Monthly Archives: April 2021

After a devastating wildfire season that saw a baby boy die and 1,200 square miles of the state burn, Washington lawmakers are poised to fight fire with money. A lot of money.

Legislation thats received unanimous support would see Washington spend an additional $125 million over the next two years to extinguish, prevent and live with fires. Both legislative houses have passed House Bill 1168 and Gov. Jay Inslee is expected to sign the bill, which would see the state spend $328 million on the efforts by 2027.

The push, led by Department of Natural Resources Commissioner Hilary Franz, would see the state hire 100 firefighters and replace antique firefighting equipment. A forest restoration workforce paid to make Washingtons state and some federal lands less combustible would be created almost from scratch, and communities in fire-prone areas most of Eastern Washington would be better protected from fire.

To its supporters, the funding represents a consequential step toward combating the fires that are consuming huge swaths of the state. Since 2015, 4,843 square miles of Washington have burned, an area the size of Connecticut that accounts for nearly 7% of Washingtons total land mass. That toll is only expected to grow as climate change shrinks snowpack and delivers hotter, longer summers.

While she stressed that it will take years to change the nature of wildfire in Washington, Franz said the funding will change the trajectory of the states fire fight.

Relying on luck and hope during fire season has turned our wildfire problem into a crisis, Franz said by email. This is absolutely a turning point in our fight to protect Washingtons communities and natural resources from smoke and flames.

A firefighter uses an ignition tank to set underbrush on fire during a prescribed burn in Okanogan-Wenatchee National Forest near Liberty, Wash., in May, 2019. More prescribed burning and thinning of forests to promote forest health will be possible now that the Legislature reached bipartisan agreement on funding such projects. (Photo: Dan DeLong/InvestigateWest)

Washingtons fire history can be reduced to numbers and dates, figures Rep. Larry Springer recited for the House in early March. In the 1990s, about 134 square miles of the state burned on average each year. By the 2000s, that number rose to 295 square miles. During the past five years, it stood at 763 square miles.

In the statehouse, though, the story of Washington summers of flame and smoke came through in snapshots offered by senators and representatives. Front of mind were the death of one-year-old Uriel Hyland, a Renton boy killed as his parents fled a central Washington fire in August, and the destruction of Malden, a town of 300 burned in a September firestorm south of Spokane.

Eastern Washington lawmakers also spoke to the smaller pains of life now shaped by fire.

Rep. Alex Ybarra, R-Quincy, described flakes of ash wafting in the air like it had after Mount St. Helens erupted. Rep. Marcus Riccelli, D-Spokane, spoke of the summer youth soccer practices canceled because of the smoke. With hundreds of homes lost to fires, said Rep. Joel Kretz, R-Wauconda, said Okanogan and Ferry counties now face a homelessness crisis.

When you lose the number of homes weve lost in a tight market, it takes a long time to replace them, said Kretz, who joined Springer in sponsoring the bill. Weve still got people living in camp trailers who lost homes two years ago.

Washingtons bigger burns are the result of two environmental debts coming due climate change driven by humanitys greenhouse gas emissions, and mismanagement of the forests and scrubland in the state. While the legislation acknowledges the former, it addresses the latter.

Following the U.S. Forest Services lead, land managers spent most of the 20th century extinguishing as many wildfires as they could, as fast as they could. Aggressive firefighting has left forests across the western United States primed for megafires like those that devoured 1,600 square miles of Washington timberland in 2015, creating an ash-gray moonscape. On the dry slopes east of the Cascades, brush, branches and dead trees that wouldve burned under natural conditions, clearing out the underbrush and some trees, are now packed too tightly for trees to stay healthy.

A 20-year plan put forward by the Department of Natural Resources estimated that about 1,950 square miles of Washington forest need intervention to be brought back to health. While much of that is managed by the U.S. Forest Service, the legislation would expand the states ability to help revive federal land.

Large as it is, infusion of funding wont clear Washingtons summer skies or stop the fires from burning. But it is an important step toward limiting the human and ecological damage they cause, said Rachel Baker, forest program director for the Washington Environmental Council.

The aim isnt to stop all fires everywhere, Baker said. A century of doing so is part of the reason Washington forests are burning so intensely now; forests, particularly those in dry climates like Eastern Washington, are healthiest when they regularly see low-intensity fires that clear the forest floor and destroy the combustible materials that fuel catastrophic blazes.

The reality is that wildfires are going to be an ongoing challenge we face because of climate change, Baker said. Wildfire is here to stay.

A downed tree is engulfed in flames during a prescribed burn in Okanogan-Wenatchee National Forest near Liberty, Wash., in May 2019. (Photo: Dan DeLong/InvestigateWest)

That is not to say, Baker continued, that wildfire cant be made less damaging by fixing Washingtons forests.

Removing the excess fuel that has built up will make forests less likely to burn to ash when fire does arrive; larger trees will weather the low fires, as they had for millennia.

For decades, money meant to go to prevent fires by improving forests has been shifted by necessity to firefighting. Going forward, Washington would build up a robust workforce trained to clear underbrush and thin forests either by hand or through controlled burns, a practice used only sparingly in Washington and most western states.

While the funding hike directed toward forest restoration is only half that going to firefighting, that $17 million-a-year boost represents a dramatic shift in the state.

The legislation would enable Washington to set up programs at Washington State University and elsewhere to train a forest restoration workforce. Students would learn to remove underbrush and snags while thinning stands where trees grow too densely. Some would also be certified to use controlled fire to clear out the forests, a technique that is often more efficient and can, if conditions are correct, restore much larger swaths of forest.

At present, the forestry industry lacks trained workers to meet the demands ahead, said Jason Callahan of the Washington Forest Protection Association, a trade group representing private owners of forestland.

If theres no one to do the work, it wont get done, Callahan told the Senate Ways and Means Committee.

Labor shortages are a real thing in the forest products industry, he continued. These are skilled, green jobs that pay well above the average wages in rural communities.

Most of the money, though, will go toward firefighting, which would receive 56% of the new funding. Protection is a pressing concern, as about 951,000 homes in Washington sit near forests threatened by wildfire.

The most endangered communities lie in a swath extending from Spokane southwest to the Columbia River, and then running north past Wenatchee into the Methow Valley. Much of Central and Eastern Washington, in other words, where summer fires have become a constant.

Fire season is unfortunately becoming the fifth season, Paul Jewell, a lobbyist for the Washington Association of Counties, told the Senate Ways and Means Committee. During the same hearing, Laura Osiadacz, a Kittitas County Commissioner and volunteer firefighter, described fire as literally an annual event on the east side of the Cascades.

Washington state firefighters rely on Cold War-vintage surplus equipment, making fast and decisive firefighting difficult. As envisioned in the legislation, $35 million a year will be spent to build up the states wildland firefighting force by more than 100 firefighters and 20 bulldozers and bring it into the 21st Century.

A firefighter watches a prescribed burn as it approaches a forest road that will be used to contain the fire in Okanogan-Wenatchee National Forest near Liberty, Wash., in May 2019. (Photo: Dan DeLong/InvestigateWest)

The bill would see the Department of Natural Resources fleet of Vietnam War-vintage helicopters upgraded two of the Hueys would be set up, for the first time, to fight fire at night and reinforced by new fixed-wing aircraft. One of the planes, a Pilatus PC-12, would fly high-speed detection missions searching for fires with infrared sensors. The expansion is expected to cost $14 million in 2023, and then about $3.3 million a year going forward.

Another $1.25 million a year would fund a camera system to replace the fire lookouts that generations ago spent the summers living atop dozens of Washington peaks. The lookout system has been dismantled over the past 25 years without replacement. Under the bill, the Department of Natural Resources would place cameras on mountaintops to watch state lands prone to lightning strikes and human-caused fires.

Those investments arent a signal that Washington is poised to return to putting out all fires everywhere, the strategy that landed the state and much of the West in its current predicament, said Baker of the Washington Environmental Coalition. The aim, she said, is to effectively fight the fires that must be fought while shaping the forests and communities near them to thrive with fire.

A couple decades down the line, I would hope to see fires on the landscape that arent affecting people and are in keeping with the character of the ecosystems, Baker said.

Thanks to the legislation, crews made up of inmates from state prisons would also, for the first time, be paid more than a pittance for their time on the fire lines. Department of Corrections-staffed crews, which amount to 330 firefighters, would be paid at least minimum wage for their work.

Beyond that, the Department of Natural Resources is expected to create a firefighting crew comprised of people who learned the trade while incarcerated. The 20-person crew would work year-round rehabbing state forests and conducting controlled burns between fire seasons.

Addressing the House on March 9, Springer told his colleagues that waiting for Mother Nature to deliver deeper snows or wetter summers was delusion. A plan is needed, he argued, and the one Franz brought forward is it.

While legislators dickered over aspects of the bill, not one ultimately voted against it.

In a legislative session that has seen the Republican minority complain helplessly as Democrats acted on nearly all of their environment-related priorities, the fire bill was exceptional. Sen. Keith Wagoner, R-Sedro-Woolley, described the bill as the most important piece of legislation to pass through the Legislature this session other than the pandemic relief package.

Legislative Republicans loudly praised the Department of Natural Resources which often serves as a foil for the GOP, and timberland Democrats and its chief, Franz, a Democrat who held leadership roles in several environmental advocacy organizations before being elected as Public Lands Commissioner in 2016.

Commissioner Franz has done an exceptional job of bringing a huge amount of energy and enthusiasm to her position, and, frankly, I believe shes transformed her agency, Sen. Brad Hawkins, R-East Wenatchee, said on the Senate floor.

Franz or her successors will have to draw on that goodwill deeply in the years ahead. Even those celebrating the landmark investment in firefighting and prevention acknowledge that it is a start, not a solution.

This is an all-hands-on-deck moment, Franz said, and we will rise or fall together.

Where the money goes

Firefighting $70.8 million

Aerial firefighting: The state plans to spent $17.2 million to buy new aircraft and improve its aging helicopter fleet. It will also begin contracting for another large air tanker, to dump more fire retardant on large fires.

Firefighters: Adding more than 100 firefighters and paying minimum wage to Department of Corrections crews staffed with incarcerated people will cost about $16.4 million.

Bulldozers: Another $11.3 million will go to buy and staff 20 bulldozers, which will be used to create fire breaks between fires and populated areas. At present, the Department of Natural Resources has only one bulldozer dedicated to firefighting.

Local fire crews: The department will spend $11.8 million expanding local fire departments in fire-prone areas of the state.

Forest restoration $34.5 million

Restoring fire-prone forests: Through a variety of programs, the Department of Natural Resources will spend $14.5 million to clear brush and fallen trees from dense forests, leaving larger trees more likely to survive when fire does come.

Assisting small landowners: The state expects to spend $9.4 million helping owners of small forests clean up their timberland to make it more fire resistant.

Fixing federal land: Another $7.9 million will be spent restoring federally owned forests near state forest land.

Living with fire $19.6 million

Hazard reduction on private land: The Department of Natural Resources will spend $6.6 million helping residents of fire-prone areas make their homes and properties more resistant to fire.

Community grants: Another $4.3 million will be devoted to grants to help communities are risk of catastrophic fires prepare for them.

Feature image: Firefighter Steven Thime hops onto a tree stump to survey the progress of a prescribed burn in Okanogan-Wenatchee National Forest near Liberty, Wash., May 7, 2019. (Photo: Dan DeLong/InvestigateWest)

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Hundreds of firefighters. 20 bulldozers. Intentional burns: Inside Washington's $328M push to break cycle of disastrous fires - InvestigateWest

The pandemic has worsened attitudes toward end-of-life care, a panelist said during an online conference Wednesday.

A recent qualitative study found that older adults are resistant to advance care planning, dont understand palliative care and have low trust in the healthcare system, commented Bill Novelli, professor of practice at Georgetown University, McDonough School of Business; and former CEO of AARP.

They basically see healthcare as politicized and they see healthcare as a business, said Novelli, a panelist during the Nathan Adelson Hospice Multicultural Symposium. Nathan Adelson is a nonprofit hospice in southern Nevada.

The pandemic also has widened ethnic and racial disparities regarding access to end-of-life care, he and other panelists said.

While she does not have the data to prove it, Rutu Ezhuthachan, M.D., medical director of United Healthcares Health Plan of Nevada Sierra Health and Life, said she believes fewer people entered end-of-life care facilities during the pandemic.

Novelli agreed. People were less willing, more reluctant to enter hospice, he said.

The pandemic laid bare racial inequities, as various races, at various points, were dying disproportionately from COVID-19 in Nevada, noted Jose Melendrez, executive director of community partnerships at the School of Public Health, University of Nevada, Las Vegas. Its important to engage stakeholders from different racial ethnic communities to help to bridge the equity gaps, he said.

When it comes to diversity, we have to be very intentional about our decision to engage them and they have a voice at every level said Melendrez, a founding member and chair of the Nevada Minority Health and Equity Coalition.

Tom Koutsoumpas, CEO of the National Partnership for Healthcare and Hospice Innovation, agreed. Underserved communities inability to access quality care is demonstrable, he said. We have to be intentional about creating measurable change, he said.

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Pandemic affected access to end-of-life care, widened inequalities, panelists say - Home Care Daily News - McKnight's Senior Living

Q&A

Heres how Penn Medicine, Trinity Health, and community faith leaders collaborated on operationalizing equity around COVID-19 vaccine distribution.

Since mid-February, a health system and community leader collaborative has been working to improve vaccination disparities in Philly. Photograph courtesy Penn Medicine

Nearly four months since the first COVID-19 vaccine was administered in Philadelphia, health commissioner Thomas Farley announced on Tuesday that the city administered its one millionth dose. Though a milestone, the city still has a long way to go only 22 percent of Philadelphias total population is fully vaccinated, according to CDC data.

More urgent, though, is the ongoing racial, economic, and geographic disparities that exist regarding vaccine sign-up and distribution.The city has attempted to close the vaccine equity gap by allowing walk-up appointments at the Center City FEMA site, operating health department clinics in traditionally underserved neighborhoods, and opening a second FEMA location in Hunting Park focused on reaching the Hispanic community. And since February, Ala Stanfords Black Doctors COVID-19 Consortium has been administering vaccines for residents of the Philadelphia zip codes with the highest incidence of COVID-19 disease and death.

The disparities in vaccination in Philadelphia have also inspired a collaboration between Penn Medicine, Mercy Catholic Medical Center-Mercy Philadelphia Campus, and community faith leaders, who worked together to launch a rotating vaccine clinic. Since mid-February, the partnership has run seven clinics out of churches, recreation centers, and school gymnasiums in West, Southwest, and South Philadelphia. In their first three clinics, they vaccinated 2,821 people, 85 percent of whom were Black.

On April 7th, the organizers behind the clinic detailed their methods in NEJMsInnovations in Care Deliveryjournal, in an article titled Operationalizing Equity: A Rapid-Cycle Innovation Approach to Covid-19 Vaccination in Black Neighborhoods. In it, the authors describe how the unique partnership between two health systems and community leaders worked to combat the structural barriers preventing communities of color from accessing vaccinations.

To learn more about their efforts, triumphs, and challenges, we spoke with Kathleen Lee, director of clinical implementation at Penn Medicines Center for Health Care Innovation and assistant professor of emergency medicine at Penn, who helped design the clinic model.

NextHealth: Why did this rotating vaccination clinic get started?Lee: The genesis of the clinic stemmed from ongoing conversations our C-suite was having throughout the pandemic about the racial inequities related to COVID-19. Though, its important to note that this was a huge coordinated effort between us at Penn Medicine, Trinity Health, and faith leaders throughout the city, including Terrilynn Donnell, [pastor] W. L. Herndon, and [reverend] William Shaw. When it came to the topic of vaccines, we knew that one of the major driving factors of disparity is the structural barriers that limit vaccine access to underserved communities, specifically Black and Brown communities. Around January, we took an intimate look at those barriers as they emerge across Philadelphia in order to determine how to best create an incredibly inclusive environment for getting vaccinated. Around the same time, conversations started taking place between the health systems and community leaders to cultivate relationships and to leverage community networks and healthcare partnerships.

What did the collaborative identify as major barriers to vaccine access, and what were your solutions?We found that geography and technology were preventing ease of access, so we brainstormed ways to create rapid-cycle solutions for a wide-spread implementation effort. We decided vaccine administration needed to be done in communities themselves, instead of making patients travel to a healthcare setting. Also, we built an SMS-based and an interactive-voice recording system for folks to schedule vaccine appointments. Overall, our objective was to have multiple, low-tech intake strategies with every step coordinated with and for the community to ensure that equity was at the core of every aspect of the endeavor. In a matter of months, we had created the #VaccineCollaborative, a novel multi-health system, community-partnered COVID-19 vaccination clinic.

What have you found to be some of the clinics biggest accomplishments?Seeing the uptake work with the scheduling paradigm we created was truly delightful. Our first clinic location filled so quickly, and it was great to know that people were able to schedule their appointment in a way that is easier to use. Similarly, many folks had signed up a loved one who wasnt able to do it themselves. That digital nudge drove home how communal and community-driven our effort was. But the uptake was reflected in more than just the scheduling system. In our feedback surveys, we had people write, It was like you were glad to see me (we were!) and Thank you for having clinicians who look like me. That kind of feedback is invaluable.

Another major accomplishment was the streamlined process we designed. As I said earlier, we strove to accommodate all types of sign-up strategies, rather than relying on one technique. It allowed us to honor walk-ins, which we know is very important to many people, especially those who need a no-technology method. We also made sure to create a no/low-wait experience by conducting a group-based consent process and having our vaccinators use Ready signs. That way, patients were shuttled through not in a rushed way, though so that they didnt have to deal with long lines. This was especially helpful when it was extremely cold outside. Nobody deserves to wait in the cold!

Those providing the vaccines used Ready signs to keep patients moving through the clinic and reduce wait times. Photograph courtesy Penn Medicine

What challenges did the collaborative face along the way?Setting up a novel clinic in a non-healthcare environment is a big task to take on. We leveraged resources from the healthcare systems to bring all the necessary supplies on site, including vaccine refrigerators, monitoring equipment, medical supplies, wheelchairs, and other items. Seeing a nimble operation happen outside of a hospital setting was amazing. We did run into some infrastructure challenges at the beginning, which we anticipated might happen. For example, at the recreation center, we discovered there werent enough accessible entrances for patients with limited mobility. In response, our health system employees tapped into their networks and got a custom ramp donated.

Another hurdle arose when more people outside of our targeted group became interested in getting vaccinated at our clinics. From the beginning, weve been very transparent and intentional with our mission in order to promote equity for local residents. Thats why we added a preliminary step on all our engagement platforms that required active acknowledgment of our mission statement prior to signing up. (It reads: IMPORTANT: The purpose of this clinic is to address the vast racial inequity in COVID outcomes and vaccine distribution by vaccinating our West & Southwest Philly *Black and Brown* communities hit hard by COVID. Here are the zip codes this clinic is designed to serve: 19104, 19131, 19139, 19142, 19143, 19151, 19153.) Though we didnt turn anyone away or validate based on race or Philadelphia zip code, we found that about 36 percent of individuals who started the text process didnt follow through with signing up after reading the mission disclosure.

How might this model be applied to other communities outside of Philadelphia?Our model was designed for generalized ability and scalability, but putting it into action does require intentional and coordinated effort, resourcing, and leadership. And in order to promote vaccine equity, diversity and inclusion need to be at the forefront every step of the way. I think our article says it best in terms of steps to take: Engage community leaders early to inform design, activate their networks, and build bridges of trust between health systems and the community around vaccination. Embrace no/low-tech platforms to support vaccine ambassadorship and distribution. Reimagine clinic flows to enable an on-time model with minimal to no wait to ensure an uncompromising patient experience. Though partnerships have to be done at every level, I do think leaders in the healthcare system should be role models and take initiative in order to truly help and improve the lives of community members. If not us, then who?

Where do you see this rotating clinic going from here?We plan to be intentional about this long-term and hope to extend the pilot for months to come. We already submitted an RFP to city officials, which has been approved.

More here:

Pop-Up Clinic Working to Improve Philly Vaccination Disparities - Philadelphia magazine

A group of business and community leaders will advise Oakland County Executive Dave Coulter and his team on how to best leverage $244 million in federal funding coming the county's way.

The $1.9 trillion American Rescue Plan was signed by President Joe Biden last month, which includes billions in COVID-19 assistance for state, county, and local governments.The county is expecting to receive around $244 million in direct funding from the American Rescue Plan.

Coulter's plan is to develop an intentional and targeted strategy in order for these new federal dollars to make the biggest short-term and long-term impact. To help in those efforts, he has reconvened and expanded the 31-member 2021 COVID-19 Economic Recovery Task Force.

Oakland County communities receiving millions in federal aid from American Rescue Plan

Local governments experiencing 'dramatic change' during COVID-19 pandemic

The group of business and community leaders will provide insight to county officials on the greatest community needs and advise them on how to best utilize the new funding. Individuals representing theeducation, foundation, local government, construction, restaurant, labor, health care and business communities will be on the task force.

Our first priority for this funding from the American Rescue Plan has to be continuing our fight against the coronavirus pandemic and ensuring economic recoveries, said Coulter. But we also will have the opportunity to take on some transformational projects that will help improve the lives of our residents and businesses. This group of advisors can provide invaluable insight into the needs in the community.

The task force will meet for the first time on Monday, with Coulter asking each member to share their thoughts, experiences, and expertise on where the county is in its recovery from the pandemic and what needs to be accomplished in the coming months to ensure a full recovery.

During the meeting, the task force will review current economic and community data, American Rescue Plan funds, and discuss indicators for the county's future.

Last year, we were dealing with the daily demands of an unprecedented public health crisis, said Coulter. But now, we can be more strategic and intentional with the federal funding and I look forward to working with these and other community leaders to help crystalize our short, medium and long term plans.

Last spring, the county received $219 million in federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funding. The county utilized this funding to award grants to more than 15,000 local businesses; 22 local chambers of commerce; 57 cities, villages, and townships, 278 non-profit and 31 veterans services organizations; 28 local school districts as well as retailers, restaurants, cultural institutions, and community centers.

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Business as usual at area high schools, despite Whitmer's request for pause

COVID vaccine hesitancy could be affected by breakthrough cases, Johnson & Johnson pause

Henry Ford COVID model predicts hospital surge to plateau in 2 weeks

Whitmer urges use of COVID treatments; does not place new restrictions

Excerpt from:

Dave Coulter reconvenes task force to leverage $244 million in federal aid - The Daily Tribune

What do we gain when we include diverse communities in the conversation on climate change? And what do we lose when we dont?

On Tuesday, April 20, at 7 p.m., scientists, engineers, experts and leaders from diverse backgrounds including School of Education PhD students Dawn Crim and Yaa Oparebea Ampofo bring their perspectives to the state of the regional, national and global conversation about climate change at a virtual Crossroads of Ideas discussion.

This event is being moderated byCrim, who is the Secretary of the Wisconsin Department of Safety and Professional Services, and a PhD student with the Department of Educational Leadership and Policy Analysis.

Sign up to receive the webinar link.

The past year has revealed in stark terms what many of us already knew: Every crisis disproportionately affects people, communities and businesses of color, says Crim. It is possible to reverse these patterns of inequity, but to do that we need to be intentional. We must work with and listen to the people, communities and businesses we seek to help.

The April 20 webinar will feature:

The Crossroads of Ideas program is apublic lecture series that addresses vital social science topics.

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Crossroads of Ideas exploring equity and climate change April 20 - School of Education - University of Wisconsin-Madison