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We hope that you'll come back.

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Do I have a choice?

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That's not the answer.

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Of course I will come back, Paul.

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Start that one again.

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Welcome to County Connection, the official podcast of the Washington State Association of Counties,

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where we dive into the legislative issues shaping the future of our communities.

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From budgets to public safety, infrastructure to elections,

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we'll break down what's happening in Olympia and how it impacts counties from across the Evergreen State.

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Stay informed, stay engaged, and join us as we amplify the voice of Washington's 39 counties.

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Welcome back everybody to episode two of the County Connection podcast.

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I'm Paul Jewell, government relations director with the Washington State Association of Counties.

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Back here in the Eric Johnson old office studio,

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and today I've got Jamie Bodden, the managing director of the Washington State Association of Local Public Health Officials.

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Jamie, this is your second podcast. Welcome back.

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It is, and I think we might be joined by the ghost of Eric Johnson.

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If we're careful enough and quiet enough, he might make an appearance.

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Eric, you know Eric's still with us, right?

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Yes.

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Okay.

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Eric, if you're out there, I'm sorry that Jamie's here.

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If you listen quietly, you can hear the crunch of peanut M&Ms.

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That's pretty good. I like that one actually.

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I think Eric would like that one too.

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All right. Well, getting back to it, thanks for joining us again, Jamie.

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It's really great to have you.

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Last time we just kind of talked about what you'd expect for the upcoming 2025 legislative session.

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Now that we're in our second week, you probably have a better idea of what you know we are going to be seeing.

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And I guess you're here to talk about a couple of specific bills today, is that right?

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A couple of bills that we were involved with and active with this week,

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as well as kind of what's coming up next week as well.

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So this week on Wednesday, we testified in support of one of our Wasolfo priority bills in the Senate, 5163.

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The sponsor is Senator Orwell, and we heard that in Senate Health and Human Services.

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And that is our child fatality modernization bill.

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Tough subject.

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Tough subject.

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Child fatality review teams, their purpose is to review when a child has died because of non-natural causes.

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So, you know, think accidents, injuries, violence, falls, unintended death.

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So really heavy subjects.

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But those review teams convene locally and discuss what are some of the things that community prevention

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and other strategies could have been better to prevent that death and future death and injury for future children.

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So heavy subject, but really valuable tool in prevention and especially preventing and protecting our most vulnerable in our communities.

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These teams that are part of the apparatus or organization that you mentioned, are these professionals?

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Are they volunteers? Are they are they government employees?

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Yeah. So the review coordinators are local health jurisdiction staff and review teams can include a whole, you know, diverse group of community partners.

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So often a review team will have someone from law enforcement.

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They'll have somebody from health care. They'll have schools involved in some way, whether that's principals, superintendents, maybe even teachers.

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There might be faith groups involved. There might be community groups.

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If a family was really involved in the community, often, you know, social services might be involved.

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So a large a large group of different community members come together and be part of these review teams.

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Is the review team always the same group of community members or does it change based on the incident that occurred?

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Because you mentioned like if the family was super involved in the community, there might be community groups.

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The reason I ask is the first folks that you mentioned, you know, are kind of professionals that probably see this kind of, you know, as difficult as these situations are, they probably see them.

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Of course, you know, hopefully educators and some of those folks don't, but they certainly have a lot of contact with youth.

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And so it made sense to me that they would be part of the team. But you also mentioned if the family, like I said, was really involved in the community, are there positions that kind of change based on the incident or are they pretty constant?

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They're both. You know, there's there's there's the constants of public safety is as part of that review, you know, no matter what, because it's non natural, you know, some usually law enforcement is involved in some way.

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If it's an accident, law enforcement is involved in the response. If it's violence, you know, so a fatality due to homicide law enforcement's involved.

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So they're usually always part of part of a review team. But it also depends on the circumstances. If the child, you know, was from high school, high school, you know, high school principal or high school teachers might be involved.

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If the child was younger, say, for maybe it's daycare or maybe, you know, other other more appropriate reviewers might be part of that team.

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So what does the bill do? Does the bill actually create and set up these teams or do they already exist in the bill?

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Gives them some other authorities. Yeah, these teams already exist. We actually have 17 of them established across our state within local health jurisdictions.

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F.P.S. So public foundational public health services funding. We talked about this, I think, last week a little bit. Those help support our child fatality review teams.

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So those 17 teams, it have been pretty long standing. Nine are, you know, more relatively new.

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And those review teams sometimes will meet monthly, sometimes will meet quarterly, sometimes will meet once a year, might review one fatality in a review or might review three or four, depending on, you know, the content.

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So they might say we're going to do four reviews and they're all about overdoses. So it really depends on the content review. It really depends on the number of deaths that they want to review the heaviness of, you know, of of a fatality for our small communities.

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You know, a death could be, you know, far reaching in its impact. And so those teams vary. They get trained. There's partnership with our state Department of Health and Children, Youth and Families in those reviews as well.

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I imagine being a part of those teams and reviewing, like you said, some of the some of the heavier incidents that might occur with a child fatality. That can be a pretty emotional experience for those folks. Are there supports in place for those team members?

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Yes, that is part of that whole review process, too, and something that the coordinator is trained to do, being able to provide that mental health self care for those review members, the coordinators themselves, as they're the ones gathering a lot of the information and data and records for those stories and kind of putting that all together.

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It is, you know, it does take a toll on your mental health as part of those reviews. And so that's a big part of kind of the post review debrief and just post review care of those team members.

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So what we're proposing in our legislation isn't really necessarily establishing the teams. It's more modernizing and updating the statutory language that authorizes these teams.

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So through FPHS funding and getting more teams established, we've identified where our statute is either a bit out of sync with national standards and guidance or a bit murky and ambiguous.

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And so we're looking to get more in line with the federal standards and clarify some of that ambiguity, tighten up some things.

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So we're looking to modify the review age through 18 years of age to capture high school age kids, knowing that they're really critical population for certain strategies and interventions that we that we might want to prevent around automobile accidents and other things.

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We're looking to tighten up some of the data protections around family confidentiality, while also maintaining and assuring access to all the records that we might need, whether that's electronic health records or school records or other things.

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So, you know, just clarifying that we have access to the things that we need, but also have confidentiality and privacy measures in place.

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We are also proposing to streamline the mandating reporting process. So if there is success suspected abuse or neglect in the home and there's other children present so there was a fatality but there's also you know other kids present in a situation still

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mandating reporting laws kick in, and rather than having, you know, four or five people thinking that one of the other mandated reporters in the room is going to make the report and there's a lot of confusion.

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We outline a process of no this is part of the conversation and there's one designated person and they do the reporting on behalf of everybody present to state and local agencies.

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And then we also emphasize the prevention aspect of this work. The purpose is to identify preventive measures that we need to implement locally, as well as statewide to prevent further injury and death around among our children.

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So you mentioned there are 17 teams. We have 39 counties. Yeah, so that's not even one team per county.

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This bill doesn't provide funding or requirements for more teams you're, you're doing that through your foundational public health services program working this bill really focuses on expanding the age from or to high school age, children I assume did it.

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What was the age limit before that it was ambiguous and that was part of the challenge was said 18 but it didn't say like up to 18 or through 18 and so we wanted to clarify that and you're working on confidentiality some streamline.

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And then for mandated reporting, and you mentioned emphasizing prevention I want to dig into that one a little bit more. I assume that prevention is is really kind of what these groups should be focused on right after after the incident has occurred after the

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fatality has taken place if you know whether it was an accident or whether it was something else. I assume they're doing some sort of a devaluation of the systems that were in place to support that family or maybe that weren't in place or maybe where failures occurred or other things.

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Can you give me some idea of what they'd be looking for. Yeah, exactly. So let's say there was a death because of abuse and neglect. And, you know, our state has processes in place to try to protect children when they're in situations like that but let's say the school suspected

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made reports, and something fell through the cracks. So that review might identify hey, this is where, you know, the process broke down, we need to tighten up that policy and procedure, we need to make sure that we're closing the loop on any communications

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or that there's a streamlined communication process to the right authorities that we can make these reports fast, you know, better more improved. So identifying those cracks, maybe it is a review of an automobile accident, and it ends up being that there was some distracted

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driving occurring somebody you know a teen was texting and driving. And so, maybe it is let's put in place, and this is a frequent occurrence happening, you know regionally or across the state and one of the reasons why we coordinate with our state partners

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is so we can identify trends and other things and so maybe this rises to that sense of this is a bigger issue not just in one jurisdiction but in multiple jurisdictions, so we want to put together a statewide campaign around distracted driving to do more education

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outreach to address you know some of the concerns that we have around that. Well, Jamie, this is an incredible program. That's a very tough tough assignment for these folks that are working on these teams. I assume this is not a controversial bill at all I would hope.

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Anything we need to need to know about there as far as what are you expecting politically. Are you are you finding that there's good support for for this particular bill. Yeah, we have both a wide range of sponsors in the Senate we also have a house bill that's being

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heard next week on Tuesday so a companion bill. What's that bill number that bill number is 1459. Okay, the sponsor is a new house member representative burn bomb from the peninsula, and both have a good amount of sponsors that have signed on to the bill, bipartisan

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support. When we had the hearing in the Senate this week, all in favor so, and we've been working with with committee members so they're aware of the issue I think we have good support.

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We've worked with advocates over the interim to hone and refine that language so that that ambiguity is further clarified that we are working to address.

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We hope, and we're hopeful that we can get it across the finish line this year. Okay, so that Senate Bill 5163 and House Bill 1459 5163 had the hearing this week.

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1459 will be heard in the house next week if members want to sign up to testify, or just sign in in support of the bills they certainly can.

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If they want to, we certainly encourage them to contact their legislators and ask them to support them as well. Absolutely. Thanks, Jamie let's talk about the other bill that you wanted to come in and chat.

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Yeah, so pivoting a little bit to a women, infants and children program or WIC program for short, often implemented by local health jurisdictions as well. There is a small bill, but we think of quite powerful bill in the Senate that is being sponsored by now

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Senator Richelly formerly representative Richelly.

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And this bill is really important because it removes some of the licensure requirements that are currently needed to do hematological testing for WIC program participants so essentially blood prick testing for anemia and lead as part of the WIC program so family enrolls in WIC, they do the intake

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form part of that is to get iron and lead levels, so that they can determine whether there's anemia or not that impacts kind of the the dietary recommendations of the WIC program.

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Right now and medical assistant licensure or above is required to do that test. It is an incredibly simple test. It's literally, you know, a finger prick or a heel prick if it's a baby to do that test so the skill set is very limited.

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There's a lot of other states that already have this requirement removed so that anybody who works in a WIC program can conduct this test, and we're really excited by the opportunity to have that done in Washington State, mostly because we have workforce issues across

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other states, particularly rural areas where it's hard to find MA's to do to do this work in the WIC program so sometimes that means we end up rescheduling, you know appointments for WIC families of here's your intake but you have to come back next week to do this one

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test for the intake or, oh if you have time today, you need to drive across town or to this next, you know, this next town and go to this health care facility to get this test done and then they have to send those test results back to the WIC program and then

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we have to call you back in and go over these results for you. Now we would be able to do everything in one visit, which is incredibly easy for families, and it's just really great for our workforce.

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Okay, so you mentioned MA what's an MA, MA is a medical assistant.

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Okay, so this bill would allow, even if there's not a medical assistant or an MA available at the intake for someone who is applying for eligibility for the WIC program to.

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I'm going to try to say this to conduct the hematological testing necessary as part of that intake and that hematological testing did I say it right again.

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I'm getting good at this, say that 10 times fast everybody out there is really a blood test, looking for essentially anemia testing for lead and iron levels.

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And is it every family member that has to get this test, whoever is being enrolled. So, it could be mom and baby.

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It could be just the children, whoever is eligible and is being enrolled into the program. So, the iron test is to look for anemia, and then they'll do a lead test to look at blood lead levels, because that's also a really critical population if there is elevated lead.

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It's a really critical population to do lead prevention mitigation in the home in the home. Yeah. Why don't you explain anemia really quickly.

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Anemia essentially just means it's low iron in your blood. For pregnant women, it can cause a number of poor birth outcomes, including low birth weight, diminished birth or weight gain in infants, after after birth.

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There's some also some potential complications for mom during delivery for children who are anemic against stunted growth.

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It also impacts just their ability to gain muscle and put on weight appropriately too. So, it's one of those key kind of outcomes, and it can be resolved with food, right?

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You just you eat more iron enriched food. So, it's one of those things that the WIC program looks at, because it's all about improving the diets of the people in the program.

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Yeah, because WIC is primarily a nutrition program. It is a nutrition program. Yeah, correct. So, this would give the people who are managing or doing the caseworker job for this particular family, give them an idea of what their needs might be nutrition wise.

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Exactly. Interesting. So, now we understand why people need the blood test. WIC is a nutrition program, figuring out what those nutritional needs are, or where the deficiencies exist, super important.

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Not having a medical assistant available has been a problem. So, this just means anybody who's doing that intake could actually do like you mentioned, it's a pinprick and a little bit of a blood test.

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I have to tell you, I don't want to be the person who does that. I can't even give myself a pinprick. I cut myself and it hurts so bad and I just want to cry.

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Who is it that wants to be the person that has to do the or gets to do the pinprick in the little baby's foot? For goodness sakes, that sounds horrible.

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I mean, that's part of the program. So, you get trained how to talk to the families, how to talk to if it's a little kid, what's going to happen, and that is all part of just the care that WIC programs provide.

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They are braver than me, way braver than me, and so are you, Jamie, just for advocating for that.

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I know this.

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Okay, Jamie, well, anything else that you want to mention today? What is this bill? What's the number?

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Sure, this bill number is 5244. It was heard this morning, so Thursday morning in Senate Health and Long Term Care and are excited to work and move this bill forward as well.

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So there's no House version of this one?

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No, I don't believe so, which is okay. We're excited to work on it regardless. We have a wonderful, again, a group of sponsors on this bill as well.

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And I suppose our members could get involved the same way that they got involved or that they could get involved with the other one. They could sign in, support, they could certainly call their legislators. We'd love to have them do that.

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Absolutely, and especially if you have your local WIC program within your counties, this can be a really great bill for them to continue to be successful, to get, you know, our non-MAs an additional skill set and trainings, but just also be better providers of the program for our families when they're more engaged in the program.

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We have better health outcomes and that's really good for everybody.

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Jamie, thanks for sharing all this information about these bills today. We went into a lot of detail. This is a lot of great work that public health is doing in our communities and it's so important.

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I'm sure that the listeners learned a little bit more about public health than they knew before. I certainly did. I had no idea that some of this work was being done.

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I can't say enough about how great it is that you're continuing to do the advocacy work that you are and you're making the progress that you are.

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I know our members are going to want to support these. I think we've given them, you know, some really good ideas here. I hope you'll come back and share some more with us a little bit later.

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Yeah, looking forward to coming back next week and talking more public health issues.

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Sounds good, Jamie. Take care until then.

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