County releases plans to tackle major public health issues

A wide-ranging plan that could lead to more help for victims of domestic abuse, house visits from medical personnel and improved transportation for the homeless was revealed last week.

“This is a night of celebration,” Laura Luginbill, assessment and healthy communities director, said at the event to release Island County’s Community Health Improvement Plan.

The plan is aimed at addressing access to health care, housing, interpersonal abuse, and depression and suicide. A work group was formed to address each topic, with a goal to implement by 2020. Many of the strategies are already in progress.

One of these strategies includes plans to actively bring training on helping victims of interpersonal abuse to the community. The work group already has a training program and has identified individuals from several public sectors who have stated their interest in receiving the training, which will be piloted in February.

“It’s really amazing the pace they’ve been able to keep up,” said Luginbill.

The training will focus on recognizing and responding to domestic and sexual abuse for colleagues, staff, volunteers and other community members. In 2016, just under 30 percent of Island County 10th graders reported in the Healthy Youth Survey having been physically hurt on purpose by an adult, leaving a mark, bruise or injury. Reports from the sheriff’s office said that 23 percent of the county’s assault cases involve domestic violence or abuse, and it’s likely current data underestimates the incidence rate, according to the plan.

Cinde Robinson, executive director of Citizens Against Domestic and Sexual Abuse in Island County and a co-leader of the work group, said at the plan’s release event that the group’s goal is to get the information to as many people in the community as possible so that they can help if someone comes to them when they have a problem.

The work group focused on access to health care is also working on a strategy to bring services to the community. One potential method is expanding the practice of emergency medical services personnel going into people’s homes to assess preventative care needs and direct them toward the appropriate providers.

Paramedics in the county have already been taking intervention steps, but this plan will allow for the coordination of other agencies that provide services, according to Dr. Paul Zaveruha, EMS director for WhidbeyHealth.

“It allows us to get more organized outreach from many other agencies and some of them being significantly under utilized,” said Zaveruha. “We’re looking forward to bringing more horse power to the outreach program.”

Another method may involve a van or a bus that is staffed with nurses who can go out into the community and deliver services.

“Mobile integrated care and paramedicine is all about prevention. …To prevent them from, one, physically having to deal with a crisis but, two, also the expenses of emergency care is the most expensive health care,” said Luginbill.

The group is in the beginning stages of reviewing the feasibility of this health outreach model with partners such as fire departments and WhidbeyHealth.

The work group also wants to improve access to care by creating a centralized resource for comprehensive information about local providers and services. This would include an online directory of all available services in the county and a health care resource center that would be staffed with knowledgeable individuals who can provide phone and walk-in support, according to the report. Most of the work on this strategy will not begin until 2019.

“We don’t have the capacity or bandwidth to do all of the strategies and start them all at once,” said Luginbill.

Many of the goals set forth by the housing group have already been put into motion, such as establishing the year-round shelter in Oak Harbor. The group’s goals and strategies are centered around where housing and health intersect, according to Joanne Pelant, county housing coordinator and co-leader of the group.

One of the goals is to improve transportation of housing clients to the Haven shelter for the homeless from the jail or emergency rooms during off hours of public transit. Luginbill said the group is in the beginning stages of partnering with Island Transit and county’s planning department to find solutions.

There are fewer goals and strategies outlined for the suicide and depression group because of some uncertainty around funding for behavioral health in the state, said Luginbill. The topic also lacks a clear leader in the community, unlike the other groups, she said. For now, the goal is to increase awareness about available resources and educate the public about signs and symptoms of depression.

The group noticed a gap in data on suicide rates for older adults, which make up a significant portion of Island County’s population. Improving the available data is another one of the goals moving forward, said Luginbill. These strategies will become better defined as implementation of the plan is evaluated annually, she said.

Each group has determined process evaluation measures for annual updates on implementation, and at the end of the three years, each group’s outcome measures will be assessed.

Assessments will include state and federal measures, such as the Healthy Youth Survey, emergency visits and number of clients helped at the housing support center.

The full plan is available on the Island County’s assessment and healthy community website. Interested individuals can sign up to receive quarterly updates.

Those who want to participate in future work groups or receive training can contact Luginbill at l.luginbill@co.island.wa.us

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