Public Health & Safety Committee

TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 1 CONVENE: 8:00 a.m. PRESENT: Chair Leatta Dahlhoff and Councilmembers Peter Agabi and Angela Jefferson. Staff: Police Chief Jon Weiks, Assistant Fire Chief Shawn Crimmins, and Police Administrative Services Manager Laura Wohl. CHANGES TO There were no changes to the agenda. AGENDA: APPROVAL OF MINUTES: PUBLIC HEALTH & SAFETY COMMITTEE, APRIL 12, 2022: MOTION: Councilmember Jefferson moved, seconded by Councilmember Agabi, to approve the minutes of April 12, 2022 as published. A voice vote approved the motion unanimously. VETERAN POST- Police Chief Weiks introduced Kim Nedrow, President of Balanced Being TRAUMATIC Inc., and founder of the Association for Integrated Healing, serving STRESS military, veterans, first responders, and their families dealing with trauma. DISORDER Ms. Nedrow’s briefing focused on Post Traumatic Stress (PTS) and Post BRIEFING: Traumatic Stress Disorder (PTSD) and how affected individuals are supported. Ms. Nedrow said the organizations are based in Thurston County and serve most of Western Washington. Trauma is an experience everyone deals with differently. PTS is different from PTSD. Most individuals deal with PTS throughout their life in some form or another. PTSD is a designated disorder and depending on the situation there are many ramifications for having to classify that as a disorder that can create varying degrees of impact to people in terms of the disability percentage for some situations or acknowledgement and ownership of the disability by the individual. Everyone deals with the disorder differently and it is possible to experience healing. The work of the organization is not focused on the mental health arena but rather a mind, body, and spirit process as our bodies when experiencing trauma protect themselves with some individuals able to compartmentalize situations. However, at some point, bodies begin to suffer and require a relief valve. Lacking an avenue to release trauma, the symptoms of post traumatic stress and trauma can overwhelm an individual Some symptoms of PTS and PTSD include being easily startled or frightened, always on guard for danger, self-destructive behavior, such as drinking too much or driving too fast, trouble sleeping, trouble TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 2 concentrating, irritability, angry outbursts or aggressive behavior, or overwhelming guilt or shame. While talk therapy can be beneficial for some people, it often does not help individuals who have stored traumas. CranioSacral therapy is a gentle manual therapy that uses light touch to relieve pain, stress, and discomfort by therapists using careful placement of their hands to locate restrictions in the CranioSacral system and assisting the body in releasing those blockages, encouraging the body’s natural ability to repair injury and heal physical and emotional trauma. Ms. Nedrow described her professional and working experience with the University of Washington Brain Injury Alliance, Washington State Brain Injury Council and Lewis Mason Thurston Area Agency on Aging with Alzheimer patients and their families. First responders and veterans can experience a one-incident trauma or cumulative trauma. Families are also impacted. Often family members are invited to experience a treatment dependent upon the situation. She explained that the treatment process does not push individuals to share information about their trauma but rather it is a process over time of learning to trust which often helps individuals share information about their trauma through a therapy process that connects an individual’s brain and emotions with their body resulting in an alignment enabling the healing and release of trauma from the body. Councilmember Jefferson shared that the issue is important personally to her as May is Mental Health Month. It is appropriate for the committee to receive the information as the nation has lived through a traumatic event. She has been diagnosed with PTSD and her intent was removing the stigma to encourage conversations as a community because City employees, police officers, and firefighters are also affected by day-to-day trauma. It helps to have trauma defined so that many in the community understand and becoming more willing to discuss how it affects people. Ms. Nedrow shared a five-minute video of four veterans participating in treatments and how the treatments have contributed to their physical and emotional healing. Chair Dahlhoff thanked Ms. Nedrow for attending and sharing the information. Ms. Nedrow invited the committee to participate in a treatment to understand and benefit from the experience. She encouraged members to contact her for an appointment. Councilmember Jefferson asked about the next steps as she believes the issue is appropriate to pursue more discussions at this time. Chair Dahlhoff offered that the conversations should be in support of the Council’s strategic goals and priorities, which include elements that speak to PTSD and trauma. She added that she prefers actionable items rather than ongoing discussions, TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 3 such as considering the topic during Tumwater University or the Police Citizens Academy, or during community conversations. Councilmember Agabi supported moving in the direction of actionable items as well. He acknowledged that although he works in an office environment, he often experiences stress. He asked whether the City’s health benefit structure is conducive for employees to receive treatment. Chair Dahlhoff suggested deferring the question to the City’s HR Department to determine if first responders have access to multiple types of therapies. DISTRICT Police Chief Weiks introduced Frankie Peters, Thurston County District COURT UPDATE: Court Executive Officer. Mr. Peters provided an overview of court services available to community members, to include Criminal and Infraction, Civil related cases for Civil Protection Orders, Probation Supervision, and Mental Health and Veterans Court. The City moved its district court services to Thurston County District Court in 2013. Mr. Peters explained that Thurston County District Court is a limited court of jurisdiction and only handles misdemeanors, gross misdemeanors, infractions, civil matters that include DUIs, thefts, trespassing, assault 4’s, speeding tickets, civil small claims, and civil protection orders. Known as the People's Court, the Court administers approximately 89% of all court filings within the court system of the entire state. Thurston County District Court handles the majority of all court cases in the county. The court receives approximately 600 misdemeanor filings from the City and approximately 200 infractions each year. The court processes 4,000 misdemeanors and 18,000 infractions each year in the entire county. Mr. Peters shared information on the office structure supporting the Court based on different misdemeanors and civil matters. The Court is experiencing an increase in civil matters caused in part by the pandemic involving housing landlord/tenant issues, small claims, and petitions for anti-harassment orders. The Mental Health and Veterans Courts typically serve 10 to 12 participants from the City of Tumwater each year. The program was initially focused on medium risk and medium needs of individuals. Over time, services were expanded to high risk and high needs to meet the change in needs from the community. The program has been offered throughout the pandemic. To continue the services, the Court considered the assessment process for participating in Mental Health and Veterans Courts based on national and state standards. Based on success rates, moving a person to a program within five to six months generally results in the person successfully completing the program and moving forward. However, the timing was not sufficient to address the needs of individuals as most need resources TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 4 immediately. The Court re-evaluated the assessment process and considered ways to expedite the process while providing the resources for services. The assessment process involves the participant, attorneys, and prosecutors. Councilmember Jefferson asked about the difference between a medium risk and high risk veteran. Mr. Peters explained that it generally is defined by the mental health needs of the veteran and the extent of the need. The three-month assessment process was reduced to one week. Following identification of an eligible participant, the individual meets with a licensed program manager to complete the assessment with participants who are either in custody or not in custody. Following initial discussions, the program manager contacts resources to enroll individuals within program(s) within a week. The office provides wraparound services and assigns each individual a care coordinator who works with the individual on the applicable resources of need to ensure the success of the individual. Chair Dahlhoff asked whether there is any overlap with the Law Enforcement Assisted Diversion Program. Mr. Peters said there is no overlap with the program as those individuals are in a pre-charge status and are working through the diversionary services prior to entering the Court system. The special courts handle individuals who have been charged through either Superior Court or District Court. At some point, he is hopeful there would be a transition in the future to identify participants sooner rather than after being charged. With the changes in the assessment and wraparound services, the Court is able to focus attention on high risk and high needs and evaluate how the Court can continue to provide the resources. Prior to the pandemic, the programs emphasized quantity over quality. That approach is not effective for the community and the focus is now on quality within the service provided to participants even after they graduate from the program to prevent recidivism. The Court is working with the Washington State Center for Court Research to conduct data analysis of court activities, specifically for probation and the Mental Health Court to track graduations and recidivism rates. Today, the Mental Health and Veterans Courts are two- year programs. Many participants have indicated that two years is too long for them to dedicate in lieu of a plea deal with probation of only one year. However, those individuals are no longer receiving mental health services. The goal is to bridge the gap by providing the mental health resources to all participants while increasing the attractiveness of the program. The Court is considering a one-year program for lesser offenses to ensure participants receive services. The services also serve the Probation Department. Probation counselors meet regularly with individuals and direct them to resources, such as job search assistance and housing. It has been recognized that there is a disconnect between pre- and post-deposition and the intent is to continue services if some of the individuals did not take TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 5 advantage or were not enrolled in Mental Health and Veterans Courts. As a result, a mental health probation position was created within the Courts dedicated to providing resources focused on the needs of the individuals to create success. Pre-trial services in the county have been expanded with the creation of the Pre-Trial Unit serving District Court. The service provides monitoring and some diversion services and assistance to community members to ensure they are successful. The District Court received approval for hiring an interpreter coordinator, a certified court interpreter for District Court, Superior Court, and Family Juvenile Court to ensure those services are provided immediately in the most effective manner to all those entering the Court system. Additionally, the Court over the last several years has attempted to establish a Substance Abuse Monitoring Program of individuals who are assigned orders by the court to provide weekly UAs or wearing a blood-alcohol monitoring device (ankle device). The cost of weekly UAs and daily monitoring and maintenance of the blood-alcohol monitoring device is typically more than participants can afford. Often, because of the cost and the inability of participants paying for the service, the Court assesses whether they pose a risk to the public and whether placement into custody is necessary, which is not the desired route if the Court wants to ensure success by enabling participants to maintain their jobs and housing. The county has approved a funding source for all defendants who cannot afford to pay for those services effective June 1, 2022. Chair Dahlhoff inquired as to the source of information identifying graduation dates of the Mental Health and Veterans Courts. Mr. Peters advised that the graduation dates are not published on the website but the court dockets on the website include a link to the zoom channel broadcasting graduation ceremonies. He offered to forward graduation dates to the committee. Chair Dahlhoff commented on the importance of tracking data for the last several years to identify potential trends in Tumwater that might link with calls to the Fire and Police Departments that might influence the Council to consider developing policies or assessing whether the City has created barriers or obstacles to community members. Mr. Peters said his intent is to analyze trends at any moment in time to ascertain recent trends. The Washington State Center for Court Research is developing a process for providing access immediately. The Court currently has immediate access to data on racial disparities and charge disposition and sentencing. The Court is expanding the ability to access data immediately for Mental Health and Veterans Courts. He has had conversations with a new data analyst at the Center for Court Research for expansion of data access to a variety of TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 6 different processes spanning public counsel, prosecutors, law enforcement agencies, and other data that resides outside the Courts. Councilmember Agabi asked whether it is possible to track the number of individuals who were jailed because they were unable to afford the cost of the monitoring program. Mr. Peters said the data is difficult to track as it is essentially a “what if” scenario. However, in 2019, approximately 450 people were assigned a blood alcohol-monitoring device who were indigent and lacked the ability to pay court costs. Chair Dahlhoff thanked Mr. Peters for the update and invited him to provide periodic updates to the committee. NARCAN Assistant Fire Chief Shawn Crimmins reported the Fire Department at this DISTRIBUTION time has been unable to provide Narcan distribution because of the UPDATE: department works under the direction of the Medical Program Director’s license. The program is undergoing some changes. During 2021, Narcan was administered by bystanders 29 times prior to ALS arrival. Law enforcement administered Narcan 13 times prior to EMS arrival. Data on basic life support calls were not included as the search criteria are based off medication administration. Last year, EMS resuscitations with Narcan totaled 61 incidents. Narcan can be administered safely in those situations where the patient did not overdose on drugs, which speaks to the high number of resuscitations. There were 31 attempted resuscitations with “suspected” or “confirmed” narcotic overdose and 11 Code 9 incidents (suspected or confirmed narcotic overdose). There has been a 40% increase in overdose cardiac arrest between 2020 and 2021, which is significant. First responders are experiencing an increase in fentanyl overdoses in Tumwater. Assistant Fire Chief Crimmins reviewed current goals for Thurston County Medic One, Fire, and EMS to reduce overdose. The goal is to initiate a Narcan “Leave Behind” program utilizing EMS responders who have contact with patients who have overdosed on narcotics. At this time, the Department is tied to current protocols and what the Medical Program Director allows. The county is exploring the development of a Narcan Kit to include educational resources for opiate users on how to avoid overdose and what to do if someone has overdosed. Other efforts include continuation of crafting and modifying Thurston County Protocols to include a “Narcan Leave Behind” program through the Thurston County Protocol Committee, agency support, and Medical Program Director support. The protocols require adjustment through a process over the course of the next year that requires approval by the Washington State Department of Health followed by training of first responders. It is likely the program will be initiated by paramedic units first followed by BLS TUMWATER PUBLIC HEALTH AND SAFETY COMMITTEE MINUTES OF VIRTUAL MEETING May 10, 2022 Page 7 responders and EMTs. Councilmember Jefferson asked about the availability of Narcan today. Assistant Fire Chief Crimmins advised that Narcan is available through public pharmacies and through the Thurston County Public Health Department. Chair Dahlhoff added that she participated in the training to administer Narcan. Thurston County is providing training to administer the nasal form of Narcan. It is also possible to obtain a Narcan kit. The county is also providing training to businesses and hotels in Tumwater. She recommended scheduling a Council worksession for the Council to receive Narcan training. Police Chief Weiks confirmed he would follow up with City Administrator Doan to schedule training for the Council. FIRST Police Chief Weiks reported the 2017-2022 Nisqually Jail Service AMENDMENT TO Agreement expired on January 1, 2022. Because neither entity realized the NISQUALLY JAIL contract had expired, both parties worked on drafting a First Amendment to SERVICE Nisqually Jail Service Agreement to provide both entities time to enter into AGREEMENT: a new contract by the end of 2022. The request is authorization to move the First Amendment to Nisqually Jail Service Agreement forward to the City Council for consideration and approval. Chair Dahlhoff asked for clarification as to whether the long-term plan is to transition to the Lewis County Jail. Police Chief Weiks responded that prior to the pandemic the Courts discussed whether municipalities can legally house inmates in tribal jails. Because of the pandemic, the issue has lessened. The Nisqually Jail has always been a good partner with the Police Department. However, because of uncertainties in terms of space, it was necessary for the City to seek alternative jails, which prompted conversations to use the Lewis County Jail. The issue could resurface as the Courts begin opening. At this time, the department intends to maintain both contracts. Nisqually Jail provides medical and mental health services to inmates. MOTION: Commissioner Jefferson moved, seconded by Councilmember Agabi, to forward the First Amendment to Nisqually Jail Service Agreement to the City Council for consideration and approval. A voice vote approved the motion unanimously. ADJOURNMENT: With there being no further business, Chair Dahlhoff adjourned the meeting at 9:12 a.m. Prepared by Valerie L. Gow, Recording Secretary/President Puget Sound Meeting Services, psmsoly@earthlink.net