KPHD contemplating health issues for homeless

The Kitsap Public Health District is redefining its approach to working with the homeless, realizing that issue has so many problems related to health.

“The biggest problem is housing—or the lack thereof,” Dr. Gib Morrow, KPHD health officer, said at their board meeting Nov. 7.

Morrow also said he’s glad governments are changing policies to deal with the lack of inventory.

Other issues include rising mortgage rates and increasing housing costs. He said the cost of housing in Kitsap County has increased $100,000 in the past few years.

Morrow said economic factors play a part in problems like mental health and addiction. He said there has been a dramatic increase in the number of overdose deaths. That’s because drug users who take fentanyl don’t survive long enough to make it to a hospital.

KPHD board member and Bremerton Mayor Greg Wheeler said governments need to do a better job of finding out causes of homelessness. It’s not just lack of affordable housing. “We don’t see ones not camping on our streets,” he said.

Wheeler added more basic help is needed, such as walk-up shelters “that get people out of the elements.”

Board member Drayton Jackson said it needs to be a community effort, not just one agency. He said he appreciates that KPHD understands the many health issues associated with homelessness.

“Us getting involved is promising,” he said, adding he hopes they actually talk to the homeless because “they are the experts in setting up a system” that will be sustainable and “help those who really need to be helped.”

He said addicts and the homeless often won’t go to a doctor because of the bias of being judged. He added he hopes the board is open to bringing “voices to the table who are actually going through this.”

Also, Morrow said respiratory season is underway with three influenza cases, but “once it starts cases start to take off.” He also said the number of COVID cases has been up and down, but nowhere near what was expected.

Legislative priorities

With the state session coming up in January, policy analyst Adrienne Hampton talked to the board about setting priorities.

Hampton said she hopes the KPHD will pass resolutions to push the legislature for action on things like pediatric shortages in Kitsap.

She said there are four focus areas:

1. Public health services: Continued funding is needed.

2. Equitable access: Support health care policies that reduce service gaps, especially for Black and Indigenous people.

3. Respond to emerging needs: Such as transportation and housing options, along with health education.

4. Support community partners: Include community voices and even statewide partnerships with other public health agencies.

Hampton said the legislature already has priorities such as: data access, child fatalities, vaccines, syphilis treatment; and expanding the emergency powers of the Secretary of Health.

Board member and County Commissioner Christine Rolfes questioned why the KPHD has not supported home kitchens that help small businesses often run by refugees. “The public health world kills it” every year, the former state senator said.

Retiring KPHD administrator Keith Grellner said he would vote against it again if it comes back in the form it has for six straight years. “It’s not safe enough until the sanitary code is the same” as other food businesses.

Jackson said this is just the type of thing that government needs to compromise on, so the “health department doesn’t discriminate.”

Rolfes added, “This is the one thing in thirty years Keith and I disagree on.”

Budget talks

Grellner then talked about the draft budget that will return to the board in December.

He said the budget is $19.165 million with 80% for staffing, which is set at 136 full-timers, the same as it’s been since 2021. Grellner said because of the size of staff they are always short eight to 10 people with ongoing recruiting.

The rest of the budget is stable despite rising costs, he said, adding the district is only one of five in the state that is accredited.

KPHD has no taxing authority, so its revenue comes from contracts and grants (30%), service fees (28%) and the legislature (23%). This year’s budget request is to also spend $3.18 million in reserves.

Grellner said he likes to err on the side of having a conservative budget. “Weird things happen, especially in the legislature. We don’t count our chickens before they hatch.”

He said many of the funds have to be spent on certain things, so it’s not like they have a “slush fund.” They also have to save two months minimum spending in reserves that they can’t spend. “Heaven forbid if anything serious happens,” he said. “We only have two months to recover costs.”

Environmental fees

After listening to a presentation by environmental health director John Kiess, the board decided to raise environmental fees for 2024. He said it’s actually part of an eight-year plan that started in 2017.

The plan already has been adjusted at least twice: once to help during COVID pandemic struggles, and then last year the board decided increases needed to be capped at 6% or as low as 3%. Since the Consumer Price Index is 6.8% the increase next year will be the high cap of 6%.

Even with the increases, “We do not fully recover costs for services,” Kiess said, adding they use reserves to fill the gap, and the hikes only amount to from $20 to $50 a year.