Dear fellow King County employee,

Eric Stark

Last week one of our own employees was injured in the line of duty, a victim of a senseless act of gun violence.

Eric Stark, a seven-year Metro Transit employee and member of the Amalgamated Transit Union, demonstrated extraordinary heroism when, after having been shot, he steered his Metro coach and passengers away from the shooter to safety. His quick thinking prevented further injuries and likely saved lives.

Eric’s courage and selfless commitment to his passengers is remarkable and inspiring, and I know you join me in wishing him a speedy recovery. As a community we grieve the lives lost in this terrible and senseless incident, and look for answers to why it happened.

This event is another tragic reminder that we must act to end the epidemic of gun violence that plagues our nation.

King County has embraced a public health approach to gun violence, using research and data to develop solutions to help prevent firearm tragedies from occurring in our community. We are partnering with local retailers on the Lok-it-up program, which can prevent firearm theft and keep guns from getting into the wrong hands.

State and federal law pre-empt our ability to regulate firearms, but that won’t stop us from doing what we can do within our own authority to fight this scourge.

We need support from our leaders at the national level to continue this fight. It’s time for them to show the kind of bravery and selflessness that Eric displayed, to take a stand to end the culture of gun violence in this country.

Sincerely,

Dow Constantine

King County Executive

During 2017, employees from the Public Health – Seattle & King County Community Health Services Division (CHS) suggested their Leadership Team spend more time with CHS employees getting to know them and their work. After viewing the results from the annual employee engagement survey, this seemed like a great opportunity to help leadership learn about the work being done by front line employees and share more information about roles across the division.

This project became known as “What’s My Job?” and included a member of the CHS Leadership Team spending up to a half-day on the job with employees – observing, helping, participating or discussing (or all of these). CHS Employees were encouraged to submit a request.

“The project does even more than help us know the employees and their work – we also get to understand clients, and it opens pathways for employees to stay in contact with members of the Leadership Team,” said TJ Cosgrove, Director of CHS Division.

One recent “What’s My Job?” opportunity included a visit at the downtown Seattle Buprenorphine Pathways Program. The “Bupe” program is an on-demand opioid treatment program at Downtown Public Health Center, in partnership with the Robert Clewis Center Needle Exchange.  It is one of the most innovative programs in Public Health – and staff are working with some of the most challenging clients in King County.

CHS’ Michelle Pennylegion, Program Quality Manager, and Maureen Peterson, Finance and Administrative Services Manager, spent a half-day with the program.

“Evident to us from the moment we arrived was how our staff engage, relate to, and join with each client who bravely enters the clinic seeking our help and care,” said Michelle.

To make the most of their visit, they split up. Michelle spent her “What’s My Job?” with Advanced Registered Nurse Practitioners Wendy Dell and Shana Cantoni, hearing real stories from several clients. Maureen spent her time with Community Health Worker Malin Hamblin and Dr. Joe Breuner, from Swedish Family Residency, to learn about the importance of creating relationships with clients. Bupe team member and Registered Nurse Mandy Sladky was out during the visit. Below are testimonials from Michelle and Maureen about their visits.

Michelle Pennylegion, Program Quality Manager, shares her experience with Bupe Advanced Registered Nurse Practitioners Wendy Dell and Shana Cantoni

“With Wendy and Shana, I instantly felt their genuine and gentle style, which helps create an atmosphere of openness and safety. I believe our clients also feel this as soon as they enter the clinic space,” said Michelle.

Michelle explains how this safe environment means that providers can elicit both general and specific information from clients, and clients are able to share intimate details about their struggle and the impact these struggles have on their lives.

“It became clear to me that when clients are able to share honestly, they can receive more complete care, such as gaining access to needed resources and other support,” she said.

Michelle also notes how humbling it was to listen as clients told their stories.

“There was a client who shared about his ‘life-long’ struggle seeking and receiving treatment,” she said. “He was grateful for the staff and the Downtown Public Health Center because he didn’t have to repeatedly relive his past negative experiences.”

Maureen Peterson, Finance and Administrative Services Manager, shares her experience with Bupe Community Health Worker Malin Hamblin and Dr. Joe Breuner

“I saw right away how important it is to meet clients ‘where they are’ and how Bupe staff are not judgmental toward their clients. Our providers are trying to help clients make short-term decisions that will get them to the point where they can make the decision to quit using,” said Maureen.

Maureen explains how Bupe staff build relationships with their clients by sharing information with each person in a direct compassionate manner.

“Malin does a little bit of everything and believes in ‘loving people when they are not at their best’,” said Maureen. “She has a gentle personality and shows great compassion, drawing from nine years working in needle exchange.”

“Wendy is a prescriber for the program, and is very straightforward while still being very kind,” said Maureen. “Clients were open with her, and they discussed goals for the week without dwelling on anything negative.  The visits were quick and delivered in a positive way.”

It is this gentle, empathetic way Bupe employees interact with their clients that help contribute to their recovery, notes Maureen. Regardless of their situation, Bupe staff are here to help.

“Joe provided treatment to a client in the context of a family medicine visit,” she said. “Clients are provided the same straightforward, caring treatment from Joe and discuss their goals with him.”

Excited to expand service to clients in 2019

The Bupe program began as a pilot in 2016 in whatever space could be made available at the Downtown Seattle Public Health Center. This was to demonstrate that King County Public Health can create a “low barrier” program for opioid treatment, which means clients get suboxone on their first visit. For the expansion occurring later this year, the program will move to the 4th floor and will triple its capacity to service clients.

Maureen and Michelle could see how Bupe staff were incredibly positive about the program and the care they provide, and are looking forward to the expansion.

“Ultimately, we were struck by the uniqueness of each client’s journey – and how our wonderful staff stand with clients, without hesitation, as they each take their next step and then help again as they navigate to the next,” Michelle and Maureen wrote in their follow-up message to staff. “Thank you Bupe Team for introducing us to your amazing work!”

For more information about the Bupe program visit the King County Heroin and Prescription Opiate Addiction Task Force website.

Becoming a trauma-informed organization

Patty Hayes, RN, MN is director of Public Health – Seattle & King County. She is responsible for the operations of the 9^th largest public health department in the U.S. (ranked by population served); a staff of nearly 1500; six divisions; and delivery of public health services to the more than 2 million people who live in and visit King County.  Public Health touches King County communities in untold ways, including disease investigation and control, food safety through restaurant inspections, health and wellness services for low income moms, babies, and families; refugee health, emergency medical services, chronic disease and injury prevention, health services for inmates in King County correctional facilities, and much more. Public Health – Seattle & King County is nationally recognized as a leader in implementing innovative public health services, and has a deeply held commitment to delivering high quality and equitable services to all. One recent innovation that Patty is excited about is transforming Public Health into a trauma informed health department. We sat down with her to learn more.

Patty, what does it mean to be a trauma informed organization?

Understanding the widespread impact on health of intergenerational trauma, racism and oppression is core to effective public health work. The effect that direct and vicarious trauma has on individuals, communities, organizations and systems needs to be recognized as a huge impact to the health and well-being of individuals and communities. Knowing the potential paths for healing and recovery means that public health must work to be trauma informed and wellness focused in all of our lines of business. One key aspect of that is recognizing the signs of trauma in communities, understanding how our policies and systems perpetuate this trauma and then responding by integrating this knowledge into improving policies and practices. We also need to actively promote healing and to prevent re-traumatization by and among staff, communities and systems.

Why is bringing a trauma informed lens to your work important?

There is now an abundance of evidence showing that trauma and toxic stress are common, and can have significant impacts on people’s health. We want to reduce the negative impacts of trauma on the health of King County communities; to promote integration of core concepts of trauma-informed practice; and to create a shared culture and common language – beginning with our own staff. If we can wholly embody our trauma-informed-guiding-principles as a staff and organization, we will be better able to collaborate with communities to improve their collective health. Being trauma-informed is really about a long term, sustainable culture change.

How have you implemented this approach at Public Health?

Because of the discrete and disparate lines of business in the department, each of our divisions needs to explore how to bring a trauma informed approach to their work. We are implementing our Guiding Principles through three main strategies – training, mini-grants for staff projects, and Human Resources (HR) systems change. Training means developing a core curriculum and building staff capacity to offer training, as well integrating trauma-related information into our department’s existing employee orientation and other trainings. There were 25 staff-led projects that were funded by mini-grants in order to explore what our Guiding Principles mean in the context of their division of team’s unique lines of business. Finally, we are exploring recommendations regarding our HR policies and practices, including developing a more restorative, healing and prevention oriented approach to HR problem solving and investigations.

Where will this effort go? What’s next?

To have a trauma informed practice become part of the fabric of our public health practice will require continued effort. This is a journey in lock step with our Equity and Social Justice work. We are talking with our staff about the next leg of that journey. There is no roadmap for this work, and culture change takes time. Some of what’s being considered is how best to integrate this work with our Equity and Social Justice mission, how to  partner with other County departments and initiatives, and how best to sustain and evaluate our progress going forward.

Conflict Awareness in the Workplace, April 18: We all encounter difficult people. Whether you are a supervisor, a customer service professional, or have a challenging co-worker, it’s important to know how to rise above your initial emotional reaction and turn negative situations into positive outcomes. Topics include understanding why we label people as difficult, types of difficult people, tools and techniques for resolving issues, coping strategies for dealing with the effects of difficult people, and conflict management strategies. Register and learn more.

Introduction to Organizational Performance Measurement, May 8: Have you ever struggled to create measures for your program? Do you ever find yourself getting lost in the sea of measurement jargon? Do you ever wonder why we even measure organizational performance? If you find yourself answering “yes” to any of these questions and have a desire to improve your skills and knowledge of organizational performance measurement, this course is for you. Register and learn more.

View more learning and development opportunities at www.kingcounty.gov/learning.