How is Thurston County addressing its public health challenges? New director speaks

Ebola cases started popping up in the United States in 2014, just a few years into David Bayne’s career at the Georgia Department of Public Health. His experienced there affirmed his commitment to public health and kept him on a trajectory that led him to Thurston County.

“I watched people who had never heard of public health before, all of a sudden go, ‘Who are these guys?’” Bayne said. “That was a real trigger point for me of going, ‘I would love to be in a place where I’m helping the average person understand the role that we have for them.’”

Bayne rose to Director of Strategic Partnerships and Policy in his nearly seven years at the department. Reflecting on his time there, he said he would often pivot from responding to an infectious disease outbreak to helping a family access food programs and preparing for emergencies.

“It’s never ending,” Bayne said. “Even in the time I’ve been in public health, it’s grown. ... There’s always pieces of the puzzle that keep getting in. I love that. Public health is in all things, ultimately. It’s one of the few areas where you can say that with a straight face.”

Thurston County hired Bayne to lead its Public Health and Social Services Department (PHSS) in December with a $145,000 starting salary, The Olympian previously reported. He replaced interim director Kurt Hardin who filled the role left by former director Schelli Slaughter at the start of 2022.

PHSS responds to a range of health issues, from infectious diseases to homelessness. It also regulates food safety, septic systems and more. In Bayne’s words, the department aims to improve the safety and health of the county population wherever it’s most at risk.

Over three months into the job, Bayne sat down with The Olympian to discuss his past experience and current vision for the department. The discussion occurred as the department has been transitioning away from its heavy focus on COVID-19, responding to a worsening opioid crisis and working to mitigate homelessness.

Bayne’s journey to Thurston County

Bayne moved to Thurston County in 2018 to work at the Washington state Department of Health. He served as Deputy Secretary of Strategic Partnerships until becoming the county’s PHSS director.

Though he loved working for Georgia and Washington state, Bayne said he has a soft spot for county health departments.

“The state in many ways operates as a pass-through for a lot of funding and provides a lot of high-level guidance,” Bayne said. “The on-the-ground-work is really happening, in many ways, at the county level.”

Bayne said he felt drawn to the opportunities and challenges of working in a mid-sized local health jurisdiction. Thurston County especially felt unique because it is the state capital and features an urban and rural divide, he said.

He also has personal reasons for taking the county post. As a resident and father, he said he wanted to give back to the community.

“The thought that I could lead the department in my hometown community was really exciting,” Bayne said. “I’ve got two kids, a 5-1/2-year-old and a 4-year-old, and I have this vested interest that where they grow up is a place that is welcoming and healthy.”

In many ways, Bayne said working in public health feels like “full circle” experience. He was born in Milwaukee, Wisconsin but he spent most of his childhood in Connecticut. His family eventually relocated to Atlanta, Georgia where he lived for over two decades.

Earlier in this life, he said his family lived just below the poverty line. They eventually achieved a middle-class life, but he said that experience affected their health.

“To be in a place where I get to have such a direct impact with some of the social determinants of health, knowing how much it impacted me and my family, it’s a big deal,” he said.

He said one of his main priorities at the county is to measure and address health disparities among populations with different racial identities and socioeconomic statuses.

“This idea about disparity is something we can’t escape from,” Bayne said. “As we’re moving forward, as I’m trying to figure out how to move in our post-COVID (emergency) environment, I want to do that in a way that is honoring and centering around those disparities as well.”

COVID-19 response

Bayne started at PHSS just as it was dismantling its emergency response to the COVID-19 pandemic.

He described this period as an “unwinding” phase where the department is refocusing on health issues that were not as much of a priority during the past three years.

“It’s the COVID pandemic phase moving into a COVID endemic phase,” Bayne said. “How do we operate in a way where COVID becomes another infectious disease that we deal with? … What do we unwind? What do we keep? That is a big challenge we still face.”

The Centers for Disease Control and Prevention describes Thurston County’s COVID-19 Community Level as “low,” along with all the other counties in Washington state.

But PHSS is still responding to outbreaks in congregate care settings and encouraging vaccinations among the public. Bayne said there seem to be fewer significant spikes in COVID-19 activity, but those trends are still not as predictable as he would hope.

For his part, Bayne said he still chooses to wear a mask if he’s near someone who’s immuno-compromised or if he’s at a large gathering.

Bayne said he thinks PHSS learned to quickly adapt and mobilize a lot of people during the pandemic, and to build relationships with non-traditional partners such as local business and community organizations.

“To me, we have to keep building on that,” Bayne said. “We have to continue to learn how to make that more effective next time.”

Bayne said the public health system suffered wins and losses in communicating with the public.

“We as a public health system did not fare as well against misinformation,” Bayne said. “That’s still something we’re fighting back against, working through and trying to figure out best practices.”

Opioids and overdoses

Overdose deaths have been increasing and have even affected the county jail, according to Thurston County officials.

Officials have blamed that trend on an influx of fentanyl, a synthetic opioid that’s 50-100 times stronger than morphine.

Coroner Gary Warnock has said his office counted 153 overdose deaths in 2022 and 114 of those deaths involved fentanyl. For comparison, Warnock counted 51 overdose deaths involving fentanyl in 2022 and just 10 in 2019.

Bayne co-chairs the Thurston County Opioid Response Task Force with Prosecuting Attorney Jon Tunheim. In December, the Board of Health voted to continue the 2021-2022 Opioid Response Plan through 2023.

That plan calls for measures to prevent and treat opioid abuse; prevent further overdose deaths; increase the distribution of naloxone, which reverses overdoses; and collect more data, among other goals.

Bayne said he has been getting up to speed on the task force’s action plan, but he said a critical component is education. Like with COVID-19, he said PHSS has a role to play in dispelling misinformation and stigmas around addiction.

Not everyone understands the prevalence of fentanyl and its risks, Bayne said. Education has taken the form of social media posts and direct presentations to community partners.

“I love the task force being an avenue for us to have really good conversations and really good methods for getting the word out on what we need to do,” Bayne said.

PHSS also sees as “really critical” its work to ensure community partners are supplied with naloxone. PHSS offers naloxone training through the Thurston County Syringe Services Program.

Homelessness

Bayne said the homeless response system is stressed with uneven funding, and local providers are overwhelmed.

“I think our provider community, which is incredible in Thurston County, … they are stressed to the max,” Bayne said. “A lot of them are at capacity in terms of who they can serve, and they need more staffing. It’s not an easy market to hire people to work in that particular field.”

Bayne said PHSS has identified disparities in the system, but they haven’t been able to address them all.

The number of people counted in Thurston County’s Point in Time (PIT) homeless census increased from 766 in 2022 to 792 in 2023, according to preliminary numbers released in March.

Though the data shows an increase in 2023, the PIT has historically undercounted the homeless population and its methodology has varied year to year.

The PIT census is a requirement for federal grants, but Bayne said it also helps PHSS see high-level trends among demographic groups over time.

“I don’t want to pretend that the PIT count is the definitive mark of how we can measure homelessness, but it is one of our more consistent ways that we’ve been able to do it,” Bayne said.

Bayne said the county has been making some progress in its response efforts.

For one, Bayne said the county’s Office of Housing and Homeless Prevention (OHHP) has participated in Gov. Jay Inslee’s Rights of Way Initiative, an effort to relocate people camped near highways.

Additionally, he said OHHP has served as a local leader in Built for Zero, a national movement to end homelessness using data, and the Anchor Community Initiative, a program that supports efforts to end homelessness among youth and young adults.

However, Bayne said he’s especially excited by the recent creation of a Lived Experience Steering Committee in the local homeless policy community.

“You want people who are experiencing living this to actually be part of the solution, to give us feedback and for their voices to be heard in our decision-making process,” he said. “This is so key.”

Inclusive efforts like this will help PHSS understand and address health disparities in the county, he said.

“It’s a representation of where I want all of our different sorts of efforts in offices to go,” Bayne said. “It’s to keep centering that as they make decisions going forward.”