Um, so I think I

1715
00:52:53,545 --> 00:52:53,746
d say we

1716
00:52:53,746 --> 00:52:54,880
re

1717
00:52:54,880 --> 00:52:56,849
actively monitoring the

1718
00:52:56,849 --> 00:52:57,490
situation, but it is, uh,

1719
00:52:57,490 --> 00:52:57,349
there

1720
00:52:57,349 --> 00:52:57,950
s a lot that

1721
00:52:57,950 --> 00:52:58,184
s uncertain.

1722
00:52:58,184 --> 00:52:58,351
And it

1723
00:52:58,351 --> 00:52:59,852
s it

1724
00:52:59,852 --> 00:53:02,252
s tough to know

1725
00:53:02,388 --> 00:53:03,655
this early, uh, yet how, uh,

1726
00:53:03,655 --> 00:53:05,291
this will impact everything.

1727
00:53:05,291 --> 00:53:06,926
What the potential scale of it

1728
00:53:06,926 --> 00:53:07,893
all will be. Um, so, yes, it is

1729
00:53:07,893 --> 00:53:09,610
possible that we come back to

1730
00:53:09,610 --> 00:53:10,696
the Board of health, the county,

1731
00:53:10,696 --> 00:53:11,863
and sort of petition for

1732
00:53:11,863 --> 00:53:13,863
additional financial support.

1733
00:53:14,266 --> 00:53:15,340
But I would say in anticipation

1734
00:53:15,340 --> 00:53:15,334
of all of the cuts, we

1735
00:53:15,334 --> 00:53:17,202
ve done

1736
00:53:17,202 --> 00:53:18,505
a few things. So, um,

1737
00:53:18,505 --> 00:53:20,706
implementing some strategies to

1738
00:53:20,706 --> 00:53:21,874
kind of economize the care and

1739
00:53:21,874 --> 00:53:22,841
sort of making things more

1740
00:53:22,841 --> 00:53:23,900
efficient, uh, what we

1741
00:53:23,900 --> 00:53:25,900
re

1742
00:53:25,278 --> 00:53:26,779
doing. So we want to sustain

1743
00:53:26,779 --> 00:53:28,747
specifically capacity for

1744
00:53:28,747 --> 00:53:29,948
priority services like

1745
00:53:29,948 --> 00:53:31,617
screening and treatment of hiv

1746
00:53:31,617 --> 00:53:32,584
and syphilis, um, uh,

1747
00:53:32,584 --> 00:53:33,920
especially for people who are

1748
00:53:33,920 --> 00:53:36,422
uninsured and really rely on

1749
00:53:36,422 --> 00:53:36,989
our clinics for health care. So

1750
00:53:36,989 --> 00:53:37,689
a few things that we

1751
00:53:37,689 --> 00:53:39,689
ve done,

1752
00:53:39,859 --> 00:53:42,280
decreasing the frequency of

1753
00:53:42,280 --> 00:53:43,462
visits for Prep monitoring so

1754
00:53:43,462 --> 00:53:44,963
we can expand capacity for the

1755
00:53:44,963 --> 00:53:46,331
number of people we can see.

1756
00:53:46,331 --> 00:53:47,600
And then also removing the

1757
00:53:47,600 --> 00:53:48,934
recommendation for frequent

1758
00:53:48,934 --> 00:53:50,703
Gonorrhea and chlamydia testing

1759
00:53:50,703 --> 00:53:52,972
specifically for msm, because

1760
00:53:52,972 --> 00:53:54,407
that is actually the major

1761
00:53:54,407 --> 00:53:55,808
proportion of all the total

1762
00:53:55,808 --> 00:53:56,976
expenditures that the state is

1763
00:53:56,976 --> 00:53:57,976
spending on this Prep drug

1764
00:53:57,976 --> 00:53:58,142
assistance program. So we

1765
00:53:58,142 --> 00:54:00,142
re

1766
00:54:00,145 --> 00:54:01,313
trying to decrease those costs.

1767
00:54:01,313 --> 00:54:02,447
Um, and then, you know, like

1768
00:54:02,447 --> 00:54:03,949
you said, we also anticipate

1769
00:54:03,949 --> 00:54:05,830
people might lose coverage for

1770
00:54:05,830 --> 00:54:05,417
their insurance. And so we

1771
00:54:05,417 --> 00:54:06,385
re

1772
00:54:06,385 --> 00:54:08,321
training more staff to be

1773
00:54:08,321 --> 00:54:10,721
certified to be health

1774
00:54:10,890 --> 00:54:12,910
insurance navigators. Um, and

1775
00:54:12,910 --> 00:54:13,392
working with our Ryan White

1776
00:54:13,392 --> 00:54:14,460
program, also to make sure that

1777
00:54:14,460 --> 00:54:16,295
we have adequate case

1778
00:54:16,295 --> 00:54:17,396
management for people with hiv

1779
00:54:17,396 --> 00:54:18,431
and seeing if we can kind of

1780
00:54:18,431 --> 00:54:19,980
shift funds around to

1781
00:54:19,980 --> 00:54:20,990
contribute to people

1782
00:54:20,990 --> 00:54:20,466
s premiums

1783
00:54:20,466 --> 00:54:21,867
if they can

1784
00:54:21,867 --> 00:54:22,468
t afford them. So a

1785
00:54:22,468 --> 00:54:22,835
few things that we

1786
00:54:22,835 --> 00:54:24,203
re kind of

1787
00:54:24,203 --> 00:54:24,937
considering. But yeah, it

1788
00:54:24,937 --> 00:54:25,104
s

1789
00:54:25,104 --> 00:54:27,104
it

1790
00:54:27,139 --> 00:54:27,306
s going to be an issue and

1791
00:54:27,306 --> 00:54:28,841
we

1792
00:54:28,841 --> 00:54:29,241
ll see.

1793
00:54:29,241 --> 00:54:30,842
Yeah.

1794
00:54:30,842 --> 00:54:33,212
And one other one other thing

1795
00:54:33,212 --> 00:54:34,646
to add to that is, um, I was

1796
00:54:34,646 --> 00:54:36,815
really excited to see the

1797
00:54:36,815 --> 00:54:38,618
continued success of the mobile

1798
00:54:38,618 --> 00:54:40,753
outreach team. That really

1799
00:54:40,753 --> 00:54:43,153
looks amazing. Actually, the

1800
00:54:43,989 --> 00:54:46,389
28% viral suppression in that

1801
00:54:46,792 --> 00:54:49,395
population. Um, that funding is

1802
00:54:49,395 --> 00:54:49,695
federal, which is also shaky,

1803
00:54:49,695 --> 00:54:50,362
which hasn

1804
00:54:50,362 --> 00:54:52,362
t really been

1805
00:54:52,431 --> 00:54:53,732
mentioned. Is there a chance

1806
00:54:53,732 --> 00:54:55,501
that that could be funded

1807
00:54:55,501 --> 00:54:57,901
through, say, another source

1808
00:54:58,838 --> 00:55:00,105
like Ryan White or another, uh,

1809
00:55:00,105 --> 00:55:01,600
because that that it looks it

1810
00:55:01,600 --> 00:55:02,775
looks like what you want to do

1811
00:55:02,775 --> 00:55:04,877
is prioritize the funding for

1812
00:55:04,877 --> 00:55:06,440
the highest impact

1813
00:55:06,440 --> 00:55:06,411
interventions.

1814
00:55:06,411 --> 00:55:07,546
Yeah. That

1815
00:55:07,546 --> 00:55:09,949
s correct. I mean, I

1816
00:55:09,949 --> 00:55:11,160
think at this moment, uh, it

1817
00:55:11,160 --> 00:55:12,417
looks like, you know, funding

1818
00:55:12,417 --> 00:55:13,819
is either sort of level or

1819
00:55:13,819 --> 00:55:15,888
hopefully will stay that way

1820
00:55:15,888 --> 00:55:16,221
for e. Um, and so you

1821
00:55:16,221 --> 00:55:16,521
re right,

1822
00:55:16,521 --> 00:55:17,857
I think we

1823
00:55:17,857 --> 00:55:19,920
re trying to

1824
00:55:19,920 --> 00:55:20,325
prioritize the things that we

1825
00:55:20,325 --> 00:55:21,793
think have the highest impact.

1826
00:55:21,793 --> 00:55:23,662
And so we hope to be able to

1827
00:55:23,662 --> 00:55:24,697
preserve that. Um, and Max

1828
00:55:24,697 --> 00:55:26,698
clinic, I think those are sort

1829
00:55:26,698 --> 00:55:27,933
of two of our big, uh, programs

1830
00:55:27,933 --> 00:55:29,701
that we think are having the

1831
00:55:29,701 --> 00:55:32,701
greatest impact. So, yeah, we

1832
00:55:34,373 --> 00:55:36,208
will see.

1833
00:55:36,208 --> 00:55:38,608
Thank you. Board member

1834
00:55:38,744 --> 00:55:41,113
Hartville. Um, and thank you.

1835
00:55:41,113 --> 00:55:42,815
Cannon on, uh, doctor cannon on

1836
00:55:42,815 --> 00:55:44,450
that, uh, candid discussion

1837
00:55:44,450 --> 00:55:48,500
regarding H.R. One and its

1838
00:55:48,287 --> 00:55:51,230
impact. Um, on, um, Medicaid

1839
00:55:51,230 --> 00:55:53,759
population. So, um, it is

1840
00:55:53,759 --> 00:55:55,894
something that, um, uh, that is

1841
00:55:55,894 --> 00:55:58,290
of public health concern, um,

1842
00:55:58,290 --> 00:56:00,699
in King County. So thank you so

1843
00:56:00,699 --> 00:56:02,835
much. Okay. So next we will

1844
00:56:02,835 --> 00:56:04,270
have doctor. We will have board

1845
00:56:04,270 --> 00:56:06,380
member, board member.

1846
00:56:06,380 --> 00:56:07,839
Hartfield, your hand is still

1847
00:56:07,839 --> 00:56:09,608
up. Where you working? Okay.

1848
00:56:09,608 --> 00:56:10,876
Board member. Gojo, thank you

1849
00:56:10,876 --> 00:56:12,511
for your patience. Please. You

1850
00:56:12,511 --> 00:56:14,511
have the floor.

1851
00:56:15,147 --> 00:56:17,383
Hi. Thank you. Board member and

1852
00:56:17,383 --> 00:56:20,383
chair Daniels and board member.

1853
00:56:20,485 --> 00:56:23,355
Archer and doctor Cannon. Um,

1854
00:56:23,355 --> 00:56:26,558
I, uh, I work in South King

1855
00:56:26,558 --> 00:56:29,261
County. Uh, and my primary

1856
00:56:29,261 --> 00:56:31,297
populations, um, that my

1857
00:56:31,297 --> 00:56:33,566
programs serve are our youth

1858
00:56:33,566 --> 00:56:34,300
and people who are unhoused.

1859
00:56:34,300 --> 00:56:36,300
And I

1860
00:56:36,635 --> 00:56:38,804
d like to know what, um,

1861
00:56:38,804 --> 00:56:40,839
what those efforts are that are

1862
00:56:40,839 --> 00:56:42,542
being directed to decrease the

1863
00:56:42,542 --> 00:56:44,760
number of people who are

1864
00:56:44,760 --> 00:56:45,644
pregnant with syphilis and

1865
00:56:45,644 --> 00:56:47,479
people who are, on, uh, excuse

1866
00:56:47,479 --> 00:56:49,879
me. And congenital syphilis

1867
00:56:50,160 --> 00:56:51,884
cases.

1868
00:56:51,884 --> 00:56:53,919
Uh, yeah. Thank you for that

1869
00:56:53,919 --> 00:56:56,319
question. Is absolutely an

1870
00:56:56,488 --> 00:56:57,189
important, um, public health

1871
00:56:57,189 --> 00:56:57,956
crisis that we

1872
00:56:57,956 --> 00:56:59,910
re in. Uh,

1873
00:56:59,910 --> 00:57:00,525
because this is completely

1874
00:57:00,525 --> 00:57:02,600
preventable. So I think public

1875
00:57:02,600 --> 00:57:03,496
health is doing several things,

1876
00:57:03,496 --> 00:57:04,530
uh, trying to, of course,

1877
00:57:04,530 --> 00:57:05,300
increase awareness about

1878
00:57:05,300 --> 00:57:05,397
syphilis. There

1879
00:57:05,397 --> 00:57:05,831
s still a lot

1880
00:57:05,831 --> 00:57:06,265
of people who don

1881
00:57:06,265 --> 00:57:07,766
t know what

1882
00:57:07,766 --> 00:57:10,503
it is, um, you know, young

1883
00:57:10,503 --> 00:57:12,904
people and others, uh, doing

1884
00:57:12,904 --> 00:57:13,239
testing in multiple locations.

1885
00:57:13,239 --> 00:57:13,906
You know, we

1886
00:57:13,906 --> 00:57:15,574
ve done testing

1887
00:57:15,574 --> 00:57:17,843
and sort of libraries and data

1888
00:57:17,843 --> 00:57:20,110
centers in South County. Um,

1889
00:57:20,110 --> 00:57:22,949
and, and, uh, score, which is

1890
00:57:22,949 --> 00:57:23,983
one of the, the jails, um, and

1891
00:57:23,983 --> 00:57:25,484
have had good success with

1892
00:57:25,484 --> 00:57:27,586
that, actually. And we can

1893
00:57:27,586 --> 00:57:28,253
initiate people treating in

1894
00:57:28,253 --> 00:57:29,210
jail before they

1895
00:57:29,210 --> 00:57:29,622
re released

1896
00:57:29,622 --> 00:57:30,220
that way when they

1897
00:57:30,220 --> 00:57:30,222
re out,

1898
00:57:30,222 --> 00:57:31,757
they

1899
00:57:31,757 --> 00:57:33,559
re already sort of treated

1900
00:57:33,559 --> 00:57:35,328
and not having to worry about

1901
00:57:35,328 --> 00:57:36,461
transmission. Um, and then

1902
00:57:36,461 --> 00:57:37,229
specifically for people with

1903
00:57:37,229 --> 00:57:37,530
pregnancy, I think that

1904
00:57:37,530 --> 00:57:39,331
s a

1905
00:57:39,331 --> 00:57:40,466
sort of challenging population,

1906
00:57:40,466 --> 00:57:40,632
because increasingly we

1907
00:57:40,632 --> 00:57:42,167
re

1908
00:57:42,167 --> 00:57:43,969
seeing more that they are

1909
00:57:43,969 --> 00:57:45,971
unhoused and or, uh, you know,

1910
00:57:45,971 --> 00:57:48,340
having substance use, uh, sort

1911
00:57:48,340 --> 00:57:50,476
of mixed into the picture. So,

1912
00:57:50,476 --> 00:57:52,378
um, you know, we have a team

1913
00:57:52,378 --> 00:57:54,747
that focuses specifically on

1914
00:57:54,747 --> 00:57:54,913
this, this population. Um, and

1915
00:57:54,913 --> 00:57:55,815
we

1916
00:57:55,815 --> 00:57:57,717
re able to kind of support

1917
00:57:57,717 --> 00:57:58,583
them to get treated, uh, you

1918
00:57:58,583 --> 00:58:00,185
know, using a number of

1919
00:58:00,185 --> 00:58:01,320
different strategies, uh, you

1920
00:58:01,320 --> 00:58:02,588
know, incentives and sort of

1921
00:58:02,588 --> 00:58:02,888
finding them a place to stay

1922
00:58:02,888 --> 00:58:03,689
while they

1923
00:58:03,689 --> 00:58:05,757
re being treated so

1924
00:58:05,757 --> 00:58:05,925
that we can locate them. Um, so

1925
00:58:05,925 --> 00:58:07,525
it

1926
00:58:07,525 --> 00:58:08,160
s the sort of multi-pronged

1927
00:58:08,160 --> 00:58:09,127
approach, and I

1928
00:58:09,127 --> 00:58:10,463
m happy to give

1929
00:58:10,463 --> 00:58:11,730
you additional information if

1930
00:58:11,730 --> 00:58:12,864
you would like, uh, can maybe

1931
00:58:12,864 --> 00:58:13,866
send it to you after the

1932
00:58:13,866 --> 00:58:14,230
meeting.

1933
00:58:14,230 --> 00:58:15,668
I

1934
00:58:15,668 --> 00:58:18,668
d appreciate that. That would

1935
00:58:19,438 --> 00:58:20,390
be great. Um, and, um, part of

1936
00:58:20,390 --> 00:58:20,739
the thing that I

1937
00:58:20,739 --> 00:58:22,739
m thinking

1938
00:58:23,750 --> 00:58:25,778
about is that some of the

1939
00:58:25,778 --> 00:58:28,778
testing and data centers and

1940
00:58:30,480 --> 00:58:33,480
libraries, um, has been, has

1941
00:58:33,351 --> 00:58:35,751
been diminishing, um, because

1942
00:58:35,955 --> 00:58:37,990
the, the organizations that

1943
00:58:37,990 --> 00:58:39,892
actually engaged people at

1944
00:58:39,892 --> 00:58:41,993
those locations have pulled

1945
00:58:41,993 --> 00:58:42,161
back from them. Um, and I

1946
00:58:42,161 --> 00:58:44,161
m

1947
00:58:44,229 --> 00:58:47,366
also I was really hoping to see

1948
00:58:47,366 --> 00:58:49,167
data from the clinics in South

1949
00:58:49,167 --> 00:58:50,936
County at the Federal Data

1950
00:58:50,936 --> 00:58:53,338
Center and the Kent Engagement

1951
00:58:53,338 --> 00:58:55,474
Center, and those numbers were

1952
00:58:55,474 --> 00:58:58,474
not included in your report.

1953
00:58:59,244 --> 00:59:01,480
And also, just to add to the

1954
00:59:01,480 --> 00:59:03,549
concern, as far as the health

1955
00:59:03,549 --> 00:59:06,549
of the population goes, though,

1956
00:59:07,486 --> 00:59:09,886
that funding was, um,

1957
00:59:10,189 --> 00:59:12,589
eliminated from the University

1958
00:59:12,892 --> 00:59:15,892
of Washington at least, and,

1959
00:59:16,629 --> 00:59:19,300
um, so could you just speak to

1960
00:59:19,300 --> 00:59:22,300
that whole that whole, um,

1961
00:59:22,434 --> 00:59:25,434
issue of providing low barrier

1962
00:59:26,805 --> 00:59:29,408
access to hiv diagnosis and

1963
00:59:29,408 --> 00:59:31,143
treatment in South King County?

1964
00:59:31,143 --> 00:59:32,344
Yes. Yeah. That is, uh, I

1965
00:59:32,344 --> 00:59:33,812
totally agree with you. And I

1966
00:59:33,812 --> 00:59:36,782
think this is a priority for

1967
00:59:36,782 --> 00:59:37,783
our program to support services

1968
00:59:37,783 --> 00:59:37,950
in South County. So we

1969
00:59:37,950 --> 00:59:39,552
re

1970
00:59:39,552 --> 00:59:40,653
working with a few community

1971
00:59:40,653 --> 00:59:42,653
health centers and

1972
00:59:42,755 --> 00:59:45,124
organizations to try to, uh,

1973
00:59:45,124 --> 00:59:47,920
boost their capacity for doing

1974
00:59:47,920 --> 00:59:50,162
more sort of low barrier care.

1975
00:59:50,162 --> 00:59:51,330
Um, as you alluded to, in the

1976
00:59:51,330 --> 00:59:52,898
wake of sort of loss of a

1977
00:59:52,898 --> 00:59:55,167
couple of centers that we had

1978
00:59:55,167 --> 00:59:56,635
there, um, specifically about

1979
00:59:56,635 --> 00:59:58,700
the engaged clinics. I can

1980
00:59:58,700 --> 00:59:59,372
follow up with you again after

1981
00:59:59,372 --> 01:00:01,306
the meeting to give you some of

1982
01:00:01,306 --> 01:00:03,742
the sort of details about that.

1983
01:00:03,742 --> 01:00:05,311
Um, but yeah, I think we are

1984
01:00:05,311 --> 01:00:07,580
actively focusing on boosting

1985
01:00:07,580 --> 01:00:07,779
our capacity there. Um, I think

1986
01:00:07,779 --> 01:00:08,748
that

1987
01:00:08,748 --> 01:00:11,170
s sort of the next big

1988
01:00:11,170 --> 01:00:11,917
priority for our program. Uh,

1989
01:00:11,917 --> 01:00:12,217
we I do agree it

1990
01:00:12,217 --> 01:00:12,485
s a it

1991
01:00:12,485 --> 01:00:14,485
s a

1992
01:00:15,520 --> 01:00:17,356
major issue that we are facing.

1993
01:00:17,356 --> 01:00:19,892
And just one one final

1994
01:00:19,892 --> 01:00:22,610
question. Why why is it not

1995
01:00:22,610 --> 01:00:23,462
currently a priority of the

1996
01:00:23,462 --> 01:00:25,231
program?

1997
01:00:25,231 --> 01:00:27,231
Uh, which.

1998
01:00:29,635 --> 01:00:31,938
The, um, uh, additional access

1999
01:00:31,938 --> 01:00:32,871
to testing and treatment in

2000
01:00:32,871 --> 01:00:34,871
South King County?

2001
01:00:35,107 --> 01:00:35,641
Oh, it is it is a priority. Uh,

2002
01:00:35,641 --> 01:00:36,410
maybe. I don

2003
01:00:36,410 --> 01:00:37,843
t know if I

2004
01:00:37,843 --> 01:00:39,445
misspoke, but, uh, yes, that is

2005
01:00:39,445 --> 01:00:40,846
a major priority for us to to

2006
01:00:40,846 --> 01:00:43,846
increase capacity for that in

2007
01:00:44,317 --> 01:00:46,218
South County. Yeah.

2008
01:00:46,218 --> 01:00:47,586
I look forward to connecting

2009
01:00:47,586 --> 01:00:49,210
with you after the meeting. And

2010
01:00:49,210 --> 01:00:52,210
thank you again for your

2011
01:00:52,624 --> 01:00:54,624
presentation.

2012
01:00:55,327 --> 01:00:58,927
Thank you so much. Board member

2013
01:01:00,565 --> 01:01:00,783
Archer Lee, doctor Cannon and I

2014
01:01:00,783 --> 01:01:02,201
don

2015
01:01:02,201 --> 01:01:02,468
t see any other I don

2016
01:01:02,468 --> 01:01:04,169
t see

2017
01:01:04,169 --> 01:01:06,569
any additional questions or

2018
01:01:06,638 --> 01:01:09,341
comments. Okay. All right. This

2019
01:01:09,341 --> 01:01:12,177
brings us to item number ten on

2020
01:01:12,177 --> 01:01:14,113
the agenda. And update on

2021
01:01:14,113 --> 01:01:15,214
findings and recommendations

2022
01:01:15,214 --> 01:01:15,647
from the from Washington

2023
01:01:15,647 --> 01:01:17,482
s

2024
01:01:17,482 --> 01:01:19,882
Maternal Mortality Review Panel

2025
01:01:20,219 --> 01:01:21,920
report. And this was an item

2026
01:01:21,920 --> 01:01:24,122
that I suggested on the agenda.

2027
01:01:24,122 --> 01:01:26,859
And while chair mosquito who

2028
01:01:26,859 --> 01:01:28,994
can be here today. Um, uh, she

2029
01:01:28,994 --> 01:01:31,394
did express support for

2030
01:01:31,663 --> 01:01:33,131
continuing this conversation

2031
01:01:33,131 --> 01:01:35,868
and the slides for this agenda

2032
01:01:35,868 --> 01:01:36,635
item will begin on page 31, I

2033
01:01:36,635 --> 01:01:39,350
believe, for the meeting

2034
01:01:39,271 --> 01:01:41,473
packet, our presenters will be

2035
01:01:41,473 --> 01:01:43,175
using a slightly shorter, um,

2036
01:01:43,175 --> 01:01:45,577
deck to keep us on schedule.

2037
01:01:45,577 --> 01:01:47,780
Today we are joined by Deborah

2038
01:01:47,780 --> 01:01:49,214
Gardner and Anne McCue.

2039
01:01:49,214 --> 01:01:50,816
Maternal Mortality Review

2040
01:01:50,816 --> 01:01:52,751
coordinators for the Washington

2041
01:01:52,751 --> 01:01:55,187
State Department of Health. Um,

2042
01:01:55,187 --> 01:01:57,422
I will kick us off and then I

2043
01:01:57,422 --> 01:02:01,220
will turn it over to Deborah

2044
01:02:02,495 --> 01:02:04,730
and Anne and, um, so before we

2045
01:02:04,730 --> 01:02:07,650
begin, I really want to ask

2046
01:02:07,650 --> 01:02:08,567
this board to, to to do

2047
01:02:08,567 --> 01:02:11,137
something with me. I really

2048
01:02:11,137 --> 01:02:12,671
want us to to pause for a

2049
01:02:12,671 --> 01:02:13,272
second. Um, what we

2050
01:02:13,272 --> 01:02:14,730
re about to

2051
01:02:14,730 --> 01:02:16,730
hear isn

2052
01:02:16,408 --> 01:02:16,608
t easy. Um, and we

2053
01:02:16,608 --> 01:02:17,276
re

2054
01:02:17,276 --> 01:02:18,143
going to, we

2055
01:02:18,143 --> 01:02:20,112
re going to talk

2056
01:02:20,112 --> 01:02:21,780
about rates and numbers and

2057
01:02:21,780 --> 01:02:22,814
recommendations, but I

2058
01:02:22,814 --> 01:02:24,820
ve spent

2059
01:02:24,820 --> 01:02:24,516
more than two decades as a

2060
01:02:24,516 --> 01:02:25,351
nurse in women

2061
01:02:25,351 --> 01:02:27,352
s health. And I

2062
01:02:27,352 --> 01:02:29,388
can tell you behind every

2063
01:02:29,388 --> 01:02:32,240
number in this report is a

2064
01:02:32,240 --> 01:02:34,159
person, a birthing person,

2065
01:02:34,159 --> 01:02:35,927
someone who cared. Hope,

2066
01:02:35,927 --> 01:02:38,196
someone who wanted to build a

2067
01:02:38,196 --> 01:02:39,698
life, raise a child and

2068
01:02:39,698 --> 01:02:42,980
contribute to this community.

2069
01:02:43,869 --> 01:02:45,670
We all serve the they were not

2070
01:02:45,670 --> 01:02:45,905
strangers. Each one was

2071
01:02:45,905 --> 01:02:47,272
someone

2072
01:02:47,272 --> 01:02:47,839
s child, someone

2073
01:02:47,839 --> 01:02:48,707
s

2074
01:02:48,707 --> 01:02:50,376
partner, someone

2075
01:02:50,376 --> 01:02:52,344
s best friend.

2076
01:02:52,344 --> 01:02:54,680
Each one was our neighbor. Each

2077
01:02:54,680 --> 01:02:57,680
one was a Washingtonian, and

2078
01:02:58,250 --> 01:02:59,752
each one was ours. So before we

2079
01:02:59,752 --> 01:03:00,218
move on into the data, I

2080
01:03:00,218 --> 01:03:02,154
m

2081
01:03:02,154 --> 01:03:04,756
asking us to hold that truth in

2082
01:03:04,756 --> 01:03:06,591
this room. Please let it

2083
01:03:06,591 --> 01:03:09,280
matter, because the way we

2084
01:03:09,280 --> 01:03:10,796
honor their lives is simple. We

2085
01:03:10,796 --> 01:03:12,931
listen closely, and then we

2086
01:03:12,931 --> 01:03:13,966
act. Always say helping others

2087
01:03:13,966 --> 01:03:15,567
heals us. Let

2088
01:03:15,567 --> 01:03:17,967
s let that guide

2089
01:03:19,872 --> 01:03:21,940
us in how we listen. Today, Deb

2090
01:03:21,940 --> 01:03:23,441
and you have the floor. Please

2091
01:03:23,441 --> 01:03:24,576
take it away.

2092
01:03:24,576 --> 01:03:26,379
Thank you so much, Chair

2093
01:03:26,379 --> 01:03:28,646
Daniels. I really appreciate,

2094
01:03:28,646 --> 01:03:30,315
uh, taking that moment in our

2095
01:03:30,315 --> 01:03:32,351
review of maternal deaths. We

2096
01:03:32,351 --> 01:03:32,551
always have an acknowledgement

2097
01:03:32,551 --> 01:03:34,860
that

2098
01:03:34,860 --> 01:03:36,321
s similar at the beginning

2099
01:03:36,321 --> 01:03:36,655
of our review meetings. So I

2100
01:03:36,655 --> 01:03:38,156
m

2101
01:03:38,156 --> 01:03:39,691
going to talk today and my

2102
01:03:39,691 --> 01:03:41,691
colleague, my epidemiologist

2103
01:03:41,694 --> 01:03:42,761
colleague Annie McCue, is also

2104
01:03:42,761 --> 01:03:43,662
available especially for

2105
01:03:43,662 --> 01:03:43,821
answering any questions. I

2106
01:03:43,821 --> 01:03:45,431
m

2107
01:03:45,431 --> 01:03:45,582
going to go through our slides.

2108
01:03:45,582 --> 01:03:46,198
I

2109
01:03:46,198 --> 01:03:47,399
m going to give you some

2110
01:03:47,399 --> 01:03:49,267
background about the Maternal

2111
01:03:49,267 --> 01:03:50,602
Mortality Review panel, and

2112
01:03:50,602 --> 01:03:52,704
then talk about findings and

2113
01:03:52,704 --> 01:03:53,973
then recommendations from the

2114
01:03:53,973 --> 01:03:56,373
new Maternal Mortality Review

2115
01:03:57,420 --> 01:03:59,411
Panel report. So some overview

2116
01:03:59,411 --> 01:04:00,780
and background, uh, Washington

2117
01:04:00,780 --> 01:04:02,130
state has a maternal mortality

2118
01:04:02,130 --> 01:04:03,649
review panel that was

2119
01:04:03,649 --> 01:04:06,490
established by the legislature

2120
01:04:06,786 --> 01:04:08,220
in 2016. And then in 2019, the

2121
01:04:08,220 --> 01:04:09,621
law was amended to make the

2122
01:04:09,621 --> 01:04:11,823
panel permanent and add some

2123
01:04:11,823 --> 01:04:13,893
details to it. It directs the

2124
01:04:13,893 --> 01:04:15,294
mmp to conduct comprehensive

2125
01:04:15,294 --> 01:04:16,462
reviews of every death of a

2126
01:04:16,462 --> 01:04:18,263
Washington resident that

2127
01:04:18,263 --> 01:04:19,331
happened in pregnancy through

2128
01:04:19,331 --> 01:04:21,660
one year after the end of

2129
01:04:21,660 --> 01:04:22,801
pregnancy, and then to present

2130
01:04:22,801 --> 01:04:24,370
a legislative report of every

2131
01:04:24,370 --> 01:04:25,671
three years. It also enables

2132
01:04:25,671 --> 01:04:27,720
Doe to do things like access

2133
01:04:27,720 --> 01:04:28,607
the kind of records they need

2134
01:04:28,607 --> 01:04:31,509
to set the panel up to review

2135
01:04:31,509 --> 01:04:33,212
these cases. Uh, as I said, the

2136
01:04:33,212 --> 01:04:34,246
mmp is housed at the Department

2137
01:04:34,246 --> 01:04:35,481
of Health in our state, the

2138
01:04:35,481 --> 01:04:36,982
Washington State Department of

2139
01:04:36,982 --> 01:04:38,316
Health. We are by far the

2140
01:04:38,316 --> 01:04:40,453
largest committee or panel of

2141
01:04:40,453 --> 01:04:41,820
this kind in the country. We

2142
01:04:41,820 --> 01:04:43,322
had 80 members or so in the

2143
01:04:43,322 --> 01:04:45,958
last term and just about 100

2144
01:04:45,958 --> 01:04:47,692
right now, about 35 to 50 at

2145
01:04:47,692 --> 01:04:49,594
each review meeting. And an

2146
01:04:49,594 --> 01:04:51,230
incredible breadth of clinical

2147
01:04:51,230 --> 01:04:52,731
and non-clinical expertise and

2148
01:04:52,731 --> 01:04:53,999
backgrounds, including a strong

2149
01:04:53,999 --> 01:04:55,340
priority focus on American

2150
01:04:55,340 --> 01:04:56,735
Indian and Alaska Native

2151
01:04:56,735 --> 01:04:58,103
communities. And I mentioned

2152
01:04:58,103 --> 01:04:59,572
that breadth. This is a word

2153
01:04:59,572 --> 01:05:01,139
cloud that is just a glimpse

2154
01:05:01,139 --> 01:05:02,107
into some of the expertise

2155
01:05:02,107 --> 01:05:04,750
areas, everything from

2156
01:05:04,750 --> 01:05:05,610
indigenous lactation counseling

2157
01:05:05,610 --> 01:05:06,945
to maternal fetal medicine to

2158
01:05:06,945 --> 01:05:08,514
substance use disorder, to

2159
01:05:08,514 --> 01:05:08,680
lived experience and more.

2160
01:05:08,680 --> 01:05:10,680
We

2161
01:05:11,116 --> 01:05:13,385
re very lucky in Washington,

2162
01:05:13,385 --> 01:05:15,287
so our process at the state

2163
01:05:15,287 --> 01:05:17,622
level, Doe identifies and

2164
01:05:17,622 --> 01:05:19,692
confirms deaths. Doe requests,

2165
01:05:19,692 --> 01:05:21,292
medical and other records, and

2166
01:05:21,292 --> 01:05:23,228
then writes a de-identified

2167
01:05:23,228 --> 01:05:24,597
summary for the panel to use.

2168
01:05:24,597 --> 01:05:25,597
The panel meets to review

2169
01:05:25,597 --> 01:05:25,781
deaths in a process that I

2170
01:05:25,781 --> 01:05:27,320
ll

2171
01:05:27,320 --> 01:05:29,401
talk about in a moment and make

2172
01:05:29,401 --> 01:05:30,836
recommendations for prevention.

2173
01:05:30,836 --> 01:05:32,505
And then every three years, as

2174
01:05:32,505 --> 01:05:34,172
we prepare for these reports,

2175
01:05:34,172 --> 01:05:35,741
and the mmr and Doe work to

2176
01:05:35,741 --> 01:05:36,675
consolidate, narrow down,

2177
01:05:36,675 --> 01:05:38,510
prioritize those

2178
01:05:38,510 --> 01:05:40,679
recommendations for the report,

2179
01:05:40,679 --> 01:05:42,814
compile them with data and have

2180
01:05:42,814 --> 01:05:44,115
what we are presenting today. I

2181
01:05:44,115 --> 01:05:46,510
want to go over just a couple

2182
01:05:46,510 --> 01:05:47,386
of definitions that will give

2183
01:05:47,386 --> 01:05:47,845
context to the data. I

2184
01:05:47,845 --> 01:05:49,655
m going

2185
01:05:49,655 --> 01:05:51,190
to talk about. We talk about

2186
01:05:51,190 --> 01:05:51,457
pregnancy associated deaths.

2187
01:05:51,457 --> 01:05:52,357
And that

2188
01:05:52,357 --> 01:05:54,259
s just literally a

2189
01:05:54,259 --> 01:05:55,494
term about timing. That is any

2190
01:05:55,494 --> 01:05:57,960
death from any cause

2191
01:05:57,960 --> 01:05:58,597
whatsoever, pregnancy related

2192
01:05:58,597 --> 01:06:00,320
or not, that happened to take

2193
01:06:00,320 --> 01:06:02,680
place during pregnancy through

2194
01:06:02,680 --> 01:06:03,635
one year. After some of those

2195
01:06:03,635 --> 01:06:05,300
pregnancy associated deaths are

2196
01:06:05,300 --> 01:06:06,204
pregnancy related, they were

2197
01:06:06,204 --> 01:06:07,772
caused or worsened by

2198
01:06:07,772 --> 01:06:08,573
pregnancy. And this is, you

2199
01:06:08,573 --> 01:06:09,842
know, the kind of things that

2200
01:06:09,842 --> 01:06:11,543
could immediately come to mind,

2201
01:06:11,543 --> 01:06:13,440
like a pregnancy complication

2202
01:06:13,440 --> 01:06:15,481
or chain of events that

2203
01:06:15,481 --> 01:06:17,282
pregnancy initiated. But it can

2204
01:06:17,282 --> 01:06:18,750
even be an unrelated condition

2205
01:06:18,750 --> 01:06:20,252
that was aggravated by some

2206
01:06:20,252 --> 01:06:22,870
aspect of pregnancy, birth,

2207
01:06:22,870 --> 01:06:23,889
postpartum. And some of the

2208
01:06:23,889 --> 01:06:24,956
docs are not pregnancy related.

2209
01:06:24,956 --> 01:06:26,592
Cause a no connection to

2210
01:06:26,592 --> 01:06:26,791
pregnancy, and occasionally

2211
01:06:26,791 --> 01:06:28,260
there

2212
01:06:28,260 --> 01:06:28,827
s a death that the panel

2213
01:06:28,827 --> 01:06:29,600
determines they don

2214
01:06:29,600 --> 01:06:30,762
t have

2215
01:06:30,762 --> 01:06:33,162
enough information to determine

2216
01:06:33,399 --> 01:06:35,867
whether it was related. So they

2217
01:06:35,867 --> 01:06:37,402
conduct very respectful reviews

2218
01:06:37,402 --> 01:06:39,204
of each potentially pregnancy

2219
01:06:39,204 --> 01:06:41,206
related death. Using that case

2220
01:06:41,206 --> 01:06:42,407
narrative, I described, they

2221
01:06:42,407 --> 01:06:43,708
determine whether the death was

2222
01:06:43,708 --> 01:06:45,510
pregnancy related using the

2223
01:06:45,510 --> 01:06:47,212
definition we just reviewed,

2224
01:06:47,212 --> 01:06:48,680
and they look at the deaths

2225
01:06:48,680 --> 01:06:50,349
from preventable to was it

2226
01:06:50,349 --> 01:06:52,250
preventable, not just from a

2227
01:06:52,250 --> 01:06:53,518
clinical perspective, but also

2228
01:06:53,518 --> 01:06:55,154
from an equity or social

2229
01:06:55,154 --> 01:06:56,888
determinants of health

2230
01:06:56,888 --> 01:06:58,390
perspective? Ask questions like

2231
01:06:58,390 --> 01:07:00,390
whether racism, discrimination,

2232
01:07:00,625 --> 01:07:02,695
and bias played a role and what

2233
01:07:02,695 --> 01:07:04,496
factors contributed to those

2234
01:07:04,496 --> 01:07:06,632
preventable deaths. And then

2235
01:07:06,632 --> 01:07:08,467
they make recommendations, both

2236
01:07:08,467 --> 01:07:10,936
interventions at the time of or

2237
01:07:10,936 --> 01:07:12,137
systems changes upstream that

2238
01:07:12,137 --> 01:07:13,338
could prevent deaths like that.

2239
01:07:13,338 --> 01:07:14,606
And those become the basis for

2240
01:07:14,606 --> 01:07:16,408
the recommendations in the

2241
01:07:16,408 --> 01:07:17,977
report. So I mentioned the

2242
01:07:17,977 --> 01:07:19,644
report. I think my colleague

2243
01:07:19,644 --> 01:07:21,146
Annie can put the link to the

2244
01:07:21,146 --> 01:07:23,249
report in the chat. You all MAY

2245
01:07:23,249 --> 01:07:23,448
have it available as well.

2246
01:07:23,448 --> 01:07:25,183
There

2247
01:07:25,183 --> 01:07:27,552
s a qr code for it here.

2248
01:07:27,552 --> 01:07:29,488
We submitted this report in

2249
01:07:29,488 --> 01:07:30,889
DECEMBER 2025. It was the

2250
01:07:30,889 --> 01:07:32,925
fourth of these reports in

2251
01:07:32,925 --> 01:07:33,992
Washington. It includes our

2252
01:07:33,992 --> 01:07:36,992
newest data, which are from

2253
01:07:37,129 --> 01:07:39,300
2021 and 2022, and then some

2254
01:07:39,300 --> 01:07:40,232
cumulative findings for like

2255
01:07:40,232 --> 01:07:42,334
some demographics and things

2256
01:07:42,334 --> 01:07:44,469
like that going back through

2257
01:07:44,469 --> 01:07:44,636
2014 to 2022. There

2258
01:07:44,636 --> 01:07:45,571
s

2259
01:07:45,571 --> 01:07:47,139
recommendations for the

2260
01:07:47,139 --> 01:07:48,440
legislature and for other

2261
01:07:48,440 --> 01:07:48,807
audiences, and there

2262
01:07:48,807 --> 01:07:50,142
s also

2263
01:07:50,142 --> 01:07:51,900
some new components like

2264
01:07:51,900 --> 01:07:51,276
storytelling, people

2265
01:07:51,276 --> 01:07:52,711
s

2266
01:07:52,711 --> 01:07:53,579
experience in Washington of

2267
01:07:53,579 --> 01:07:55,347
pregnancy, birth and

2268
01:07:55,347 --> 01:07:56,314
postpartum, and success stories

2269
01:07:56,314 --> 01:07:56,548
from a from the previous

2270
01:07:56,548 --> 01:07:58,149
report

2271
01:07:58,149 --> 01:07:59,250
s recommendations. This

2272
01:07:59,250 --> 01:08:00,619
is also the second of our

2273
01:08:00,619 --> 01:08:01,821
reports with an addendum from

2274
01:08:01,821 --> 01:08:03,555
the American Indian Health

2275
01:08:03,555 --> 01:08:05,323
Commission with findings and

2276
01:08:05,323 --> 01:08:06,558
recommendations from American

2277
01:08:06,558 --> 01:08:08,958
Indian and Alaska Native

2278
01:08:10,620 --> 01:08:11,864
communities and health leaders.

2279
01:08:11,864 --> 01:08:12,397
So I mentioned storytelling in

2280
01:08:12,397 --> 01:08:12,998
the report. I

2281
01:08:12,998 --> 01:08:14,232
m not going to

2282
01:08:14,232 --> 01:08:15,901
read these to you, but I just

2283
01:08:15,901 --> 01:08:17,969
wanted to highlight them on the

2284
01:08:17,969 --> 01:08:21,500
screen to show the weight of

2285
01:08:21,500 --> 01:08:21,940
this, um, to, uh, to show the

2286
01:08:21,940 --> 01:08:23,709
weight of this and to

2287
01:08:23,709 --> 01:08:26,211
understand, to help the reader

2288
01:08:26,211 --> 01:08:27,212
understand how these issues

2289
01:08:27,212 --> 01:08:27,546
really do affect people

2290
01:08:27,546 --> 01:08:29,314
s

2291
01:08:29,314 --> 01:08:30,348
lives. Even people who maybe

2292
01:08:30,348 --> 01:08:30,549
had a challenging time but

2293
01:08:30,549 --> 01:08:31,984
didn

2294
01:08:31,984 --> 01:08:33,180
t pass away. Um, I also

2295
01:08:33,180 --> 01:08:34,219
think there MAY not be a chat,

2296
01:08:34,219 --> 01:08:36,321
but I think you have the link

2297
01:08:36,321 --> 01:08:37,656
to the report in another

2298
01:08:37,656 --> 01:08:38,256
format. So let

2299
01:08:38,256 --> 01:08:40,292
s talk about the

2300
01:08:40,292 --> 01:08:41,727
data and findings briefly here.

2301
01:08:41,727 --> 01:08:42,360
So a couple of things to

2302
01:08:42,360 --> 01:08:43,610
consider when we

2303
01:08:43,610 --> 01:08:44,596
re talking

2304
01:08:44,596 --> 01:08:46,699
about this. So maternal

2305
01:08:46,699 --> 01:08:48,299
mortality is thankfully a rare

2306
01:08:48,299 --> 01:08:50,302
event though every death is one

2307
01:08:50,302 --> 01:08:50,469
to many. But the fact that it

2308
01:08:50,469 --> 01:08:51,803
s

2309
01:08:51,803 --> 01:08:52,137
a rare event means that it

2310
01:08:52,137 --> 01:08:53,271
s

2311
01:08:53,271 --> 01:08:55,400
difficult with those small

2312
01:08:55,400 --> 01:08:56,842
numbers to discern things like

2313
01:08:56,842 --> 01:08:58,310
true change or really compare

2314
01:08:58,310 --> 01:08:59,845
demographic differences on a

2315
01:08:59,845 --> 01:09:00,179
year to year basis. We do it

2316
01:09:00,179 --> 01:09:00,645
anyway. It

2317
01:09:00,645 --> 01:09:00,846
s just there

2318
01:09:00,846 --> 01:09:02,846
s

2319
01:09:03,480 --> 01:09:04,490
challenges around it and we can

2320
01:09:04,490 --> 01:09:04,916
still make meaningful

2321
01:09:04,916 --> 01:09:06,217
recommendations and

2322
01:09:06,217 --> 01:09:08,220
interventions from what we do

2323
01:09:08,220 --> 01:09:09,587
know. Um, we also often get

2324
01:09:09,587 --> 01:09:10,822
asked about Washington compared

2325
01:09:10,822 --> 01:09:12,240
to the us, we can

2326
01:09:12,240 --> 01:09:13,992
t actually do

2327
01:09:13,992 --> 01:09:15,994
a really good comparison

2328
01:09:15,994 --> 01:09:17,362
because the us rates leave out

2329
01:09:17,362 --> 01:09:19,640
some things like accidental

2330
01:09:19,640 --> 01:09:20,532
deaths, including overdose,

2331
01:09:20,532 --> 01:09:22,201
which is one of our major

2332
01:09:22,201 --> 01:09:23,702
causes or major cause of death

2333
01:09:23,702 --> 01:09:25,871
or injury. Deaths like homicide

2334
01:09:25,871 --> 01:09:26,204
and suicide. We also don

2335
01:09:26,204 --> 01:09:27,939
t have

2336
01:09:27,939 --> 01:09:29,742
county level data because of

2337
01:09:29,742 --> 01:09:31,376
extremely small or nonexistent

2338
01:09:31,376 --> 01:09:33,110
numbers for each county. The

2339
01:09:33,110 --> 01:09:34,280
state law has very strict

2340
01:09:34,280 --> 01:09:36,115
requirements around

2341
01:09:36,115 --> 01:09:38,115
confidentiality, which limits

2342
01:09:38,751 --> 01:09:40,152
us, but counties can still find

2343
01:09:40,152 --> 01:09:41,486
relevant information and

2344
01:09:41,486 --> 01:09:42,855
recommendation based on their

2345
01:09:42,855 --> 01:09:43,956
needs, their demographics, what

2346
01:09:43,956 --> 01:09:45,724
they know is going on, and

2347
01:09:45,724 --> 01:09:48,393
extrapolate from the report to

2348
01:09:48,393 --> 01:09:49,828
apply in their regions. So the

2349
01:09:49,828 --> 01:09:51,229
pregnancy related maternal

2350
01:09:51,229 --> 01:09:52,798
mortality rate actually

2351
01:09:52,798 --> 01:09:55,167
increased in these two years,

2352
01:09:55,167 --> 01:09:57,202
2021 through 2022. And this is

2353
01:09:57,202 --> 01:10:00,104
the first increase to date in

2354
01:10:00,104 --> 01:10:02,504
these Washington mmr reports.

2355
01:10:02,774 --> 01:10:04,810
Um, that rate was 30.5 per

2356
01:10:04,810 --> 01:10:04,974
100,000 live births. And it

2357
01:10:04,974 --> 01:10:06,611
s

2358
01:10:06,611 --> 01:10:07,379
statistically significantly

2359
01:10:07,379 --> 01:10:08,120
higher than the state

2360
01:10:08,120 --> 01:10:09,415
s rate in

2361
01:10:09,415 --> 01:10:11,816
the period of the last report,

2362
01:10:11,816 --> 01:10:13,816
2017 through 2020, which was 19

2363
01:10:15,520 --> 01:10:17,455
per 100,000. Causes of these

2364
01:10:17,455 --> 01:10:18,791
pregnancy related deaths,

2365
01:10:18,791 --> 01:10:20,125
behavioral health related

2366
01:10:20,125 --> 01:10:22,227
deaths accounted for nearly

2367
01:10:22,227 --> 01:10:23,595
half, 45% of all of the

2368
01:10:23,595 --> 01:10:25,130
pregnancy related deaths in

2369
01:10:25,130 --> 01:10:26,364
these two years. Most of these

2370
01:10:26,364 --> 01:10:27,332
were accidental overdose

2371
01:10:27,332 --> 01:10:28,933
deaths, and most of those

2372
01:10:28,933 --> 01:10:30,200
involved fentanyl. Other

2373
01:10:30,200 --> 01:10:31,936
leading causes of death

2374
01:10:31,936 --> 01:10:34,336
included Covid 19, primarily in

2375
01:10:34,373 --> 01:10:36,373
2021 and cardiovascular

2376
01:10:37,976 --> 01:10:39,410
conditions. 82% of these

2377
01:10:39,410 --> 01:10:40,645
pregnancy related deaths were

2378
01:10:40,645 --> 01:10:42,381
found to be preventable. There

2379
01:10:42,381 --> 01:10:43,982
was at least some chance of the

2380
01:10:43,982 --> 01:10:45,951
death being averted if a factor

2381
01:10:45,951 --> 01:10:47,419
that contributed to it had been

2382
01:10:47,419 --> 01:10:48,620
different. This is very similar

2383
01:10:48,620 --> 01:10:51,523
to in the previous report that

2384
01:10:51,523 --> 01:10:52,958
found 80%, and this is a

2385
01:10:52,958 --> 01:10:53,458
striking number. This is very

2386
01:10:53,458 --> 01:10:55,193
high. It

2387
01:10:55,193 --> 01:10:56,327
s also a motivation to

2388
01:10:56,327 --> 01:10:57,128
act because it means we

2389
01:10:57,128 --> 01:10:58,797
understand what

2390
01:10:58,797 --> 01:10:59,364
s going on. Um,

2391
01:10:59,364 --> 01:11:00,265
we know what

2392
01:11:00,265 --> 01:11:02,400
s going on. We can

2393
01:11:02,400 --> 01:11:02,701
take action. It also reflects

2394
01:11:02,701 --> 01:11:03,902
the panel

2395
01:11:03,902 --> 01:11:05,637
s continuing

2396
01:11:05,637 --> 01:11:07,439
understanding of preventive

2397
01:11:07,439 --> 01:11:09,708
ability, which has grown over

2398
01:11:09,708 --> 01:11:11,900
the years of its work.

2399
01:11:11,900 --> 01:11:12,444
Disparities by race and

2400
01:11:12,444 --> 01:11:13,645
ethnicity are really important

2401
01:11:13,645 --> 01:11:15,948
to pay attention to in this

2402
01:11:15,948 --> 01:11:17,282
report. One that stands out is

2403
01:11:17,282 --> 01:11:18,783
that non-Hispanic American

2404
01:11:18,783 --> 01:11:20,185
Indian and Alaska Native people

2405
01:11:20,185 --> 01:11:21,687
experienced much higher

2406
01:11:21,687 --> 01:11:22,988
maternal mortality rates than

2407
01:11:22,988 --> 01:11:24,957
any other racial or ethnic

2408
01:11:24,957 --> 01:11:26,958
group. For example, their rate

2409
01:11:26,958 --> 01:11:28,460
was 7.3 times higher than

2410
01:11:28,460 --> 01:11:30,610
non-Hispanic white people,

2411
01:11:30,610 --> 01:11:31,797
which is not the baseline. The

2412
01:11:31,797 --> 01:11:33,632
baseline is no preventable

2413
01:11:33,632 --> 01:11:34,165
pregnancy related deaths. Um,

2414
01:11:34,165 --> 01:11:34,833
and again, that

2415
01:11:34,833 --> 01:11:35,000
s a reason why

2416
01:11:35,000 --> 01:11:35,901
we

2417
01:11:35,901 --> 01:11:36,902
ve got that addendum from

2418
01:11:36,902 --> 01:11:39,171
the American Indian Health

2419
01:11:39,171 --> 01:11:40,773
Commission in the report. And

2420
01:11:40,773 --> 01:11:42,207
also black communities,

2421
01:11:42,207 --> 01:11:43,375
multiracial communities, and

2422
01:11:43,375 --> 01:11:44,943
Native Hawaiian or Pacific

2423
01:11:44,943 --> 01:11:46,611
Islander communities also

2424
01:11:46,611 --> 01:11:48,611
experience disproportionately

2425
01:11:49,982 --> 01:11:52,484
high rates looking by, um,

2426
01:11:52,484 --> 01:11:54,719
urban rural residency insurance

2427
01:11:54,719 --> 01:11:56,721
status and age are also really

2428
01:11:56,721 --> 01:11:58,257
critical. So even though there

2429
01:11:58,257 --> 01:11:59,524
are more pregnancy related

2430
01:11:59,524 --> 01:12:00,893
deaths among people living in

2431
01:12:00,893 --> 01:12:02,828
urban areas, the maternal

2432
01:12:02,828 --> 01:12:04,496
mortality rate was highest

2433
01:12:04,496 --> 01:12:05,831
among people in rural areas,

2434
01:12:05,831 --> 01:12:07,299
which really underscores the

2435
01:12:07,299 --> 01:12:08,967
importance of having access to

2436
01:12:08,967 --> 01:12:10,435
quality rural maternity health

2437
01:12:10,435 --> 01:12:12,435
services, including emergency,

2438
01:12:12,670 --> 01:12:13,805
prenatal emergency support.

2439
01:12:13,805 --> 01:12:15,507
People who are covered by

2440
01:12:15,507 --> 01:12:16,541
Medicaid as primary insurance,

2441
01:12:16,541 --> 01:12:18,410
which of course is a stand in

2442
01:12:18,410 --> 01:12:20,780
for a lot of socioeconomic and

2443
01:12:20,780 --> 01:12:21,914
related factors, had the

2444
01:12:21,914 --> 01:12:23,682
highest frequency and the

2445
01:12:23,682 --> 01:12:25,284
highest rate of pregnancy

2446
01:12:25,284 --> 01:12:26,484
related deaths. Um, which

2447
01:12:26,484 --> 01:12:27,952
underscores the importance of

2448
01:12:27,952 --> 01:12:29,210
access to care and support for

2449
01:12:29,210 --> 01:12:31,421
people with Medicaid and

2450
01:12:31,689 --> 01:12:32,824
pregnancy and postpartum. And

2451
01:12:32,824 --> 01:12:34,125
then the maternal, the

2452
01:12:34,125 --> 01:12:35,827
pregnancy related mortality

2453
01:12:35,827 --> 01:12:37,229
rate was most, uh, excuse me,

2454
01:12:37,229 --> 01:12:39,431
pregnancy related mortality was

2455
01:12:39,431 --> 01:12:41,866
most common among people ages

2456
01:12:41,866 --> 01:12:43,569
30 to 34, but the highest rate

2457
01:12:43,569 --> 01:12:44,770
was among people age 40 and

2458
01:12:44,770 --> 01:12:45,937
older. Which reminds us that

2459
01:12:45,937 --> 01:12:48,306
risk increases with age,

2460
01:12:48,306 --> 01:12:50,441
especially for those over 40.

2461
01:12:50,441 --> 01:12:51,743
The panel did identify

2462
01:12:51,743 --> 01:12:53,780
discrimination bias,

2463
01:12:53,780 --> 01:12:55,780
interpersonal racism, or

2464
01:12:55,680 --> 01:12:57,248
structural racism in 76% of

2465
01:12:57,248 --> 01:12:58,884
preventable pregnancy related

2466
01:12:58,884 --> 01:13:00,652
deaths in these two years. That

2467
01:13:00,652 --> 01:13:02,587
includes bias about substance

2468
01:13:02,587 --> 01:13:04,223
use disorder, reminding us that

2469
01:13:04,223 --> 01:13:05,423
communities most burdened by

2470
01:13:05,423 --> 01:13:07,659
these and perinatal health

2471
01:13:07,659 --> 01:13:09,261
inequities have the expertise,

2472
01:13:09,261 --> 01:13:10,729
cultural knowledge to lead

2473
01:13:10,729 --> 01:13:12,230
solutions to reduce maternal

2474
01:13:12,230 --> 01:13:14,650
mortality and must be centered

2475
01:13:14,650 --> 01:13:14,966
as leaders in implementation of

2476
01:13:14,966 --> 01:13:17,336
many of the report

2477
01:13:17,336 --> 01:13:18,704
recommendations, the timing of

2478
01:13:18,704 --> 01:13:19,671
pregnancy related deaths. Now,

2479
01:13:19,671 --> 01:13:21,406
a lot of people, when they hear

2480
01:13:21,406 --> 01:13:23,108
maternal mortality, they think

2481
01:13:23,108 --> 01:13:24,676
death and childbirth, or they

2482
01:13:24,676 --> 01:13:26,444
hear pregnancy related death,

2483
01:13:26,444 --> 01:13:27,713
death during pregnancy. But

2484
01:13:27,713 --> 01:13:29,814
actually most of the deaths are

2485
01:13:29,814 --> 01:13:31,917
postpartum in this period. Um,

2486
01:13:31,917 --> 01:13:34,219
if you look, most of them even

2487
01:13:34,219 --> 01:13:36,219
incurred later postpartum 43

2488
01:13:36,254 --> 01:13:38,356
days to one year, nearly half

2489
01:13:38,356 --> 01:13:40,250
of those deaths, deaths

2490
01:13:40,250 --> 01:13:42,270
occurred, followed by those

2491
01:13:42,270 --> 01:13:44,362
between pregnancy. Excuse me,

2492
01:13:44,362 --> 01:13:47,362
two days after, uh, pregnancy

2493
01:13:47,365 --> 01:13:49,501
in 42 days. Um, one day after

2494
01:13:49,501 --> 01:13:51,901
pregnancy. Anyway, that period.

2495
01:13:52,371 --> 01:13:55,240
Excuse me? After pregnancy. Um,

2496
01:13:55,240 --> 01:13:57,750
but that does that number

2497
01:13:57,750 --> 01:13:58,543
skewed towards later postpartum

2498
01:13:58,543 --> 01:13:59,711
is even more pronounced when

2499
01:13:59,711 --> 01:14:02,548
you look at the unintentional

2500
01:14:02,548 --> 01:14:04,450
overdose deaths, 82% of those

2501
01:14:04,450 --> 01:14:06,170
occurred in later postpartum.

2502
01:14:06,170 --> 01:14:07,453
Really? Again, underscoring the

2503
01:14:07,453 --> 01:14:08,653
importance of care support and

2504
01:14:08,653 --> 01:14:10,588
health insurance coverage

2505
01:14:10,588 --> 01:14:10,756
through one year postpartum. So

2506
01:14:10,756 --> 01:14:11,456
let

2507
01:14:11,456 --> 01:14:13,392
s talk about

2508
01:14:13,392 --> 01:14:13,591
recommendations in the report.

2509
01:14:13,591 --> 01:14:14,893
They

2510
01:14:14,893 --> 01:14:16,628
re all organized under

2511
01:14:16,628 --> 01:14:16,861
three priority recommendations.

2512
01:14:16,861 --> 01:14:17,796
And I

2513
01:14:17,796 --> 01:14:19,798
ll go through those in a

2514
01:14:19,798 --> 01:14:20,765
moment. And the legislative

2515
01:14:20,765 --> 01:14:21,320
ones come first. They

2516
01:14:21,320 --> 01:14:22,200
re in

2517
01:14:22,200 --> 01:14:22,401
their own section. And then

2518
01:14:22,401 --> 01:14:23,601
there

2519
01:14:23,601 --> 01:14:24,836
s a separate section for

2520
01:14:24,836 --> 01:14:26,138
recommendations for all the

2521
01:14:26,138 --> 01:14:27,372
other audiences. We did want

2522
01:14:27,372 --> 01:14:27,805
the legislative ones to stand

2523
01:14:27,805 --> 01:14:28,373
out, but don

2524
01:14:28,373 --> 01:14:30,208
t MISS, you know,

2525
01:14:30,208 --> 01:14:32,110
one section or the other. These

2526
01:14:32,110 --> 01:14:33,945
are the three recommendation

2527
01:14:33,945 --> 01:14:35,180
areas, basically focusing on

2528
01:14:35,180 --> 01:14:36,448
improving health care quality

2529
01:14:36,448 --> 01:14:38,448
and access, strengthening

2530
01:14:38,450 --> 01:14:40,840
community support services, and

2531
01:14:40,840 --> 01:14:42,840
providing equitable, culturally

2532
01:14:42,420 --> 01:14:44,255
responsive care. So the first

2533
01:14:44,255 --> 01:14:45,658
one in detail, to ensure

2534
01:14:45,658 --> 01:14:47,125
Washingtonians have access to

2535
01:14:47,125 --> 01:14:48,594
high quality health care,

2536
01:14:48,594 --> 01:14:49,827
including mental health care,

2537
01:14:49,827 --> 01:14:51,530
substance use disorder

2538
01:14:51,530 --> 01:14:52,731
treatment, and preventive care

2539
01:14:52,731 --> 01:14:54,566
throughout pregnancy, birth,

2540
01:14:54,566 --> 01:14:56,135
and postpartum. By

2541
01:14:56,135 --> 01:14:57,636
strengthening and funding care

2542
01:14:57,636 --> 01:14:59,203
coordination, improving

2543
01:14:59,203 --> 01:15:00,472
communication and protocols,

2544
01:15:00,472 --> 01:15:01,573
and ensuring providers actually

2545
01:15:01,573 --> 01:15:03,274
have the skills and training

2546
01:15:03,274 --> 01:15:04,542
and professional support they

2547
01:15:04,542 --> 01:15:05,110
need to provide high quality

2548
01:15:05,110 --> 01:15:05,910
care. I

2549
01:15:05,910 --> 01:15:07,845
m going to show you a

2550
01:15:07,845 --> 01:15:09,147
couple example recommendations

2551
01:15:09,147 --> 01:15:10,248
under each, but again that by

2552
01:15:10,248 --> 01:15:11,450
no means are they all the

2553
01:15:11,450 --> 01:15:11,650
recommendations in the report.

2554
01:15:11,650 --> 01:15:12,317
There

2555
01:15:12,317 --> 01:15:13,485
s like over 90

2556
01:15:13,485 --> 01:15:14,519
recommendations when you add

2557
01:15:14,519 --> 01:15:15,554
them all up. But here are a

2558
01:15:15,554 --> 01:15:17,356
couple examples in this

2559
01:15:17,356 --> 01:15:18,924
category. So one for the

2560
01:15:18,924 --> 01:15:20,459
legislature to protect and

2561
01:15:20,459 --> 01:15:21,827
increase funding for family

2562
01:15:21,827 --> 01:15:22,995
friendly, judgment free

2563
01:15:22,995 --> 01:15:24,629
substance use disorder and

2564
01:15:24,629 --> 01:15:26,231
opioid use disorder, and

2565
01:15:26,231 --> 01:15:27,732
treatment and support for

2566
01:15:27,732 --> 01:15:29,435
pregnant and postpartum

2567
01:15:29,435 --> 01:15:30,769
patients, including in rural

2568
01:15:30,769 --> 01:15:32,537
areas with limited access to

2569
01:15:32,537 --> 01:15:32,837
community services. There

2570
01:15:32,837 --> 01:15:34,172
s a

2571
01:15:34,172 --> 01:15:35,607
recommendation for state and

2572
01:15:35,607 --> 01:15:37,643
local agencies, health care

2573
01:15:37,643 --> 01:15:39,643
systems, facilities providers,

2574
01:15:40,145 --> 01:15:41,680
and community organizations to

2575
01:15:41,680 --> 01:15:43,282
follow best practices in a

2576
01:15:43,282 --> 01:15:45,500
health communication to counter

2577
01:15:45,500 --> 01:15:47,500
health misinformation and

2578
01:15:47,219 --> 01:15:48,653
disinformation about vaccines

2579
01:15:48,653 --> 01:15:49,655
or other topics relevant to

2580
01:15:49,655 --> 01:15:51,556
health and pregnancy and

2581
01:15:51,556 --> 01:15:52,991
postpartum. Another ones for

2582
01:15:52,991 --> 01:15:54,626
similar audiences to raise

2583
01:15:54,626 --> 01:15:56,228
awareness about urgent maternal

2584
01:15:56,228 --> 01:15:57,863
warning signs, perinatal mood

2585
01:15:57,863 --> 01:15:59,464
and anxiety disorders, and

2586
01:15:59,464 --> 01:16:00,732
substance use disorder. Opioid

2587
01:16:00,732 --> 01:16:02,000
use disorder in pregnancy

2588
01:16:02,000 --> 01:16:03,802
through public health messaging

2589
01:16:03,802 --> 01:16:05,802
strategies and patient

2590
01:16:05,870 --> 01:16:06,504
education. Um, there

2591
01:16:06,504 --> 01:16:07,405
s also I

2592
01:16:07,405 --> 01:16:08,741
wanted to highlight this

2593
01:16:08,741 --> 01:16:11,750
recommendation because it calls

2594
01:16:11,750 --> 01:16:12,610
out a King County program. So

2595
01:16:12,610 --> 01:16:13,979
this is a recommendation for

2596
01:16:13,979 --> 01:16:15,580
all different levels of

2597
01:16:15,580 --> 01:16:17,150
agencies and organizations to

2598
01:16:17,150 --> 01:16:18,160
follow strategies for medical

2599
01:16:18,160 --> 01:16:19,551
outreach and workforce

2600
01:16:19,551 --> 01:16:21,252
development to increase access

2601
01:16:21,252 --> 01:16:22,687
to prenatal, postpartum, and

2602
01:16:22,687 --> 01:16:24,322
primary care for unhoused

2603
01:16:24,322 --> 01:16:25,724
people. And then one of the

2604
01:16:25,724 --> 01:16:26,858
examples we actually

2605
01:16:26,858 --> 01:16:28,293
highlighted public health.

2606
01:16:28,293 --> 01:16:30,693
Seattle, King County Street

2607
01:16:31,830 --> 01:16:33,464
Medicine Program. So the second

2608
01:16:33,464 --> 01:16:34,733
of these three priority areas

2609
01:16:34,733 --> 01:16:36,668
about strengthening community

2610
01:16:36,668 --> 01:16:38,203
support services, this is

2611
01:16:38,203 --> 01:16:39,537
investing in developing and

2612
01:16:39,537 --> 01:16:41,390
expanding comprehensive

2613
01:16:41,390 --> 01:16:42,173
community support services that

2614
01:16:42,173 --> 01:16:43,408
are that address essential

2615
01:16:43,408 --> 01:16:45,243
needs in pregnancy and

2616
01:16:45,243 --> 01:16:46,944
postpartum. So things like home

2617
01:16:46,944 --> 01:16:48,714
visiting, social work, doula

2618
01:16:48,714 --> 01:16:50,140
support and wraparound support

2619
01:16:50,140 --> 01:16:52,183
for mental health and substance

2620
01:16:52,183 --> 01:16:53,351
use disorder. A couple examples

2621
01:16:53,351 --> 01:16:54,653
from this. So there are a few

2622
01:16:54,653 --> 01:16:56,200
for the legislator that I

2623
01:16:56,200 --> 01:16:57,789
wanted to highlight about

2624
01:16:57,789 --> 01:16:59,290
universal access to those

2625
01:16:59,290 --> 01:17:00,592
wraparound services through at

2626
01:17:00,592 --> 01:17:02,194
least a year postpartum,

2627
01:17:02,194 --> 01:17:04,960
including home visiting, doulas

2628
01:17:04,960 --> 01:17:06,231
and peer support. Also

2629
01:17:06,231 --> 01:17:07,833
protecting both existing and

2630
01:17:07,833 --> 01:17:08,660
funding new programs that meet

2631
01:17:08,660 --> 01:17:09,400
people

2632
01:17:09,400 --> 01:17:10,769
s needs in pregnancy and

2633
01:17:10,769 --> 01:17:12,769
postpartum. Things like

2634
01:17:12,904 --> 01:17:14,372
transit, housing, income and

2635
01:17:14,372 --> 01:17:15,307
child care to be universally

2636
01:17:15,307 --> 01:17:15,941
available. There

2637
01:17:15,941 --> 01:17:17,241
s one for

2638
01:17:17,241 --> 01:17:18,710
funders and state and local

2639
01:17:18,710 --> 01:17:20,244
agencies to increase funding

2640
01:17:20,244 --> 01:17:21,746
and capacity for community

2641
01:17:21,746 --> 01:17:23,348
based organizations to support

2642
01:17:23,348 --> 01:17:24,950
people in pregnancy and

2643
01:17:24,950 --> 01:17:25,183
postpartum. And then there

2644
01:17:25,183 --> 01:17:27,183
s

2645
01:17:27,219 --> 01:17:28,620
one for Doe and local health

2646
01:17:28,620 --> 01:17:30,188
departments to invest in

2647
01:17:30,188 --> 01:17:31,222
building healthy and safe

2648
01:17:31,222 --> 01:17:31,623
communities. There

2649
01:17:31,623 --> 01:17:32,991
s a lot of

2650
01:17:32,991 --> 01:17:35,593
examples of what that looks

2651
01:17:35,593 --> 01:17:37,620
like. So the third priority

2652
01:17:37,620 --> 01:17:38,630
recommendation is making sure

2653
01:17:38,630 --> 01:17:40,298
all of that care and support is

2654
01:17:40,298 --> 01:17:42,330
equitable and culturally

2655
01:17:42,330 --> 01:17:44,330
responsive throughout pregnancy

2656
01:17:44,870 --> 01:17:46,104
and postpartum, and also trauma

2657
01:17:46,104 --> 01:17:47,839
informed, grounded and trauma

2658
01:17:47,839 --> 01:17:50,174
informed practices and actively

2659
01:17:50,174 --> 01:17:51,810
addressing racial injustice. So

2660
01:17:51,810 --> 01:17:53,945
a couple examples under this

2661
01:17:53,945 --> 01:17:55,413
one health care system, state

2662
01:17:55,413 --> 01:17:56,914
agencies and academic

2663
01:17:56,914 --> 01:17:58,383
institutions to work together

2664
01:17:58,383 --> 01:17:59,951
to build and sustain a diverse

2665
01:17:59,951 --> 01:18:01,219
maternal health workforce that

2666
01:18:01,219 --> 01:18:02,788
reflects the communities it

2667
01:18:02,788 --> 01:18:04,389
serves, when for state and

2668
01:18:04,389 --> 01:18:05,990
local agencies, along with

2669
01:18:05,990 --> 01:18:07,659
organizations to deliver

2670
01:18:07,659 --> 01:18:09,595
ongoing, culturally relevant

2671
01:18:09,595 --> 01:18:11,960
messaging about how to safely

2672
01:18:11,960 --> 01:18:12,330
access perinatal care,

2673
01:18:12,330 --> 01:18:14,466
including for immigrant and

2674
01:18:14,466 --> 01:18:16,134
refugee communities. Language

2675
01:18:16,134 --> 01:18:17,635
specific messages about health

2676
01:18:17,635 --> 01:18:19,370
insurance access, privacy

2677
01:18:19,370 --> 01:18:20,705
protections, and opportunities

2678
01:18:20,705 --> 01:18:22,140
to receive perinatal care and

2679
01:18:22,140 --> 01:18:23,809
support regardless of insurance

2680
01:18:23,809 --> 01:18:24,800
or immigration status. There

2681
01:18:24,800 --> 01:18:25,277
s

2682
01:18:25,277 --> 01:18:26,878
one for both state and local

2683
01:18:26,878 --> 01:18:28,580
agencies and jurisdictions to

2684
01:18:28,580 --> 01:18:29,981
work together with and fund

2685
01:18:29,981 --> 01:18:31,483
tribal and indigenous led

2686
01:18:31,483 --> 01:18:33,585
provider training programs that

2687
01:18:33,585 --> 01:18:35,585
emphasize culturally relevant

2688
01:18:35,754 --> 01:18:37,556
health care and communication,

2689
01:18:37,556 --> 01:18:38,790
and another one for Doe and

2690
01:18:38,790 --> 01:18:40,258
health care systems to fund

2691
01:18:40,258 --> 01:18:42,394
tribal led, indigenous led, and

2692
01:18:42,394 --> 01:18:43,962
community led efforts to access

2693
01:18:43,962 --> 01:18:45,563
to expand access to prenatal

2694
01:18:45,563 --> 01:18:46,865
and birthing care in American

2695
01:18:46,865 --> 01:18:48,400
Indian and Alaska Native

2696
01:18:48,400 --> 01:18:50,402
communities, including in rural

2697
01:18:50,402 --> 01:18:52,237
areas. I want to acknowledge

2698
01:18:52,237 --> 01:18:55,600
that there is a lot of context

2699
01:18:55,600 --> 01:18:58,600
at every level, um, local,

2700
01:18:58,409 --> 01:19:00,678
state, national, global that

2701
01:19:00,678 --> 01:19:02,213
currently and potentially in

2702
01:19:02,213 --> 01:19:03,715
emerging contexts can make

2703
01:19:03,715 --> 01:19:05,490
these recommendations both more

2704
01:19:05,490 --> 01:19:06,485
challenging to implement and

2705
01:19:06,485 --> 01:19:08,820
arguably even more important.

2706
01:19:08,820 --> 01:19:10,622
So looking at Medicaid access

2707
01:19:10,622 --> 01:19:12,424
changes I mentioned, Medicaid

2708
01:19:12,424 --> 01:19:14,580
covers 45% of births in

2709
01:19:14,580 --> 01:19:15,260
Washington. I think when you

2710
01:19:15,260 --> 01:19:15,177
look at rural areas, we

2711
01:19:15,177 --> 01:19:17,177
re

2712
01:19:17,495 --> 01:19:18,930
talking 70%. So see some

2713
01:19:18,930 --> 01:19:21,990
intersectionality there in our

2714
01:19:21,990 --> 01:19:22,534
disparities and inequities. And

2715
01:19:22,534 --> 01:19:23,969
there are rural maternity care

2716
01:19:23,969 --> 01:19:24,803
shortages tying into all of

2717
01:19:24,803 --> 01:19:25,971
that. There

2718
01:19:25,971 --> 01:19:27,739
s challenges and

2719
01:19:27,739 --> 01:19:30,108
access fears around perinatal

2720
01:19:30,108 --> 01:19:31,409
and reproductive care, access,

2721
01:19:31,409 --> 01:19:32,711
challenges to mental health

2722
01:19:32,711 --> 01:19:33,211
care access. There

2723
01:19:33,211 --> 01:19:34,947
s a lot of

2724
01:19:34,947 --> 01:19:36,147
budget limitations at every

2725
01:19:36,147 --> 01:19:38,216
level and challenges in the

2726
01:19:38,216 --> 01:19:38,416
current funding landscape.

2727
01:19:38,416 --> 01:19:39,651
There

2728
01:19:39,651 --> 01:19:41,219
s misinformation and

2729
01:19:41,219 --> 01:19:41,419
disinformation out there.

2730
01:19:41,419 --> 01:19:42,520
There

2731
01:19:42,520 --> 01:19:44,856
s threats to immigrant,

2732
01:19:44,856 --> 01:19:46,257
Bipoc and lgbtq plus

2733
01:19:46,257 --> 01:19:48,600
communities, including people

2734
01:19:48,600 --> 01:19:49,427
who are perceived as parts of

2735
01:19:49,427 --> 01:19:49,594
those communities. And there

2736
01:19:49,594 --> 01:19:51,263
s

2737
01:19:51,263 --> 01:19:52,630
just a lot of uncertainty about

2738
01:19:52,630 --> 01:19:54,980
all sorts of aspects of health,

2739
01:19:54,980 --> 01:19:56,000
environment and society in the

2740
01:19:56,000 --> 01:19:56,835
future. And this is one reason

2741
01:19:56,835 --> 01:19:58,103
the report includes

2742
01:19:58,103 --> 01:19:59,704
recommendations about both

2743
01:19:59,704 --> 01:20:02,104
protecting what already exists

2744
01:20:02,140 --> 01:20:03,575
and taking new steps, and why

2745
01:20:03,575 --> 01:20:05,760
some recommendations require

2746
01:20:05,760 --> 01:20:05,577
funding or legislative support,

2747
01:20:05,577 --> 01:20:07,577
and some don

2748
01:20:07,880 --> 01:20:08,947
t. So implementing

2749
01:20:08,947 --> 01:20:10,382
recommendations and

2750
01:20:10,382 --> 01:20:11,783
highlighting success stories to

2751
01:20:11,783 --> 01:20:14,920
know that we can do something

2752
01:20:14,920 --> 01:20:16,587
about this, um, recommendation

2753
01:20:16,587 --> 01:20:17,856
implementation happens on a lot

2754
01:20:17,856 --> 01:20:19,424
of different levels. I like to

2755
01:20:19,424 --> 01:20:21,626
think of it as centralized and

2756
01:20:21,626 --> 01:20:21,793
decentralized. So centralized.

2757
01:20:21,793 --> 01:20:22,526
We

2758
01:20:22,526 --> 01:20:22,727
re talking about anything

2759
01:20:22,727 --> 01:20:23,661
that

2760
01:20:23,661 --> 01:20:25,263
s statewide. So

2761
01:20:25,263 --> 01:20:26,664
legislative change or other

2762
01:20:26,664 --> 01:20:27,866
statewide efforts. Um,

2763
01:20:27,866 --> 01:20:29,300
Washington State Department of

2764
01:20:29,300 --> 01:20:30,936
Health led work, the work of

2765
01:20:30,936 --> 01:20:32,236
the Washington State Perinatal

2766
01:20:32,236 --> 01:20:32,394
Collaborative. And if you

2767
01:20:32,394 --> 01:20:33,171
re

2768
01:20:33,171 --> 01:20:34,372
not familiar with the

2769
01:20:34,372 --> 01:20:35,306
Washington State Perinatal

2770
01:20:35,306 --> 01:20:36,841
Collaborative, I highly

2771
01:20:36,841 --> 01:20:38,543
recommend looking it up, maybe

2772
01:20:38,543 --> 01:20:39,911
getting involved in that. Um,

2773
01:20:39,911 --> 01:20:40,178
they do a lot of amazing work,

2774
01:20:40,178 --> 01:20:41,379
and they

2775
01:20:41,379 --> 01:20:42,780
re kind of a hub of

2776
01:20:42,780 --> 01:20:43,214
implementation, but that

2777
01:20:43,214 --> 01:20:45,160
s just

2778
01:20:45,160 --> 01:20:46,851
one piece of it. Anything that

2779
01:20:46,851 --> 01:20:47,652
any person or entity or group

2780
01:20:47,652 --> 01:20:48,954
does towards these

2781
01:20:48,954 --> 01:20:49,821
recommendations is part of

2782
01:20:49,821 --> 01:20:49,985
implementation. And that

2783
01:20:49,985 --> 01:20:50,688
s

2784
01:20:50,688 --> 01:20:52,824
where I see it as

2785
01:20:52,824 --> 01:20:54,660
decentralized. So any local or

2786
01:20:54,660 --> 01:20:56,828
regional efforts led by any

2787
01:20:56,828 --> 01:20:58,630
organization, institution,

2788
01:20:58,630 --> 01:21:00,431
coalition, board, individual

2789
01:21:00,431 --> 01:21:02,330
health department and so forth,

2790
01:21:02,330 --> 01:21:03,835
from the practice level to the

2791
01:21:03,835 --> 01:21:05,437
regional level. Um, this could

2792
01:21:05,437 --> 01:21:07,500
include regional perinatal

2793
01:21:07,500 --> 01:21:08,740
collaboratives, regional county

2794
01:21:08,740 --> 01:21:10,141
boards of health, or many other

2795
01:21:10,141 --> 01:21:10,408
examples. Literally, we

2796
01:21:10,408 --> 01:21:12,110
ve had

2797
01:21:12,110 --> 01:21:13,110
like a doula practice change

2798
01:21:13,110 --> 01:21:15,411
something based on a

2799
01:21:15,914 --> 01:21:17,883
recommendation. So I want you

2800
01:21:17,883 --> 01:21:20,251
to think next about how can

2801
01:21:20,251 --> 01:21:21,686
this report connect to your

2802
01:21:21,686 --> 01:21:23,210
priorities? Which

2803
01:21:23,210 --> 01:21:25,210
recommendations are most

2804
01:21:25,223 --> 01:21:25,523
relevant in King County? How do

2805
01:21:25,523 --> 01:21:26,358
the report

2806
01:21:26,358 --> 01:21:27,992
s findings and

2807
01:21:27,992 --> 01:21:30,280
recommendations align with your

2808
01:21:30,280 --> 01:21:31,930
work and priorities? How can

2809
01:21:31,930 --> 01:21:33,364
they be useful in your work?

2810
01:21:33,364 --> 01:21:34,700
What kind of collaboration

2811
01:21:34,700 --> 01:21:36,334
might go on from, you know,

2812
01:21:36,334 --> 01:21:37,836
efforts that already exist or

2813
01:21:37,836 --> 01:21:39,538
new efforts that somebody would

2814
01:21:39,538 --> 01:21:41,172
like to create and just what

2815
01:21:41,172 --> 01:21:41,373
your next steps might be? I

2816
01:21:41,373 --> 01:21:43,275
m

2817
01:21:43,275 --> 01:21:45,443
putting my contact information

2818
01:21:45,443 --> 01:21:47,278
here as long as as well as my

2819
01:21:47,278 --> 01:21:48,847
epidemiologist, epidemiologist,

2820
01:21:48,847 --> 01:21:50,481
colleague Andy McCue. And thank

2821
01:21:50,481 --> 01:21:51,917
you so much for your time.

2822
01:21:51,917 --> 01:21:52,117
Happy to take questions. If

2823
01:21:52,117 --> 01:21:54,117
there

2824
01:21:54,786 --> 01:21:56,588
s time.

2825
01:21:56,588 --> 01:21:59,758
Thank you so much, Deb. And

2826
01:21:59,758 --> 01:22:02,158
Annie. Um, amazing report.

2827
01:22:02,727 --> 01:22:05,196
Looks like we have one hand,

2828
01:22:05,196 --> 01:22:06,998
um, board member Gadgil, you

2829
01:22:06,998 --> 01:22:08,998
have the floor.

2830
01:22:09,835 --> 01:22:11,836
Thank you again, chair Daniels.

2831
01:22:11,836 --> 01:22:14,606
And thank you for this really

2832
01:22:14,606 --> 01:22:14,773
informative presentation. And

2833
01:22:14,773 --> 01:22:16,773
it

2834
01:22:17,108 --> 01:22:18,576
s, um, it

2835
01:22:18,576 --> 01:22:19,770
s. Yeah, it

2836
01:22:19,770 --> 01:22:21,770
s very

2837
01:22:21,413 --> 01:22:24,382
sad to hear. And at the same

2838
01:22:24,382 --> 01:22:26,217
time, um, I hate to ask this

2839
01:22:26,217 --> 01:22:29,688
question, but I, I think we

2840
01:22:29,688 --> 01:22:33,324
need to have it for all all

2841
01:22:33,324 --> 01:22:36,194
data these days. Um, actual

2842
01:22:36,194 --> 01:22:38,620
numbers are, are are missing

2843
01:22:38,620 --> 01:22:41,320
more and more. It feels like

2844
01:22:41,320 --> 01:22:43,432
from from presentations about,

2845
01:22:44,435 --> 01:22:44,670
um, anything uh, and so it

2846
01:22:44,670 --> 01:22:44,836
s,

2847
01:22:44,836 --> 01:22:46,836
it

2848
01:22:48,139 --> 01:22:50,539
s hard to especially

2849
01:22:52,511 --> 01:22:52,677
advocate for resources when we

2850
01:22:52,677 --> 01:22:54,677
don

2851
01:22:54,780 --> 01:22:56,514
t know what the numbers are

2852
01:22:56,514 --> 01:22:57,849
of things. And so this this

2853
01:22:57,849 --> 01:22:58,600
applies across the board. I

2854
01:22:58,600 --> 01:22:59,450
m

2855
01:22:59,450 --> 01:23:01,252
not singling you out for that.

2856
01:23:01,252 --> 01:23:04,689
And in fact, my purpose for

2857
01:23:04,689 --> 01:23:07,125
raising my hand was, um, I

2858
01:23:07,125 --> 01:23:09,694
checked in with nurses that are

2859
01:23:09,694 --> 01:23:12,964
on my team this morning about,

2860
01:23:12,964 --> 01:23:14,232
um, how can we get people into

2861
01:23:14,232 --> 01:23:17,232
prenatal care? Because I know

2862
01:23:17,969 --> 01:23:22,169
that that is a huge issue. And

2863
01:23:22,640 --> 01:23:25,677
then I think it also relates to

2864
01:23:25,677 --> 01:23:29,277
the high number of deaths due

2865
01:23:29,680 --> 01:23:32,680
to opioid overdose. After, um,

2866
01:23:32,784 --> 01:23:35,253
the postpartum period. And so

2867
01:23:35,253 --> 01:23:38,853
what they told me is, among

2868
01:23:39,557 --> 01:23:42,557
other things, people who are,

2869
01:23:42,794 --> 01:23:45,194
um, using substances, for

2870
01:23:45,463 --> 01:23:48,463
example, and our pregnancy are

2871
01:23:49,601 --> 01:23:52,601
very worried about, um, the

2872
01:23:53,438 --> 01:23:55,407
impact of being reported to cps.

2873
01:23:55,407 --> 01:23:57,208
And they know that health care

2874
01:23:57,208 --> 01:23:59,208
providers are mandatory

2875
01:24:00,845 --> 01:24:02,814
reporters. So my suggestion is,

2876
01:24:02,814 --> 01:24:06,414
how could King County Board of

2877
01:24:07,252 --> 01:24:10,252
Health work to address policy

2878
01:24:11,222 --> 01:24:14,192
that could, um, that could

2879
01:24:14,192 --> 01:24:17,192
mitigate that barrier to people

2880
01:24:17,695 --> 01:24:21,295
choosing to access care of fear

2881
01:24:22,267 --> 01:24:23,502
of very negative consequences

2882
01:24:23,502 --> 01:24:24,970
to themselves? Thank you.

2883
01:24:24,970 --> 01:24:26,271
Thank you. Um, if I can speak

2884
01:24:26,271 --> 01:24:28,239
briefly to both of those and

2885
01:24:28,239 --> 01:24:29,741
thank you for that feedback.

2886
01:24:29,741 --> 01:24:31,109
Um, the report has a lot more

2887
01:24:31,109 --> 01:24:32,510
specific numbers than I went

2888
01:24:32,510 --> 01:24:33,945
through. This is a very short

2889
01:24:33,945 --> 01:24:35,814
version of our presentation

2890
01:24:35,814 --> 01:24:37,682
that typically can go up to 45

2891
01:24:37,682 --> 01:24:39,551
minutes or more. So we did cut

2892
01:24:39,551 --> 01:24:41,219
the data section down to the

2893
01:24:41,219 --> 01:24:41,419
short slides version. But

2894
01:24:41,419 --> 01:24:42,253
that

2895
01:24:42,253 --> 01:24:43,188
s helpful feedback to

2896
01:24:43,188 --> 01:24:45,123
know. And please do look at the

2897
01:24:45,123 --> 01:24:46,457
report for actual numbers. I

2898
01:24:46,457 --> 01:24:47,191
also just wanted to mention

2899
01:24:47,191 --> 01:24:47,692
that I know there

2900
01:24:47,692 --> 01:24:48,693
s at least

2901
01:24:48,693 --> 01:24:50,528
one I believe, maybe even

2902
01:24:50,528 --> 01:24:52,290
multiple recommendations in the

2903
01:24:52,290 --> 01:24:52,197
report that align with what

2904
01:24:52,197 --> 01:24:54,197
you

2905
01:24:54,732 --> 01:24:55,800
re talking about. Uh, 1.22

2906
01:24:55,800 --> 01:24:56,834
if you look for that is about

2907
01:24:56,834 --> 01:24:58,436
strengthening support for

2908
01:24:58,436 --> 01:25:00,380
programs for pregnant and

2909
01:25:00,380 --> 01:25:01,539
postpartum people experiencing

2910
01:25:01,539 --> 01:25:02,840
substance use disorder who MAY

2911
01:25:02,840 --> 01:25:05,760
not otherwise take care if they

2912
01:25:05,760 --> 01:25:05,235
fear intervention by cps. So

2913
01:25:05,235 --> 01:25:05,744
I

2914
01:25:05,744 --> 01:25:06,411
m so glad that

2915
01:25:06,411 --> 01:25:07,412
s coming up.

2916
01:25:07,412 --> 01:25:10,615
And thank you for saying all

2917
01:25:10,615 --> 01:25:11,950
that. See, um.

2918
01:25:11,950 --> 01:25:13,885
Thank you, thank you.

2919
01:25:13,885 --> 01:25:15,387
Boardmember board member

2920
01:25:15,387 --> 01:25:17,222
Hartfield, you have before.

2921
01:25:17,222 --> 01:25:19,290
Uh, yeah. Thank you for that.

2922
01:25:19,290 --> 01:25:21,690
Um, thorough and really

2923
01:25:22,227 --> 01:25:23,928
sobering presentation. Um, one

2924
01:25:23,928 --> 01:25:25,396
of my questions was the same

2925
01:25:25,396 --> 01:25:27,665
one that board member Gadgil

2926
01:25:27,665 --> 01:25:30,435
raised about, um, knowing what

2927
01:25:30,435 --> 01:25:33,338
the actual end is behind these

2928
01:25:33,338 --> 01:25:35,640
numbers. Um, my second question

2929
01:25:35,640 --> 01:25:38,640
was, are you also collecting

2930
01:25:38,744 --> 01:25:41,579
data on, um, housing status?

2931
01:25:41,579 --> 01:25:44,849
Um, whether do you know the

2932
01:25:44,849 --> 01:25:46,151
percentage that are unhoused?

2933
01:25:46,151 --> 01:25:46,384
And can you speak to that? I

2934
01:25:46,384 --> 01:25:47,819
know we

2935
01:25:47,819 --> 01:25:49,187
ve got one at least one

2936
01:25:49,187 --> 01:25:50,989
piece of data in the report

2937
01:25:50,989 --> 01:25:52,989
related to that.

2938
01:25:53,858 --> 01:25:55,993
Yeah. No problem. Um, as far as

2939
01:25:55,993 --> 01:25:58,290
like the first part with the

2940
01:25:58,290 --> 01:26:01,629
whether this is the true end,

2941
01:26:01,632 --> 01:26:03,935
we do a linkage with, um, the

2942
01:26:03,935 --> 01:26:05,870
death certificate. Birth

2943
01:26:05,870 --> 01:26:07,539
certificate. And we use things

2944
01:26:07,539 --> 01:26:09,939
like the pregnancy checkbox.

2945
01:26:10,175 --> 01:26:12,577
But, um, if someone is being if

2946
01:26:12,577 --> 01:26:14,245
someone has a traditional death

2947
01:26:14,245 --> 01:26:16,810
certificate, um, that comes

2948
01:26:16,810 --> 01:26:17,582
through the vital statistics

2949
01:26:17,582 --> 01:26:20,151
team, then we are getting

2950
01:26:20,151 --> 01:26:22,653
catching that person. Um, and

2951
01:26:22,653 --> 01:26:24,956
then as far as housing, um,

2952
01:26:24,956 --> 01:26:28,556
that can come through in kind

2953
01:26:28,660 --> 01:26:30,929
of abstracted records. Uh, but

2954
01:26:30,929 --> 01:26:33,164
we are working to develop a

2955
01:26:33,164 --> 01:26:35,233
flag that would identify if

2956
01:26:35,233 --> 01:26:36,901
someone is actually like

2957
01:26:36,901 --> 01:26:38,236
putting down a church address

2958
01:26:38,236 --> 01:26:38,770
or does not have an actual

2959
01:26:38,770 --> 01:26:39,203
address. So that

2960
01:26:39,203 --> 01:26:41,203
s something

2961
01:26:41,305 --> 01:26:42,974
that will be, um, adding into

2962
01:26:42,974 --> 01:26:44,974
the next report.

2963
01:26:45,644 --> 01:26:45,944
If I recall correctly, wasn

2964
01:26:45,944 --> 01:26:47,112
t

2965
01:26:47,112 --> 01:26:48,412
it nearly a third of the

2966
01:26:48,412 --> 01:26:49,981
pregnancy related deaths were

2967
01:26:49,981 --> 01:26:52,981
among people who faced housing

2968
01:26:53,585 --> 01:26:54,180
instability or were unhoused?

2969
01:26:54,180 --> 01:26:54,785
Um, I don

2970
01:26:54,785 --> 01:26:56,855
t know what off the

2971
01:26:56,855 --> 01:26:58,623
top of my head, but we do

2972
01:26:58,623 --> 01:26:59,323
identify a fair amount.

2973
01:26:59,323 --> 01:27:01,323
Okay.

2974
01:27:01,525 --> 01:27:03,928
And my final question was just

2975
01:27:03,928 --> 01:27:05,290
about, um, King County and sort

2976
01:27:05,290 --> 01:27:06,697
of our role on the Board of

2977
01:27:06,697 --> 01:27:06,998
Health that while it

2978
01:27:06,998 --> 01:27:08,133
s, you

2979
01:27:08,133 --> 01:27:09,968
know, obviously, really, really

2980
01:27:09,968 --> 01:27:11,968
important for confidentiality

2981
01:27:12,304 --> 01:27:15,140
reasons to, you know, limit the

2982
01:27:15,140 --> 01:27:17,174
local information. Um, does

2983
01:27:17,174 --> 01:27:19,574
King County, though, have

2984
01:27:20,412 --> 01:27:21,779
access to information to, to

2985
01:27:21,779 --> 01:27:22,314
these data? I guess for our

2986
01:27:22,314 --> 01:27:22,681
county, because it

2987
01:27:22,681 --> 01:27:23,849
s really

2988
01:27:23,849 --> 01:27:26,217
hard to think about

2989
01:27:26,217 --> 01:27:28,217
implementing recommendations

2990
01:27:28,519 --> 01:27:31,519
without knowing how your local

2991
01:27:31,723 --> 01:27:32,724
area is actually impacted.

2992
01:27:32,724 --> 01:27:34,626
Um, and do you want to speak to

2993
01:27:34,626 --> 01:27:36,528
that or do you want me to?

2994
01:27:36,528 --> 01:27:38,596
Sure I can, I can speak to it

2995
01:27:38,596 --> 01:27:40,231
and then you can add, um,

2996
01:27:40,231 --> 01:27:42,000
because this is such a small

2997
01:27:42,000 --> 01:27:44,803
number, like for one year, we

2998
01:27:44,803 --> 01:27:46,738
have about 20 around give or

2999
01:27:46,738 --> 01:27:48,738
take 20 pregnancy related

3000
01:27:49,307 --> 01:27:49,840
deaths. Um, just as the count,

3001
01:27:49,840 --> 01:27:51,376
we don

3002
01:27:51,376 --> 01:27:53,578
t even provide the

3003
01:27:53,578 --> 01:27:53,778
county to the panel members as

3004
01:27:53,778 --> 01:27:54,645
they

3005
01:27:54,645 --> 01:27:56,981
re reviewing the case

3006
01:27:56,981 --> 01:27:59,217
because it it can be that

3007
01:27:59,217 --> 01:28:01,519
identifiable. I will say that

3008
01:28:01,519 --> 01:28:03,220
you can see from our data that

3009
01:28:03,220 --> 01:28:04,822
a lot of deaths are happening

3010
01:28:04,822 --> 01:28:05,824
in urban areas. And I think

3011
01:28:05,824 --> 01:28:07,225
that a lot of the

3012
01:28:07,225 --> 01:28:09,527
recommendations would apply to

3013
01:28:09,527 --> 01:28:10,394
King County. Um, and you can

3014
01:28:10,394 --> 01:28:11,128
kind of like Deb

3015
01:28:11,128 --> 01:28:13,128
s mentioned in

3016
01:28:13,665 --> 01:28:14,650
the in the presentation based

3017
01:28:14,650 --> 01:28:16,650
on what you

3018
01:28:16,767 --> 01:28:18,669
re seeing from, uh,

3019
01:28:18,669 --> 01:28:21,390
general populations, you can

3020
01:28:21,390 --> 01:28:22,540
kind of make that, uh, pathway

3021
01:28:22,540 --> 01:28:24,420
to our report and pull out

3022
01:28:24,420 --> 01:28:25,410
what, what is really going to

3023
01:28:25,410 --> 01:28:27,512
apply to King County. But I

3024
01:28:27,512 --> 01:28:28,647
would say that a lot of them, a

3025
01:28:28,647 --> 01:28:30,415
lot of the recommendations

3026
01:28:30,415 --> 01:28:31,883
probably do apply.

3027
01:28:31,883 --> 01:28:33,885
I agree with all that. I mean,

3028
01:28:33,885 --> 01:28:35,220
King County has such diversity

3029
01:28:35,220 --> 01:28:37,956
on so many levels, including

3030
01:28:37,956 --> 01:28:38,323
urban and rural areas. Um, I

3031
01:28:38,323 --> 01:28:39,590
would say it

3032
01:28:39,590 --> 01:28:40,324
s all relevant.

3033
01:28:40,324 --> 01:28:41,526
Thank you.

3034
01:28:41,526 --> 01:28:43,526
Thank you.

3035
01:28:43,761 --> 01:28:45,797
Thank you. Boardman. Heartfelt

3036
01:28:45,797 --> 01:28:48,766
board member Lucero, you have a

3037
01:28:48,766 --> 01:28:50,235
floor.

3038
01:28:50,235 --> 01:28:52,103
Um, I just want to say thank

3039
01:28:52,103 --> 01:28:54,939
you for this report. I think

3040
01:28:54,939 --> 01:28:56,807
that, um, in contrast to the

3041
01:28:56,807 --> 01:28:58,910
federal system, you are

3042
01:28:58,910 --> 01:29:01,450
highlighting the reason for,

3043
01:29:01,450 --> 01:29:03,881
um, work around Dei. Um,

3044
01:29:03,881 --> 01:29:06,881
because being able to identify

3045
01:29:06,884 --> 01:29:09,287
these key populations and, you

3046
01:29:09,287 --> 01:29:11,289
know, specific interventions to

3047
01:29:11,289 --> 01:29:13,925
be able to address, um, you

3048
01:29:13,925 --> 01:29:16,161
know, the high impact is really

3049
01:29:16,161 --> 01:29:17,662
key. Um, I also want to point

3050
01:29:17,662 --> 01:29:18,963
out that, you know, when it

3051
01:29:18,963 --> 01:29:20,331
comes to substance use

3052
01:29:20,331 --> 01:29:22,534
disorder, we need to look at

3053
01:29:22,534 --> 01:29:23,701
the full continuum of care. So

3054
01:29:23,701 --> 01:29:24,769
from prevention, early

3055
01:29:24,769 --> 01:29:26,871
intervention all the way

3056
01:29:26,871 --> 01:29:28,506
through treatment, aftercare is

3057
01:29:28,506 --> 01:29:29,641
really lacking, particularly

3058
01:29:29,641 --> 01:29:31,510
for pregnant and parenting

3059
01:29:31,510 --> 01:29:32,577
people. Um, so, you know, just

3060
01:29:32,577 --> 01:29:33,611
to highlight here that the

3061
01:29:33,611 --> 01:29:36,110
number of treatment centers

3062
01:29:36,748 --> 01:29:38,449
opening on JULY 11th, um, with

3063
01:29:38,449 --> 01:29:39,817
the 15 beds dedicated to

3064
01:29:39,817 --> 01:29:42,217
serving pregnant and parenting

3065
01:29:42,820 --> 01:29:42,973
people opening in JANUARY. And

3066
01:29:42,973 --> 01:29:43,520
I

3067
01:29:43,520 --> 01:29:43,755
ll have to tell you, that

3068
01:29:43,755 --> 01:29:45,220
s

3069
01:29:45,220 --> 01:29:46,224
just not even going to scratch

3070
01:29:46,224 --> 01:29:46,491
the surface. And so I think

3071
01:29:46,491 --> 01:29:48,226
that that

3072
01:29:48,226 --> 01:29:50,940
s really key. Um,

3073
01:29:50,940 --> 01:29:51,429
also wanted to point out the,

3074
01:29:51,429 --> 01:29:53,965
you know, impact of work

3075
01:29:53,965 --> 01:29:55,834
requirements for Medicaid, um,

3076
01:29:55,834 --> 01:29:56,768
eligibility, uh, and how we

3077
01:29:56,768 --> 01:29:58,803
might be able to work as a

3078
01:29:58,803 --> 01:30:00,400
community to be to get through

3079
01:30:00,400 --> 01:30:00,204
that paperwork. Because really,

3080
01:30:00,204 --> 01:30:00,705
that

3081
01:30:00,705 --> 01:30:00,872
s what it is. It

3082
01:30:00,872 --> 01:30:02,841
s

3083
01:30:02,841 --> 01:30:04,743
paperwork burden. Um, and then

3084
01:30:04,743 --> 01:30:06,911
finally to highlight, um,

3085
01:30:06,911 --> 01:30:09,130
stigma and bias within hospital

3086
01:30:09,130 --> 01:30:10,214
systems, uh, because I know one

3087
01:30:10,214 --> 01:30:11,615
of the reasons that we have

3088
01:30:11,615 --> 01:30:12,984
such prominent information

3089
01:30:12,984 --> 01:30:14,452
related to American Indians,

3090
01:30:14,452 --> 01:30:16,287
Alaska Natives is because of a

3091
01:30:16,287 --> 01:30:18,287
particular incident that

3092
01:30:19,156 --> 01:30:21,993
really, uh, you know, showcased

3093
01:30:21,993 --> 01:30:23,394
the the bias within health care

3094
01:30:23,394 --> 01:30:25,230
delivery systems or just health

3095
01:30:25,230 --> 01:30:26,631
care systems, period. So again,

3096
01:30:26,631 --> 01:30:28,767
I just want to thank you for

3097
01:30:28,767 --> 01:30:30,435
this report. Um, and I look

3098
01:30:30,435 --> 01:30:32,470
forward to working with all of

3099
01:30:32,470 --> 01:30:35,106
you in interventions that are,

3100
01:30:35,106 --> 01:30:36,441
um, going to have impact.

3101
01:30:36,441 --> 01:30:38,430
Thank you. And likewise, and

3102
01:30:38,430 --> 01:30:38,976
yes, everything you say very

3103
01:30:38,976 --> 01:30:40,478
much is aligned with

3104
01:30:40,478 --> 01:30:41,579
recommendations in the report.

3105
01:30:41,579 --> 01:30:42,147
And yeah, I

3106
01:30:42,147 --> 01:30:42,446
m glad we

3107
01:30:42,446 --> 01:30:43,648
re all

3108
01:30:43,648 --> 01:30:46,480
thinking about the same

3109
01:30:46,117 --> 01:30:47,251
challenging things.

3110
01:30:47,251 --> 01:30:49,190
Thank you. Board member.

3111
01:30:49,190 --> 01:30:51,419
Lucero. Board member. Garcia.

3112
01:30:51,489 --> 01:30:52,857
Thank you for the presentation.

3113
01:30:52,857 --> 01:30:53,910
Uh, as sobering as it is, it

3114
01:30:53,910 --> 01:30:54,559
s

3115
01:30:54,559 --> 01:30:56,428
better that we are aware of

3116
01:30:56,428 --> 01:30:58,950
these issues. Um, and so thank

3117
01:30:58,950 --> 01:31:01,633
you very much for bringing this

3118
01:31:01,633 --> 01:31:03,340
up. Um, and, um, presenting,

3119
01:31:03,340 --> 01:31:04,735
uh, one of the things I, you

3120
01:31:04,735 --> 01:31:06,104
know, was looking into as you

3121
01:31:06,104 --> 01:31:08,440
were going through here is some

3122
01:31:08,440 --> 01:31:10,840
of the recommendations on

3123
01:31:12,310 --> 01:31:15,310
postpartum, um, and what kind

3124
01:31:15,713 --> 01:31:17,215
of resources has our public

3125
01:31:17,215 --> 01:31:20,215
health, uh, and King County

3126
01:31:21,453 --> 01:31:23,870
Public Health pointed towards

3127
01:31:23,870 --> 01:31:23,254
that aspect of things that

3128
01:31:23,254 --> 01:31:24,550
we

3129
01:31:24,550 --> 01:31:27,550
re very fortunate in the

3130
01:31:27,920 --> 01:31:30,194
city of Baron that we have, uh,

3131
01:31:30,194 --> 01:31:31,395
one doula who is a black woman

3132
01:31:31,395 --> 01:31:31,553
led doula service BlackBerry.

3133
01:31:31,553 --> 01:31:32,764
I

3134
01:31:32,764 --> 01:31:34,199
ve learned a lot about this

3135
01:31:34,199 --> 01:31:36,199
particular challenge through

3136
01:31:37,235 --> 01:31:37,502
their advocacy, but in a lot of

3137
01:31:37,502 --> 01:31:38,737
us, I

3138
01:31:38,737 --> 01:31:40,939
m also a board member

3139
01:31:40,939 --> 01:31:43,474
represented via our sca Small

3140
01:31:43,474 --> 01:31:45,443
Cities Association, and a lot

3141
01:31:45,443 --> 01:31:46,911
of the small cities in South

3142
01:31:46,911 --> 01:31:49,460
King County and around the

3143
01:31:49,460 --> 01:31:52,460
county. Just budget wise, are

3144
01:31:52,417 --> 01:31:54,619
strapped and wanting to, uh,

3145
01:31:54,619 --> 01:31:56,321
invest into this. So I just

3146
01:31:56,321 --> 01:31:57,755
wanted to have a reality check

3147
01:31:57,755 --> 01:31:59,257
on to what kind of funding has

3148
01:31:59,257 --> 01:32:01,526
the county allocated towards

3149
01:32:01,526 --> 01:32:03,194
this specifically, like doula

3150
01:32:03,194 --> 01:32:06,764
postpartum? Since a lot of this

3151
01:32:06,764 --> 01:32:08,732
happens after birth? And, um,

3152
01:32:08,732 --> 01:32:10,267
how will the current budget

3153
01:32:10,267 --> 01:32:10,432
crunch impact that? As I

3154
01:32:10,432 --> 01:32:12,432
m

3155
01:32:12,437 --> 01:32:14,706
preparing for my own budget in

3156
01:32:14,706 --> 01:32:16,740
the city of Bern?

3157
01:32:16,740 --> 01:32:16,974
Thank you for highlighting all

3158
01:32:16,974 --> 01:32:17,842
of that. And I

3159
01:32:17,842 --> 01:32:19,343
m hoping that

3160
01:32:19,343 --> 01:32:21,713
the report, especially the

3161
01:32:21,713 --> 01:32:23,581
findings about how critical

3162
01:32:23,581 --> 01:32:25,683
this is in later postpartum,

3163
01:32:25,683 --> 01:32:27,652
can help add some momentum to

3164
01:32:27,652 --> 01:32:30,652
any support seeking to address

3165
01:32:31,656 --> 01:32:33,424
postpartum issues. So thank you.

3166
01:32:33,424 --> 01:32:35,424
I just.

3167
01:32:36,194 --> 01:32:37,395
Want to respond to board Member

3168
01:32:37,395 --> 01:32:40,395
Garcia about a couple of

3169
01:32:40,998 --> 01:32:42,667
things. Um, so in terms of

3170
01:32:42,667 --> 01:32:43,768
services that Public Health

3171
01:32:43,768 --> 01:32:45,704
Seattle and King County

3172
01:32:45,704 --> 01:32:47,572
provides, we provide a number

3173
01:32:47,572 --> 01:32:49,240
of maternal and child health

3174
01:32:49,240 --> 01:32:51,442
related services to ensure

3175
01:32:51,442 --> 01:32:53,612
healthy pregnancies and early

3176
01:32:53,612 --> 01:32:54,912
childhood development. Um, so

3177
01:32:54,912 --> 01:32:56,130
just not running through

3178
01:32:56,130 --> 01:32:57,615
everything, but just a couple

3179
01:32:57,615 --> 01:32:58,750
of the programs we have, the

3180
01:32:58,750 --> 01:33:01,150
women, infants and Children

3181
01:33:01,185 --> 01:33:02,620
program, um, which supports

3182
01:33:02,620 --> 01:33:04,422
pregnant postpartum

3183
01:33:04,422 --> 01:33:05,623
breastfeeding individuals as

3184
01:33:05,623 --> 01:33:07,258
well as children up to age

3185
01:33:07,258 --> 01:33:09,260
five. We have a nurse family

3186
01:33:09,260 --> 01:33:10,895
partnership that pairs low

3187
01:33:10,895 --> 01:33:12,864
income, first time mothers with

3188
01:33:12,864 --> 01:33:15,660
a registered nurse for home

3189
01:33:15,660 --> 01:33:16,835
visits from early pregnancy

3190
01:33:16,835 --> 01:33:18,335
until, I believe, until the

3191
01:33:18,335 --> 01:33:18,903
child is two. Uh, there

3192
01:33:18,903 --> 01:33:20,903
s also

3193
01:33:21,338 --> 01:33:22,707
a family waste program, which

3194
01:33:22,707 --> 01:33:24,707
provides pregnancy and

3195
01:33:25,430 --> 01:33:27,443
parenting support, peer support

3196
01:33:28,112 --> 01:33:30,470
for families that identify as

3197
01:33:30,470 --> 01:33:32,283
black, African American, Native

3198
01:33:32,283 --> 01:33:33,851
American, Alaska Native and

3199
01:33:33,851 --> 01:33:35,851
Pacific Islander, Native

3200
01:33:35,887 --> 01:33:38,156
Hawaiian communities. Um, and

3201
01:33:38,156 --> 01:33:40,224
then we also have a first steps

3202
01:33:40,224 --> 01:33:42,193
maternity support services and

3203
01:33:42,193 --> 01:33:44,593
infant case management program.

3204
01:33:46,300 --> 01:33:48,499
Um, and this is for individuals

3205
01:33:48,499 --> 01:33:50,101
that are on Apple Health. And,

3206
01:33:50,101 --> 01:33:51,769
um, it helps to support healthy

3207
01:33:51,769 --> 01:33:53,400
pregnancies through care

3208
01:33:53,400 --> 01:33:54,805
coordination and family

3209
01:33:54,805 --> 01:33:55,506
support. Um, in terms of the

3210
01:33:55,506 --> 01:33:56,508
funding, we

3211
01:33:56,508 --> 01:33:57,875
d have to get back

3212
01:33:57,875 --> 01:33:58,809
to you with specifics. You

3213
01:33:58,809 --> 01:34:00,178
know, some of these programs

3214
01:34:00,178 --> 01:34:02,130
are federally funded, some of

3215
01:34:02,130 --> 01:34:03,347
them receive, um, state

3216
01:34:03,347 --> 01:34:05,350
funding. Some of them are

3217
01:34:05,350 --> 01:34:06,384
funded through fs dollars. Some

3218
01:34:06,384 --> 01:34:07,852
of them are like completely

3219
01:34:07,852 --> 01:34:08,190
braided funding, you know, so

3220
01:34:08,190 --> 01:34:10,190
it

3221
01:34:11,255 --> 01:34:13,124
s a mix. Um, but just to, to

3222
01:34:13,124 --> 01:34:15,493
get a, you know, some a

3223
01:34:15,493 --> 01:34:17,462
sampling of the wide variety of

3224
01:34:17,462 --> 01:34:19,631
services that we provide to

3225
01:34:19,631 --> 01:34:21,732
support healthy pregnancies and

3226
01:34:21,732 --> 01:34:23,934
to help prevent, um, maternal

3227
01:34:23,934 --> 01:34:25,503
mortality in our county.

3228
01:34:25,503 --> 01:34:25,703
Thank you very much, director.

3229
01:34:25,703 --> 01:34:26,604
That

3230
01:34:26,604 --> 01:34:27,400
s really appreciated. I

3231
01:34:27,400 --> 01:34:29,400
m

3232
01:34:29,441 --> 01:34:30,909
hoping to circle back on how

3233
01:34:30,909 --> 01:34:31,409
the funding for it works. It

3234
01:34:31,409 --> 01:34:31,976
sounds like there

3235
01:34:31,976 --> 01:34:32,677
s a lot of

3236
01:34:32,677 --> 01:34:33,770
services there. I

3237
01:34:33,770 --> 01:34:35,770
m not sure

3238
01:34:36,213 --> 01:34:38,216
how geographically they are

3239
01:34:38,216 --> 01:34:40,251
impacting. Uh, speaking of

3240
01:34:40,251 --> 01:34:41,753
southern ca city, just making

3241
01:34:41,753 --> 01:34:44,656
sure that that we are doing our

3242
01:34:44,656 --> 01:34:47,656
part to promote and support

3243
01:34:47,692 --> 01:34:49,594
referrals and those programs,

3244
01:34:49,594 --> 01:34:51,161
uh, especially, you know, for

3245
01:34:51,161 --> 01:34:52,597
us cities that have, uh, South

3246
01:34:52,597 --> 01:34:52,756
King County as a regions, I

3247
01:34:52,756 --> 01:34:54,198
m

3248
01:34:54,198 --> 01:34:57,435
kind of connecting the dots and

3249
01:34:57,435 --> 01:34:59,803
previous presentation on sti,

3250
01:34:59,803 --> 01:35:01,739
hiv to current presentation.

3251
01:35:01,739 --> 01:35:03,341
And how in that particular

3252
01:35:03,341 --> 01:35:04,475
geographic impact, South King

3253
01:35:04,475 --> 01:35:06,210
County was just bearing the

3254
01:35:06,210 --> 01:35:06,644
brunt. And historically, we do

3255
01:35:06,644 --> 01:35:08,479
that here. I

3256
01:35:08,479 --> 01:35:09,848
m enduring and

3257
01:35:09,848 --> 01:35:11,582
just wanted to make sure that

3258
01:35:11,582 --> 01:35:12,817
we do as much as possible to

3259
01:35:12,817 --> 01:35:14,218
lift up the current programs

3260
01:35:14,218 --> 01:35:16,588
that are out there, keep

3261
01:35:16,588 --> 01:35:18,656
funding as much as we can, and

3262
01:35:18,656 --> 01:35:21,225
also look at to how to improve,

3263
01:35:21,225 --> 01:35:22,961
maybe more culturally specific,

3264
01:35:22,961 --> 01:35:24,620
like doulas. I heard a lot

3265
01:35:24,620 --> 01:35:26,462
about, you know, in-home

3266
01:35:26,965 --> 01:35:28,466
nursing. Um, but just, uh,

3267
01:35:28,466 --> 01:35:29,234
learning. And I have a lot to

3268
01:35:29,234 --> 01:35:29,834
learn, and I

3269
01:35:29,834 --> 01:35:32,234
m always open to

3270
01:35:32,369 --> 01:35:33,380
that. How to keep this in the

3271
01:35:33,380 --> 01:35:33,237
forefront because there

3272
01:35:33,237 --> 01:35:34,839
s so

3273
01:35:34,839 --> 01:35:38,439
many things. But this is really

3274
01:35:39,510 --> 01:35:41,910
sobering. So thank you.

3275
01:35:42,460 --> 01:35:44,382
Thank you. Board member Garcia,

3276
01:35:44,382 --> 01:35:46,170
any board member Garcia, was

3277
01:35:46,170 --> 01:35:48,417
there anything else? Okay,

3278
01:35:49,186 --> 01:35:51,489
okay, okay. Um, any additional

3279
01:35:51,489 --> 01:35:53,391
questions or comments from the

3280
01:35:53,391 --> 01:35:54,580
board members? Uh, I will say

3281
01:35:54,580 --> 01:35:54,692
this. Now that we

3282
01:35:54,692 --> 01:35:56,692
ve heard

3283
01:35:57,295 --> 01:35:59,330
this, um, I really want to name

3284
01:35:59,330 --> 01:36:01,699
where I believe it must lead

3285
01:36:01,699 --> 01:36:04,736
us. Um, we have just been

3286
01:36:04,736 --> 01:36:06,904
handed a data. The stories, the

3287
01:36:06,904 --> 01:36:09,600
recommendations. Um, what? We

3288
01:36:09,600 --> 01:36:11,750
do not yet have is a vehicle to

3289
01:36:11,750 --> 01:36:11,543
carry them forward. So, I

3290
01:36:11,543 --> 01:36:13,543
m

3291
01:36:14,611 --> 01:36:17,140
asking for one, and we would

3292
01:36:17,140 --> 01:36:18,816
not be the first right here in

3293
01:36:18,816 --> 01:36:20,151
Washington County. Board of

3294
01:36:20,151 --> 01:36:21,619
health have already heard this

3295
01:36:21,619 --> 01:36:24,190
call and answered, actually,

3296
01:36:24,322 --> 01:36:25,623
last fall, um, Clark County

3297
01:36:25,623 --> 01:36:27,458
Board of Health passed a

3298
01:36:27,458 --> 01:36:29,360
resolution committing to

3299
01:36:29,360 --> 01:36:30,328
closing the gaps in pregnancy

3300
01:36:30,328 --> 01:36:31,796
related care for their

3301
01:36:31,796 --> 01:36:33,931
residents. They turned a

3302
01:36:33,931 --> 01:36:35,599
presentation into a promise.

3303
01:36:35,599 --> 01:36:37,769
And I believe King County can

3304
01:36:37,769 --> 01:36:39,671
do the same, and that we can

3305
01:36:39,671 --> 01:36:41,105
tailor it to the families we

3306
01:36:41,105 --> 01:36:41,906
serve. So I

3307
01:36:41,906 --> 01:36:44,800
m calling on this

3308
01:36:44,800 --> 01:36:46,100
board to form a sort of

3309
01:36:46,100 --> 01:36:47,712
maternal and perinatal

3310
01:36:47,712 --> 01:36:49,247
workgroup. A group of board

3311
01:36:49,247 --> 01:36:51,382
member volunteers willing to

3312
01:36:51,382 --> 01:36:53,351
take what we heard today and

3313
01:36:53,351 --> 01:36:54,418
shape it into a perinatal

3314
01:36:54,418 --> 01:36:54,718
resolution for the board

3315
01:36:54,718 --> 01:36:56,153
s

3316
01:36:56,153 --> 01:36:56,920
full, um, for the full board

3317
01:36:56,920 --> 01:36:58,920
s

3318
01:36:59,390 --> 01:37:00,925
consideration. Um, I am not

3319
01:37:00,925 --> 01:37:02,727
asking us to decide its

3320
01:37:02,727 --> 01:37:04,280
contents right now. The

3321
01:37:04,280 --> 01:37:05,229
language and the commitments

3322
01:37:05,229 --> 01:37:07,398
belong to the workgroup built

3323
01:37:07,398 --> 01:37:07,555
together and with care. When

3324
01:37:07,555 --> 01:37:09,555
I

3325
01:37:09,567 --> 01:37:11,702
m asking for right now is

3326
01:37:11,702 --> 01:37:14,605
simpler. Who is willing to do

3327
01:37:14,605 --> 01:37:15,106
this? Work with me? I will also

3328
01:37:15,106 --> 01:37:15,673
share that I

3329
01:37:15,673 --> 01:37:17,673
ve spoken with

3330
01:37:17,975 --> 01:37:19,777
Chair Mosqueda about this, and

3331
01:37:19,777 --> 01:37:22,513
I bring it forward with her

3332
01:37:22,513 --> 01:37:24,849
support and her permission. So

3333
01:37:24,849 --> 01:37:27,251
I will open the floor. If this

3334
01:37:27,251 --> 01:37:29,540
is moved you the way that it

3335
01:37:29,540 --> 01:37:30,455
moves me daily, I will be

3336
01:37:30,455 --> 01:37:32,256
honored to have you at the

3337
01:37:32,256 --> 01:37:33,724
table. If you are willing to

3338
01:37:33,724 --> 01:37:35,125
serve, please raise your hand

3339
01:37:35,125 --> 01:37:37,940
now so we can capture your

3340
01:37:37,940 --> 01:37:39,697
name. And if you want to think

3341
01:37:39,697 --> 01:37:41,599
about it, um. And would you

3342
01:37:41,599 --> 01:37:43,768
reach out to Joey? Um,

3343
01:37:43,768 --> 01:37:44,902
Carpenter, Garzanti, our board

3344
01:37:44,902 --> 01:37:45,202
administrator, after today

3345
01:37:45,202 --> 01:37:47,202
s

3346
01:37:47,672 --> 01:37:50,672
meeting? Either way, the table

3347
01:37:53,477 --> 01:37:56,413
is open. Okay. And so it looks

3348
01:37:56,413 --> 01:38:00,130
like. Okay, I see from my

3349
01:38:01,419 --> 01:38:02,186
screen, I see Vice Chair Foster.

3350
01:38:02,186 --> 01:38:03,554
Yes, i

3351
01:38:03,554 --> 01:38:04,889
d love to. Thank you.

3352
01:38:04,889 --> 01:38:06,824
Okay. Thank you, thank you.

3353
01:38:06,824 --> 01:38:07,859
Vice chair c, board member.

3354
01:38:07,859 --> 01:38:08,626
Heartfelt.

3355
01:38:08,626 --> 01:38:10,610
Yeah.

3356
01:38:10,610 --> 01:38:11,950
Thank you. Board member. Awful

3357
01:38:11,950 --> 01:38:11,896
I c board member.

3358
01:38:11,896 --> 01:38:13,300
Gojo. I

3359
01:38:13,300 --> 01:38:14,532
m in.

3360
01:38:14,532 --> 01:38:17,602
Thank you. Board member. Gojo I

3361
01:38:17,602 --> 01:38:18,969
see board member. Garcia.

3362
01:38:18,969 --> 01:38:20,437
Minute to win it.

3363
01:38:20,437 --> 01:38:22,837
Thank you. Board member.

3364
01:38:22,974 --> 01:38:23,174
Garcia. Did I MISS Anyone

3365
01:38:23,174 --> 01:38:25,174
else

3366
01:38:30,981 --> 01:38:32,349
s hand? Okay. Okay. And,

3367
01:38:32,349 --> 01:38:33,718
um. And like I said, if you

3368
01:38:33,718 --> 01:38:35,987
want to think on it, reach out

3369
01:38:35,987 --> 01:38:36,187
to Joi. Um, after, um, after

3370
01:38:36,187 --> 01:38:38,187
today

3371
01:38:38,456 --> 01:38:41,456
s meeting. Thank you so

3372
01:38:41,826 --> 01:38:44,896
much. Uh, Debs and any, um, for

3373
01:38:44,896 --> 01:38:46,798
your report. Um, it has

3374
01:38:46,798 --> 01:38:49,198
definitely been eye opening.

3375
01:38:51,101 --> 01:38:53,204
Uh, so next, we will move on to

3376
01:38:53,204 --> 01:38:56,204
updates. Do any board members

3377
01:38:57,575 --> 01:38:58,510
have updates to share? Board

3378
01:38:58,510 --> 01:39:00,770
member. Heartfelt. Board

3379
01:39:00,770 --> 01:39:01,846
member. Garcia, I. I see your

3380
01:39:01,846 --> 01:39:06,460
hands up. Or is it up there?

3381
01:39:06,217 --> 01:39:09,217
Okay. Okay. Any updates to

3382
01:39:09,587 --> 01:39:11,990
share? Going once, going twice.

3383
01:39:11,990 --> 01:39:14,990
Okay. Not seeing anyone. Okay.

3384
01:39:15,893 --> 01:39:18,395
All right. Okay. Oh. Board

3385
01:39:18,395 --> 01:39:20,631
member. Mustafa, I see you.

3386
01:39:20,631 --> 01:39:23,501
Uh, yeah. Thank you. Uh, just

3387
01:39:23,501 --> 01:39:25,269
the program of the, uh, health

3388
01:39:25,269 --> 01:39:26,337
program. Department of health.

3389
01:39:26,337 --> 01:39:28,539
Because of the Trump

3390
01:39:28,539 --> 01:39:29,973
administration, it was been

3391
01:39:29,973 --> 01:39:32,376
yesterday. It was the last

3392
01:39:32,376 --> 01:39:33,777
meeting, and we graduated from

3393
01:39:33,777 --> 01:39:35,979
that. The Community Advisory

3394
01:39:35,979 --> 01:39:36,614
Council and health equity zone.

3395
01:39:36,614 --> 01:39:37,214
So we don

3396
01:39:37,214 --> 01:39:37,648
t we don

3397
01:39:37,648 --> 01:39:38,149
t have

3398
01:39:38,149 --> 01:39:39,317
funding. That

3399
01:39:39,317 --> 01:39:41,119
s the program we

3400
01:39:41,119 --> 01:39:42,419
started four years ago. We

3401
01:39:42,419 --> 01:39:44,189
stopped that. So now I just

3402
01:39:44,189 --> 01:39:45,550
want to update you guys for

3403
01:39:45,550 --> 01:39:46,891
that.

3404
01:39:46,891 --> 01:39:49,291
Thank you. Board member

3405
01:39:51,529 --> 01:39:51,929
Mohammed, board member Gojo.

3406
01:39:51,929 --> 01:39:53,364
Okay. I

3407
01:39:53,364 --> 01:39:55,165
m speaking as a private

3408
01:39:55,165 --> 01:39:56,967
citizen right now and not as a

3409
01:39:56,967 --> 01:39:59,367
representative of Health Point,

3410
01:40:00,204 --> 01:40:04,842
but I do want to, um, I do want

3411
01:40:04,842 --> 01:40:07,842
to, uh, uh, appreciate my

3412
01:40:08,646 --> 01:40:11,460
organization for stepping into

3413
01:40:11,215 --> 01:40:13,951
the East King County area. Um,

3414
01:40:13,951 --> 01:40:16,951
a very large, important, uh,

3415
01:40:18,189 --> 01:40:20,589
primary care. Uh, delivery

3416
01:40:22,627 --> 01:40:25,363
location. Um, is closing, and,

3417
01:40:25,363 --> 01:40:28,320
uh, that would leave a huge gap

3418
01:40:28,320 --> 01:40:31,320
in an already spread thin

3419
01:40:31,235 --> 01:40:32,804
primary care system. Um, in

3420
01:40:32,804 --> 01:40:35,873
South King County. And we are

3421
01:40:35,873 --> 01:40:38,209
going to be opening a clinic in

3422
01:40:38,209 --> 01:40:40,511
that same space to preserve the

3423
01:40:40,511 --> 01:40:42,480
primary care there. And, um,

3424
01:40:42,480 --> 01:40:44,810
prenatal care, perinatal care

3425
01:40:44,810 --> 01:40:47,810
has been identified as a

3426
01:40:47,318 --> 01:40:50,187
priority. Um, service at that

3427
01:40:50,187 --> 01:40:52,187
location.

3428
01:40:54,558 --> 01:40:57,558
Thank you. Board member Gojo.

3429
01:40:59,196 --> 01:41:01,596
Okay. Any additional updates?

3430
01:41:02,132 --> 01:41:04,602
All right. Um, next. Is there

3431
01:41:04,602 --> 01:41:08,202
any other business to come for?

3432
01:41:10,775 --> 01:41:12,877
To come before the board? Okay.

3433
01:41:12,877 --> 01:41:15,277
Hearing none. Seeing none.

3434
01:41:16,447 --> 01:41:17,848
Okay. Quick reminder, our next

3435
01:41:17,848 --> 01:41:20,000
Board of Health meeting is