[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