Minutes - Tacoma Pierce County Coalition to End Homelessness Provider Meeting – May 3rd, 2019
Welcome
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James Pogue, Comprehensive Life Resources
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Website – http://pchomeless.org/ - info about meetings and signup for the listserv
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Resources website –
http://piercecountyresources.com/ - lots of resources on the site.
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Lots of interest in resources and funding to transport people to a location after discharge from prison – finally working on this topic
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Maureen mentioned the need for safe parking – often hear the need for shelter for Domestic Violence and single women as well.
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Want to include the Key Peninsula in our work
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Anchor Initiative – focusing 3rd Friday of the month on youth issues.
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Lots of the subcommittee work has created our best programs – listserv, Hire253, Resources Database
Tacoma Needle Exchange/Dave Purchase Project
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Hanna Carol-Day, Tacoma Needle Exchange –
hanna@nasen.org
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David Venes ( davidv@nasen.org ), Paul LaKosky (paul@nasen.org )and Laura Reynolds (
laura@nasen.org ) are all here too
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History –
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Was the first needle exchange in the US – established in 1988
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Founded by Dave Purchase (thus the Dave Purchase Project – it all makes sense now. –ed)
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30 years of harm reduction
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Use original model – bring used needles to receive new needles (like an exchange, maybe. –ed)
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Harm Reduction – a practical and respectful approach
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Harm reduction accepts that drug use is part of our world, and seeks to minimize harmful impacts. It uses no condemnation, and is non-judgmental and users non-coercive tactics
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Affirms dignity of people, even when using drugs
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Doesn’t minimize the harm and dangers of drug use
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Program benefits
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Reduces disease – 20% less HIV in communities with needles exchanges (reason enough to have a needle exchange. –ed)
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Saves on incarceration and healthcare (again, reason enough to have a needle exchange. –ed)
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Less syringe litter (on its own merits, a great reason to have a needle exchange. –ed)
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Free syringes reduced reuse and sharing (wow, these are all great reasons – hard to imagine how needle exchanges can still be controversial. –ed)
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Offer screening for HIV and Hepatitis (hard not to like this one too –ed.)
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Distribute naloxone to allow people to have a better chance of surviving an overdose (another amazing service – ed.)
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Referrals to healthcare – including abstinence-based and medication assisted treatments (boy that sounds like the right thing to do –ed.)
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Tacoma Needle Exchange offerings
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Provide clean injection equipment – critical in preventing infections and transmission of disease
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Community syringe pickup and disposal – we’ll clean up a site littered with syringes.
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Overdose prevention education
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Naloxone distribution – offered to anyone in the community – community organizations, law enforcement, friends or family. Tacoma Fire Department can even provide a Narcan kit to folks.
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Provide safe sex supplies
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Wound care kits
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Referrals to Substance Use treatment – both abstinence based and medication assisted
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Education about harm reduction, safe practices
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Deliver anywhere in Pierce County 5 days a week (or nearly 5 days a week, there were some specifics I didn’t get –ed.)
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Care coordinator on site – Dave Venes (Yay David. –ed)
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Local Impact in 2018
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Exchange 2.5 million syringes (is it just me, or is that a bit of a jaw-dropping number of syringes. –ed)
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12,000 transactions
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Over 3,000 naloxone kits – allowing 735 overdose reversals (again, wow, what a positive impact.-ed)
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Distributed 2,825 fentanyl test kits
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Provided 124 HIV/Hepatitis C (HCV) tests
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Provided 512 healthcare kits
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Locations
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Tacoma Pierce County Health Department Parking Lot – Pacific and 37th – open M, W, F - 11am-4pm
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Central Tacoma - The Corner of 14th and G Street in Tacoma, WA 98405 – open M, T, Th, F - 10am-1pm
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Puyallup Tribal Exchange - East Portland Ave. and East Wright Ave. Tacoma, WA 98404 – open Saturday 11am-2pm
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Deliveries – call 253-381-5229 – available many days from 9-1pm
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Contact Information
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Hanna Carol-Day
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253-334-9576
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Bruce - How do you deal with the concept that you are enabling this community? Hanna – we aren’t enabling. Our model says this is part of our world, and since it is happening, we can help them be safer in this process. And,
by building relationships, when they are ready to change, we are ready to help. Paul – many arguments can be made against the needle exchange – none are based in fact. No data says it facilitates drug use – all the data says it helps keep people safe and
alive until they are ready for services.
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Carolyn – I appreciate this great work. You always hear this is so controversial – do you bump up against laws or policy decisions that make your work harder to do? Paul – recently there has been a lot more pushback. There
are distribution and drug paraphernalia laws – sometimes for needles. (paraphernalia is an odd word – back in the day, the Romans used the word – from the Greek words para (beyond) and pherne (dowry)- to identify the goods a wife brought with her to a
marriage that were her own. These items were “beyond the dowry” – the dowry being a gift from the bride’s family to the husband. In the 15th Century, the English apparently felt trusting women with much of anything was a bit too generous, and
limited the legal possessions of women – paraphernalia - to just the small personal articles – like a dress or jewelry. It wasn’t until the 18th century that paraphernalia is used to describe equipment, as in “Bridles, Saddles and other equestrian
paraphernalia”. And then somehow “drug paraphernalia” became a thing – and now when we hear paraphernalia, we think bong instead of choice pieces of furniture. –ed.).
The supreme court says that the Public health department can authorize needle exchanges for health reasons. Some policies come up, and we fight back against them
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Al – if I show up and am high, and I want 50 needles, can I get 50 needles. Paul – we’d like to give people what they need, and trust that they know what they need. Fiscally, that doesn’t work. If you come and get 50 and exchange
50, that is fine. If you got 50 last week and don’t’ have them and come to get 100, we’ll give you 10, and a safety pack, and you have to come and exchange. We’ll give 10 a day until the needle exchange is open again. Al – so you don’t give them out willy-nilly.
Paul - We use the exchange model – one clean one for a dirty one. We get blamed for dirty needles, so we work hard to prevent that
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Theresa – I want to talk about a benefit they don’t talk about. I live across from their G street site. Before they started coming, there were needles everywhere. When the van is there, the community is calmer. There was a
lot of blowback when they came, but the way they run it is well done. We recommend welcoming the needle exchange with open arms.
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Maureen – I knew Dave Purchase – one of the things that allowed it to happen was the support of the chief of police. As we look around at the county, at communities responding to Martin vs. Boise (https://nlchp.org/homeless-persons-cannot-be-punished-for-sleeping-in-absence-of-alternatives-9th-circuit-decision-establishes/
), and homelessness, it is an opportunity to engage when neighbors express concerns – the needles are always the first complaint – needles by their house or school or park. Hanna – we work to get our name out there and let folks know about the services we
provide.
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Brendon – what is your viewpoint on safe injection sites. Bruce – any plans for them? Paul – Pierce County Council has passed a budgetary restriction that if the health department engages in discussion of injection sites, the
health department will lose funding. Safe injection spaces work – 30 years of evidence – not one person has died in a safe injection space. But, they only work in a particular context. Save injection is different from a “safe consumption” space, which means
smoking, snorting or injecting. Safe injection is injection only. Safe consumption needs fume management and such. Will one come tomorrow? No. ever? Not sure. It needs a lot of research – you need a lot of injection users – sites have to be near where
people use. Personally – I support them – but they need research and proper community engagement. They do reduce deaths.
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Bruce – goal to reduce death or use? Paul – both.
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Al – Are you in discussions with safe streets and other groups to get the message out? Paul - we are trying to engage the community and get more feedback on how to provide services. The presence of a syringe exchange reduces
litter on the street. Does that matter when a parent’s child finds one? No. all homeless aren’t drug users, and all drug users aren’t homeless. Many of our exchange folks are homeless, and many are not – it is the whole spectrum. Homelessness does not
equal drug addiction.
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James – delivery, what do you deliver? Paul – we deliver harm reduction supplies and naloxone anywhere in PC. Dennis picks up the phone and then delivers. Call by 11am for delivery that day.
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James – if you use 311 to complain about needles, does that go to you? Paul – yes.
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Questions - a friend runs a Portland needle exchange. Do you allow folks from other agencies to come out and volunteer? Paul – yes, but they need training. We are careful about what situations we put volunteers into.
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When you said Vancouver, did you mean Vancouver Washington or Vancouver British Columbia? Paul – British Columbia.
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Hanna- one new thing we are doing – once a month on the first Thursday, we are doing overdose prevention and distribution of naloxone at the Stability Site. That was exciting to get started.
Pierce County Emergency Management
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Serena McWha, Access and Functional Needs Coordinator, Pierce County Emergency Management -
serina.mcwha@piercecountywa.gov
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My background is in social work, in nursing homes and retirement communities. Social work and advocacy is near to my heart.
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I got my first experience with emergency management on FAST team
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Functional Assessment Services Team (FAST)
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Team of social service professionals who volunteer and are trained in disaster preparedness
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Developed in California after lessons learned from Hurricane Katrina and some California Wires – developed at the state level by the human services department. They gathered their social workers and trained them to respond in
shelters to reduce the impact of the disaster for people with disabilities and access and functional needs.
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Lessons are learned from disaster responses, but still people with disabilities and functional needs are disproportionately affected
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In 2012, sent Sherri Badger to bring this model to Washington State
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Major duty of the FAST team is to coordinate with emergency shelters
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Qualifications
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Two years of professional experience
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ICS 100/200/7700 (different training courses – info at
https://training.fema.gov/nims/ -ed)
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Pass background check
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Work under difficult and stressful conditions (are there social workers not working under difficult and stressful conditions? Just curious. –ed)
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We draw on your experiences and expertise with Behavioral health, Developmental disabilities, Etc.
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Have a monthly sustainment meeting where we keep volunteer involved. The program has been around since 2012, but hasn’t been deployed, so we’ve not opened too many emergency shelters. We have trainings and exercises to keep
folks growing and involved.
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If you are interested in participating in our team, we meet monthly, and a 2-day training is coming in November.
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We want a representative from every type of discipline (but probably not “lax discipline”, my own specialty, I’m imagining – ed.)
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We funnel staff to assess needs and want members who already know who to call. If someone needs oxygen in a couple hours, need folks that can make that happen.
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TEAM does not self-deploy – it is deployed by the Duty officer. 3 FAST coordinators can also deploy the team. Duty Officer number 253-798-7470
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Have trailers with blankets, mother and baby supplies, funded by FEMA. They are deployable to King, Pierce and Snohomish.
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Pierce County Access and Functional Needs Coalition
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Meets every 4th Thursday at 9am. Putting a plan together to operationalize this group. We don’t know where people are that need resources. People with functional needs are the most impacted in emergencies, and we
have resources, but we don’t know where the need is. We work agencies like the Center for Independence (an amazing group -
http://www.cfisouth.org/ -ed), Catholic Community Services (
http://www.ccsww.org/ ), the Health Department (
https://www.tpchd.org/ ) , TACID (another organization I adore -
https://www.tacid.org/ -ed.), and people that work directly with individuals and know how to get to those individuals. We want a way to collect needs and escalate to the right folks to get those needs met.
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During Katrina, learned that the disability world and the emergency management folks had no connection. Neither knew how to coordinate with the other. We are trying to close that gap still, which means working with agencies
and coalitions and the network and membership.
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High Risk Disaster Planning Summit
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June 22nd, - free event, will hear from county emergency managers and lessons learned from disasters from the last year, including the air quality issues from last summer. Have a table top exercise as well. I’d like
to invite you all. It is a free, 1-day event at Blix Elementary on 38th between McKinley and Portland ave. Registration is required. Lunch is provided (so, there is such a thing as a free lunch –ed.)
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Access and Functional Needs Coordinator – the homeless population falls under this category. FEMA has a broad definition of people impacted in a disaster – someone who has special needs has
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Communication needs – ASL or another language
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Maintaining Health – someone who needs dialysis, or has a service animal, or some other need
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We provide Safety, support, self-determination
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Transportation is always a challenge
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Natalie Stice, Emergency Management Guru, Pierce County Emergency Management
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I am in the operations division of Pierce County Emergency Operations
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Duty Officer Program
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For Pierce County 1,800 miles square – over 900,000 people. 23 cities and towns we contract with. Provide services for whole County, excep except City of Tacoma, City of Lakewood and City of Puyallup. If you are inside those
three jurisdictions, you have to run requests through emergency management in that municipality.
o
We have 8 duty officers and 6 duty managers. They work 24x7 (probably not all at the same time, though…-ed). One duty office is on-call for a full week – and is available for calls 24x7. We log all communication. We
get tons of calls, for search and rescue, hazardous material issues, alerts and warning based on zip code or map perimeters. We have protocols that go through the duty manager. If a duty officer is overloaded, can ramp up response as needed. Don’t be afraid
to call us.
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Have 3 shelter trailers – we have them at a central location in Spanaway at the Radio Shop. We had them distributed around the County. We have cots, blankets. They are different than the FAST trailers, ,which are needed for
helping folks with functional needs.
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Scenario – if you call the duty officer, we are trained to answer 24x7 – someone will answer the phone. You make a request – you’ll need to identify fiscal agent -nothing is free – we may need to know who will assume the cost.
Cost may be billed to City or Agency.
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In the snow storm, we have essential personnel transport – “4x4’s” volunteers – can help with Search and Rescue and in snowstorms in urban areas. Our five 4x4s did 700 transports of emergency personnel. We transport first responders,
hospital staff, fire fighters, and 911 dispatch operators. After 2 weeks our volunteers needed a break. For the hospital, it has to go through the house nurse to limit abuse of the system. Our volunteer spend own time/money and gas – though there is some
minimal reimbursement (I hope the doctors tip generously…-ed).
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Joy – you keep saying urban areas. We had folks on the Key Peninsula stuck in their house for 4 or 5 days. Could you provide services there? Natalie – If Uber or taxi or Lyft or bus service not work, will activate volunteers.
Joy – we found a volunteer to get food to person in crisis. Natalie – we can’t go out to 900,000 people to meet those sorts of needs. People need a level of preparedness. King County had their whole east side cut off because of the snow. Clallam County
had a similar situation, but not a crisis, since the residents, unlike in East Pierce County, were prepared. Joy – can you train them to be prepared? Kayla – since we serve folks who are very low income and work hard to get resources – we serve folks who
have no resources. Natalia - Emergency management can’t solve this problem along. If a shelter is stood up, we can support that.
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Maureen – I appreciate your limits. But you are a community, governmental agency, and I’m suggesting there are ways to respond to the folks we serve, who don’t have the luxury of personal preparation. We can help you do that.
Serena – we need people to step up and be part of that.
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Providing some of this support is the premise behind the Community Emergency Response Team (CERT). We need community members willing to stand up this group to help at the County level. We have kind of a board struggling to get
things up. Contact Serena to get better involved with this.
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Al – You mentioned we need to go through the City’s Emergency Management? Natalie – yes. Al – this group we are talking about, has very well-defined procedures for well-defined disasters. There is a learning curve on both sides.
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Martha – I thought they don’t run the shelters, they provide what is needed. The Red Cross runs those shelters. Do you work with Marvin at the services corp? Serina – yes.
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We have 219 identified shelters in Pierce County – we don’t have staff to run them. (Emergency Management shelters are different than homeless shelters. Emergency Management identifies a huge number of facilities willing to
be used in an emergency, then catalogs their characteristics so when a disaster does happen, emergency management can stand up a few of those facility with the right features in the right geographic location to be the shelter. -ed) If you have a homeless
shelter running above capacity – even if we were open, if your individual agency or shelter has more than you can handle, it is an emergency for you – so call us (or have Tacoma call us). The red cross will not open a shelter unless there are at least 25
people, but that is the threshold that needs to be met. Puyallup staffs their shelter with their public works folks. We can help get resources and transportation, but someone generally has to pay for it.
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Maureen – following Al’s point – we have to work with very structured systems. Is there a value in looking ahead to summer. We were told to expect wildfires this summer and people will be subject to smoke and heat. That seems
like an immediate issue. Serena – at the summit, we can engage on that topic. Judy Olsen is the air quality expert at the Health Department. The health department is not responsible for the cooling stations and air quality – we should continue to talk about
as a group. The health department passes on advisories, but doesn’t setup cooling stations. That is done as a group effort – it was a huge unmet need last year. Natalie- when we get a request, we push out information about places to go. There has to be
a request- there are no triggers related to temperature or air quality. In Pierce County, we have many cooling places people can go to. We’d need enough people not able to use existing locations before we add an inclement weather or cooling station shelter.
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Theresa – whoever in Tacoma needed to request a shelter for 25 people, then Tacoma would be paying for it? Natalie - If they initiated the request, they would be paying for it. There are so many dependencies. Serena – I couldn’t’
tell you what it would cost. Natalie – for the Amtrak derailment, we brought in buses that were temperature controlled for temporary shelter. The duty officer knows where the resources are.
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Nathan – how would a mall react to us bussing people there. Is there really no plan for hot weather? Serena – the red cross is our lead in the sheltering – if we had lots of people that needed a cooling station, one would be
established.
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Question – except for an official state of emergency, someone else is on the dime. Natalie – we have to be requested. Question – the community has to establish need and request it. Serena – we are trying to get a volunteer
group to take some more work on.
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James – there could be a need for a subcommittee to address emergency management. (you could just feel the buzz of excitement at the suggestion of another subcommittee. –ed).
Legislative Update
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Federal
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Chaos at the Federal Level – within that chaos, have to keep our eye on things. New word – “Housing as Infrastructure”. Money will come, and we need to make sure it gets to our people.
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In the federal tax bill that passed a couple years ago – Opportunity Zones were created – supposedly targeted at high need economic development areas – it is the Tacoma Pierce County Economic Development board managing that program.
We have to see if there is a benefit for the folks we care about
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Martin vs. Boise has survived a new court challenge. Municipalities are taking it seriously and doing training for their own staff. If a jurisdiction doesn’t provide a place to do basic human needs (shelter), people have a right
to use public space to do that. We need to think about how we help the 18 local cities and unincorporated Pierce County come up with or review plans so we get the most possible services for our folks.
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The federal government isn’t defending Obamacare, and is working to abolish it. If Obamacare ends, we will have problems.
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State
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$1M in Transportation budget to clear encampment in City of Tacoma Right of Way – you want to keep an eye on how the city uses that $1M.
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I sent a list of all the capital budget items. $1M went to the landlord mitigation fund, which gives a 14 day notice to pay or vacate, and judicial discretion on evictions.
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State sales tax for local jurisdictions to use the sales tax for affordable housing (Yipee –ed.)
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Operating budget – I’ve lost my tracking on that and it will resurface. There is Permanent Supportive Housing money in there.
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The governor vetoed part of real estate excise tax, because he was worried that that tax was all folks need to do – he wanted to have a broader package with more support
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The debt bills – there are 4 debt bills that affect your clients
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1066 – debt collectors just can’t call you up or send you letters.
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Medical debt – people have 120 days before hospitals can start to collect.
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Surprise Medical debt - there is protection against that
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Protection against balance billing – different between what insurance company pays and what the hospital bills
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Limit interest on unpaid consumer debt - 1602 bill
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Would be good to put together some FAQs
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Might invite Laurie Jenkins to come talk about debt relief.
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60 notice for any amount of rent increase
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Child care is signed. – (applause for Kelly. –ed)
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We are a planning state – in the middle of the Comprehensive Plan amendments. The City of Tacoma and County are in the middle of amendments to the plan. The City is incorporated the affordable housing action plan. The County
is including the 4 growth corridors.
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Chris Beale – one vote preventing them from getting out of their affordable housing plan (Councilmember Beale held steady on Tuesday, but the rest of the council reversed their earlier decision. –ed)
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We have a duty and an obligation to hold up the principals we talk about, particularly when the land was once public.
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Al – off to Europe for the next two weeks (he claims it is a river cruise, but that is exactly what someone going there on a covert operation would say - -ed)
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Maureen posted about every city in the region and what percentage of occupants are rent burdened. It shows that if you earn less than $34k, you can’t afford housing.
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I’m on the behavioral health advisory board overlooking the state moneys for behavioral health. They formed a housing committee to gather information about the issue of housing and mental health.
Good of the Order
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Rich – took a tour of the Stability site with State Senator Hans Zeiger (http://hanszeiger.src.wastateleg.org/ - although when I went to his website, the headline said “INNOVATIVE
OLYMPIA PAGE SCHOOL BREEDS FUTURE LAWMAKERS”, which I’m hoping is some questionable phrasing, not a questionable program... –ed). It was a good meeting.
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Washington Low Income Housing Alliance – May 20th due date at annual conference -
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Larry – some progress and some disappointments with this legislative session. What should we focus on next – am thinking about focusing on Homeless Youth. Would like some work sessions to get idea on strategy making that would
lead to the next legislative agenda – what is it we want to get done
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Gina – working to assist homeless families on Key
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Maureen – interested in Safe Parking
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When DV shelters began, we would post information in women’s bathrooms everywhere. We could post homeless information there.
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Kara - Senator O’Ban wants to help get folks living in prison into service – looking for a cozy drop in center open before 8am so folks discharged at 5am have somewhere to go. (or, heaven forbid, just release folks from prison
at a 8am…part of me just wants to picket the jail until the pull their heads out of their Equidae equus asinus… -ed).
Coming Attractions
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May 17th, FUSE Washington – how to develop strong messaging around homelessness and how to address it
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May 24th, Committee Work Time -
and probably another presentation
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May 31st, Do people that paint bricks end up in the first ring of hell (Limbo), or is it a direct path to the 6th ring (heresy). Our panel includes experts from the afterlife, including St. Peter and Dante
himself, as well as Don King, because, why not. Hear the evidence, ask some questions, and come to your own conclusions.
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June 14th, City of Destiny Awards – bask in the glory of the Coalition’s recognition
Restaurant Review
While I tent to avoid fast food, I’m not always successful. I do a have a soft spot for the beans and rice at Popeye’s, and the occasional Taco Bell 7-layer burrito does end up in my hand. But a recent find in the healthier “near fast-food”
category has been the Pita Pit (921 Pacific Ave, Tacoma, WA or 4784 Borgen Blvd, Gig Harbor, WA or elsewhere). Yes, it is a chain, but a Canadian chain, so that somehow makes it OK. It is basically a subway type operation, but with a Pita for bread,
a middle-eastern menu lean, and a lot of great veggies. At most fast-food delis like subway, the meats and breads are a bit suspect – usually rather over-processed, and taste that way. Pita Pit largely avoids that. I typically get their falafel sandwich,
with has OK falafel, but the fresh cucumbers, tomatoes, onions, spinach, feta and some quite good tzatziki (yogurt with cucumber and garlic) make the sandwich a joy. My 14 year old goes for a custom job, with chicken, hummus (surprisingly good) and a bunch
of veggies. The Pita Pit will absolutely appeal to your teenage epicure. Yes, Pita Pit’s meats seem a bit processed – but less than their competitors. It is still a chain, after all. But you have some good veggie options, and can pile on the fresh veggies
in an absolutely delicious way. There is a gluten free pita option, it being the 21 century and all. Typically, we’ll stop there on our way to a day hike somewhere - the sandwiches hold up great to a few hours in the bag – and as we sit next to a raging
river, they make a great meal. They’ll do a catering tray as well, for a bit of a change of pace at you next lunch work session. Anyway, next time you’re heading to the foothills trail for a bike ride and picnic along the Carbon River, you might consider
a stop at pita pit on your way out of town. Mid-exercise, your body with appreciate the protein and the veggies, and what few carbs are there will fuel your further adventures.
Attendees:
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Donald Pitchford, House of Prayer Foundation
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Kristinia Argent – Community Volunteer
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Kara Koehn – Northwest Integrated Health
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Dave Venes – Dave Purchase Project
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Paul LaKosky – Dave Purchase Project/Tacoma Needle Exchange
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Bruce Morris, Chaplain, Tacoma Fire Department
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Hanna Carol-Day, Tacoma Needle Exchange
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Shelly Lileks, Northwest Integrated Health
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Laura Reynolds, Tacoma Needle Exchange
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Serina McWha, Pierce County Emergency Management
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Al Ratcliffe, Me
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Martha Sheppard, Tacoma Salvation Army
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Carrie Ching, Molina Healthcare
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Pamm Silver, Molina Healthcare
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Patty Schneider, Catholic Community Services
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Bill Harrison, Medicare
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Gail Misner, Molina Healthcare
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CC Mendoza, Metropolitan Development Council
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Andrea Sanz, Tacoma Rescue Mission
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Brendan Baker, Veterans Administration
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Charleen Fitzgerald, Coordinated Care
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Jeremy Walk, Housing Advocate
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Elijah Moon, Department of Social and Health Services
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Maureen Howard, Housing Advocate
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Gina Cabiddu, Children’s Home Society Washington
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Larry Seaquist, League of Women Voters
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Carolyn Read, St. Leo’s Parrish Volunteer
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Alina Flores, Sea Mar Community Health
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Kayla Scrivner, Tacoma Pierce County Health Department
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Reginald Blackman, NW Integrated Health
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Tim Jumper, Sound Outreach
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Kelly Blucher, Goodwill
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Marybeth McCarthy, Tacoma Community College
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Kevin Glasel, Tacoma Community College
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Richard Berghammer, Fellowship Bible Church
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Greta Brackman, Comprehensive Life Resources
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Nathan Blackmer, Comprehensive Life Resources
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Natalie Stice, Pierce County Emergency Management
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Theresa Power-Drutis, New Connections
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Yuki, Coordinated Care
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Joy Stanford, Shared Housing Services
Gerrit F. Nyland
Director of Client Information Systems, SW
Catholic Community Services of Western Washington
Mobile: 253-304-5105