[0:05] Good afternoon, everyone. Thank

[0:06] you so much for joining us here

[0:09] today. On JULY 16th, 2020.

[0:12] Excuse me. JULY 16th, 2026. The

[0:13] King County Board of Health

[0:14] meeting will come to order. I

[0:14] m

[0:16] Teresa Mosqueda, chair of the

[0:16] board. It

[0:17] s wonderful to see

[0:19] everyone here. And I understand

[0:21] that we do have a quorum. Uh,

[0:22] clerk. Hey, do you mind calling

[0:23] the roll?

[0:25] Sure. Thank you. Board member.

[0:29] Dunn. Board member. Lewis.

[0:31] Board member. Von Reichbauer.

[0:33] Board member. Foster. Board

[0:36] member. Juarez. Board member.

[0:38] Rinke. Board member. Saca.

[0:41] Board member. Falcon. Board

[0:44] member. Garcia.

[0:45] Board PRESIDENT.

[0:48] Thank you. Board member. Shroff.

[0:52] Board member. Blas. Board

[0:54] member. Core here. Board

[0:59] member. Packet. Board member.

[1:01] De Castro present. Board

[1:03] member. Chiu. Present. Board

[1:06] member. Gojo. Board member.

[1:09] Hartfield present. Board

[1:12] member. Daniels present.

[1:15] Present.

[1:17] Board member Mohammad.

[1:18] PRESIDENT Present.

[1:20] Board member. Green. Board

[1:23] member. Archer. Poli.

[1:23] Present.

[1:25] Board member. Lu.

[1:27] Chia.

[1:29] Board member Milan Garneau.

[1:32] Board member. Elkins. Board

[1:35] member Thomas present. Board

[1:36] member.

[1:38] Williams present.

[1:41] Board member. De Los Angeles

[1:45] board member Bowen board

[1:47] member. Lucero. Board member.

[1:50] Gilli. Chair. Mosqueda.

[1:50] Present.

[1:51] You have a quorum.

[1:53] Thank you so much. Did anyone

[1:54] want to announce themselves

[1:56] that MAY have come in after

[1:57] their name was called in the

[2:00] roll call. Okay, wonderful. And

[2:03] as always, we welcome

[2:05] alternates who are here in the

[2:07] place of our regular board

[2:09] members. Are there any

[2:10] alternates serving in the place

[2:11] of our regular board members

[2:13] here with us today that would

[2:16] like to announce themselves?

[2:17] Okay, excellent. And as we see

[2:20] new board members join us, if

[2:21] the clerks could help me with,

[2:23] um, announcing them, that would

[2:24] be great. We again, thank you

[2:26] all for joining us here today.

[2:29] Um, and I want to say, um, it

[2:30] s

[2:32] been very nice to be able to

[2:34] have an opportunity to connect

[2:36] with you all via zoom. We

[2:38] continue to meet via zoom, uh,

[2:38] because there

[2:39] s frankly not

[2:40] enough seats here at the King

[2:42] County Council. Um, given our

[2:44] larger size of the board

[2:46] meeting. That said, I will be

[2:48] here in person to be present

[2:50] with our staff and team who are

[2:52] here with us in chambers. And

[2:53] while we don

[2:53] t have enough

[2:55] chairs, if there are people who

[2:56] ever do feel like they want to

[2:57] come in person, of course you

[2:59] are welcome. And to our

[3:00] presenters, we do think that

[3:01] it

[3:02] s probably easier for folks

[3:03] to join via zoom, because then

[3:05] the presentations can be easily

[3:07] seen by all members on the

[3:08] zoom. But we are also wanting

[3:10] to make sure that anybody who

[3:12] prefers to come in person for a

[3:13] presentation or serving on the

[3:15] diocese, welcome to do so. We

[3:17] continue to see, um, that

[3:19] communicable diseases are

[3:22] amongst our community members,

[3:23] including Covid, which is still

[3:25] present in addition to other

[3:26] communicable diseases. So in an

[3:29] effort to, uh, live our public

[3:31] health values, we do offer this

[3:33] hybrid format and encourage

[3:34] folks to do what is ever most

[3:36] comfortable to them and to stay

[3:38] home. If you are sick. Uh, with

[3:40] that, we do have a full agenda

[3:41] today. I want to note that we

[3:44] will have the, chairs. Um,

[3:45] excuse me. The director

[3:45] s

[3:47] report from director Sandra

[3:49] Valenciano, who will provide an

[3:51] regular update. You can also

[3:53] find her written report. Uh, in

[3:54] the meeting materials,

[3:56] beginning on page ten. We will

[3:59] also have Joy Carpine-Cazzanti,

[4:01] our board administrator, give

[4:02] us a quick update about board

[4:03] membership and this summer

[4:04] s

[4:05] recruitment efforts for the

[4:07] upcoming year 2027. We

[4:07] ll have

[4:08] a briefing on the pet

[4:10] businesses and public health,

[4:12] zoonotic disease code and

[4:14] rates. These proposed changes

[4:15] will come before the board at

[4:17] our SEPTEMBER meeting for an

[4:18] actual vote. So today is just a

[4:20] briefing. We will have an

[4:22] update on the Seattle and King

[4:23] County Continuum of Care

[4:24] efforts. Thank you very much to

[4:27] Board Member Liu for who, uh,

[4:29] requested this item. And it is

[4:30] very timely given that the

[4:32] Continuum of Care application

[4:35] was just due on JULY 3rd. And

[4:36] the ongoing conversations that

[4:36] we

[4:38] re having across the region

[4:39] and nation about the importance

[4:40] of the continuum of care

[4:42] dollars, we will have a

[4:44] discussion and panel that will

[4:45] include the King County

[4:46] Regional Homelessness

[4:47] Authority, the Downtown

[4:48] Emergency Services Center, and

[4:50] labor partners who provide

[4:51] direct services to our most

[4:55] vulnerable from the Office of

[4:57] Opioid, Office of Professional

[4:59] Employees, and International

[5:01] Union protect 17 and Service

[5:02] Employees International Union

[5:04] Health Care 1199 northwest.

[5:05] Finally, we will have a

[5:07] briefing about the impacts of

[5:09] the current political

[5:10] environment on gender affirming

[5:12] care. Thank you very much to

[5:13] Board member Tripoli for

[5:15] requesting this item on our

[5:17] work plan as well. At the end

[5:18] of the meeting, if there

[5:18] s any

[5:19] updates that board members

[5:20] would like to share, you will

[5:21] have an opportunity to do so

[5:23] under go to the order and

[5:25] please note that our AUGUST

[5:27] 20th meeting is canceled and

[5:28] the next meeting will be at our

[5:30] regularly scheduled third

[5:32] Thursday time. That would be

[5:34] SEPTEMBER 17th, beginning at 1

[5:36] P.M.. So we do take a little

[5:37] bit of an AUGUST recess for

[5:39] Board of Health as well. Uh,

[5:40] with that, we are now on to

[5:41] approval of the minutes. I

[5:41] d

[5:43] like to ask our vice chair,

[5:44] vice chair, foster or vice

[5:45] chair Daniels, would you like

[5:48] to move approval of the minutes

[5:51] from JUNE 18th, 2026?

[5:54] This is this is board member

[5:55] Daniels. I so moved.

[5:58] Thank you. Vice, uh, vice chair

[6:00] Daniel. I vice chair Daniels

[6:04] for moving approval of the JUNE

[6:06] 18th, 2026 meeting minutes. The

[6:07] meeting minutes are in front of

[6:08] us. Are there any corrections,

[6:11] additions, or comments? Hearing

[6:12] none. All in favor of approving

[6:14] the JUNE 18th, 2026 meeting

[6:15] minutes. Please say aye.

[6:17] Aye. Hi.

[6:20] Any opposed? Any abstentions?

[6:21] Okay.

[6:23] The abstain.

[6:25] Uh, thank you. Board member.

[6:26] Williams. So noted. Board

[6:28] member Williams is abstaining.

[6:29] All the other votes were in

[6:31] favor. Thank you very much. Uh,

[6:32] that brings us to public

[6:33] comment. I believe we do have

[6:35] people in person and perhaps

[6:36] online who would like to

[6:38] provide public comment. As a

[6:39] reminder, if you are online,

[6:41] please push star six. If you

[6:41] re

[6:42] on the phone or use the raise

[6:43] hand feature and zoom to

[6:44] indicate that you

[6:44] d like to

[6:46] provide public comment. Uh,

[6:48] board member Dunn, I see you

[6:49] joining us on screen. Thank you

[6:50] very much for joining at the

[6:52] Board of Health here today. And

[6:53] before I move on with any other

[6:54] public comment, are there any

[6:56] other board members that are

[6:56] joining us that would like to

[7:00] announce their presence? Okay.

[7:01] Well, thank you. Board member

[7:03] Dunn. And again, um, if the

[7:04] team if the clerks can help,

[7:05] uh, signal if there

[7:06] s any other

[7:06] board members joining us, I

[7:07] m

[7:08] happy to welcome them. Uh, you

[7:10] made it just in time for public

[7:11] comment. Um, board member Don,

[7:12] I know you were looking forward

[7:13] to that. So why don

[7:13] t we go

[7:14] ahead and get started with

[7:15] public comment right away?

[7:16] Again, if you

[7:17] re on zoom use to

[7:18] raise hand feature or push star

[7:21] six, and do we have anybody

[7:22] online that would like to

[7:24] provide public comment?

[7:25] So far?

[7:26] Not yet. We will continue to

[7:29] watch for that. Okay. With

[7:30] that, for folks in person, you

[7:31] do have two minutes. You

[7:32] ll see

[7:33] a yellow light when it

[7:33] s

[7:35] indicating your time needs to

[7:36] wrap up. Please keep your eye

[7:39] on comments germane to the

[7:41] agenda and refrain from

[7:42] impugning any members of the

[7:44] public, the staff. Excuse me,

[7:45] any members of the staff, the

[7:47] electeds and board members? Uh.

[7:48] With that, please go ahead and

[7:50] call public comment.

[7:52] Thank you. Chair Mosqueda.

[7:54] First person in chambers is

[7:56] Alex Zimmerman.

[7:56] Nice. That

[7:57] s my friend Alex.

[7:58] You have been called. Please

[8:00] leave your sign at your seat.

[8:03] In accordance with our King

[8:05] County rules. And your time has

[8:08] started, please start us time.

[8:08] All right? Don

[8:09] t come to

[8:11] microphone. Why will you watch.

[8:15] For Alex? Your time has started.

[8:23] What are you doing?

[8:24] We

[8:25] re not going to put the

[8:26] camera on you until you put

[8:27] your sign down. Thank you so

[8:28] much.

[8:30] Hi. My name, Alex Zimmerman. I

[8:31] wanna speak about something

[8:34] that is absolutely absurd. You

[8:35] are real, Bendita. You are a

[8:38] real killer. So we have today

[8:40] agenda number ten about

[8:41] something. What a scare you

[8:43] have here. I explain to you my

[8:47] experience. Okay? King County

[8:50] housing Authority spent $100

[8:52] million for dozens, thousands

[8:53] of legal immigrants. People

[8:58] with documents. We have 20,000

[9:00] homeless, 20,000 homeless cost

[9:03] us every year. Approximately $1

[9:06] billion in 500 dying every year.

[9:08] Situation. What is here with

[9:12] this Nazi Gestapo killer? What

[9:14] is I see here in this screen?

[9:15] You know what is meant. How is

[9:16] this possible? You know what

[9:20] this means. So, King country

[9:21] Housing Authority, I

[9:23] investigate this all. We come

[9:25] to conclusions. So they are

[9:27] pure criminal because they

[9:31] violate executive order from

[9:32] Donald Trump at his one year

[9:34] old right now. So all

[9:36] government department posts a

[9:38] big only to citizens. I cannot

[9:40] find a low income. A thousand

[9:43] people cannot find this 20,000

[9:45] homeless, almost all American

[9:48] citizens we can provide to them

[9:50] a room, you know what I mean.

[9:51] They said, that

[9:51] s exactly

[9:52] what

[9:52] s happened. You don

[9:53] t do

[9:55] this because you, burn Jeter

[9:56] and Killer. That

[9:56] s exactly who

[9:57] you are. You

[9:58] re more dangerous

[10:00] than Nazi. Viva Trump. Even

[10:02] your American Revolution stand

[10:04] up slave and happy cow. Stop

[10:08] stealing money from me.

[10:09] Anybody else signed up for

[10:12] public comment? Anybody else in

[10:13] chambers that would like to

[10:14] provide public comment? I

[10:15] m not

[10:17] seeing anybody in chambers and

[10:19] nobody else online going once,

[10:21] going twice. Okay. Thank you so

[10:21] much. Let

[10:22] s go ahead and move

[10:24] on with the agenda that does

[10:26] bring us to Director Valenciano

[10:27] for an update. Thank you very

[10:28] much, Director Valenciano, for

[10:29] your written report and for

[10:31] being here with us again in

[10:32] person. Great to see you.

[10:34] Please go ahead.

[10:37] Thank you. Chair Mesquita. Um,

[10:40] hello. Board of health members.

[10:42] Uh, I only have a few minutes

[10:44] today for updates, so I wanted

[10:45] to first start off with

[10:47] thanking all of our public

[10:49] health staff for their work on

[10:52] our fifa response. So luckily,

[10:55] we survived our fifa World Cup

[10:58] and everything went pretty

[11:00] smoothly in King County. So

[11:02] yes, snaps to all of our public

[11:04] health staff. We spent a whole

[11:06] lot of time preparing for fifa

[11:08] World Cup, and really, I think

[11:09] we got lucky that there were no

[11:11] major public health issues or

[11:12] outbreaks or foodborne

[11:14] outbreaks during this time, but

[11:14] I

[11:15] m just super thankful to all

[11:17] of the staff that were involved

[11:19] in the response in planning.

[11:23] Um, on our mcc team and now in

[11:25] the post, um, debrief period.

[11:27] So thank you to everybody. Uh,

[11:29] although I will say I

[11:29] m

[11:31] mourning that Colombia, uh, got

[11:32] eliminated from the World Cup.

[11:35] Not gonna lie. Um, I very

[11:36] quickly did want to share an

[11:37] update, as I

[11:38] m sure you all

[11:40] have seen on the news. Uh,

[11:42] there is an active and ongoing

[11:45] outbreak of Cyclospora, so I

[11:46] wanted to go over that. Um,

[11:47] because I

[11:48] m sure there MAY be

[11:49] concerns about what this might

[11:51] mean here in King County. Uh,

[11:53] so just so everyone is aware of

[11:55] Cyclospora, this is a

[11:57] gastrointestinal illness that

[11:59] is caused by a parasite.

[12:01] Cyclospora. Um, people can

[12:03] become infected when they

[12:06] consume food or water that is

[12:08] contaminated with the parasite.

[12:10] The illness typically does not

[12:12] spread from person to person.

[12:15] So this is good. Um, and case

[12:17] counts typically do rise around

[12:20] spring and summertime. Um, cdc

[12:22] typically considers MAY 1st

[12:25] through AUGUST 31st the annual

[12:28] Cyclospora season. Previous

[12:29] outbreaks have been linked to

[12:31] consuming contaminated fresh

[12:33] produce. Uh, in terms of

[12:35] symptoms, they usually begin

[12:38] about a week after exposure,

[12:39] but the onset can be anywhere

[12:41] from two days to 14 days after

[12:43] being exposed, with the most

[12:45] common symptoms being watery,

[12:48] diarrhea, uh, loss of appetite,

[12:50] weight loss, bloating, nausea

[12:53] and fatigue. Less commonly, low

[12:55] grade fever and vomiting. Uh,

[12:57] without treatment.

[12:59] Unfortunately, symptoms can be

[13:01] remitting and relapsing. Um, so

[13:03] really important to have it

[13:05] diagnosed and be treated. Um,

[13:07] but the illness, although it

[13:09] can be severe in terms of

[13:11] symptoms, is not usually life

[13:12] threatening. Um, in terms of

[13:13] what

[13:14] s currently happening

[13:17] since MAY 1st of this year, cdc

[13:19] has received over 1600

[13:22] confirmed cases. Domestic cases

[13:24] of Cyclospora cases, and they

[13:26] are currently reviewing over

[13:29] 5000 additional cases that MAY

[13:30] have also been acquired in the

[13:32] United States. The cdc, the

[13:34] fda, state and local health

[13:36] departments are currently

[13:38] investigating uh, several

[13:40] multistate outbreaks of

[13:41] Cyclospora infections to

[13:42] identify the source of

[13:45] infection. Um, in Washington

[13:47] state. Cyclospora. This is a

[13:50] reportable condition. Cases

[13:53] identified since MAY 2026 have

[13:55] primarily been linked here to

[13:58] international travel, and we do

[13:59] not have any outbreak related

[14:02] cases detected in King County.

[14:03] We do investigate every single

[14:05] case of Cyclospora, since

[14:05] that

[14:07] s reported to us by a lab

[14:09] or a doctor to determine where

[14:10] people MAY have been exposed,

[14:12] given the rise of what

[14:12] s

[14:14] happening in other states, we

[14:16] are very closely monitoring for

[14:18] any signs that people MAY have

[14:19] been exposed to the parasite

[14:22] locally. So far in 2026, we

[14:23] ve

[14:25] had a total of 19 cases among

[14:27] King County residents, only one

[14:28] of which was exposed to the

[14:30] parasite locally. And again,

[14:32] none have been associated with

[14:32] what

[14:33] s happening in other

[14:36] states. The timing distribution

[14:37] of the cases that we

[14:38] ve had so

[14:39] far does match what we have

[14:42] seen in years past. In general,

[14:44] about 90% of the cases in King

[14:46] County residents are diagnosed

[14:48] between JUNE through AUGUST,

[14:50] and about 80% of them are

[14:52] linked to international travel.

[14:54] Um, currently, there

[14:55] s no

[14:57] evidence that the outbreak

[14:57] that

[14:58] s ongoing is impacting us

[15:00] here in King County. So we

[15:00] re

[15:01] monitoring, but we

[15:01] re not

[15:02] seeing, you know, an unusual

[15:05] rise in cases. We did send out

[15:07] a health alert to all of our

[15:08] health care partners in King

[15:10] County, advising our health

[15:12] care partners to consider the

[15:13] diagnosis and the event that

[15:13] they

[15:15] re seeing any patients

[15:17] with symptoms of Cyclospora.

[15:18] And to make sure that they

[15:18] re

[15:20] specifically testing for the

[15:23] parasite. Um, and then making

[15:24] sure that, you know,

[15:26] individuals are treated

[15:28] appropriately, should they have

[15:32] the illness. Um, at this time,

[15:32] there

[15:34] s no confirmed source of

[15:36] infection. And this is why what

[15:37] we

[15:37] re seeing is that we

[15:37] re

[15:38] seeing, you know, ongoing

[15:40] numbers of cases rising because

[15:41] they have not been able to

[15:42] determine what the source of

[15:44] infection is. You know, what

[15:46] has been the contaminant, um,

[15:48] food source in previous

[15:50] outbreaks, it has been, uh,

[15:52] related to fresh produce, but

[15:53] it could be a variety of

[15:54] different things. So in the

[15:57] past, it has been linked to

[15:59] raspberries, cabbage, basil,

[16:01] cilantro, parsley, broccoli,

[16:03] snow peas. Um, so a variety of

[16:05] different things that could be,

[16:08] you know, um, uh, impacted by

[16:09] this parasite. So while we

[16:10] re

[16:12] not recommending at this time

[16:13] that anyone in our community,

[16:16] uh, avoids any particular

[16:18] items, just want to note that

[16:20] for individuals who MAY be

[16:21] immunocompromised, they could

[16:23] consider, um, not, you know,

[16:26] limiting these until unofficial

[16:27] source of infection is

[16:29] identified. But again, we don

[16:29] t

[16:30] have that. And they are

[16:31] actively working as quickly as

[16:33] possible to identify a source

[16:35] of infection. We will continue

[16:37] to provide updates as that

[16:39] source is identified. Another

[16:40] important thing is, is that

[16:42] cooking at high temperatures

[16:44] does kill the parasite. So

[16:47] heating food to 158

[16:50] f or higher

[16:51] is effective at eliminating the

[16:53] risk of the parasite. Um, so if

[16:54] any, you know, foods are going

[16:56] to be ingested of those that

[16:58] MAY be have linked in the past,

[16:59] you know, be helpful to cook

[17:00] those to high temperatures,

[17:02] washing your hands and any

[17:04] fresh produce under running

[17:06] water before eating, cooking,

[17:08] cutting is also a good best

[17:09] practice, but unfortunately

[17:10] washing alone does not

[17:12] eliminate the risk. It really

[17:13] is heating to high

[17:15] temperatures. Um, and then just

[17:17] lastly, I want to note that,

[17:18] um, you know, when food

[17:21] outbreaks happen and especially

[17:23] when they happen like this with

[17:25] multiple multiple states being

[17:28] impacted, a very strong federal

[17:30] response is needed to manage

[17:33] this type of complex foodborne

[17:35] outbreak and multi-state

[17:37] investigations. And

[17:38] unfortunately, what we

[17:38] re

[17:40] seeing right now is in part due

[17:42] to a lack of federal public

[17:44] health leadership, changes to

[17:46] food surveillance, and the loss

[17:47] of public health staff at the

[17:49] centers for Disease Control.

[17:51] Um, so, you know, really, when

[17:52] we

[17:53] re having these kinds of

[17:54] foodborne outbreaks that can

[17:56] impact a large number of

[17:58] people, these investigations

[18:00] are typically inherently

[18:01] complex, and it

[18:02] s always hard

[18:03] to make sure that, you know,

[18:05] individuals can recall what

[18:05] they

[18:07] ve eaten for the previous

[18:08] two weeks, right, to try to

[18:10] identify a source. Um, but it

[18:13] really requires collaboration

[18:14] and coordination between local

[18:15] health departments, state

[18:17] health departments and federal

[18:20] public health leaders. Um, so

[18:20] we

[18:23] re hopeful that, um, will

[18:23] they

[18:24] ll be able to identify a

[18:26] source of the infection soon.

[18:28] But again, here, we

[18:28] re working

[18:30] closely with our health care

[18:31] partners and the state

[18:33] Department of Health to monitor

[18:35] things very closely and make

[18:37] sure that we provide updates to

[18:39] the public. Thank you.

[18:42] Thank you very much, doctor. We

[18:44] have, um, another board member

[18:45] that joined us. I just wanted

[18:47] to welcome board member Pete

[18:48] von Reichbauer. Thank you for

[18:49] being with us as well.

[18:50] Colleagues, are there any

[18:52] questions that you have for

[18:54] Doctor Valenciano on her report

[18:59] out? Well, you heard it here.

[19:00] Cook your food. Don

[19:01] t eat that

[19:03] raw lettuce for right now. Um,

[19:05] congratulations to the entire

[19:07] team. Uh, for all that you did,

[19:08] especially during the World

[19:11] Cup. And, uh, very, very

[19:12] pleased that there was no major

[19:14] outbreaks, um, either in our

[19:16] region or across the three

[19:18] countries during that time

[19:20] period. Uh, really, thank you

[19:21] for all that you do. This is in

[19:23] addition to the daily work that

[19:25] you provide. Any additional

[19:27] questions seeing none. Thank

[19:28] you very much, Doctor

[19:29] Valenciano. Again, a written

[19:30] report on page ten in your

[19:31] materials. Thank you, as

[19:32] always, for being here with us.

[19:33] And if we don

[19:34] t see you before,

[19:35] we will see you at the

[19:37] SEPTEMBER meeting. Thanks.

[19:39] Okay. This moves us on to item

[19:42] number eight on our agenda. We

[19:44] have, um, an update on the

[19:45] board membership and

[19:47] recruitment efforts for next

[19:50] year, 2027. Thanks again to Joy

[19:51] Carpine-Cazzanti, who is here

[19:52] with us as a board

[19:53] administrator, to give us an

[19:54] update. Thanks for your work

[19:57] annually to get us prepared for

[19:58] having a full board

[19:59] representation and all the

[20:00] preparation that goes into

[20:02] recruitment. Over to you.

[20:04] Thank you. Uh, yes, I

[20:05] m Joy

[20:06] Carpine-Cazzanti, your board

[20:08] administrator from Public

[20:09] Health, and today i

[20:10] ll provide

[20:13] a brief update on our 2027

[20:14] board membership and the

[20:16] recruitment process that we are

[20:18] undertaking to fill a vacancy.

[20:20] As I reported last month, the

[20:22] board has four positions that

[20:23] will expire at the end of this

[20:26] year. Board member Butch de

[20:28] Castro position. Lisa Chu

[20:28] s

[20:30] position, Christopher

[20:32] Archiopoli position, and

[20:35] alternate Francoise Milinganyo

[20:38] position. Board members two are

[20:40] Chipotle and alternate Melanie

[20:42] Garneau will seek

[20:44] reappointment. Board member

[20:46] Butch de Castro has served on

[20:48] the board for many years. And

[20:49] we definitely appreciate that

[20:52] and all his expertise. But he

[20:54] will not return to us next

[20:58] year. Uh, he represents public

[21:01] health facilities and providers

[21:05] and, um, if approved by the

[21:06] board and the King County

[21:08] Council, his alternate, Karen

[21:09] Hartfield, will move into his

[21:12] position next year. This leaves

[21:12] Karen Hatfield

[21:13] s alternate

[21:15] position vacant, and public

[21:17] Health has advertised the

[21:19] opportunity to apply. And this

[21:21] application period will close

[21:26] next week. On JULY 22nd. At the

[21:27] end of the day, as required, we

[21:29] posted vacancy advertisements

[21:31] in the Seattle Times and local

[21:33] papers across King County.

[21:34] Public health has shared

[21:35] information on our blog,

[21:38] website and social media and

[21:39] sent the opportunity to the

[21:41] Board of Health email listserv

[21:43] and other community partners. I

[21:45] encourage board members to

[21:46] share the opportunity with your

[21:49] networks as well. I sent an

[21:51] email yesterday with more

[21:53] details that you can share. As

[21:55] of this morning, we have

[21:58] received six applications. Uh,

[21:58] we

[21:59] re hoping to get a few more

[22:00] if you are able to help us

[22:02] spread the word. Just a

[22:04] reminder about the process

[22:05] state requirements place

[22:07] responsibility for the

[22:09] recruitment, selection and

[22:11] recommendation of membership

[22:13] with the Board of Health and

[22:14] the King County Council makes

[22:16] the official appointments.

[22:18] Public health staff are doing

[22:19] an initial review of applicants

[22:22] now for eligibility, and those

[22:23] who are eligible will be

[22:24] reviewed by board members. Our

[22:27] Polly Mohamed and Alternate

[22:28] Hartfield, as well as chair

[22:30] chair, mosquitoes, Team. These

[22:32] board members will review

[22:34] applications, conduct

[22:36] interviews in AUGUST or early

[22:38] SEPTEMBER, and then at the

[22:39] SEPTEMBER board meeting, we

[22:39] ll

[22:40] make a recommendation to the

[22:42] full board on who to bring to

[22:44] the OCTOBER meeting for an

[22:46] interview. Thanks to all of you

[22:48] in advance for your work with

[22:51] me over the next month. In

[22:52] OCTOBER, the board will

[22:54] consider four resolutions

[22:56] recommending reappointment of

[22:57] the returning members and

[22:58] appointment of the new

[23:00] alternate. If approved, these

[23:02] will be transmitted to the King

[23:03] County Council for their

[23:05] consideration, and acting in

[23:07] OCTOBER will allow us time for

[23:09] final action by the Council

[23:10] before the end of the year. So

[23:10] I

[23:12] ll continue to provide

[23:14] updates as we work towards

[23:15] recommendations for the full

[23:18] board approval in OCTOBER, and

[23:18] I

[23:19] m happy to answer any

[23:20] questions.

[23:22] Well, let me say thanks again

[23:23] for all the work that you and

[23:25] the team put into the

[23:26] recruitment, and the board

[23:27] members who volunteered to be

[23:28] part of the subcommittee, and

[23:30] all of our staff. Um, I

[23:30] m

[23:31] really pleased that so many

[23:33] board members are seeking

[23:34] reappointment. That

[23:35] s wonderful

[23:36] and look forward to continuing

[23:38] to partner with you. I want to

[23:40] say thank you to board member

[23:43] de Castro. I think your service

[23:45] on the Board of Health, MAY

[23:46] predate me, and I feel like

[23:47] I

[23:48] ve been here for eight years

[23:50] or seven years or so. So, um, I

[23:51] just wanted to offer you a

[23:53] second. If you wanted to chime

[23:55] in and offer any words, I know

[23:55] we

[23:56] ll have a chance to chat

[23:57] with you again, but just want

[23:58] to say thanks for your ongoing

[24:00] service, and I you served as

[24:01] vice chair in addition to

[24:03] various leadership roles. So

[24:03] anything else you

[24:04] d like to

[24:06] share? Board member de Castro.

[24:07] Thank you. Very, very nice of

[24:08] you to give some space. I

[24:08] ll

[24:09] just say briefly in the

[24:11] immediate, just thank you to

[24:14] all my colleagues here, uh, you

[24:15] know, including those in the

[24:17] past to to do this service for

[24:19] the community of Seattle and

[24:20] King County at large. It

[24:20] s been

[24:22] a privilege, but I can

[24:24] definitely say more. Um, as we

[24:26] close the year. But thank you.

[24:27] Excellent. Thank you. And thank

[24:28] you again for your leadership,

[24:30] especially during the Covid

[24:31] days. I remember you stepping

[24:33] onto screen and, uh, really

[24:35] stepping up. So thank you. Uh,

[24:36] board member Hartfield, thank

[24:37] you for your interest in

[24:39] serving as a permanent member

[24:40] as well. Thanks for serving as

[24:41] an alternate. And we are

[24:42] thrilled that you

[24:42] re interested

[24:45] in seeking this position in an

[24:46] ongoing manner. Is there

[24:47] anything you

[24:48] d like to add?

[24:49] Um, no. I

[24:51] m excited to have the

[24:54] opportunity to represent, and

[24:55] I

[24:56] ve been enjoying my service

[24:58] so far, so it sounds like a win

[25:00] win for all of us.

[25:01] Absolutely. And we

[25:01] ll have a

[25:02] chance to hear more from you in

[25:04] the upcoming meetings as well.

[25:05] But I really appreciate your

[25:06] interest in continuing to serve

[25:08] here and for your work. Um,

[25:09] already with this board and

[25:11] colleagues, you heard from our

[25:13] board administrator that, uh,

[25:14] we are continuing to push out

[25:16] the announcement about the

[25:16] position that

[25:17] s open as an

[25:20] alternate. So if you have not

[25:21] already shared that with your

[25:23] listservs, community members,

[25:24] neighbors, put it on your

[25:26] social media, please do. And

[25:27] maybe we can send a little

[25:28] blurb out just as a reminder

[25:29] for folks so it

[25:30] s easy to grab.

[25:33] Um, and again, the deadline,

[25:34] JULY 22nd, is when we

[25:34] re

[25:36] looking to fill that alternate

[25:37] position. So if people can get

[25:38] their applications in before

[25:40] that, that would be great.

[25:41] Okay. Thanks so much, Joy.

[25:42] Anything else that you need

[25:44] from us at this juncture? No.

[25:46] Okay. Well that moves us on,

[25:48] folks. Thank you so much. Um,

[25:49] more to come on that topic and

[25:51] more to be heard from board

[25:52] member de Castro and board

[25:54] member Hartfield. Uh, item

[25:57] number ten on the agenda is a

[25:58] briefing about the Seattle and

[25:59] King County

[26:00] s efforts around

[26:02] the continuum of care. Again, I

[26:03] want to thank board member Liu,

[26:06] who had suggested this item be

[26:07] included in our board

[26:10] discussion here today. And much

[26:12] of the board has been briefed

[26:14] in part on the continuum of

[26:15] care dollars that we are so

[26:17] desperately in need of from the

[26:18] Federal Housing and Urban

[26:21] Development, um, grants that we

[26:23] regularly rely on to the tune

[26:26] of over $60 million here in

[26:28] King County alone, is how much

[26:32] we continue to invest in these

[26:33] items. Um, I

[26:34] m going to hold

[26:36] for just a second because I

[26:36] m

[26:38] so excited to talk about

[26:39] Continuum of Care. I actually

[26:41] forgot to go to agenda number

[26:43] nine. Is that correct? Team?

[26:45] Um, so sorry for the preemptive

[26:48] jump in on a continuum of care

[26:50] items. Um, so if folks could

[26:51] just, uh, hold tight for that

[26:52] item. Uh, board member Liu,

[26:54] apologies for that. I know, uh,

[26:54] that was something that you

[26:56] were teed up to speak to. So

[26:56] we

[26:57] re going to go back to

[26:59] agenda number nine. Um, if you

[27:00] don

[27:01] t mind. Agenda number nine

[27:04] is equally important. This is a

[27:05] preview of an item that will

[27:07] come before our, um, fall

[27:09] discussion in the SEPTEMBER

[27:10] meeting. The board will

[27:12] continue to have a conversation

[27:14] and potentially vote on pet

[27:15] business and public health,

[27:16] zoonotic diseases, code and

[27:19] rate updates. Board members who

[27:21] MAY vote on such a change in

[27:21] this fall

[27:22] s a meeting will

[27:23] include board members who are

[27:24] elected officials, and that

[27:25] s

[27:27] only because of the impact on

[27:29] fees and rates. The slides for

[27:31] the briefing, uh, for this

[27:33] item, item number nine, again,

[27:35] that those item, those slides

[27:36] begin on page 15 of your

[27:39] packet. And you might recall

[27:40] this topic for board members

[27:41] who were here with us last

[27:43] year, we had a presentation

[27:45] last SEPTEMBER as well. And

[27:47] those slides have also been

[27:49] included in your packet on um,

[27:51] beginning on page 35. This

[27:52] year, Public Health has been

[27:53] providing additional

[27:55] information at the board prep

[27:57] meetings and through email

[27:59] communications to board members

[28:01] about the zoonotic disease

[28:03] codes and rates. And we would

[28:05] very much appreciate if you

[28:06] have any questions today to

[28:09] jump in and ask those. I have

[28:10] told our public health team,

[28:11] sometimes this item gets

[28:14] confused with other animal

[28:16] related public policies. And so

[28:18] we will be clarifying here

[28:20] today what zoonotic disease

[28:22] code and rates refers to. Um,

[28:25] as there are many health issues

[28:27] that relate to animals in King

[28:28] County. We want to have a clear

[28:29] understanding of what this

[28:30] relates to and what it doesn

[28:30] t.

[28:30] I

[28:32] m very thankful that we have,

[28:33] again with us from Public

[28:34] Health, Ryan Kellogg, who

[28:35] s the

[28:36] assistant director of public

[28:37] health, environmental and

[28:40] Health division doctor. Jocelyn

[28:40] Mullins, who

[28:41] s a public health

[28:43] veterinarian. Leah Helms, who

[28:45] is the manager of Solid waste

[28:46] rodent and zoonotic disease

[28:49] programs. And, um, Michael

[28:50] Perez, who

[28:50] s the finance and

[28:52] administrative service manager,

[28:54] uh, to provide us an overview

[28:56] of zoonotic disease codes and

[28:57] rates. And again, this is a

[28:58] briefing with subsequent

[28:59] conversation to come in

[29:01] SEPTEMBER. I also want to thank

[29:02] board member Lewis who is here

[29:03] with us. Thank you, Board

[29:05] Member Lewis, for dialing in.

[29:06] And any other board members

[29:07] who

[29:07] d like to announce

[29:08] themselves before we move on

[29:11] with agenda number nine. Okay.

[29:13] Take it away, MR. Kellogg, and

[29:15] sorry for the false start.

[29:16] There.

[29:17] Great. Thank you. Chair.

[29:17] Mosquito. I

[29:19] m also very excited

[29:20] about the continuum of care

[29:21] presentation, and I appreciate

[29:23] being here with you and other

[29:24] Board of Health members. Again,

[29:24] I

[29:26] m Ryan Kellogg, assistant

[29:27] mental health director here at

[29:28] Public Health. We

[29:29] re pleased to

[29:31] be back to share an update with

[29:32] the board following our

[29:33] briefing last SEPTEMBER on

[29:34] public health

[29:35] s role in

[29:37] zoonotic disease prevention and

[29:37] the board

[29:38] s pet business

[29:40] regulations. In addition to

[29:40] today

[29:42] s presentation on our

[29:44] code update process, your

[29:45] packets include last year

[29:45] s

[29:47] presentation that provides more

[29:48] context on public health

[29:48] s role

[29:50] in zoonotic disease prevention

[29:51] and the importance of standards

[29:53] for pet business operations.

[29:54] Um, as the chair mentioned, I

[29:54] m

[29:56] joined today by our public

[29:57] health veterinarian doctor

[29:58] Jocelyn Mullins, and Leah

[29:59] Helms, who manages our pet

[30:01] business program. Mike Perez,

[30:03] our finance and administrative

[30:04] services manager. Environmental

[30:06] health is on deck to assist

[30:07] with any questions from the

[30:09] board on the proposed changes.

[30:12] Um, next slide please. Sean,

[30:14] for our time today, we

[30:14] re

[30:16] planning to share details on

[30:16] why we

[30:18] re updating the codes.

[30:18] What

[30:20] s being proposed as

[30:21] changes, how we

[30:22] re engaging

[30:24] businesses in the public, and

[30:26] next steps. Next slide. Please

[30:28] join for a little bit of

[30:28] background. We

[30:29] re overdue for

[30:30] an update to the Pet Business

[30:31] Standards and title eight,

[30:33] which have not been updated

[30:34] since their are adopted by the

[30:37] board initially in 2010, when

[30:38] Public Health initially

[30:39] launched the program. The

[30:40] updates, which will be

[30:41] presented to the board in

[30:43] SEPTEMBER, will align with our

[30:44] current understanding of

[30:45] zoonotic diseases, risks and

[30:46] prevention interests and will

[30:48] also reflect substantial

[30:49] changes in the industry. Since

[30:51] the code was initially adopted.

[30:52] In addition to the code update,

[30:54] the program fees are also in

[30:55] need of updating when

[30:56] Environmental Health Services

[30:58] presented our most recent rate

[30:59] study to the board last

[31:02] OCTOBER. In OCTOBER 2024, we

[31:04] noted at the time that the pet

[31:06] program fees have not kept pace

[31:07] with the changes in the level

[31:09] of effort and are not aligned

[31:10] with Environmental Health

[31:10] s

[31:11] full cost recovery model for

[31:12] rate based programs. So we

[31:12] ll

[31:14] be providing more information

[31:16] on that next slide, please.

[31:19] Troy. Um, so overall, we

[31:19] re

[31:20] focusing the proposed code

[31:23] changes in five areas. The

[31:24] policy changes or the pet

[31:25] business standards are in Board

[31:29] of Health Code section 8.03

[31:30] related to pet businesses,

[31:32] including improvements in

[31:33] animal health and worker

[31:35] safety, strengthening infection

[31:37] control and disease prevention,

[31:38] reducing risks of animals in

[31:40] public settings, and updating

[31:42] and streamlining requirements.

[31:45] And title two, along with other

[31:46] environmental health fees. This

[31:47] is the. This is where we

[31:47] ll be

[31:49] proposing some changes to

[31:51] stabilize the program and meet

[31:51] the board

[31:52] s policy and

[31:54] expectations for full cost

[31:56] recovery. Um, and just to

[31:59] provide some clarification to

[31:59] follow up on the chair

[32:00] s

[32:00] earlier comments, we

[32:01] ll note

[32:02] that title eight has three

[32:05] sections in it. It has the, um,

[32:07] pet business regulations,

[32:08] rodent control and rabies

[32:10] control, which includes the

[32:11] board

[32:12] s requirement that all

[32:14] animals over four months are

[32:17] vaccinated. We and our proposal

[32:18] are focused on the pet business

[32:22] regulations and section 8.03.

[32:24] We are aware of a potential

[32:25] proposal from Regional Animal

[32:26] Services and King County

[32:27] Department of Executive

[32:29] Services to add a rabies

[32:31] vaccine reporting requirements

[32:34] in section 8.04, but that is

[32:35] separate and distinct from what

[32:36] public Health is proposing to

[32:37] the board. In SEPTEMBER. I

[32:37] ll

[32:39] close my intro comments by

[32:41] noting that we have more pets

[32:42] than kids in King County. In

[32:44] the businesses that serve them

[32:45] are a critical and growing

[32:47] industry. In King County. The

[32:48] health standards that the board

[32:50] sets in title eight help ensure

[32:52] standards are consistent across

[32:54] businesses and, more

[32:55] importantly, that our pets stay

[32:56] safe and healthy when in the

[32:57] care of others outside our

[32:59] home. So, to get us started on

[33:02] the policy changes in section

[33:02] 8.03, I

[33:03] ll turn it over to

[33:04] Doctor Jocelyn Mullins to

[33:06] provide an overview of those

[33:08] changes.

[33:11] Great. Thank you so much, Ryan,

[33:12] and thank you for having us

[33:14] here today. So the proposed

[33:16] policy changes include updated

[33:18] standards to improve animal

[33:21] health and worker safety. And

[33:22] this includes establishing

[33:23] clear enclosure size

[33:25] requirements for animals,

[33:27] setting expectations for group

[33:29] housing practices, including

[33:30] considerations for the

[33:32] co-housing of groups of dogs or

[33:34] cats and strengthening

[33:36] supervision requirements. This

[33:38] kind of space and compatibility

[33:39] requirements for animals are

[33:41] grounded in evidence based

[33:43] animal care practices that

[33:45] encourage adequate movement,

[33:46] ensure proper social

[33:48] interactions among animals, and

[33:51] reduce stress among animals so

[33:52] that a better ability for

[33:54] animals to have normal

[33:56] interactions and have lower

[33:57] stress means that they are less

[33:59] likely to develop illness or

[34:01] bite, and the goal of these

[34:03] requirements are therefore to

[34:05] reduce the risk of zoonotic

[34:07] disease spread within

[34:09] businesses and improve the

[34:10] safety of staff who are working

[34:12] with those animals. And we

[34:12] ve

[34:14] included a more detailed list

[34:15] and frequently asked questions

[34:16] in your packet that walks

[34:17] through each of those changes

[34:20] in more depth. Next slide

[34:24] please. There are changes that

[34:26] will also strengthen infection

[34:28] control and disease prevention

[34:29] requirements for pet

[34:30] businesses, again, with a goal

[34:32] of improving animal and human

[34:34] safety. And these include clear

[34:36] expectations for infection

[34:38] control plans and a plan for

[34:40] staff training on zoonotic

[34:41] diseases and working with

[34:43] animals. And it clarifies

[34:45] procedures for reporting animal

[34:46] bites that occur within pet

[34:47] businesses. We

[34:48] re also adding a

[34:50] new requirement for an

[34:52] isolation plan, and this will

[34:54] include procedures for timely

[34:55] management of sick or injured

[34:58] animals within pet businesses.

[34:59] And these updates are again,

[35:00] really grounded in our best

[35:02] public health practices to

[35:04] reduce disease transmission

[35:06] risk in pet care settings and

[35:08] ensure that cleaning and

[35:09] sanitation requirements are

[35:11] clear, and that sick and

[35:12] injured animals are promptly

[35:14] recognized, isolated and

[35:17] treated appropriately. Next

[35:20] slide join. We

[35:21] re also adding

[35:23] standards for business models

[35:24] that have emerged since the

[35:27] first code was drafted. There

[35:28] are new business models in our

[35:30] county, such as cat cafes, that

[35:32] really change how the public

[35:33] interacts with animals and pet

[35:35] businesses. So unlike

[35:37] supervised one on one

[35:39] interactions between animals

[35:40] and potential adopters or

[35:42] purchasers in shelters or in

[35:44] pet stores, these new models

[35:45] allow the public to interact

[35:46] with groups of animals in

[35:48] shared spaces, so these new

[35:50] standards will ensure that

[35:51] those interactions can occur

[35:53] safely and prevent disease

[35:55] transmission to the public.

[36:00] Next slide. Joy, thanks. And

[36:01] lastly, we

[36:01] re making some

[36:02] changes that don

[36:03] t change the

[36:05] core policy direction of

[36:08] section 8.03, but instead

[36:10] include improved clarity and

[36:12] simplify how the code is used,

[36:14] and align it with best current

[36:16] practice in state law. So these

[36:17] changes make it easier for

[36:19] business owners and the public

[36:20] to understand and apply the

[36:22] code. Additional details are

[36:24] again provided in the packet

[36:25] provided to board members for

[36:27] their review. But first, a few

[36:30] specific things. We focused on

[36:31] simplifying the code to make it

[36:33] easier to understand and apply

[36:34] in practice, which includes

[36:36] streamlining requirements to

[36:38] reduce the complexity, removing

[36:41] outdated or redundant language,

[36:42] and updating some definitions

[36:43] so it

[36:44] s clearer which

[36:45] businesses are being regulated.

[36:46] We

[36:47] re also aligning language

[36:48] with current state law,

[36:50] including updates related to

[36:53] animal sales. And second, we

[36:53] re

[36:54] updating permitting

[36:56] requirements to better reflect

[36:57] the current risk and

[36:59] operational realities in pet

[37:01] businesses. So this includes

[37:03] removing low risk categories

[37:05] such as fish only, pet shops.

[37:05] And we

[37:07] re also adding clearer

[37:09] expectations around permit

[37:11] display. So permits are visible

[37:13] to customers and strengthening

[37:14] our ability to deny permits in

[37:16] cases of outstanding fees or

[37:19] unresolved noncompliance. So

[37:19] with that, I

[37:20] ll turn it back to

[37:22] Ryan to go over the background

[37:23] and proposal on pet business

[37:25] fees in Board of Health title

[37:28] two.

[37:31] Thanks, Doctor Mullins. Um, so

[37:33] starting with the overview of

[37:35] our proposed fee changes, um,

[37:38] our objectives, uh, first and

[37:40] foremost are to stabilize the

[37:41] program revenue, the fee

[37:42] structure, as I mentioned

[37:44] before, has remained largely

[37:46] unchanged since the program was

[37:48] established in 2010. Certain

[37:50] rates for larger pet businesses

[37:52] were updated by the board in

[37:54] 2024, when Environmental Health

[37:55] Services presented the

[37:55] division

[37:57] s rate study. But we

[37:58] noted at the time there was an

[38:01] adequate level of effort data

[38:02] associated with the different

[38:03] business categories, and we

[38:04] committed to the board to

[38:06] return with a more specific

[38:08] proposal, which is what we will

[38:10] be presenting in SEPTEMBER with

[38:11] an overview today. Um, I

[38:12] d like

[38:13] to also note that the pet

[38:15] business program is very small,

[38:18] um, funded at full level. Um,

[38:18] it

[38:21] s 1.5 FTEs, um, covering

[38:23] just over 500 permitted

[38:25] businesses. Um, the proposal

[38:26] that we

[38:26] re sharing will

[38:28] increase the program fees to

[38:29] reflect the actual service

[38:31] costs, consistent with the

[38:32] Board of Health Policy for full

[38:34] cost recovery, while not

[38:36] reducing services. And then

[38:38] looking ahead to maintain

[38:38] stability, we

[38:39] ll continue to

[38:41] review levels of effort. And

[38:41] we

[38:42] ll also adjust rates

[38:43] annually, similar to other

[38:45] environmental health permits to

[38:47] account for inflation. Um, I

[38:48] ll

[38:50] note that since 2010, we

[38:50] ve

[38:51] also seen significant changes

[38:53] in the industry. As Jocelyn

[38:55] mentioned, uh, business

[38:56] business models have become

[38:57] more complex, including some

[38:58] dog daycares growing

[39:00] significantly in scale. And

[39:00] there

[39:01] s been increased demand

[39:04] from the public for oversight

[39:05] and from businesses for for

[39:07] technical assistance and

[39:08] ongoing guidance. So the goal

[39:09] here is to move towards a

[39:11] sustainable fee structure that

[39:12] supports baseline program

[39:14] capacity and allows us to

[39:16] continue providing consistent,

[39:18] reliable service. Next slide.

[39:20] Please drive. This is a list of

[39:22] the types of businesses that

[39:23] have regulatory standards and

[39:25] title aid and related fees. And

[39:28] title two fees paid by these

[39:30] businesses include. Plan review

[39:32] for new, remodeled and expanded

[39:34] facilities, annual permits and

[39:36] inspections, and a limited

[39:38] amount of general education and

[39:39] technical assistance that

[39:41] include, like regular program

[39:42] newsletters, maintaining

[39:43] program information and

[39:44] resources on Environmental

[39:45] Health

[39:46] s website, and response

[39:48] to customer inquiries and

[39:52] support requests. Next slide. I

[39:52] just wanted to give a little

[39:54] bit of a review of how we

[39:56] arrive at an environmental

[39:57] health permit fee. It

[39:57] s

[39:59] calculated by multiplying the

[40:01] hourly rate, or the cost per

[40:04] hour for providing services. By

[40:05] the time required for that

[40:08] service. Next slide. And the

[40:10] the focus of the proposed

[40:11] changes are on the amount of

[40:14] time required to administer

[40:15] individual business permit

[40:17] permits, including, as I

[40:18] mentioned before, plan review,

[40:20] permit issuance, annual

[40:21] inspections, and some level of

[40:22] education and technical

[40:24] assistance. This is based on

[40:26] review of our current levels of

[40:27] effort. I

[40:28] ll also note that as

[40:29] we

[40:30] re bringing the title a

[40:31] proposal forward, we don

[40:31] t

[40:33] expect the proposed policy

[40:34] changes into title eight that

[40:35] the board will be considering

[40:37] in SEPTEMBER to significantly

[40:38] influence or increase the level

[40:39] of protection and moving

[40:42] forward. A note about the

[40:43] timing. Also, that note on the

[40:44] bottom of this slide, the

[40:47] proposed fee changes. It

[40:50] reflects our 2026 fee schedule,

[40:52] not what businesses will be

[40:54] paying in 2027 when the new

[40:55] fees go into effect. That

[40:56] s

[40:58] because ea adjusts our rates

[40:59] annually to account for

[41:01] inflation. Pursuant to Board of

[41:03] Health Policy and Title two,

[41:03] and we don

[41:04] t know yet the

[41:06] specific increases for

[41:08] inflation in 2027 until later

[41:09] in the year, when we have the

[41:11] cpi forecast from the King

[41:11] County

[41:12] s Office of Economic and

[41:17] Financial Analysis. Next slide.

[41:18] So now under the proposed

[41:20] changes, there are five areas

[41:21] in the fee structure that we

[41:21] re

[41:22] proposing to change to better

[41:24] align with how the program

[41:25] operates today. I

[41:25] ll review

[41:27] each of these in more detail in

[41:28] the following slides. We want

[41:30] to make our plan review fees

[41:32] clearer and more predictable up

[41:35] and reduce processing delays.

[41:35] We

[41:36] re adjusting the time, as I

[41:37] mentioned before, with

[41:38] inspection and permitting, to

[41:40] reflect the actual level of

[41:43] effort establishing tiered fees

[41:44] for daycare and boarding

[41:45] facilities that have had

[41:46] significant differences of

[41:48] growth and scale and

[41:49] complexity. Establish a one

[41:52] time double permit fee for

[41:54] currently operating unpermitted

[41:55] businesses who are

[41:57] non-responsive to our outreach,

[41:59] and then update miscellaneous

[42:00] service fees that are not

[42:02] accounted for elsewhere, like

[42:03] variance request inspections

[42:07] and return visits. Next slide.

[42:09] So starting with the first

[42:11] three, um, the upfront plan

[42:14] review, will be proposing to do

[42:16] our fees upfront consistent

[42:18] with other environmental health

[42:20] programs. The current pet

[42:21] Business Plan review fee

[42:23] assesses a one hour fee,

[42:24] followed by additional hourly

[42:27] fees for any additional time.

[42:29] Um, for for a small group of

[42:31] less complicated plan reviews

[42:32] like poultry retail or mobile

[42:34] groomer, satellite adoption and

[42:36] pet food retailer will maintain

[42:38] that at a one hour rate, plus

[42:40] any additional hours if needed.

[42:42] Our experience is that for

[42:43] other plans, they

[42:43] re more

[42:45] complex. They take a minimum of

[42:47] three hours to complete, so the

[42:48] current practice of charging an

[42:50] hour upfront, then doing follow

[42:51] up billing billings doesn

[42:52] t do

[42:53] a good job. It

[42:54] s not efficient,

[42:54] and it also doesn

[42:55] t do a good

[42:57] job of communicating the actual

[42:59] cost up front. It can also slow

[43:00] the permitting process, this

[43:01] final approval is contingent on

[43:03] all of our fees being paid, so

[43:03] it

[43:04] ll be more efficient for us

[43:06] and applicants to have the full

[43:09] fee paid upfront. The next is

[43:11] this new tiered structure for

[43:13] daycare and boarding permits.

[43:13] There

[43:15] s considerable

[43:16] variability, as I mentioned, in

[43:17] the scale of complexity that

[43:17] we

[43:19] ve seen developed over time

[43:21] with this industry group. And

[43:22] to assess that variability and

[43:23] the level of effort needed,

[43:23] we

[43:25] re proposing a tiered fee

[43:26] structure based on the number

[43:27] of animals in a business

[43:27] s

[43:29] care. Um, smaller operations

[43:31] would have lower fees, while

[43:32] larger, more complex operations

[43:33] would have higher fees. It

[43:34] s

[43:36] not inconsistent with how our

[43:39] food permits, food permits are

[43:40] structured. So at the time of

[43:42] the fees were established that

[43:43] daycare and boarding in

[43:44] particular were not at the size

[43:46] and scale that we see today. So

[43:47] establishing this tiered

[43:48] structure creates a more

[43:50] equitable, um, fee system that

[43:51] reflects the level of impact

[43:54] and oversight needed. And then

[43:55] last on this slide, we

[43:55] re

[43:56] proposing to update permit fees

[43:58] to reflect, as I mentioned

[43:59] before, the actual time and

[44:00] effort to conduct the

[44:02] inspections based on data that

[44:04] we have available to us. Now,

[44:06] the initial fees were

[44:07] established based on level of

[44:09] effort estimates at the time of

[44:10] the program was first

[44:11] established, and since that

[44:12] time, we have a much better

[44:13] understanding of what

[44:13] s

[44:15] actually needed to oversee the

[44:18] permits permitted businesses.

[44:24] Next slide. So we we estimate

[44:26] that we have approximately 100,

[44:29] 100 unpermitted businesses

[44:30] currently operating in county.

[44:32] That and have a shared interest

[44:33] with a permitted

[44:34] establishments, a set a level

[44:37] playing field. We become aware

[44:38] of these facilities through

[44:39] public complaints and more

[44:41] recently through research and

[44:44] available business databases.

[44:44] One tool we

[44:46] re proposing is to

[44:47] incentivize compliance by

[44:49] establishing a one time double

[44:50] permit fee. We would only apply

[44:52] this when a business is

[44:54] non-responsive to our outreach.

[44:55] Our objective is compliance,

[44:57] not letting the additional fee,

[44:59] you know, so we we we

[45:00] acknowledge that there are

[45:01] likely some businesses out

[45:02] there that just aren

[45:03] t aware

[45:04] that they need this permit. And

[45:04] so we

[45:06] re confident that this

[45:07] tool will be helpful to gain

[45:08] compliance with those

[45:09] businesses. There

[45:10] s another

[45:11] group of businesses that are

[45:13] more complex, and they

[45:13] re in

[45:15] their compliance needs. They

[45:16] MAY have underlying zoning

[45:18] issues, maybe actively

[45:20] resisting, excuse me, getting a

[45:22] permit. Um, the proposed fees

[45:23] that we

[45:23] re putting forward

[45:24] don

[45:25] t include assumptions for

[45:27] managing those more complex

[45:27] cases. That

[45:28] s part because of

[45:29] the kind of the scale of this

[45:31] program. And we also don

[45:31] t want

[45:32] to burden those costs under the

[45:34] existing permitted

[45:35] establishments. So to

[45:37] meaningfully kind of address

[45:37] that issue, that

[45:38] s an

[45:39] outstanding thing that

[45:40] environmental health would need

[45:42] to ultimately have additional

[45:44] revenue and staff resources to

[45:47] meaningfully address. So last

[45:49] is this group of updated

[45:51] service fees, um, that are

[45:52] activities not captured by the

[45:53] base permit fee, including

[45:55] variances, free inspections and

[45:57] return field visits. And this

[45:57] helps ensure that the

[46:00] businesses that are requiring

[46:01] those additional level of

[46:02] service are paying for that

[46:03] service directly, rather than

[46:04] distributing those costs

[46:06] broadly across all permits,

[46:10] fees. Next slide. So I

[46:10] d like

[46:11] to give just a couple of

[46:13] examples of what the changes

[46:14] will look like for a couple of

[46:16] business types. An example one

[46:18] the fees for a pet groomer, the

[46:20] actual level of effort

[46:21] reflected in the proposed rates

[46:24] increases by 45 minutes to 2

[46:26] hours total, resulting in an

[46:31] increase from $281 to $450.

[46:34] Again in $2,026. Um. An example

[46:36] two where this is an

[46:37] illustration of the new tiered

[46:39] system for daycare and boarding

[46:41] facilities. Um, recognizing the

[46:42] difference in operational scale

[46:44] for the smallest group of of

[46:45] what we call tier one

[46:46] businesses that accommodate ten

[46:48] or fewer animals, the actual

[46:50] effort increases 15 minutes,

[46:52] increasing the permit cost by

[46:55] $57. And for larger tier for

[46:56] businesses that accommodate

[46:57] more than 60 animals, the

[47:01] actual effort changes from 2.25

[47:04] to 4 hours. The kind of the the

[47:06] larger shift between tier one

[47:07] and tier four just is to

[47:09] recognize that we didn

[47:09] t have a

[47:11] tiered structure before. So all

[47:14] of these tiers started at 506.

[47:15] Um, hence the tier four being a

[47:17] larger increase because it

[47:17] s

[47:19] reflecting a larger level of

[47:21] effort. So just to put this in

[47:23] perspective with what customers

[47:25] are paying for services,

[47:27] grooming and bathing services,

[47:30] um, customers are charged 40 to

[47:32] $200 depending on the breed

[47:34] level of treatment and boarding

[47:38] rates range from 50 to $175 per

[47:39] day at establishments. You

[47:40] know, that said, I want to

[47:42] appreciate that fees are only

[47:43] one part of the cost of running

[47:45] a business, and that any cost

[47:47] increase has an impact. And we

[47:48] feel the proposed level of

[47:50] effort accurately reflects the

[47:51] time we need to ensure that

[47:52] facilities meet Board of Health

[47:54] standards, and also what

[47:54] s

[47:55] needed to demonstrate to the

[47:56] public and pet owners that

[47:56] we

[47:57] re meeting their

[47:58] expectations to ensure the

[48:00] safety of their animal family

[48:01] members. So next, I

[48:01] ll turn it

[48:03] over to Leah Helms to provide a

[48:04] summary of our engagement with

[48:05] businesses on the proposed

[48:10] changes. Um, next slide, Sean.

[48:13] Thanks, Ryan. So engagement has

[48:14] been a core part of this

[48:16] process from the beginning.

[48:16] We

[48:18] ve used a variety of methods

[48:19] to reach businesses,

[48:20] stakeholders in the public,

[48:21] providing multiple

[48:23] opportunities to learn about

[48:25] the proposal, ask questions and

[48:27] provide feedback. A few

[48:28] examples include. We

[48:29] ve hosted

[48:31] two public industry engagement

[48:32] sessions. We

[48:33] ve hosted two

[48:36] public webinars and two public

[48:37] open houses. We

[48:38] ve also

[48:40] conducted surveys directly with

[48:41] several regional animal

[48:43] shelters and individual

[48:44] businesses. We

[48:44] ve shared

[48:46] updates through newsletters,

[48:47] our websites, and we have also

[48:48] made the draft rules and

[48:51] regulations that are in our

[48:52] available online for public

[48:55] review. Over the next few

[48:56] weeks, we will continue this

[48:58] work with additional targeted

[49:00] outreach, including a focus

[49:01] group with the cat cafe

[49:05] industry. Next week. So how are

[49:08] we using feedback? Feedback is

[49:09] directly informing the proposed

[49:11] code changes. We

[49:11] ve used

[49:13] feedback to refine the proposed

[49:15] code language, identify

[49:17] implementation considerations,

[49:19] and improve guidance materials

[49:20] and how the fees will be

[49:21] structured. We

[49:23] ve also taken

[49:25] equity as an important

[49:26] consideration through this

[49:27] process. We

[49:28] ve been very

[49:29] intentional about reducing

[49:31] unnecessary burden where

[49:32] possible, and making sure that

[49:32] we

[49:34] re hearing from small

[49:36] businesses, which are often the

[49:38] most affected by regulatory and

[49:40] changes. Our goal here is to

[49:42] help is to develop a code and

[49:44] fee structure that is fair,

[49:46] clear and practical to

[49:48] implement and also protective

[49:50] of public health. Next slide

[49:54] please. So how will we support

[49:56] businesses. We recognize that

[49:58] these updates will require some

[49:59] adjustments. So a key part of

[50:01] this work is making sure that

[50:02] businesses have the support

[50:04] that they need to understand

[50:06] and comply with the changes

[50:08] following adoption of the code,

[50:10] we will provide a comprehensive

[50:12] online resource that includes

[50:14] FAQs and overview of the

[50:16] changes and information about

[50:17] what requirements apply to

[50:19] different business types to

[50:22] support implementation, we will

[50:23] develop templates and guidance

[50:25] documents along with other

[50:27] tools to help businesses

[50:29] translate the code into their

[50:31] day to day operations. We

[50:32] re

[50:33] also proposing a grace period

[50:35] for existing businesses to come

[50:36] into compliance with a new

[50:38] updated code. Requirements.

[50:40] Requirements that are unchanged

[50:43] would continue to be expected.

[50:45] Variances will continue to be

[50:47] available when appropriate to

[50:49] address the unique situations

[50:52] on a case by case basis. For

[50:53] businesses that are needing

[50:55] additional assistance, we will

[50:57] offer technical assistance to

[50:58] answer questions and help them

[51:00] understand how the

[51:01] requirements, how the

[51:03] requirements apply into their

[51:06] specific settings. I

[51:06] d also

[51:07] like to take a moment and

[51:09] mention the support that will

[51:10] be providing the pet business

[51:11] customers. These are the

[51:13] clients and customers of our

[51:16] regulated businesses to help

[51:17] customers make informed choices

[51:20] about the care for their family

[51:22] members. We currently post

[51:23] permit suspensions on our

[51:24] website. There

[51:25] s currently only

[51:28] one and also provide a link for

[51:29] customers to check if a

[51:31] facility has a permit, and to

[51:33] see a list of recent

[51:34] inspections. Ryan also

[51:37] mentioned earlier that part of

[51:39] the code update will also

[51:41] include that we will ask for

[51:42] businesses to post their permit

[51:44] in a public place. We

[51:45] re also

[51:47] working to make additional

[51:49] improvements on our website,

[51:50] uh, to make sure that the

[51:52] information is more accessible

[51:54] and members can always email or

[51:56] contact us directly with

[52:00] questions. Our goal is to make

[52:02] implementation of this code

[52:04] revision clear and practical as

[52:06] possible, so businesses have

[52:08] the resources that they need to

[52:09] successfully comply with the

[52:13] updated code. Next slide please.

[52:17] So what comes next? We began

[52:18] this process with an

[52:21] introduction to the board in

[52:23] SEPTEMBER 2025, followed by

[52:25] drafting code changes through

[52:27] the fall and winter of this

[52:31] past year. In SEPTEMBER 2026,

[52:32] we will return to the board

[52:34] with the full proposed code and

[52:35] changes for consideration and

[52:37] potential action. And then

[52:39] looking ahead. Implementation

[52:42] is anticipated for early 2027,

[52:44] which will include a transition

[52:46] period to support businesses.

[52:49] Next slide please. So this

[52:51] concludes our presentation

[52:53] today. We appreciate the

[52:54] opportunity to share with the

[52:56] board, and we look forward to

[52:58] coming back in SEPTEMBER for

[53:01] the code adoption. Back to you,

[53:04] Ryan.

[53:06] Gets back to the chair.

[53:08] Back to the chair.

[53:09] Excellent. Thanks so much. So

[53:10] that was a lot of information.

[53:11] We wanted to provide you with

[53:13] this briefing in advance of the

[53:15] SEPTEMBER potential vote. Are

[53:17] there any questions folks have?

[53:18] And feel free to jump in even

[53:20] if you are not going to be a

[53:21] voting member at the SEPTEMBER

[53:22] time frame. We welcome your

[53:24] questions and dialogue here

[53:26] amongst the entire board. Uh,

[53:27] board member Lewis, please go

[53:28] ahead.

[53:31] Thank you. Um, thank you, Ryan

[53:33] and Doctor Mullins and.

[53:35] MISS Helms for this

[53:36] presentation and for sharing

[53:39] this information with us. Um, I

[53:41] just have a couple of questions

[53:42] about, uh, some of

[53:43] The small businesses that will

[53:47] be, um, seeing these, um, fee

[53:49] increases. And I was wondering

[53:50] two things. When were the fees

[53:54] last increased and if the

[53:57] department considered phasing

[53:58] the increase. I know that you

[54:00] have the one year grace period,

[54:01] but wondered if you looked at

[54:03] at all.

[54:05] Yeah, I appreciate the

[54:06] question. Councilmember Lewis.

[54:09] Thanks. Um, so as I mentioned,

[54:11] we we adjusted the fees for in

[54:13] addition to the annual cpi

[54:16] increases. Um, we did adjust

[54:17] the fees for some of the larger

[54:18] operations as part of

[54:19] Environmental Health

[54:20] s great

[54:23] study presentation in 2024, but

[54:23] there

[54:25] s been no kind of full

[54:27] review of the fee structure for

[54:28] the program since the program

[54:31] was started in 2010. And so,

[54:32] you know, the interest with

[54:34] this is kind of rebased lining.

[54:35] Um, the, the revenue structure

[54:37] for the program so that it

[54:37] s

[54:39] stable. And I really I

[54:41] appreciate the question also on

[54:42] kind of being sensitive to the

[54:44] impacts, um, particularly to

[54:47] our small businesses and the

[54:49] phased implementation of the

[54:50] fees, especially for the larger

[54:52] increases, is definitely

[54:54] something that we considered.

[54:56] But, you know, as I mentioned,

[54:58] one of our kind of objectives

[55:00] around stabilization and the

[55:02] fact that this program is at

[55:05] 1.5 FTEs, we just environmental

[55:05] health doesn

[55:06] t have alternate

[55:08] funding to support basic

[55:10] program operations, which we

[55:14] feel is at that 1.5. Um, so,

[55:16] um, phasing, implementation or

[55:18] reducing that service level,

[55:20] um, would be a result or I

[55:21] m

[55:22] sorry, reduce, reduce service

[55:24] levels would be a result of

[55:25] going through a phased

[55:26] implementation. And when we

[55:27] re

[55:28] considering reduced service

[55:28] levels, we

[55:29] d likely need to

[55:31] prioritize the higher risk of

[55:33] the larger businesses while

[55:35] reducing or eliminating routine

[55:36] inspections for smaller

[55:37] businesses, even though those

[55:38] businesses would still be

[55:39] required to pay for those

[55:41] services through their fee. So

[55:42] this would have a

[55:43] disproportionate impact on

[55:45] smaller businesses. In addition

[55:47] to likely longer service hours,

[55:48] reduced capacity for customer

[55:50] service, and availability for

[55:52] technical assistance, and the

[55:53] potential to create longer

[55:55] response and turnaround times.

[55:55] But, you know, there

[55:56] s a

[55:56] there

[55:56] s a there

[55:57] s a, you know,

[55:59] significant difference with

[56:00] this program compared to other

[56:02] environmental health programs

[56:04] that have a larger scale with a

[56:06] 1.5 fte or even a small

[56:08] reduction in that 1.5 fte will

[56:10] have a very large

[56:11] disproportional impact on the

[56:13] ability of us to provide

[56:15] provide services. I hope that

[56:16] answered your question.

[56:18] It did. Thank you.

[56:20] Thank you. Board member Garcia.

[56:21] Please go ahead.

[56:23] Thank you. Chair. Uh, thanks

[56:25] for the presentation. Really

[56:27] appreciate it. I. Big takeaway.

[56:29] We have more pets than kids. I

[56:31] have three pets. So this is

[56:33] really informative. I just

[56:35] wanted to, uh, I guess,

[56:37] clarify. Uh, the larger tier

[56:41] four is for 16 and over or six

[56:43] zero 60 and over.

[56:44] Six zero and.

[56:46] Over, six zero. Okay. And then

[56:47] what

[56:47] s there? I didn

[56:48] t see any

[56:50] tier two or tier three. Is

[56:51] there any reason.

[56:52] There weren

[56:53] t in the examples?

[56:54] We were trying not to run

[56:55] through the entire fee

[56:56] schedule, but just give you a

[56:58] sense of how the changes were

[56:59] landing from the smallest

[57:01] change to the larger change. So

[57:02] there are there are two, there

[57:03] are tier two and three.

[57:05] Okay. I just wanted to confirm

[57:05] and.

[57:08] Businesses that have between 10

[57:10] and 60 animals.

[57:12] Gotcha. Makes sense. And just

[57:13] wanted to confirm is what

[57:14] s the

[57:17] point during this process that

[57:19] the uh like I

[57:20] m in Buren and we

[57:23] have a non-profit agency that

[57:25] kind of oversees, uh, our pets.

[57:27] And I just wonder, was

[57:28] wondering at what point is

[57:30] there or maybe there already

[57:33] has been relaying to them that

[57:36] this is, uh, in the works and

[57:36] it

[57:36] s potentially going to be

[57:39] voted on just so that, um,

[57:41] yeah, they are aware locally in

[57:42] smaller cities of these

[57:43] potential changes since they

[57:46] might not directly see it.

[57:47] Yeah, yeah. Great question. And

[57:49] we, you know, want to move

[57:51] forward and not have any

[57:53] surprises. Um, and what the

[57:53] board

[57:54] s going to be voting for

[57:55] in SEPTEMBER and been doing

[57:58] active engagement with um, with

[58:01] both our regulated committees

[58:03] but also others in the

[58:05] community that have an interest

[58:06] in the in the pet business

[58:07] requirements. So we have a

[58:10] listserv that we maintain that

[58:10] we

[58:11] ve been providing regular

[58:12] updates throughout the process.

[58:15] And 2026, I think we

[58:15] ve been

[58:17] sending out two notices to the

[58:19] listserv per month. We

[58:20] ve also,

[58:20] as Leo

[58:22] s noting, hosted a

[58:24] series of open house webinars

[58:25] as opportunities to provide

[58:27] feedback. You know, early on

[58:27] when we didn

[58:28] t have the

[58:30] specific code proposals, those

[58:32] were more kind of concepts and

[58:34] getting feedback on what we

[58:35] could be doing better, what

[58:35] we

[58:37] re not doing right. Um,

[58:39] leading up to more recently,

[58:41] actually sharing a strikeout

[58:43] version of the of the code

[58:45] changes and hosting some

[58:46] conversations for folks to

[58:48] provide us feedback on that.

[58:48] We

[58:50] ve also done some specific

[58:54] outreach with individual, uh,

[58:56] individual, um, industry types.

[58:58] Um, typically has a session set

[59:01] up for cat cafes next week. Um,

[59:03] we also did some specific

[59:05] outreach to the larger shelter

[59:07] operators in Seattle and King

[59:08] County, and got some really

[59:09] good feedback from them. Um, on

[59:11] some standards that didn

[59:11] t

[59:12] really align with their

[59:13] practices, that were making

[59:14] some adjustments in the code to

[59:16] reflect that important

[59:18] feedback. Um, so we

[59:18] ve been

[59:19] doing in summary, I guess we

[59:19] ve

[59:21] been doing fairly extensive

[59:22] outreach and feedback, and I

[59:23] ve

[59:24] been getting some good comments

[59:25] back and have been making

[59:27] adjustments based on those.

[59:27] Thank you.

[59:31] Thank you. Vice Chair Daniels.

[59:33] MADAM Chair, I just had a quick

[59:34] question. During these

[59:36] listening sessions when you

[59:37] spoke to the smaller

[59:38] businesses, because they will

[59:41] be the most impacted by this

[59:44] increase in fee. Um, what have

[59:46] they, what have they expressed

[59:48] regarding the fees? Have they,

[59:52] um, how that will affect them

[59:54] when, um, uh, keeping their

[59:58] business open? Um, and how, uh,

[1:00:02] taxing that would be. Um, to

[1:00:03] their, um, uh, to the

[1:00:05] livelihood of their business.

[1:00:06] What what what has been what

[1:00:07] s

[1:00:07] what

[1:00:08] s been the general

[1:00:10] feedback from the smaller pet

[1:00:11] businesses?

[1:00:14] I might invite you to step in,

[1:00:15] but my understanding is that we

[1:00:15] haven

[1:00:17] t received any kind of

[1:00:19] direct feedback specifying

[1:00:20] like, this is going to be. And

[1:00:20] I

[1:00:21] m going to have to close my

[1:00:23] businesses business, or this is

[1:00:24] going to be significantly

[1:00:26] challenging. You know, we you

[1:00:27] know, whenever I think any

[1:00:29] agency is going through a

[1:00:31] process of increasing fees, you

[1:00:32] know, nobody wants their fees

[1:00:34] increased, right? And so I

[1:00:35] think, you know, some

[1:00:37] respondents were indicating

[1:00:38] that, you know, any increase

[1:00:39] was not something that they

[1:00:40] were that they were looking

[1:00:42] for. But I think that

[1:00:43] throughout this process, we

[1:00:43] ve

[1:00:44] done a really good job

[1:00:46] communicating what customers

[1:00:48] are getting for that fee. But

[1:00:50] Leah, let me let me see if you

[1:00:51] have anything to add from what

[1:00:51] you

[1:00:52] ve been hearing directly

[1:00:56] and engagement sessions.

[1:00:57] Um, yes. During the engagement

[1:00:58] sessions, we

[1:00:59] ve been talking

[1:01:01] about generally that the fees

[1:01:02] will be going up and that we

[1:01:03] are looking at restructuring

[1:01:04] them. We

[1:01:06] ve provided some

[1:01:07] information on our website

[1:01:09] about the how and why that will

[1:01:11] happen. Um, the final fee

[1:01:13] schedule has not yet been

[1:01:15] posted. Um, most of the fees

[1:01:18] are going up, uh, around $10 a

[1:01:20] month for some of the permit

[1:01:22] categories. Um, I think it

[1:01:22] s

[1:01:24] the pet daycare and boarding

[1:01:24] category that

[1:01:26] s splitting into

[1:01:27] tears. That is probably the

[1:01:30] biggest impact. Um, folks are

[1:01:31] definitely concerned about

[1:01:32] fees. Um, but we haven

[1:01:32] t

[1:01:35] received anything specifically

[1:01:36] stating that, um, this will

[1:01:38] cause them to not be able to

[1:01:41] run their business..

[1:01:41] Yeah.

[1:01:42] Because I know, Ryan, you said

[1:01:44] that they that you reached out

[1:01:46] to the larger businesses and

[1:01:48] they gave you feedback. Um, I

[1:01:48] m

[1:01:50] just wondering, the smaller

[1:01:52] businesses, the their, their

[1:01:53] reach out to them and what

[1:01:55] feedback that you got from

[1:01:55] them.

[1:01:55] Yeah.

[1:01:58] Good. Good clarification. Board

[1:02:00] member Daniels. Thanks. Um, so

[1:02:01] these um, so we kind of we we

[1:02:03] did multiple different, uh,

[1:02:05] outreach methods on more the

[1:02:07] kind of one direction through

[1:02:09] the newsletters, keeping people

[1:02:11] updated with the process. Um,

[1:02:13] uh, advertising opportunities

[1:02:15] to provide a comment through a

[1:02:17] survey. The group of open

[1:02:19] houses that we offered were

[1:02:21] open houses that were open to

[1:02:23] anybody that received our

[1:02:25] listserv notice. So that

[1:02:27] included a mixture of small and

[1:02:29] larger businesses. The focus

[1:02:31] sessions that we had were, at

[1:02:33] the request of a couple of

[1:02:35] different industries that we

[1:02:37] knew had greater interest in

[1:02:39] the in the proposed, mainly in

[1:02:40] the title eight changes, the

[1:02:42] policy changes, not the fee

[1:02:44] changes. And those were our

[1:02:46] larger animal shelter operators

[1:02:48] and the and the cat cafes. I

[1:02:49] hope that answers your

[1:02:50] question.

[1:02:51] Thank you.

[1:02:53] Thank you, thank you all for

[1:02:54] the engaging in this

[1:02:55] discussion. Again, we will

[1:02:56] bring this back to the

[1:02:58] SEPTEMBER meeting. And I do

[1:03:00] want to clarify, um, wanted to

[1:03:01] let folks know that all board

[1:03:02] members actually have the

[1:03:05] chance to vote on proposed code

[1:03:07] changes. There will be two

[1:03:08] separate ordinances, so one

[1:03:10] will be proposed code changes

[1:03:12] and one piece of legislation in

[1:03:14] front of us will be on fees. So

[1:03:17] all board members, regardless

[1:03:18] if you are an elected official

[1:03:20] or not, get to vote on the

[1:03:22] proposed code changes. And then

[1:03:24] because of the state law, only

[1:03:26] those who are elected in their

[1:03:28] individual jurisdictions have a

[1:03:29] chance to vote on fee

[1:03:30] legislation. But there will be

[1:03:33] two pieces of legislation, and

[1:03:34] everybody gets a chance to vote

[1:03:36] on the code changes again, that

[1:03:38] will come back to us as rules

[1:03:39] and regulations for us to

[1:03:40] consider in SEPTEMBER. If you

[1:03:41] have any questions in the

[1:03:43] meantime, um, please do reach

[1:03:45] out. Ryan and the team is

[1:03:47] available for any additional

[1:03:49] information. And thanks for

[1:03:50] preparing this presentation

[1:03:51] here for us today. Great

[1:03:52] questions on engagement with

[1:03:54] small businesses. Uh, we will

[1:03:55] be reaching out to some that

[1:03:56] are in our district as well,

[1:03:58] who have been interested in a

[1:04:00] dog cafe and how to engage in

[1:04:00] that process. And if there

[1:04:01] s

[1:04:02] any lessons learned there. Um,

[1:04:04] you mentioned cat cafes. That

[1:04:05] makes me want to sneeze, even

[1:04:08] though I own a cat. And we do

[1:04:09] love our furry friends and also

[1:04:10] want to make sure that people,

[1:04:11] as they

[1:04:11] re getting out of the

[1:04:13] house and creating social

[1:04:15] cohesion opportunities, that

[1:04:16] they they have those chances to

[1:04:18] meet people and pets in places.

[1:04:19] And that

[1:04:20] s really good for our

[1:04:21] mental health as well, to get

[1:04:23] people out of the house and

[1:04:24] engaging in small business

[1:04:25] opportunities. We want to

[1:04:26] support our small businesses as

[1:04:27] well. So let

[1:04:28] s make sure that

[1:04:29] everybody understands what

[1:04:29] s

[1:04:30] being proposed and how to

[1:04:31] navigate these new proposed

[1:04:33] rules. All right. With that I

[1:04:33] m

[1:04:34] going to oh please go ahead.

[1:04:36] And Boardmember Louis.

[1:04:38] Just a quick question. Um,

[1:04:40] Ryan, will you let us know when

[1:04:41] we can start putting

[1:04:43] information in our newsletters

[1:04:45] and our communication with our

[1:04:46] constituents?

[1:04:48] Oh, we would love that. Board

[1:04:49] member Lewis. Um, I

[1:04:50] ll follow

[1:04:51] up with Joy and get some

[1:04:53] information to you that, um, to

[1:04:54] the board that you can you can

[1:04:55] share right away.

[1:04:57] Okay. And board member Garcia.

[1:05:00] Uh, I just wanted to echo if

[1:05:02] you could maybe share that also

[1:05:04] to our sca, uh, representative

[1:05:07] for the Small Cities. Uh,

[1:05:07] outside of Seattle. It

[1:05:08] d be

[1:05:08] great. We

[1:05:09] d love to do the same

[1:05:11] outreach on. And then. Just

[1:05:13] wanted to clarify. Did that

[1:05:14] hear that? You you say that you

[1:05:16] have only five staff members

[1:05:19] that deal with the program on

[1:05:21] going out to the businesses and

[1:05:26] doing this work. 1.50 okay.

[1:05:27] Gotcha.

[1:05:28] Getting a lot of getting a lot

[1:05:29] of value out of this, out of

[1:05:31] this program.

[1:05:31] Wow.

[1:05:32] Wow okay.

[1:05:33] Thank you.

[1:05:34] Thank you.

[1:05:36] Thank you. Boardmember Garcia.

[1:05:37] And, um, you mentioned the

[1:05:40] Sound Cities Association. I do

[1:05:42] want to note, uh, our newest

[1:05:44] board member to the Sound City

[1:05:45] from the Sound Cities

[1:05:47] Association. Alternate, um,

[1:05:50] council member Perry Bloss, who

[1:05:52] is with the city of Des Moines.

[1:05:52] So we

[1:05:53] re glad that they

[1:05:53] re

[1:05:54] participating as well. And, uh,

[1:05:55] echo the comments about sharing

[1:05:57] that with sca. Thanks for the

[1:05:58] request to get a blurb that

[1:06:00] people can put on social media.

[1:06:02] And, uh, in their newsletters,

[1:06:04] Boardmember Louis. And with

[1:06:05] that, colleagues, we are going

[1:06:07] to move to the continuum of

[1:06:09] care topic. Uh, we do have

[1:06:10] quite a few people who are

[1:06:11] joining us here today for this

[1:06:13] topic. Again, I want to thank

[1:06:15] board member Lou, who had

[1:06:16] requested this item be added in

[1:06:18] partnership with other board

[1:06:18] members. After we

[1:06:19] ve had some

[1:06:20] initial conversation about the

[1:06:22] continuum of care, federal

[1:06:26] dollars, uh, about over 60

[1:06:27] million in federal dollars is

[1:06:29] how much King County relies on

[1:06:30] annually from Federal housing

[1:06:31] and Urban Development grant,

[1:06:34] um, a grant that we receive

[1:06:35] with some of the proposed

[1:06:36] changes and conditionalities

[1:06:38] tied to the request for

[1:06:40] proposals that we saw from the

[1:06:41] federal administration, we are

[1:06:43] all very nervous about walk

[1:06:44] backs that the federal

[1:06:46] administration is proposing on

[1:06:48] trusted and proven harm

[1:06:50] reduction strategies that allow

[1:06:51] for people to get placed into

[1:06:54] housing. And our team here in

[1:06:56] King County, including at the

[1:06:57] King County Regional

[1:06:58] Homelessness Authority, in

[1:07:00] partnership with providers like

[1:07:03] the Downtown Emergency um

[1:07:07] Services Center, uh desk and

[1:07:09] providers, direct workers on

[1:07:10] the front line working with our

[1:07:11] most vulnerable community

[1:07:14] members, folks from seiu

[1:07:16] healthcare, 1199 Northwest Pro

[1:07:19] Tech, 17 op. You are all union

[1:07:22] workers who work directly with

[1:07:24] folks who are needing access to

[1:07:26] not just shelter, but the

[1:07:27] throughput to permanent

[1:07:28] supportive housing to keep

[1:07:30] people off the streets. So we

[1:07:32] are here at the request of

[1:07:33] board member Lou, for

[1:07:36] additional information on page

[1:07:38] 52, in your meeting packets,

[1:07:39] you will be able to find more

[1:07:42] information about what is going

[1:07:43] to be presented here. And I

[1:07:45] want to start by asking board

[1:07:45] member Lou, if you

[1:07:46] d like to

[1:07:47] have any comments before we

[1:07:49] turn it over to our panelists

[1:07:50] and appreciate your engagement

[1:07:52] on setting this agenda.

[1:07:54] Yeah. Thank you so much. Chair.

[1:07:55] Mosquito. Again, my name is

[1:07:56] board member Victor Liu for

[1:07:58] this work context I you see his

[1:08:00] pronouns on this board. I

[1:08:02] represent community

[1:08:04] stakeholders. And then beyond

[1:08:05] that, I am also on the Health

[1:08:07] and Homelessness workgroup,

[1:08:09] also on the King County

[1:08:10] Regional Homeless Authority

[1:08:11] Continuum of Care Board as

[1:08:13] well. And also work with the

[1:08:14] Governor

[1:08:15] s Office of Equity,

[1:08:17] Community Advisory Board. In

[1:08:19] addition also in commerce,

[1:08:21] Homelessness Assistance Unit,

[1:08:22] Living Assistance Committee,

[1:08:23] and most recently, I was also

[1:08:25] selected as one of nine

[1:08:27] national leaders on the

[1:08:28] Community Strategic Team on the

[1:08:30] National Alliance to End

[1:08:32] Homelessness. So you can tell

[1:08:32] that I

[1:08:33] m deeply engaged in this

[1:08:36] homelessness work. For years

[1:08:37] and since the pandemic, I have

[1:08:38] focused my work on

[1:08:40] homelessness. Beyond working as

[1:08:41] a principal consultant,

[1:08:43] specializing in specializing in

[1:08:46] integrated managed care. And I

[1:08:47] understand from today that we

[1:08:49] have six presenters, and I

[1:08:50] think that this is a very

[1:08:52] timely time. As chair Mosqueda

[1:08:54] has noted that the local

[1:08:56] application for the notice of

[1:08:59] funding opportunity ended on

[1:09:01] JULY 3rd, and we are actually

[1:09:05] looking at $67 million in

[1:09:06] Seattle and King County as a

[1:09:07] significant amount that will

[1:09:10] impact Seattle and King County.

[1:09:11] The six presenters that we have

[1:09:14] today are just chief program

[1:09:15] officer from King County

[1:09:17] Regional Homeless Authority.

[1:09:18] Daniel Daniel, I haven

[1:09:18] t seen

[1:09:20] you for a long time. Executive

[1:09:23] director from dhsc and also

[1:09:25] union representation, Corinne

[1:09:28] Constantino, Regan McBride, Jim

[1:09:30] Hopkins and Lindsey Grant. And

[1:09:32] with that, I will pass the

[1:09:34] baton to Jeff.

[1:09:39] Thank you. Board. Marylou.

[1:09:40] Uh, thank you, board member

[1:09:44] Lou. And also for your support

[1:09:45] on our as a member of our

[1:09:47] board, uh, separately, uh,

[1:09:49] chair Mosqueda or one member of

[1:09:49] the board, could you just

[1:09:51] confirm for me that you can see

[1:09:53] my title side? Great. It should

[1:09:55] be advancing. Now to my first

[1:09:58] slide. There we go. Thank you.

[1:10:00] Um, as a board member, Lou

[1:10:01] already covered a little bit.

[1:10:01] I

[1:10:02] m here to give you a

[1:10:04] background on the Continuum of

[1:10:05] Care program, which is the

[1:10:06] largest stream of federal

[1:10:07] funding for homelessness

[1:10:09] services that, uh, that goes

[1:10:10] out nationwide and

[1:10:12] specifically, um, in King

[1:10:13] County, as you can see on the

[1:10:15] chart in front of you, we

[1:10:17] receive, uh, for program

[1:10:18] dollars 66 million, a little

[1:10:21] bit more than $66 million. And,

[1:10:23] uh, what is broken down on this

[1:10:24] slide are the various areas

[1:10:26] that those, uh, or program

[1:10:27] types, as we call them, that

[1:10:28] are supported with those funds,

[1:10:30] the largest being permanent

[1:10:31] supportive housing. That

[1:10:31] s

[1:10:33] especially relevant for this

[1:10:35] board, uh, because of the

[1:10:36] health intersections for the

[1:10:37] individuals that utilize those

[1:10:39] services. Everyone in a

[1:10:40] permanent supportive housing

[1:10:42] unit has a disabling condition

[1:10:43] and has experienced chronic

[1:10:45] homelessness. And so, uh, the

[1:10:46] individuals that would be

[1:10:48] impacted in any of those kinds

[1:10:49] of project types are going to

[1:10:51] have, uh, direct implications

[1:10:52] for the work that you all

[1:10:53] oversee. There

[1:10:55] s also some

[1:10:58] other, uh, uh, bolded program

[1:10:59] types that I wanted to lump

[1:11:00] together and note for you.

[1:11:02] Those are things that results

[1:11:04] in an individual moving into

[1:11:05] permanent housing or having

[1:11:06] permanent housing in some way,

[1:11:08] shape or form. And as you can

[1:11:08] see, that

[1:11:11] s 92% of our total.

[1:11:12] Uh, so things that are

[1:11:13] resulting in housing outcomes,

[1:11:14] uh, that

[1:11:14] s going to be really

[1:11:16] important as I get to my next

[1:11:17] slide here and talk about the

[1:11:20] amounts that we are potentially

[1:11:22] seeing at risk in this coming

[1:11:23] funding cycle and the policy

[1:11:24] changes that the Department of

[1:11:26] Housing Urban Development is.

[1:11:26] I

[1:11:27] m going to just say hud going

[1:11:29] forward, uh, are seeking to

[1:11:32] impose. So those significant

[1:11:35] changes, the most substantial

[1:11:35] I

[1:11:36] m going to use the term from

[1:11:38] here on out, tier one, I want

[1:11:39] you all to think of tier one as

[1:11:41] being the funds that are

[1:11:43] basically our renewals. It

[1:11:43] s

[1:11:44] not perfectly guaranteed, but

[1:11:46] it is highly likely to receive

[1:11:47] those funds. And it

[1:11:48] s easy to

[1:11:49] think about it that way. And

[1:11:50] everything else would fall into

[1:11:52] some other kind of a tier. So

[1:11:52] we

[1:11:53] ll call that tier two.

[1:11:54] Maybe, um, tier two. Tier one

[1:11:56] is actually a technical term,

[1:11:58] um, stemming from the funding

[1:11:59] announcement, though

[1:12:01] historically, and as you saw in

[1:12:02] that prior slide, if you think

[1:12:03] about our permanent housing

[1:12:04] interventions, that

[1:12:06] s 92% of

[1:12:07] the money we receive. And a

[1:12:08] disproportionate amount of that

[1:12:10] is permanent housing itself,

[1:12:11] permanent supportive housing.

[1:12:12] Um, this year, historically

[1:12:14] that that amount that is tier

[1:12:16] one. What we get renewed is

[1:12:22] usually in the 90 to 97% range.

[1:12:24] So almost anything that has

[1:12:26] been awarded previously is

[1:12:28] eligible for a renewal if each

[1:12:30] local community, which is also

[1:12:31] required to do a competitive

[1:12:33] process, has evaluated that

[1:12:35] project to be aligned with its

[1:12:37] local goals and performing

[1:12:38] effectively and really meeting

[1:12:40] the overall work towards ending

[1:12:42] homelessness. This year, the

[1:12:43] Department of Housing and Urban

[1:12:44] Development reduced that to

[1:12:48] 60%, so nearly half of the, uh,

[1:12:49] a little bit less than half of

[1:12:51] the existing projects

[1:12:53] nationwide are not going to be

[1:12:53] renewed. And I

[1:12:54] m going to talk

[1:12:55] a little bit more about some of

[1:12:56] those impacts for us locally.

[1:12:56] That

[1:12:58] s the most significant

[1:12:59] action that we

[1:13:00] ve seen. But

[1:13:00] there

[1:13:01] s several other various

[1:13:03] serious changes that hud has

[1:13:04] also imposed in this recent

[1:13:05] funding cycle that we

[1:13:06] re going

[1:13:07] through. Um, you can see that

[1:13:09] some of those are changing the

[1:13:11] types of projects that you can

[1:13:13] propose for them to receive. So

[1:13:14] instead of it being something

[1:13:15] or the results of permanent

[1:13:16] housing placements, ending

[1:13:16] someone

[1:13:18] s homelessness, it has

[1:13:19] to focus on things that are

[1:13:21] shorter term, uh, or supportive

[1:13:23] services instead of helping

[1:13:25] necessarily, and having as a

[1:13:27] result in permanent housing.

[1:13:27] There

[1:13:30] s also several policy

[1:13:30] changes. I won

[1:13:31] t read through

[1:13:32] all of them on this list. You

[1:13:33] can see them on the slide. This

[1:13:33] isn

[1:13:35] t everything. Um, I

[1:13:35] ll note

[1:13:38] that there is a protective

[1:13:40] order in place preventing King

[1:13:43] County and Seattle from having

[1:13:44] to comply with some of these

[1:13:45] changes. That court case, King

[1:13:47] County versus Turner in

[1:13:49] particular, uh, the

[1:13:51] requirements to I believe the

[1:13:52] language is acknowledge the sex

[1:13:54] binary of humans requiring

[1:13:56] collaboration with federal

[1:13:57] immigration enforcement and

[1:13:59] executive order compliance.

[1:14:00] Those three items in

[1:14:02] particular, we are protected

[1:14:04] from at this time, from having

[1:14:05] to comply with. But you can see

[1:14:06] on this list that

[1:14:06] s not

[1:14:07] everything that we

[1:14:07] re looking

[1:14:08] at. There

[1:14:09] s new items that have

[1:14:10] been imposed. There are there

[1:14:13] is a a lawsuit has been filed.

[1:14:15] And King County is a plaintiff

[1:14:17] in that lawsuit seeking to

[1:14:19] enjoin some of these other

[1:14:20] conditions. That hasn

[1:14:20] t

[1:14:22] happened yet. But there is that

[1:14:24] lawsuit is in process, and it

[1:14:27] was requested that by the

[1:14:28] AUGUST 10th, the court make a

[1:14:31] determination on the on that,

[1:14:33] uh, that complaint. So I

[1:14:34] m

[1:14:35] going to go to our next piece,

[1:14:36] which is that local impact

[1:14:38] again, talking about we

[1:14:38] ve got

[1:14:40] a lot of projects that are

[1:14:42] facing not getting renewed. Um,

[1:14:43] so if you just look at our

[1:14:44] total number, that

[1:14:46] s 66 to 83

[1:14:47] is the same that I had on my

[1:14:49] first slide. You can see that

[1:14:50] some numbers, some of those

[1:14:51] projects adding up to just

[1:14:54] under $40 million, would fit

[1:14:55] into that realm of funding,

[1:14:57] that tier one that we feel

[1:14:58] confident that we can see it

[1:14:59] renewed. That

[1:15:00] s not perfectly

[1:15:01] guaranteed, but we feel pretty

[1:15:03] confident about that. We also,

[1:15:05] given all the many changes that

[1:15:07] hud is imposing nationally,

[1:15:09] have worked with programs to

[1:15:10] identify places that they have

[1:15:12] greater efficiencies or could

[1:15:13] make a voluntary change to how

[1:15:15] their project operates in order

[1:15:16] to better align with hud

[1:15:16] s

[1:15:19] priorities. And so we would not

[1:15:20] have to have that project in

[1:15:22] tier one, but would be likely

[1:15:23] to still see that project

[1:15:26] continue, or it just creates a

[1:15:27] funding gap for us to be able

[1:15:29] to fit more things in our tier

[1:15:31] one, uh, opportunities. That

[1:15:31] s

[1:15:34] still leaves a gap of $22

[1:15:36] million in projects that exist

[1:15:37] today. They

[1:15:37] ve already been

[1:15:39] operating many times for many

[1:15:41] years that we would not be able

[1:15:43] to operate, although locally,

[1:15:45] and we have prioritized our

[1:15:47] projects that you could

[1:15:48] shorthand it as being permanent

[1:15:49] supportive housing project,

[1:15:50] permanent supportive housing,

[1:15:52] but projects that have

[1:15:54] leveraged tens of millions of

[1:15:55] dollars for either their

[1:15:57] capital investment to create

[1:15:59] them or the braiding of

[1:16:01] numerous funding streams,

[1:16:04] including, um, fcs supports or

[1:16:06] Medicaid dollars. In some

[1:16:08] cases, um, to into their

[1:16:09] funding model, along with

[1:16:11] Public Housing Authority funds

[1:16:13] and even things like the um,

[1:16:15] Veterans Administration funds.

[1:16:17] So although those kinds of

[1:16:19] projects are prioritized, we

[1:16:19] don

[1:16:21] t yet have my group, my

[1:16:22] readers are actually looking at

[1:16:23] the applications right now for

[1:16:25] renewals and new projects. We

[1:16:25] don

[1:16:26] t know exactly yet which of

[1:16:28] those projects, um, are which

[1:16:29] projects are going to be in

[1:16:32] that bucket of 22 million that

[1:16:34] are facing, not getting

[1:16:35] renewed. But that

[1:16:36] s the most

[1:16:37] important impact that we

[1:16:37] re

[1:16:38] looking at. And that would have

[1:16:40] downstream impacts on numerous

[1:16:41] health systems, which is why I

[1:16:43] believe board member Lou really

[1:16:44] wanted this to be highlighted

[1:16:46] for you all today. As I said

[1:16:48] though, earlier on some of

[1:16:50] this, there are multiple things

[1:16:52] underway to hopefully address

[1:16:54] or respond to that risk. First,

[1:16:55] as I noted already, there

[1:16:55] s

[1:16:57] litigation not only existing

[1:16:58] with an injunctive order put in

[1:17:00] place, but also pending

[1:17:02] litigation that is seeking to

[1:17:03] prevent some of these actions

[1:17:05] from being implemented so that

[1:17:07] these effects would just be,

[1:17:09] uh, stopped by the courts.

[1:17:09] We

[1:17:10] ve also had excellent

[1:17:12] engagement with county

[1:17:13] partners. Councilmember

[1:17:14] Mosqueda you participated in

[1:17:16] that, for example, and some of

[1:17:17] our other board members here, I

[1:17:19] believe, as well. Um, a

[1:17:20] stakeholder group that

[1:17:22] encompasses city and county

[1:17:25] stakeholders in looking at the,

[1:17:27] the the potential impacts of

[1:17:29] this and identifying plans,

[1:17:31] ideally, identifying steps that

[1:17:33] would be taken if some of these

[1:17:34] impacts were to occur. You

[1:17:36] know, things, things like ways

[1:17:37] to shore up those projects

[1:17:38] locally. So we don

[1:17:39] t disrupt

[1:17:40] that braiding of funds, things

[1:17:42] like that. Um, and then also

[1:17:45] Csra is not only relying on

[1:17:47] that legal pathway that has

[1:17:47] been taken, but also we

[1:17:48] ve been

[1:17:49] doing work to make sure that if

[1:17:51] we do need to comply with all

[1:17:54] of these, uh, new requirements

[1:17:55] and priorities, that we

[1:17:55] ve set

[1:17:58] up a, an application that will

[1:18:00] best compete to retain our

[1:18:02] federal dollars and also still

[1:18:03] aligns with our local

[1:18:05] priorities. So leaning into we

[1:18:07] actually did a review of the

[1:18:09] many degrees of consultant

[1:18:11] reports, public engagements and

[1:18:13] development of action plans

[1:18:14] that have occurred over the

[1:18:15] last 5 to 10 years and

[1:18:17] aggregated the themes across

[1:18:19] that because there was probably

[1:18:21] thousands of engagement

[1:18:22] sessions with people with a

[1:18:23] range of stakeholders that

[1:18:25] really inform that, and there

[1:18:27] is a lot of consistency in all

[1:18:29] of them about what our system

[1:18:30] priorities were. And so and

[1:18:31] there was overlap between that

[1:18:33] and what hud was requiring. So

[1:18:34] we were able to focus our local

[1:18:36] competition on those. So those

[1:18:36] are the steps we

[1:18:37] re taking

[1:18:38] right now to offset some of

[1:18:40] this impact. And then I

[1:18:42] ll flag

[1:18:42] and then I

[1:18:43] ll just run through

[1:18:44] where we

[1:18:44] re at in timeline,

[1:18:45] because I know you have several

[1:18:46] other panelists that are also

[1:18:47] going to be touching on some of

[1:18:50] these topics as well. Um, most

[1:18:52] significantly, uh, board Chair

[1:18:54] Mosqueda noted earlier than on

[1:18:57] JULY 3rd was the date that our

[1:18:59] local applications either to be

[1:19:01] a new or to renew your project,

[1:19:01] we

[1:19:02] re all due. Those are all

[1:19:03] with objective rating panels

[1:19:04] right now, and that

[1:19:04] s what

[1:19:04] s

[1:19:06] going on over the next couple

[1:19:08] of weeks, is for that to occur

[1:19:09] and for what we call our rating

[1:19:10] and ranking process, where we

[1:19:11] take everyone

[1:19:11] s scores that

[1:19:13] they were given by those rating

[1:19:14] panels and aggregated into a

[1:19:19] list on AUGUST 10th, which is

[1:19:20] the next, uh, board meeting.

[1:19:21] Well, not actually, there

[1:19:22] s

[1:19:22] there

[1:19:23] s multiple, um, funding

[1:19:24] announcements that our board

[1:19:25] has to deal with, but for this

[1:19:27] big, large funding opportunity

[1:19:29] that we call the hud, no foe.

[1:19:31] Um, the, our csc board or

[1:19:32] Continuum of Care board will be

[1:19:34] meeting on AUGUST 10th, and

[1:19:36] that is when that ranked list

[1:19:38] of applications is first

[1:19:41] presented. And authorized by

[1:19:42] the board to move forward.

[1:19:43] Essentially, that is when it

[1:19:45] becomes our final list of what

[1:19:45] we

[1:19:46] re moving forward. Hud

[1:19:48] requires that within actually

[1:19:50] within one day of that, um, we

[1:19:51] have to have distributed

[1:19:52] letters announcing to all of

[1:19:53] those applicants that they

[1:19:55] received an award. Um, our

[1:19:57] final application to hud is due

[1:19:58] on it

[1:19:59] s technically due on

[1:20:02] AUGUST 26th. Um, that, uh, no

[1:20:04] one in the country. Well,

[1:20:04] actually, I guess no one that

[1:20:05] s

[1:20:06] wise in the country submits it

[1:20:08] on AUGUST 26th. Will be

[1:20:09] planning to submit ours on

[1:20:11] AUGUST 24th. It

[1:20:12] s not uncommon

[1:20:13] that with that, many

[1:20:14] jurisdictions across the

[1:20:15] country submitting the system

[1:20:16] can get overwhelmed or

[1:20:18] encounter issues. And there is

[1:20:19] not an allowance if you

[1:20:22] encounter that for any kind of,

[1:20:23] um, you know, extension or

[1:20:24] anything like that, you

[1:20:24] re

[1:20:26] outright just not awarded

[1:20:27] funds. And so we make sure we

[1:20:28] send in our application a

[1:20:30] couple days in advance to make

[1:20:31] sure that no technical issues

[1:20:34] would result in the loss of $67

[1:20:36] million. Um, that

[1:20:36] s all my

[1:20:37] slides for now. I know you have

[1:20:38] several other presenters that

[1:20:40] are going to be going, and so

[1:20:41] I

[1:20:41] ll pause and see if there

[1:20:41] s

[1:20:43] any questions or actually, um,

[1:20:45] sorry. Uh, manager, I

[1:20:45] m not

[1:20:46] sure if you want to meet a

[1:20:46] pause for questions or wait

[1:20:47] till we get through all of the

[1:20:48] presenters.

[1:20:49] Um, I think we can go ahead and

[1:20:51] roll right over to Daniel

[1:20:52] Malone and then over to our

[1:20:54] labor partners. I will say the

[1:20:56] timeline that you presented and

[1:20:57] the update on the application,

[1:20:58] it

[1:20:59] s just I think another

[1:21:00] important reminder, as board

[1:21:03] member Liu noted, that we have

[1:21:05] so much at stake with this

[1:21:09] application and even the, um,

[1:21:12] contingency plan of 10 million

[1:21:14] at the county and 21 million at

[1:21:17] the city of Seattle is not

[1:21:19] anywhere near enough to close a

[1:21:21] federal funding gap. So we are

[1:21:22] very thankful for the joint

[1:21:24] partnership with the city of

[1:21:26] Seattle, the King County

[1:21:27] Executive Office, the Board of

[1:21:28] Health here, who has shown

[1:21:29] tremendous interest in

[1:21:30] maintaining the health of

[1:21:32] people in this region by

[1:21:34] keeping people housed, there

[1:21:35] will be so many more people

[1:21:37] falling into homelessness, not

[1:21:39] just not serving those who are

[1:21:40] currently homeless, but more

[1:21:41] people falling into

[1:21:42] homelessness. If we lose these

[1:21:43] dollars. So that will

[1:21:45] absolutely affect the health of

[1:21:46] the population as a whole. And

[1:21:49] so the timeline, the

[1:21:52] litigation, the application,

[1:21:53] all of these things all go

[1:21:55] together. We have a litigation

[1:21:57] strategy and application

[1:21:59] strategy, all in an effort to

[1:22:01] have a mitigation strategy on

[1:22:02] how much this would impact our

[1:22:04] community. So with that, to

[1:22:05] talk about what the impact

[1:22:05] would be, I

[1:22:06] ll turn it over to

[1:22:07] Daniel Malone from Downtown

[1:22:10] Emergency Services Center.

[1:22:12] Thank you so much. I really

[1:22:13] appreciate the attention you

[1:22:14] re

[1:22:15] paying to this. Uh, I

[1:22:16] ll try to

[1:22:20] build on some of, uh, what Jeff

[1:22:22] covered in his excellent

[1:22:24] presentation there about how

[1:22:29] this is likely to affect

[1:22:31] services. Uh, on the ground

[1:22:36] here in Seattle. Uh, so, a dsc

[1:22:38] is, I believe, the single

[1:22:41] largest user of continuum of

[1:22:43] care funds of, uh, service

[1:22:45] provider organizations in the

[1:22:47] state of Washington. Um, and

[1:22:47] that

[1:22:49] s because we do a lot of

[1:22:50] permanent supportive housing

[1:22:55] work. And, uh, most of the coc

[1:22:56] funds are used for permanent

[1:22:57] supportive housing, as Jeff

[1:22:58] s,

[1:23:01] uh, slides had indicated there.

[1:23:04] And also as Jeff, uh, clearly

[1:23:07] articulated, hud is through

[1:23:09] this know fo aiming to move

[1:23:11] funds away from permanent

[1:23:13] supportive housing. And the

[1:23:14] thing I want to emphasize about

[1:23:18] that is what that means then is

[1:23:20] that is an attack on people

[1:23:23] with disabilities because, uh,

[1:23:25] permanent supportive housing is

[1:23:27] an intervention specifically

[1:23:28] aimed to support people living

[1:23:32] with disabilities. And

[1:23:34] especially people with long

[1:23:36] term psychiatric and other

[1:23:37] behavioral health disabilities.

[1:23:41] Uh, one indication of the

[1:23:41] administration

[1:23:44] s hostility to

[1:23:47] people with behavioral health

[1:23:49] disabilities is that they have

[1:23:50] said explicitly in public

[1:23:53] forums that hud funding for

[1:23:55] permanent housing should only

[1:23:57] be for people who are elderly

[1:24:00] or living with physical

[1:24:03] disabilities. Um, another

[1:24:05] element of the of the current

[1:24:09] no fo that is new, um, didn

[1:24:09] t

[1:24:11] exist in previous hud practice

[1:24:15] is that they have expanded this

[1:24:17] category, uh, that they call

[1:24:19] risk review. Uh, where even if

[1:24:22] a renewal project is included

[1:24:24] in the tier one that Jeff

[1:24:27] described and, um, and

[1:24:29] therefore should be expected to

[1:24:31] be highly likely to be renewed,

[1:24:34] hud has endowed itself with,

[1:24:38] uh, new powers to reach into

[1:24:40] any application, any single

[1:24:40] project that

[1:24:42] s in the tier one

[1:24:45] part of the application through

[1:24:47] their risk review process, and

[1:24:49] reject it for some new kinds of

[1:24:51] reasons. And one of those

[1:24:55] reasons is related to a vaguely

[1:24:58] defined concept of promoting

[1:24:59] self-sufficiency for people.

[1:25:01] And it appears that what they

[1:25:04] mean by that is moving people

[1:25:06] off of public benefits,

[1:25:09] including off of, uh, housing

[1:25:12] support. So when you apply that

[1:25:14] type of thinking to people

[1:25:16] living with chronic, uh,

[1:25:18] disabling conditions,

[1:25:19] especially, uh, serious

[1:25:22] psychiatric conditions, you can

[1:25:25] see that, um, this no folk

[1:25:27] presents a very real risk to

[1:25:30] the ongoing housing support and

[1:25:33] stability for people with, uh,

[1:25:35] serious behavioral health

[1:25:37] conditions, permanent

[1:25:39] supportive housing, uh, has

[1:25:42] really become the residential

[1:25:45] backbone in our community for

[1:25:46] people with complicated and

[1:25:49] chronic psychiatric conditions.

[1:25:49] And that

[1:25:50] s for two main

[1:25:53] reasons. Affordability and the

[1:25:55] unique services that are

[1:25:56] provided. So, you know, this

[1:25:58] population of people living

[1:26:00] with disabilities, uh, most

[1:26:03] often is surviving on extremely

[1:26:06] low incomes. And when they have

[1:26:08] a disability benefit from the

[1:26:09] federal government, usually

[1:26:09] it

[1:26:11] s ssi that pays less than

[1:26:14] $1,000 a month to live on. And

[1:26:16] of course, at $1,000 a month

[1:26:17] total, it

[1:26:18] s mathematically

[1:26:20] impossible for somebody to pay

[1:26:21] for housing in the community

[1:26:22] that isn

[1:26:23] t subsidized. So

[1:26:24] permanent supportive housing

[1:26:26] covers that. By making sure

[1:26:28] that the housing cost to the

[1:26:31] individual tenant, uh, is based

[1:26:33] on their personal income, and

[1:26:36] then, uh, people with the most

[1:26:39] challenging conditions, uh,

[1:26:39] even when they

[1:26:40] re participating

[1:26:42] in treatment and taking

[1:26:45] psychiatric medications, often

[1:26:47] need the kind of robust support

[1:26:47] that

[1:26:49] s provided by permanent

[1:26:50] supportive housing to retain

[1:26:53] stability in their housing

[1:26:54] continuum of care program has

[1:26:57] long been a major source of

[1:26:58] funding for the operations of

[1:27:01] that very kind of specialized

[1:27:05] housing at dc alone, about two

[1:27:08] thirds of our around 2200

[1:27:09] permanent supportive housing

[1:27:11] units are supported by

[1:27:13] Continuum of Care funds. Um,

[1:27:15] the specific numbers are that

[1:27:21] um, 1132 units in dc, site

[1:27:23] based permanent supportive

[1:27:26] housing, and another 257

[1:27:27] scattered site units on the

[1:27:29] private rental market, where

[1:27:31] coc funding, uh is used for

[1:27:33] rental assistance. Um, for a

[1:27:37] total of almost 1400 of our

[1:27:40] about 2200 units are covered by

[1:27:42] Continuum of Care funding. So

[1:27:43] it

[1:27:45] ll be devastating to have

[1:27:47] that funding loss. Uh, at dsc,

[1:27:47] that

[1:27:50] s about $16 million a year

[1:27:52] for, uh, that comes to us

[1:27:54] through that source. And then

[1:27:56] on top of that, another $4

[1:27:57] million is covering that rental

[1:27:58] assistance that I mentioned in

[1:28:01] the private rental market. Um,

[1:28:04] so this, this no foe Jeff

[1:28:08] mentioned is, uh, is the

[1:28:10] subject of brand new litigation

[1:28:13] that has been filed, uh, in two

[1:28:15] separate actions. One of those,

[1:28:16] Jeff mentioned, King County, is

[1:28:18] one of the co plaintiffs in

[1:28:22] that, uh, uh, the other uh,

[1:28:24] litigation, a very similar case

[1:28:26] was filed by a consortium of

[1:28:28] states. And the state of

[1:28:29] Washington is the lead

[1:28:32] plaintiff in that case. Uh, uh,

[1:28:32] what

[1:28:36] s notable here is that

[1:28:39] the, uh, the previous attempt

[1:28:40] last year by hud to do this

[1:28:43] same action of shifting funds

[1:28:45] away from permanent supportive

[1:28:48] housing into other uses was

[1:28:50] also the subject of litigation.

[1:28:52] And these same plaintiffs, uh,

[1:28:54] were involved in those

[1:28:57] lawsuits. And the judge, uh,

[1:28:59] issued preliminary rulings

[1:29:01] last, uh, earlier this year.

[1:29:03] And then, um, very recently at

[1:29:06] the end of JUNE, uh, made her

[1:29:09] final ruling in that case from

[1:29:12] from last year. And, uh, she

[1:29:14] really drilled into what hud

[1:29:14] s

[1:29:16] aims were here. And I want to

[1:29:18] read you a quote from the

[1:29:18] judge

[1:29:21] s ruling, because I it

[1:29:21] s

[1:29:23] so, uh, important, I think, as

[1:29:25] to what she observed in all

[1:29:29] this. She wrote, uh, overall,

[1:29:31] the actions undertaken by hud

[1:29:32] in attempting to hastily

[1:29:34] eliminate its housing first

[1:29:37] approach serve as the hallmark

[1:29:39] of unseasoned decision making.

[1:29:40] And hud

[1:29:41] s attempt to

[1:29:43] retroactively backfill its

[1:29:44] impulsive decision making lacks

[1:29:46] a rational connection between

[1:29:48] any facts it could have found

[1:29:49] and the choices that it

[1:29:51] ultimately made. In issuing

[1:29:53] these no PFOs. Uh, that

[1:29:54] s

[1:29:55] pretty choice. Uh, comment by

[1:29:57] the judge. Now, again, that

[1:29:58] applies to last year

[1:29:59] s, uh,

[1:30:02] attempted change. Uh, with this

[1:30:04] funding. But the new novo that

[1:30:04] we

[1:30:05] re talking about now and

[1:30:07] that Jeff was describing the

[1:30:11] process for is very similar.

[1:30:13] Um, it it has many of the same

[1:30:16] kinds of conditions. And, um,

[1:30:16] that

[1:30:17] s what the plaintiffs,

[1:30:18] including King County in the

[1:30:20] state of Washington, are suing

[1:30:21] over. And so I

[1:30:22] ll just end by

[1:30:25] expressing my gratitude, uh,

[1:30:27] that, um, King County and the

[1:30:28] state of Washington are

[1:30:30] defending our communities and

[1:30:32] people with disabilities by

[1:30:33] pursuing this litigation.

[1:30:35] Thanks a lot for having me.

[1:30:37] Thank you so much. I think

[1:30:38] that

[1:30:39] s a great transition to

[1:30:41] our union community partners.

[1:30:46] Uh, 11.99 opioid and pro tag.

[1:30:48] Uh, please go ahead and jump on

[1:30:49] in. Hello? Reagan McBride

[1:30:52] Lindsey grad and, um, anybody

[1:30:53] from opi, you please feel free

[1:30:58] to jump in. Go ahead. Reagan.

[1:31:00] Thanks, chair. Mosqueda. My

[1:31:01] name is Reagan McBride. I use

[1:31:02] her pronouns. I

[1:31:04] m representing

[1:31:07] protec 17 here today and protec

[1:31:10] 17 represents, uh. Most of the

[1:31:13] staff at Kcra. So as we

[1:31:13] re

[1:31:14] talking about continuity of

[1:31:16] services, one of the things

[1:31:16] that

[1:31:17] s really important with

[1:31:19] that is continuity of the

[1:31:20] expertise that

[1:31:20] s been

[1:31:22] delivering this funding. Um,

[1:31:22] and that

[1:31:24] s coming from the Kcra

[1:31:25] staff. That

[1:31:26] s, uh, developing

[1:31:28] and providing the data for

[1:31:30] these continuum of care

[1:31:32] applications. Um, they are

[1:31:34] working with the nonprofit

[1:31:36] partners that are largely

[1:31:38] represented by seiu and Payu to

[1:31:40] deliver these critical

[1:31:41] services. Um, and that

[1:31:43] continuity of the staff that

[1:31:43] s

[1:31:45] administering these is also

[1:31:49] really important to, uh, the

[1:31:52] care of our unhoused neighbors.

[1:31:54] Um, we want to keep in mind,

[1:31:55] you know, the staff that

[1:31:57] administers this funding and

[1:32:00] these programs are our local

[1:32:01] homeless service and homeless

[1:32:03] systems experts. Um, they are

[1:32:05] not just budget line items,

[1:32:06] although I know that

[1:32:06] s most of

[1:32:07] what we

[1:32:08] re talking about here

[1:32:08] today when we

[1:32:08] re talking about

[1:32:10] funding is budget line items.

[1:32:12] Um, but to humanize not just

[1:32:13] the clients that are being

[1:32:14] served by this funding, but the

[1:32:16] staff, uh, that are providing

[1:32:18] those critical services and the

[1:32:21] critical data systems, um, and

[1:32:23] back end systems that allow for

[1:32:27] that. And I can kick it either

[1:32:27] back to Jeremy

[1:32:28] s data or over

[1:32:29] to Lindsay, whatever you

[1:32:30] prefer.

[1:32:31] Over to Lindsay. Sounds great.

[1:32:32] Thanks.

[1:32:34] So hey, good afternoon

[1:32:35] everyone. For those who don

[1:32:35] t

[1:32:35] know me, I

[1:32:36] m Lindsay, grad

[1:32:38] legislative director at seiu

[1:32:40] healthcare 1199 northwest. We

[1:32:42] represent 38,000 healthcare

[1:32:43] workers across the state of

[1:32:46] Washington, including the front

[1:32:48] care folks at Downtown

[1:32:50] Emergency Services Center. Uh,

[1:32:53] Jeff and Daniel and Reagan

[1:32:54] already really spoke to the

[1:32:56] issue. But I just want to say

[1:32:56] it

[1:32:58] s my job to reiterate, this

[1:33:00] is a very timely moment for you

[1:33:02] all to be taking on this focus.

[1:33:03] Um, the hard work that went

[1:33:06] into our next, um, Coc

[1:33:07] application by dozens and

[1:33:10] dozens of people, um, is is

[1:33:11] something that everyone should

[1:33:13] be proud of and is really

[1:33:14] important to be successful on.

[1:33:15] And the fact that you all are

[1:33:17] putting an eye on that, uh, is

[1:33:18] an important part of the

[1:33:20] process. We do not know what

[1:33:20] s

[1:33:21] going to come next. We hope

[1:33:22] that we are going to be met.

[1:33:25] Um, uh, with like response.

[1:33:26] Somebody who is also taking

[1:33:27] this work seriously and knows

[1:33:28] how important these resources

[1:33:30] are. Um, but one way or the

[1:33:31] other, it is going to be our

[1:33:31] community that

[1:33:32] s impacted. And

[1:33:34] so your leadership here is

[1:33:35] essential. Um, you know, we

[1:33:39] also all are aware of the, the

[1:33:41] direction that was announced,

[1:33:43] the intention from our

[1:33:44] executive and our mayor, uh,

[1:33:47] with regards to how our ra is

[1:33:48] going to look moving forward

[1:33:49] and how they are going to be

[1:33:51] supported in making sure that

[1:33:53] Coc funds are really provided

[1:33:55] the oversight that they need to

[1:33:57] be successful. And that is a

[1:33:58] team effort. It involves

[1:33:59] everyone on this call as well.

[1:34:01] Um, so this is the moment to be

[1:34:02] talking about this and making

[1:34:03] sure that we

[1:34:04] re on the right

[1:34:05] course. Uh, like I said, we

[1:34:06] represent the front line

[1:34:08] workers at desk. Um, and so the

[1:34:09] thing that we, you know,

[1:34:12] consider our North Star is that

[1:34:14] people can get better. They do

[1:34:15] need these supports, and they

[1:34:17] need the housing to get better.

[1:34:18] Uh, and then it is the

[1:34:20] frontline workers and the long

[1:34:21] term relationship that those

[1:34:23] workers can provide, um, who

[1:34:25] are working in all different

[1:34:25] roles. They

[1:34:26] re working in

[1:34:26] outreach. They

[1:34:28] re working, um,

[1:34:29] on the treatment side of

[1:34:29] things. They

[1:34:30] re working as

[1:34:32] residential counselors, uh, to

[1:34:34] help people get back to where

[1:34:35] they need to be. They deserve

[1:34:36] to be. And this community,

[1:34:38] frankly, needs them to be. We

[1:34:40] need to be able to get to, uh,

[1:34:43] our, our goal of zero. And we

[1:34:45] can only do that with

[1:34:46] incredibly professional,

[1:34:47] dedicated and supported

[1:34:49] workforce. Um, and so we

[1:34:50] re all

[1:34:51] looking at the same future

[1:34:52] together. It is our job to

[1:34:54] secure every dollar we can. Um,

[1:34:56] from hud on, on the coc front

[1:34:58] and then to have smart plans in

[1:35:00] place. Um, if we find we need

[1:35:01] to pivot. So thank you for your

[1:35:03] attention and please consider

[1:35:05] us a resource and a partner in

[1:35:06] this effort. We want to make

[1:35:07] sure that we are moving forward

[1:35:09] with our best possible foot,

[1:35:10] and so want to be here for your

[1:35:11] work as well. I

[1:35:11] m happy to

[1:35:13] answer any questions.

[1:35:15] Thank you so much. I will also

[1:35:18] note our friends at iu who are

[1:35:20] as well, uh, representing

[1:35:22] frontline human service

[1:35:24] providers. Um, just sent a note

[1:35:24] saying that they

[1:35:25] re not able to

[1:35:26] join us today, but echo the

[1:35:28] points that are raised by pro

[1:35:29] tech 17 and seiu healthcare.

[1:35:32] 1199 northwest. Uh, wanted to

[1:35:34] let folks, uh, start to raise

[1:35:35] their hands for questions and

[1:35:36] also see if board member Lu, if

[1:35:38] you had any additional comments

[1:35:38] that you

[1:35:40] d like to make or lift

[1:35:42] up as we conclude, this panel

[1:35:44] here.

[1:35:46] Yeah. Thank you, Chair

[1:35:47] Mosqueda, for allowing me to

[1:35:48] bring up this, uh, discussion

[1:35:50] item as we know that it

[1:35:50] s very

[1:35:53] timely. I do not have any

[1:35:54] additional comments because I

[1:35:56] believe my fellow board members

[1:35:58] MAY have questions.

[1:36:00] Excellent. Thank you so much.

[1:36:01] Uh, colleagues, again, thanks

[1:36:02] for the conversation that we

[1:36:03] had in our previous meeting

[1:36:04] where we discussed the

[1:36:07] continuum of care, uh, dollars,

[1:36:08] the Federal Housing and Urban

[1:36:10] development investments that we

[1:36:12] rely on, as you saw from Jeff

[1:36:12] s

[1:36:14] chart and from board member

[1:36:14] Lou

[1:36:17] s comments. Uh, near $67

[1:36:19] million, just in King County

[1:36:21] alone, helping to keep people

[1:36:22] not only housed, but with the

[1:36:23] direct health services that

[1:36:25] they need to stay stably

[1:36:26] housed. And you heard that

[1:36:28] story repeated from Reagan,

[1:36:30] from Lindsay, from Daniel, and

[1:36:32] from Jeff. Um, this is really a

[1:36:34] matter of keeping people

[1:36:34] housed. And as we

[1:36:35] ve told our

[1:36:37] community partners across the

[1:36:39] region, if we see these dollars

[1:36:40] go away, we will actually

[1:36:43] visibly see more people living

[1:36:44] in the street and and suffering

[1:36:46] the consequences of that. If

[1:36:48] these dollars are not enhanced.

[1:36:50] So in partnership with the

[1:36:52] federal government, who has

[1:36:54] long invested in proven

[1:36:55] practices of keeping people

[1:36:57] housed and frankly, a Housing

[1:37:00] First model, that was, um,

[1:37:02] required or encouraged of

[1:37:03] contractors in the past now

[1:37:05] being questioned. It

[1:37:05] s really

[1:37:07] important for us to lift up how

[1:37:09] critical these services are,

[1:37:11] how much this is not only

[1:37:12] important for the health of the

[1:37:13] population, but for the health

[1:37:15] of the local economy as well.

[1:37:18] And for us to be really

[1:37:19] transparent that we are doing

[1:37:21] everything we can in

[1:37:22] partnership with other

[1:37:24] jurisdictions to keep people,

[1:37:27] um, in permanent supportive

[1:37:28] housing, transitional housing,

[1:37:30] emergency housing is going to

[1:37:32] be essential. And the workforce

[1:37:34] that provides that is key to

[1:37:36] making this a success story

[1:37:38] going forward. Board members,

[1:37:40] any questions that you have?

[1:37:42] Okay. Board member Hartfield,

[1:37:43] please go ahead.

[1:37:45] Um, yeah. This is a question I

[1:37:46] think for Dan, if he

[1:37:47] s still

[1:37:51] on, um, you mentioned that, um,

[1:37:54] the new aim is to prioritize

[1:37:56] elderly and physically

[1:37:57] disabled. Can you say, like,

[1:38:00] what percentage of your current

[1:38:02] clients are not going to fall

[1:38:05] into that category? And also,

[1:38:06] is substance use considered a

[1:38:08] physical illness or a

[1:38:12] behavioral health illness?

[1:38:13] Thank you so much for the

[1:38:17] question. Um, I let me clarify

[1:38:19] something. Um, I don

[1:38:19] t think

[1:38:20] through this. No faux that hud

[1:38:27] is attempting to, uh, shift, uh.

[1:38:31] Uh, its permanent housing to

[1:38:32] remain permanent housing for

[1:38:35] people with physical

[1:38:36] disabilities or who are

[1:38:38] elderly. Uh, they have said the

[1:38:40] they want permanent housing

[1:38:42] dollars to only be used for

[1:38:43] that population. But what

[1:38:43] they

[1:38:45] re attempting to do

[1:38:46] through this, no faux, is to

[1:38:48] move the permanent housing

[1:38:49] funding to other purposes,

[1:38:51] including transitional housing

[1:38:54] and, uh, services, only for

[1:38:56] people. And it appears to be

[1:38:59] based on a theory that, uh,

[1:39:01] people with, say, substance use

[1:39:03] disorder or other behavioral

[1:39:05] health conditions will be cured

[1:39:07] of their conditions by going

[1:39:09] through these kinds of, uh,

[1:39:11] services programs or, or

[1:39:13] transitional housing programs.

[1:39:18] Um, uh, our clientele at dsc

[1:39:21] include, uh, many people who

[1:39:24] meet the definition of elderly,

[1:39:26] uh, and many of them also have

[1:39:27] co-occurring physical

[1:39:29] disabilities. But nearly 100%

[1:39:31] of them have, uh, primary

[1:39:33] behavioral health conditions,

[1:39:35] including serious mental

[1:39:37] illness and, uh, chronic

[1:39:41] substance use disorder. Um, I,

[1:39:43] I believe that substance use

[1:39:45] disorder is considered, uh, by

[1:39:49] hud to be a, uh, a behavioral

[1:39:51] health condition. I don

[1:39:51] t know

[1:39:53] if they have a specific stance

[1:39:55] on whether it qualifies as a

[1:39:57] disability or not. Um, I need

[1:40:00] to go look deeper into that to

[1:40:02] answer that.

[1:40:06] Okay. Thanks.

[1:40:08] Excellent. Any additional

[1:40:11] questions? Okay. Well, I will

[1:40:14] just, um. Uh, summarize by

[1:40:15] saying, oh, please go ahead.

[1:40:16] Boardmember Garcia.

[1:40:19] Thanks, chair. Uh, a very

[1:40:21] timely presentation. Really

[1:40:22] appreciate this information.

[1:40:22] It

[1:40:23] s worrisome, to say the

[1:40:25] least. Um, as and I, I will

[1:40:27] just clarify, I am on the

[1:40:31] public health board, per rca

[1:40:33] representation. So I

[1:40:33] m not

[1:40:35] speaking for all of our sca

[1:40:36] cities, but I do want to share

[1:40:39] the beer and des have a desk,

[1:40:42] uh, facility. Uh, so this is a

[1:40:44] very alarming, uh, I

[1:40:45] ve been

[1:40:47] following the news and

[1:40:49] legislation. What can we do? I

[1:40:50] guess, is what we

[1:40:51] ll call

[1:40:52] action. Can, uh, members from

[1:40:56] the board and others do to

[1:40:59] support, uh, the ongoing

[1:41:03] efforts to, um, not result in

[1:41:06] all our cities having more, uh,

[1:41:10] experiencing more homelessness.

[1:41:13] Can I take a stab at that? Um,

[1:41:16] uh, thank you for for that

[1:41:17] question. I think there are

[1:41:18] several things that, uh, the

[1:41:21] board could be doing. Um, that

[1:41:23] includes engaging King County

[1:41:24] s

[1:41:26] legal counsel on their strategy

[1:41:28] for the litigation to try to

[1:41:31] preserve this funding. Uh, I

[1:41:35] think that, uh, strategies to

[1:41:37] look for other resources if

[1:41:38] this money does go away in

[1:41:41] order to, uh, keep people

[1:41:43] retained in their housing. Um,

[1:41:46] is another essential part of it

[1:41:47] all. And then there

[1:41:47] s some

[1:41:49] advocacy that, uh, is being

[1:41:51] organized by some national

[1:41:53] organizations with Congress

[1:41:55] that could help with this whole

[1:41:58] situation. Um, if there would

[1:42:00] be congressional action to

[1:42:02] essentially mandate hud to

[1:42:04] renew permanent housing, uh,

[1:42:06] that would be very helpful.

[1:42:09] And, uh, the lead organization

[1:42:10] on that is the National

[1:42:11] Alliance to End Homelessness.

[1:42:15] And, uh, they have some

[1:42:18] explicit advocacy, uh, guidance

[1:42:21] for local communities to

[1:42:22] exercise with their members of

[1:42:24] Congress that I would point you

[1:42:26] to.

[1:42:28] Any additional follow up on

[1:42:28] that?

[1:42:29] Thank you. Nope. Thank you very

[1:42:31] much, MR. Moore. Hello.

[1:42:32] Excellent. And, um, hello,

[1:42:34] board member. Lucero, thank you

[1:42:35] for joining us. I forgot to

[1:42:38] mention, um, when you joined us

[1:42:39] in. Thanks for being here with

[1:42:40] us. And congratulations to you

[1:42:42] again on the Thunderbird

[1:42:43] Treatment center opening the

[1:42:45] grand opening this weekend on

[1:42:47] Vashon Island. Uh, speaking of

[1:42:48] providing care, please go

[1:42:50] ahead. Board members. Lucero.

[1:42:52] Thank you so much. And I really

[1:42:53] appreciated your attendance at

[1:42:54] the opening. Um, it

[1:42:55] s such a

[1:42:56] magical day. Uh, so my question

[1:42:58] is regarding federal funding.

[1:42:58] So I

[1:43:00] ve noticed a trend with

[1:43:04] federal funding changes. So,

[1:43:05] uh, for example, we

[1:43:06] ve seen

[1:43:07] like some changes in Snap

[1:43:10] benefits. Um, however, we did

[1:43:12] see new initiatives arising

[1:43:14] through the Maha initiatives.

[1:43:15] Right to, to be able it

[1:43:17] redirects resources but

[1:43:18] essentially provides similar

[1:43:21] service. So my question is, is

[1:43:23] with this reduction in hud

[1:43:24] funding, are you seeing other

[1:43:26] funding opportunities pop up

[1:43:28] and say SAMHSa, who just

[1:43:30] released their phase, um, or

[1:43:32] other areas where they MAY be

[1:43:33] addressing housing in a

[1:43:35] different sort of way? Because

[1:43:36] my experience has been that

[1:43:37] that

[1:43:37] s what we

[1:43:38] re seeing is it

[1:43:41] just pops up somewhere else.

[1:43:41] Yeah, I

[1:43:42] m happy to answer that

[1:43:44] for you. So the actual the

[1:43:45] program that we

[1:43:46] ve been talking

[1:43:48] about is the Continuum of Care

[1:43:49] program. That program actually

[1:43:51] is not reduced at the federal

[1:43:52] level in terms of the

[1:43:53] appropriation. It

[1:43:53] s still

[1:43:54] staying whole. In fact, it

[1:43:56] received an increase which is

[1:43:58] necessary to maintain certain

[1:43:59] inflationary changes, things

[1:44:01] like that. The issue is that

[1:44:03] hud is taking that amount and

[1:44:05] allocating about a little bit

[1:44:07] more than a third of it to only

[1:44:09] be new projects and only to

[1:44:11] your point, different kinds of

[1:44:13] projects that are what, in the

[1:44:14] homelessness space we call

[1:44:15] transitional housing. So you

[1:44:15] can

[1:44:16] t stay there for more than

[1:44:19] two years. And, uh, to Daniels,

[1:44:20] uh, kind of a metaphor earlier

[1:44:21] are really intended to take

[1:44:22] where you

[1:44:23] re at currently and

[1:44:24] have you leaving

[1:44:25] self-sufficient without receipt

[1:44:26] of any rental supports, things

[1:44:30] like that. Um, or also focus on

[1:44:31] just providing supportive

[1:44:33] services, especially, um, the

[1:44:34] type of services that the

[1:44:36] administration would see as

[1:44:37] addressing the conditions that

[1:44:38] are causing an individual

[1:44:39] s

[1:44:40] homelessness. And, uh, like

[1:44:42] resolving those and, and moving

[1:44:43] them along. So that is the

[1:44:48] shift in, um, in programming,

[1:44:48] similar to what you

[1:44:49] re talking

[1:44:50] about in other spaces, but it

[1:44:50] s

[1:44:52] not actually moving out of this

[1:44:54] federal program to a different

[1:44:54] federal program. It

[1:44:55] s all

[1:44:57] happening within it.

[1:44:59] Okay, that makes sense. And so

[1:45:01] do we have, um, you know,

[1:45:03] second and third tier

[1:45:05] strategies to maybe align to

[1:45:06] not lose resources because

[1:45:08] certainly transitional housing

[1:45:09] is a is a need. It

[1:45:10] s a gap. Um,

[1:45:12] within King County. Um, so you

[1:45:14] know, to again, just access the

[1:45:15] funds as the administration

[1:45:16] s

[1:45:17] priorities change.

[1:45:19] Um, yeah, absolutely. That was,

[1:45:20] uh, when I talked about that

[1:45:20] two part strategy that we

[1:45:21] re

[1:45:22] trying to take. One is one is

[1:45:24] the litigation space because,

[1:45:25] uh, we there

[1:45:25] s tremendous

[1:45:27] evidence behind, especially

[1:45:28] with permanent supportive

[1:45:30] housing, the benefits. I think

[1:45:31] just a couple of weeks ago,

[1:45:32] there was another recent study

[1:45:33] talking about the tremendous

[1:45:35] savings on the on incarceration

[1:45:38] side. Um, that sage provides.

[1:45:38] So we know that it

[1:45:39] s an

[1:45:41] evidence based approach. But if

[1:45:44] our litigation to preserve our

[1:45:46] existing projects and not have

[1:45:46] to comply with certain

[1:45:47] conditions isn

[1:45:48] t successful.

[1:45:49] Our other strategy that I was

[1:45:50] talking about is exactly what

[1:45:50] you

[1:45:51] re saying. Uh, it

[1:45:52] s to

[1:45:54] align with those. We just, um,

[1:45:56] on JULY 3rd was the end of our

[1:45:59] local procurement process to

[1:46:00] identify transitional housing

[1:46:02] projects or support services

[1:46:03] projects that would be brand

[1:46:05] new would align, like I said,

[1:46:06] with both the administration

[1:46:06] s

[1:46:08] priorities and with our local

[1:46:11] county priorities as the goals

[1:46:12] for what we want to see, these

[1:46:13] types of these funds support.

[1:46:15] And that is absolutely a two

[1:46:16] part approach. We

[1:46:16] re not

[1:46:17] putting all of our eggs in one

[1:46:20] basket.

[1:46:21] Okay. Thanks, Jeff. I

[1:46:22] appreciate that.

[1:46:24] Any additional comments from

[1:46:26] our panelists or board members?

[1:46:29] Okay. Uh, more to come. Uh, we

[1:46:31] will make sure if there is any

[1:46:33] update on a litigation

[1:46:35] strategy, a mitigation strategy

[1:46:37] and application strategy, that

[1:46:38] the board members here get an

[1:46:39] update as well. And for anybody

[1:46:41] who is wanting to tune in to

[1:46:42] the health, Housing and Human

[1:46:44] Services Committee meeting of

[1:46:45] the King County Council next

[1:46:47] Thursday, we will have a very

[1:46:49] similar panel presentation. So

[1:46:49] we

[1:46:50] re going to use every

[1:46:52] platform we can to lift up this

[1:46:53] issue and how important these

[1:46:55] dollars are. Thanks. All. We do

[1:46:57] have another item on our agenda

[1:46:59] to close this out for today.

[1:47:01] Our last item is a briefing on

[1:47:02] the impacts of the political

[1:47:04] environment on gender affirming

[1:47:05] care. And again, I want to

[1:47:07] thank board members Archie Poly

[1:47:12] and Yoon for their engagement.

[1:47:14] Um, with us on this, board

[1:47:15] member Archie Pulley was

[1:47:16] gracious enough to allow for us

[1:47:18] to carry this item over from a

[1:47:19] previous meeting. And so we

[1:47:21] want to make sure to give this

[1:47:23] item its due time here on page

[1:47:25] 58 of your meeting packet, you

[1:47:28] will see a full summary of the

[1:47:29] materials that are included

[1:47:32] here. And I want to welcome

[1:47:33] board member Archie Pulley to

[1:47:36] say any comments. And um, also

[1:47:38] thank Ro Yoon, who does the

[1:47:39] community engagement for Fred

[1:47:42] Hutch Vaccine Trials unit for

[1:47:43] being here with us. Remember,

[1:47:45] thanks for your patience and

[1:47:46] allowing for us to include this

[1:47:48] in the work plan. Uh, that was

[1:47:50] your leadership on display

[1:47:51] there and really excited to

[1:47:52] have this agenda item here

[1:47:54] today.

[1:47:55] Thank you, chair Mosqueda. And

[1:47:57] thank you, fellow board

[1:47:58] members. Um, before I start, I

[1:48:00] just want to answer our board

[1:48:00] member Hatfield

[1:48:01] s question.

[1:48:04] Also, um, substance use

[1:48:05] disorder and hiv are not

[1:48:07] currently diagnoses for medical

[1:48:09] frailty. So the Department of

[1:48:11] Health has submitted a

[1:48:12] recommendation to get those

[1:48:14] exemptions though. So more to

[1:48:16] come on that. Um, so thank you

[1:48:17] very much. Again, I

[1:48:18] m

[1:48:19] Christopher Archiopoli and I

[1:48:20] m

[1:48:21] a community stakeholder on the

[1:48:23] Board of Health. I identify as

[1:48:24] a person in long term recovery

[1:48:26] from substance use disorder. A

[1:48:28] person living with hiv since

[1:48:30] 2008 and a member of the queer

[1:48:31] community. I

[1:48:31] ll make sure that

[1:48:33] my friend and colleague, Ryan,

[1:48:34] has the majority of our time to

[1:48:35] speak, but I wanted to provide

[1:48:36] some history and background

[1:48:38] beforehand, handing it over to

[1:48:40] Ro. Uh, next slide, please show

[1:48:48] me. The lgbt community to the

[1:48:50] lgbtq plus community is the

[1:48:51] subject of political attacks in

[1:48:53] our society. There is no group

[1:48:55] more targeted and gender non

[1:48:57] than our transgender and gender

[1:49:00] non-binary community. In 2026

[1:49:02] alone, there have been over 800

[1:49:03] anti-transgender bills

[1:49:05] introduced across 43 states.

[1:49:07] While many of these failed,

[1:49:09] many of these have failed, 67

[1:49:12] have passed and 267 are still

[1:49:13] actively working their way

[1:49:14] through legislators, throughout

[1:49:15] the legislatures, throughout

[1:49:18] the country. In Washington

[1:49:22] state, Initiative ill. 26638

[1:49:24] would ban transgender girls

[1:49:25] from participating in k through

[1:49:27] 12 school sports. This measure

[1:49:29] failed during the 2026

[1:49:30] legislative session, but

[1:49:31] received enough signatures to

[1:49:32] appear on the NOVEMBER ballot

[1:49:34] this year. Every time we turn

[1:49:36] on the tv or open our phones,

[1:49:37] we are subjected to news items

[1:49:39] like this one. The one on this

[1:49:41] slide forcing schools to out

[1:49:44] our transgender students. 1% of

[1:49:46] our population is receiving a

[1:49:47] disproportionate amount of

[1:49:48] negative attention. It

[1:49:48] s

[1:49:49] impossible for that not to

[1:49:51] negatively impact the mental

[1:49:52] and physical health of our

[1:49:54] community. You MAY have heard

[1:49:56] the phrase the first pride was

[1:49:58] a riot. This is more than just

[1:50:00] a tongue in cheek euphemism.

[1:50:02] Although the lgbtq plus civil

[1:50:03] rights movement got its start

[1:50:05] in the early 1900s, modern

[1:50:06] pride celebrations found their

[1:50:08] inspiration. On JUNE 28th,

[1:50:10] 1969, when six New York City

[1:50:12] police Departments Department

[1:50:13] officers raided the Stonewall

[1:50:15] Inn, a bar in Greenwich Village

[1:50:18] in Manhattan, New York City.

[1:50:20] Nearly 200 customers of all

[1:50:21] identities were ejected from

[1:50:23] the bar, many arrested as law

[1:50:25] enforcement began mistreating

[1:50:26] the bar customers. The

[1:50:27] situation escalated. What

[1:50:29] started as a police raid based

[1:50:30] around new nypd

[1:50:31] s public morals

[1:50:34] push, turned into a six day

[1:50:35] resistance that included

[1:50:37] pivotal figures such as

[1:50:39] transgender activists Marsha p

[1:50:42] Johnson and Sylvia Rivera. Many

[1:50:43] identify this as a seminal

[1:50:45] moment in the movement for

[1:50:48] lgbtq plus equality, comparing

[1:50:49] its importance to Rosa Parks

[1:50:51] refusing to sit at the back of

[1:50:52] the bus in Montgomery.

[1:50:57] Montgomery, Alabama in 1955, in

[1:50:59] 2016, PRESIDENT Barack Obama

[1:51:01] designated a 7.7 acre site,

[1:51:02] including the Stonewall Inn,

[1:51:04] Christopher Park, and the

[1:51:05] surrounding Air Street at the

[1:51:07] as the Stonewall National

[1:51:08] Monument to commemorate the

[1:51:08] area

[1:51:12] s contributions to history

[1:51:13] and remembrance of the

[1:51:15] Stonewall riots, Christopher

[1:51:16] Street Liberation Day was

[1:51:19] celebrated on JUNE 28th, 1970.

[1:51:21] Since that year, we have seen

[1:51:22] pride celebrated the last

[1:51:23] weekend of JUNE each year.

[1:51:24] Although the battles for

[1:51:25] equality seem to have made

[1:51:28] significant progress, we have

[1:51:29] seen that progress stripped

[1:51:30] away in recent years is

[1:51:32] essential to stand strong in

[1:51:33] the face of adversity, to

[1:51:34] ensure those rights continue to

[1:51:36] be upheld. If it is truly

[1:51:37] important, the risk is worth

[1:51:42] the reward. Next slide.

[1:51:43] Transgender and gender

[1:51:44] non-binary individuals have

[1:51:46] stood as leaders in both the

[1:51:47] lgbtq plus civil rights

[1:51:49] movement, as well as leaders

[1:51:50] making up the fabric of our

[1:51:52] society. Many of the names

[1:51:54] Marsha p Johnson, Sylvia Rivera

[1:51:56] and Sylvia Sarah McBride. But

[1:51:57] they are not the only ones

[1:51:58] making an impact on social

[1:52:00] justice. Many others, including

[1:52:02] the names of the bottom of this

[1:52:03] slide, contribute to business,

[1:52:06] art, politics and the general

[1:52:10] good of our society. Next slide.

[1:52:13] It is my great pleasure to

[1:52:14] introduce one of those leaders.

[1:52:16] Now, Rowan is an activist and

[1:52:18] works in community engagement

[1:52:19] at the Fred Hutch Vaccine

[1:52:21] Trials Unit, focused on finding

[1:52:23] a cure for hiv. Thank you and

[1:52:27] welcome Row. The next slide.

[1:52:29] Thank you friends. My name is

[1:52:31] Rose. She her pronouns. Um, I

[1:52:34] have less than five minutes, so

[1:52:34] I

[1:52:35] m just going to jump right

[1:52:36] into it. And in a nutshell,

[1:52:38] this is all relates to gender

[1:52:39] affirming care. And you can.

[1:52:40] Make as long as you want. We

[1:52:41] re

[1:52:42] happy to go a little over. No

[1:52:44] problem okay, okay.

[1:52:47] The current landscape is

[1:52:49] characterized by increasing

[1:52:51] divergence between states.

[1:52:52] However, Washington state

[1:52:55] continues to maintain statutory

[1:52:57] protections for access to

[1:52:58] medically necessary gender

[1:52:59] affirming care. But on a

[1:53:01] federal policy initiative. In

[1:53:02] recent court, decisions have

[1:53:04] increased some legal and

[1:53:06] operational complexities. So

[1:53:08] for this, esteem, for all the

[1:53:10] esteem members of this board,

[1:53:12] the primary considerations I

[1:53:13] want to speak about is

[1:53:15] equitable access to care,

[1:53:17] behavioral health outcomes,

[1:53:20] provider capacity, and legal

[1:53:22] compliance, and then really

[1:53:23] monitoring the effects of

[1:53:25] rapidly evolving policy change

[1:53:27] that will impact patient and

[1:53:29] health systems. So this first

[1:53:32] slide I have, um, we oftentimes

[1:53:34] see a general estimate of less

[1:53:36] than a 1% to describing the

[1:53:37] population, transgender people.

[1:53:39] But I want to utilize ucla

[1:53:40] s

[1:53:42] Williams Institute, nationally

[1:53:45] recognized estimates of like

[1:53:48] 0.8% of adults 18 and over

[1:53:50] identify as transgender, and

[1:53:54] 3.3% of youth ages 13 to 17

[1:53:56] identify as transgender. So

[1:53:58] utilizing those estimates from

[1:54:00] the Williams Institute and

[1:54:01] applying that to King County

[1:54:01] s

[1:54:03] population, we

[1:54:04] re roughly

[1:54:08] estimating around 15 to 18,000

[1:54:10] transgender adults and also

[1:54:13] including 4 to 5000 transgender

[1:54:15] youth between the ages of 13 to

[1:54:17] 17. So, um, it

[1:54:18] s a big order,

[1:54:19] and I

[1:54:20] m hoping that this

[1:54:22] provides you some context of

[1:54:23] who we

[1:54:25] re speaking of as well.

[1:54:26] Um, there

[1:54:27] s no direct counts

[1:54:30] because gender identity is not

[1:54:32] comprehensively collected, and

[1:54:34] census data, um, but before

[1:54:35] even talk about gender

[1:54:38] affirming care in this current

[1:54:40] climate, um, I just want to

[1:54:41] make reference to injustice at

[1:54:43] every turn, which was one of

[1:54:47] the first reports back in 2021

[1:54:49] looking at discrimination

[1:54:50] related to trans people,

[1:54:52] non-binary people on a national

[1:54:52] level. And

[1:54:55] Already, you see that 50% of us

[1:54:57] are educating our providers of

[1:54:58] what transgender health care

[1:54:59] looks like. We

[1:55:00] re estimating

[1:55:02] that up to 20% are denied based

[1:55:04] on their gender identity alone.

[1:55:07] So already this audience is not

[1:55:09] accessing health resource in

[1:55:11] the same way because of

[1:55:13] discrimination. But on that

[1:55:15] note, I want to kind of move

[1:55:17] forward and talk about this

[1:55:19] national landscape that

[1:55:20] effectively. Um, what kind of

[1:55:23] influence my conversation. Um,

[1:55:25] so the next slide, um, I want

[1:55:28] to I just want to briefly go

[1:55:29] over this when we think of

[1:55:31] gender affirming care, I think

[1:55:32] the general public think

[1:55:34] immediately about, um,

[1:55:36] surgeries or medical

[1:55:38] transition. But this also

[1:55:42] includes, um, legal processes,

[1:55:42] whether it

[1:55:43] s the passport which

[1:55:44] is still under threat

[1:55:47] currently. Um, you know, birth

[1:55:50] certificates, any of the, um,

[1:55:53] the necessity, um, requirement

[1:55:55] for accessing some services

[1:55:57] like medical or surgical. And

[1:55:57] then we

[1:55:58] re also looking at

[1:56:00] social services as well. You

[1:56:01] know, whether it

[1:56:02] s, um,

[1:56:04] acculturation, um, being able

[1:56:06] to withstand some of the

[1:56:08] anxiety that socially you

[1:56:09] ll

[1:56:10] find amongst transgender

[1:56:11] people. Um, there

[1:56:12] s a lot of

[1:56:14] evidence based data out there,

[1:56:18] despite many puppets that claim

[1:56:19] that they know a lot about

[1:56:21] this, um, population. There

[1:56:21] s a

[1:56:23] lot of evidence based, and it

[1:56:23] s

[1:56:25] supported by the world

[1:56:27] professional of transgender

[1:56:31] health. Um, cool. The next one.

[1:56:34] Next slide please. So I want to

[1:56:36] make reference to a website

[1:56:38] resource called Trans

[1:56:42] Legislation. Um, this is an

[1:56:45] anti-trans bill tracker. And

[1:56:45] what you

[1:56:47] ll find in this, um,

[1:56:49] everything that, um,

[1:56:50] Christopher had mentioned that

[1:56:52] in the state of Washington. But

[1:56:53] more importantly, you

[1:56:53] re

[1:56:55] looking at on a national level

[1:56:56] and and it

[1:56:59] s pretty serious.

[1:57:01] Um, over the past several

[1:57:04] years, states have, um, um,

[1:57:07] have taken very strong

[1:57:10] restrictions. Um, some states

[1:57:11] expanding protections like

[1:57:12] Washington, but we

[1:57:12] re

[1:57:15] estimating as of 226, the

[1:57:16] Kaiser Family Foundation

[1:57:18] reports that 27 states have

[1:57:20] enacted laws or policies,

[1:57:21] limited youth access to gender

[1:57:22] affirming care. That

[1:57:23] s

[1:57:24] approximately half a

[1:57:26] transgender youth in states in

[1:57:29] the United States. Um, the

[1:57:31] visibility of anti-trans

[1:57:32] sentiment as it relates to

[1:57:34] young people is, um, beyond

[1:57:36] words. And my heart breaks

[1:57:39] every time. Um, I will mention

[1:57:42] one Supreme Court decision in

[1:57:44] 2025, it was United States

[1:57:46] versus Rometty decision. It was

[1:57:46] a it

[1:57:48] s a major inflection point

[1:57:52] for us. Um, that was um, on

[1:57:55] JUNE 2025, the Supreme Court

[1:57:55] upheld the Tennessee

[1:57:56] s law

[1:57:58] restricting gender affirming

[1:58:00] medical treatment for minors.

[1:58:02] Um, although this really did

[1:58:05] not prohibit gender affirming

[1:58:06] care on a national level, it

[1:58:08] did affirm states authority to

[1:58:10] regulate such care for minors,

[1:58:12] and it has impacted Washington

[1:58:14] state, which settled Children

[1:58:14] s

[1:58:16] Hospital in terms of limiting

[1:58:17] the services that they could

[1:58:19] provide for young transgender

[1:58:24] folks. Um, since early 2025,

[1:58:26] federal executive actions have

[1:58:27] sought to limit federal support

[1:58:29] for gender affirming care for

[1:58:30] individuals under the age of

[1:58:34] 19. Um, with specific direct um

[1:58:35] directives aiming at federal

[1:58:37] funding, research grants, and

[1:58:40] insurance coverage. Um, in

[1:58:42] terms of public health, um,

[1:58:42] we

[1:58:44] re seeing increased requests

[1:58:45] for guidance and related to

[1:58:47] health equity. Um, we

[1:58:47] re

[1:58:49] looking at requests about

[1:58:52] behavioral health, suicidality,

[1:58:54] suicide. Um, ideology is really

[1:58:56] high amongst transgender

[1:58:59] people. Insurance access

[1:59:01] provider workforce issues.

[1:59:03] These are things that are now

[1:59:05] into conversations with this

[1:59:08] conversation with this, um, the

[1:59:11] implication of legislation. Um,

[1:59:16] next slide please. So this has

[1:59:21] now affected a migration of

[1:59:23] transgender folks and their

[1:59:26] families in order to save their

[1:59:28] family or themselves. They have

[1:59:31] moved across. And, um, we know

[1:59:34] that the lgbt Commission in

[1:59:36] Seattle has petitioned, um,

[1:59:39] Katie Wilson to declare a state

[1:59:41] of emergency to accommodate the

[1:59:44] influx of lgbt folks coming to

[1:59:46] Washington state, especially

[1:59:48] Trans Pacific, a trans folks.

[1:59:53] Um, next slide. Um, it has

[1:59:56] threatened, um, parental

[1:59:58] autonomy and their decisions of

[2:00:00] what they can decide for their

[2:00:03] children. Um, it has limited

[2:00:05] providers that could work with

[2:00:09] them. Um, in terms of adults,

[2:00:09] you

[2:00:12] re seeing no support with

[2:00:14] their insurance. Um, on this on

[2:00:16] a national level. Not here in

[2:00:18] Seattle, Washington. Um, let

[2:00:19] s

[2:00:21] move into Washington state. Um,

[2:00:21] I

[2:00:24] m very proud. Um, Washington.

[2:00:25] Um, Washington state remains

[2:00:28] one of the strongest protective

[2:00:29] states for gender affirming

[2:00:33] care access. Um, specifically,

[2:00:36] um, and back in 2021, um,

[2:00:37] Washington state passed the

[2:00:39] Gender Affirming Treatment Act,

[2:00:45] which basically, um, prohibited

[2:00:48] categorical cosmetic exclusions

[2:00:51] or our blanket ban bans on

[2:00:54] gender affirming care. So, um,

[2:00:57] since that was passed in 2021

[2:01:00] and 2022, we saw this huge

[2:01:03] surge of trans people in

[2:01:05] Washington state accessing

[2:01:07] medical and surgical um,

[2:01:09] services. And it still

[2:01:11] continues to be the case. And I

[2:01:14] think for many other trans

[2:01:16] residents and others, United

[2:01:19] States, um, are paying

[2:01:20] attention and coming here for

[2:01:25] that reason. Um, another thing

[2:01:28] is that Washington state

[2:01:31] enacted, um, um, a shield law.

[2:01:33] Protection. What this means is

[2:01:35] that it protects patients,

[2:01:37] providers and others from civil

[2:01:39] or criminal actions and other

[2:01:40] states that restrict or

[2:01:43] criminalize, um, lawful gender

[2:01:44] affirming care provided here in

[2:01:47] Washington state. So if we have

[2:01:48] our neighbors coming to

[2:01:49] Washington State for these

[2:01:50] services, they will not be

[2:01:51] criminalized when returning

[2:01:55] back to their home state. All

[2:01:56] this to say, it

[2:01:58] s pretty heavy.

[2:02:01] All this to say that, um,

[2:02:03] Washington State has been a

[2:02:05] great leader. Um, and all this

[2:02:08] to say that, um, um, to the

[2:02:13] board members here, um, that

[2:02:13] you

[2:02:14] re just even inviting me

[2:02:16] here to speak about this

[2:02:18] because volumes about the care

[2:02:20] of transgender folks. So thank

[2:02:22] you. And on behalf of my

[2:02:23] community partners, that

[2:02:25] includes Lavender Rights

[2:02:27] Project, a Gender Justice

[2:02:29] League Utopia, and so forth,

[2:02:32] who really provide lifesaving

[2:02:34] services. Um, I look to you all

[2:02:36] to ensure that these services

[2:02:42] remain available. Thank you.

[2:02:44] Thank you very much. Um, board

[2:02:46] member, Archie. Anything else

[2:02:49] to add?

[2:02:49] I don

[2:02:49] t think I

[2:02:50] ll just echo

[2:02:52] what Rose said. Thank you so

[2:02:53] much for making the time. And

[2:02:55] we really appreciate the

[2:02:56] opportunity to share this

[2:02:58] important topic with the board.

[2:02:59] Thank you. And thanks for the

[2:03:01] calls for action and some

[2:03:04] example. Um, legislation or

[2:03:05] actions that are being taken in

[2:03:07] other jurisdictions as well. I

[2:03:09] see board member Lucero has a

[2:03:10] hand up and then we

[2:03:10] ll go to

[2:03:12] board member Hartfield.

[2:03:15] Yes. Thank you. Chair Mosqueda.

[2:03:16] First, I just want to say I

[2:03:16] m

[2:03:19] so grateful for your

[2:03:20] participation in our meeting

[2:03:22] today and for sharing

[2:03:24] information in in the way that

[2:03:27] you have. I want to acknowledge

[2:03:28] that this administration

[2:03:28] s

[2:03:32] attack on our, um, lgbtq two

[2:03:35] spirit community has been one

[2:03:39] of the most blatant acts of

[2:03:40] discrimination. That, coupled

[2:03:43] with the movement with Ice. Um,

[2:03:45] and I do recognize from a

[2:03:47] recent city council meeting,

[2:03:49] uh, that folks are coming to

[2:03:51] King County and coming to the

[2:03:53] city of Seattle as kind of

[2:03:55] refugees. So what I heard from

[2:03:58] that meeting is that we can do

[2:04:01] better. When you have an act of

[2:04:02] discrimination at the federal

[2:04:04] level, that you know, that

[2:04:06] spans across every single tier

[2:04:06] of government, there

[2:04:07] s only one

[2:04:08] response, and that

[2:04:08] s a

[2:04:10] localized response. So I want

[2:04:11] you to know that there are

[2:04:13] organizations in this community

[2:04:16] that are serving, um, our, our

[2:04:18] communities well in this way.

[2:04:19] And what our government systems

[2:04:19] haven

[2:04:21] t been successful at is

[2:04:22] we haven

[2:04:23] t been able to make

[2:04:25] sure that the resources that

[2:04:28] are available are readily

[2:04:29] accessible. Right. We haven

[2:04:29] t

[2:04:31] communicated that. So something

[2:04:32] like a two, one, one, for

[2:04:34] example, for um, for these

[2:04:36] communities who are coming to

[2:04:38] to our environment for help.

[2:04:39] And so I think that we can

[2:04:41] really do better there. There

[2:04:42] are ways that our health care

[2:04:43] environment have been able to

[2:04:44] get around some of these

[2:04:46] discriminatory laws to still

[2:04:48] provide effective services. And

[2:04:49] I can tell you that from, you

[2:04:51] know, local community health

[2:04:52] world, we are rapidly building

[2:04:54] capacity to be able to even

[2:04:57] provide more services. So I

[2:04:58] think that what King County

[2:05:00] could do and even this Board of

[2:05:03] Health could initiate, is

[2:05:05] really establishing a community

[2:05:08] response to being able to model

[2:05:09] what it looks like to really

[2:05:12] care for these communities in

[2:05:13] the ways that we

[2:05:13] re expecting

[2:05:15] the federal government to. And

[2:05:16] so I just want you to know that

[2:05:17] I

[2:05:18] m a partner in this work. I

[2:05:18] m

[2:05:20] a champion in this work with

[2:05:22] you all. And I just want you to

[2:05:24] know that our clinical teams

[2:05:26] are taking action. And, um, you

[2:05:28] know, I fully support more

[2:05:31] directed approach.

[2:05:32] Thank you.

[2:05:33] Thank you.

[2:05:35] Thank you.

[2:05:38] Uh, board member Hartfield.

[2:05:40] Um, yeah. Thank you so much for

[2:05:42] the presentation. It

[2:05:42] s nice to

[2:05:43] see you, row. I

[2:05:43] ve seen you for

[2:05:47] a long time. Um, I really

[2:05:50] appreciate, especially your

[2:05:52] broadening out the impact of,

[2:05:55] uh, gender issues beyond the

[2:05:56] medical, because I think what

[2:05:59] we read about frequently in the

[2:06:00] press is just. It

[2:06:01] s all about

[2:06:03] medical transition. And I

[2:06:05] appreciate your framing the

[2:06:06] argument in a way that people

[2:06:08] can understand and maybe

[2:06:09] empathize with a little bit

[2:06:12] more. Um, question that I had

[2:06:15] for you. Two questions, and you

[2:06:16] MAY or MAY not have the

[2:06:17] answers. One is, how are we

[2:06:19] able to quantify this sort of

[2:06:22] in migration issue, which I

[2:06:22] ve

[2:06:25] also seen in the newspaper and

[2:06:26] heard on podcasts and whatnot,

[2:06:26] and I

[2:06:27] m not really sure how we

[2:06:29] know that. And then the second

[2:06:31] question is, what would the

[2:06:33] state of emergency provide us

[2:06:35] if, um, Mayor Wilson was

[2:06:37] actually able to do that?

[2:06:38] That

[2:06:40] s a great question. Um, I

[2:06:43] think that the lgbt Commission,

[2:06:46] um, was responding as the the

[2:06:49] whole population of lgbt into

[2:06:51] spirit community versus just

[2:06:53] specifically trans people. Um,

[2:06:56] but we definitely know through

[2:06:58] a lot of my trans led

[2:07:00] organization that there are

[2:07:02] people coming from other states

[2:07:04] to specifically access care for

[2:07:06] themselves or their family. Um,

[2:07:08] and we see that with Sale

[2:07:08] Children

[2:07:09] s Hospital and so

[2:07:11] forth. So but in terms of the

[2:07:12] magnitude, I don

[2:07:13] t know, um,

[2:07:16] the commission is collaborating

[2:07:18] with several organizations that

[2:07:18] i

[2:07:20] ve mentioned just now that

[2:07:22] will be collating the

[2:07:24] information that they can that

[2:07:26] are for those who come new to

[2:07:29] Seattle, Washington, having

[2:07:31] them kind of register that

[2:07:34] through, like organizations

[2:07:35] that provide the services. So

[2:07:36] that will maybe quantify a

[2:07:38] little bit, but I think it will

[2:07:40] provide more of a narrative

[2:07:40] that

[2:07:41] s necessary to talk about

[2:07:42] where they

[2:07:44] re coming from. Um,

[2:07:47] as it relates to the services

[2:07:48] or what this emergency can

[2:07:55] provide. Um, I I don

[2:07:56] t know, I

[2:07:58] really, um, I feel that

[2:08:01] Washington State just I mean,

[2:08:03] King County just supported, um,

[2:08:05] the gender ending. Um, I

[2:08:06] m

[2:08:07] sorry, the coalition ending

[2:08:09] gender violence, gender based

[2:08:11] violence, they just released

[2:08:15] the 226 trans Resource and

[2:08:18] referral guide. Um, and that

[2:08:19] has been the last update was

[2:08:21] over ten years ago.

[2:08:22] Yeah. So that

[2:08:22] s an.

[2:08:24] Amazing thing where this money

[2:08:26] could do or resources, it could

[2:08:28] ensure that those resources

[2:08:32] stay available and maybe scale

[2:08:34] up a little bit if we have data

[2:08:35] to show that we have this

[2:08:37] influx of people. But, you

[2:08:39] know, having said that, a lot

[2:08:41] of the current organizations

[2:08:43] are probably not well trained

[2:08:44] to talk about this gender

[2:08:46] diverse community as well. So I

[2:08:46] think that

[2:08:48] s part of training

[2:08:50] for providers in addition to

[2:08:51] resources for providers, is

[2:08:53] another way that we can sustain

[2:08:55] this support.

[2:08:56] Mhm. That

[2:08:57] s great. Yeah I mean

[2:08:57] I I

[2:08:58] m really happy to hear that

[2:09:01] about the guide. And I know how

[2:09:03] difficult because primarily

[2:09:05] this is all a volunteer effort.

[2:09:05] It

[2:09:08] s all grassroots. And um

[2:09:09] perhaps the state of emergency

[2:09:12] might release some funding that

[2:09:13] is needed.

[2:09:14] I agree and it

[2:09:15] s hard to dig.

[2:09:15] It

[2:09:17] s hard to ask this community

[2:09:20] to try to defend itself when

[2:09:20] it

[2:09:23] s small. So having, um,

[2:09:26] sanctions by the city or the

[2:09:28] state really helps. And

[2:09:31] bolstering that visibility.

[2:09:32] Yeah.

[2:09:34] Thanks.

[2:09:36] Thank you so much. And board

[2:09:37] member Tripoli. Um, maybe we

[2:09:40] can work with you as a liaison

[2:09:42] to see if there is a next step

[2:09:43] that the board might want to

[2:09:44] take on this. I

[2:09:45] m also thinking

[2:09:45] maybe there

[2:09:47] s some advocacy as

[2:09:49] we head into the, uh, state

[2:09:52] legislative agenda setting time

[2:09:54] frame as well. Uh, given, uh, I

[2:09:55] think, as you mentioned, Roe,

[2:09:57] the influx of the number of

[2:09:58] community members coming to

[2:10:00] Washington state generally,

[2:10:01] this might be an area of

[2:10:02] interest for other

[2:10:04] jurisdictions, too. Um, so look

[2:10:05] forward to that. And anything

[2:10:07] else that the board can do to

[2:10:09] lift up the, um, health

[2:10:10] complications that are created

[2:10:13] and also the, uh, just

[2:10:14] additional stressors this

[2:10:16] provides in the community. What

[2:10:17] affects the mind affects the

[2:10:19] body, um, and affects our

[2:10:21] entire population health. So,

[2:10:24] uh, thank you again for the

[2:10:26] presentation. And, uh, look

[2:10:27] forward to continuing to

[2:10:28] engage. Board member. Any

[2:10:30] comments in closing and row as

[2:10:32] well?

[2:10:34] No, I think I think you again.

[2:10:36] And, um, just to sort of tack

[2:10:38] on to what ro said. Um, you

[2:10:39] know, just from my volunteer

[2:10:41] work with queer organizations

[2:10:42] like Seattle and the Bailey

[2:10:45] Bush House, I can definitely

[2:10:47] say anecdotally that there are

[2:10:48] there has been an influx of

[2:10:50] people from other states. Um,

[2:10:52] they would rather be a refugee

[2:10:54] living unhoused in their car in

[2:10:56] Seattle than live in a house in

[2:10:59] Kentucky. Um, so it is putting

[2:11:01] stress on the services that are

[2:11:02] available. Our community is

[2:11:04] already underserved, and the

[2:11:06] resources are already limited,

[2:11:07] and now they

[2:11:08] re being stretched

[2:11:10] even further, trying to treat

[2:11:11] the influx of people that are

[2:11:13] coming from other states. So

[2:11:14] yeah, thank you again. And I

[2:11:16] would love to be a liaison as

[2:11:17] we can do more work on this. So

[2:11:19] thank you. Chair Mosqueda.

[2:11:21] Excellent. Thank you so much.

[2:11:24] Okay. Um, so with that, I just

[2:11:26] want to see if there

[2:11:26] s any

[2:11:27] other comments for the good of

[2:11:29] the order. Any announcements

[2:11:31] folks might have for Board of

[2:11:33] Health colleagues? I will note

[2:11:36] again that our board meeting

[2:11:38] for AUGUST is canceled. So we

[2:11:41] will see you at the SEPTEMBER

[2:11:42] board meeting. And that is

[2:11:45] SEPTEMBER 17th at 1 P.M.. Uh,

[2:11:48] next week at County Council, at

[2:11:49] our health, Housing and Human

[2:11:50] Services Committee. As I

[2:11:50] mentioned, we

[2:11:51] re going to have

[2:11:53] a very similar presentation on

[2:11:55] the continuum of care funding.

[2:11:57] Um, and maybe of interest to

[2:11:58] colleagues. We will also have a

[2:11:59] presentation on the 39th

[2:12:01] anniversary of the federal

[2:12:02] Americans with Disabilities

[2:12:04] Act, Disability Pride month,

[2:12:07] and, um, and inviting our folks

[2:12:08] who work here at King County on

[2:12:10] implementing the Ada

[2:12:11] requirements to give us an

[2:12:14] update on how things are going.

[2:12:16] And that update is we need to

[2:12:18] do more. Um, so if you are

[2:12:20] interested in dialing in to

[2:12:22] hear some of that conversation,

[2:12:23] and if you think there

[2:12:23] s a

[2:12:25] cross area of interest to Board

[2:12:27] of Health, please let me know.

[2:12:28] Um, and if there

[2:12:30] s no items to

[2:12:31] come before the board, I thank

[2:12:33] you for your time today and the

[2:12:36] robust discussion. And with

Board of Health on 2026-07-16 1:00 PM

Agenda

Transcript