Select Committee on Federal Administration & Policy Changes Meeting — June 25, 2026

Good afternoon.

The Select Committee on Federal Administration and Policy Changes Committee meeting will come to order.

It is 2.10 p.m. June 25, 2026. I'm Councilmember Alexis Mercedes-Ring, chair of the committee.

Will the committee clerk please call the roll and let the record reflect that Councilmembers Juarez, Strauss, and Saka are excused.

Council Member Foster. Here. Council President Hollingsworth. Present. Vice Chair Kettle.

Here.

Council Member Lynn. Here. Council Member Saka.

Here.

Chair Rink. Here. There are six members present and three excused. Wonderful. Thank you. We will now move on to approval of today's agenda. I move to adopt today's agenda.

If there is no objection, the agenda is adopted. Welcome, everyone, and thank you for attending

today's Select Committee on Federal Administration and Policy Changes. As a reminder to the public,

this committee was stood up in 2025 to understand how major changes happening at the federal level are impacting residents here in the City of Seattle, all who live and work here. This year, the Federal Select Committee is meeting on a quarterly basis, with our most recent meeting had on March 5th, and we are scheduled after this meeting on September 10th, before Council heads into budget season. On today's agenda, we have three items covering two topics, health care and LGBTQ civil rights. So first of all, happy Pride Month, everybody. But today in our committee meeting, we will be hearing from our Washington State Health

care authority and Healthier Here on how changes made in the Big Betrayal Bill passed by congressional Republicans in 2025 are impacting health care here in Seattle and in Washington State. We will then hear directly from health care providers on what this looks like on the ground for their organizations and their patients. We will close with a briefing and discussion on civil rights and LGBTQ issues and how city of Seattle is responding to growing community concerns. Across the country, we have seen intense attacks against queer and trans people, both with hostile legislation and fiscal violence. So I want to say loud and clear, while we know we have more work to do here in the city of Seattle, we need to stand firm and being a welcoming city for queer and trans people.

With that, we will now open the hybrid public comment period. Public comments should relate to items on today's agenda or within the purview of this committee. Clerk, how many speakers are signed up? Currently we have 29 in-person speakers signed up and there are two remote speakers. Each speaker will have one minute.

We will start with in-person speakers first. The public comment period will be moderated in the following manner. The public comment period is up to 60 minutes. Speakers will be called in the order in which they are registered. Speakers will alternate between sets of in-person and remote speakers until the public comment period has ended. Please begin by stating your name and item that you are addressing. Speakers will hear a chime when 10 seconds are left on their time. Speakers' mics will be muted if they do not end their comments within the allotted time to allow us to call on the next speaker. The public comment period is now open, and we will begin with the first speaker on the list.

Wonderful. So I'm going to read the first five speakers listed right here if folks want to start queuing up, but the first public speaker I see here is Janice DiGucci, folLod by Courtney Smith-Giles, and then Valerie Johnson, Violet Kawaguchi, and Taylor Farley.

Good afternoon. I'm speaking on the topic of Medicaid long-term support and services. Thank you for the opportunity to testify today. My name is Janice DiGucci, and I'm executive director of Neighborhood House.

Effective October 1st, 1,200 medically fragile asylees, parolees, and other lawfully present

immigrants living in Washington will lose their Medicaid long-term support services

because of HR1.

Neighborhood House serves 141 of these 1,200 affected Washingtonians whose conditions are

nursing home level acuity. They would lose life-sustaining treatment like chemotherapy, dialysis, wound care, oxygen

therapy, and we are scrambling to connect these clients to other resources, but their future health and well-being is grim once their care and coverage is revoked. 49 of these 141 clients have

pending green card statuses. USCIS stopped granting interviews or processing applications starting

December 2025, and TPS will expire in October for Ukrainians. Please urge the Health Care Authority and Governor Ferguson to maintain Medicaid coverage and their paid caregiving support for these 1,200 vulnerable and medically frail community members. Thank you. Courtney.

Good afternoon. Good afternoon, Council members. My name is Courtney Smith-Giles. I'm here on behalf of Lifelong Health for All to speak on Medicaid long-term services and supports. We thank you for hosting this important hearing. And Lifelong is an organization born out of the AIDS crisis, providing critical health, housing, food, and nutrition, and aging supports to those who are too often left behind. We believe every person in our community has a right to be treated with dignity and compassion, regardless of who they are, no matter who they love, where they come from, or how much money they have in their pocket. It's why we at Lifelong echo the concerns expressed by our colleagues at Neighborhood House, and we too are grappling with how to continue serving between 10 and 20 clients who are expected to lose Medicaid coverage and therefore their home-based community long-term care supports October 1st. We recognize budgets are tight, and we also know that caring for this particularly vulnerable group of people who have come to this country as asylees and refugees will ultimately show up in less desirable and frankly more expensive settings if we don't find a way to continue funding their care services. I'd also be .

Thank you. Valerie Johnson. Hello.

My name is Valerie Johnson.

I am a Florida hate crime refugee.

I landed here April 9th, homeless.

I was just brought here by a charity, and there was nowhere to go.

We need desperately, desperately housing for refugees coming in because we've got a choice, death or homelessness.

There's no middle ground.

On this Sunday, I was walking alone.

I am a trans man, and I was walking alone on the Seattle Art Walk, trying to stay awake,

because it's not safe to sleep alone.

And I was beaten by a man because I was trans. This is not safe.

We need help. Thank you.

Thank you for being here, Valerie.

Thank you. Next we have Violet.

Hello, I'm Violet Kawaguchi, the executive director of the Kawaguchi-O'Connor Initiative, a Washington state 501c3 that helps trans people fleeing legislatively hostile states settle here in Seattle.

So I want to preface this by saying that we have a lot of people who have built up the courage to come to this building right now and talk to you all.

So I implore you all to please listen with an open mind and an open heart and really internalize what these people have to say. Because things are getting very bad. Oklahoma, for example, just is, to my knowledge,

well on their way towards getting gender-affirming care removed from Medicaid coverage. This is happening in many, many states. Seattle is the number one destination in this country because we have infrastructure, we have community, there are organizations spun up to support these people. When they flee, they will flee here. And if Texas or Florida does what Oklahoma is doing right now, this city needs to prepare for thousands of people fleeing here in months or weeks.

So thank you very much.

Thank you, Violet. Next we have Taylor Farley.

Hello. Most of you know me. I am Taylor Farley. I'm with Queer Power Alliance Executive Director. Our community is under attack, as you know, and organizations protecting LGBTQIA plus people are struggling to survive.

LGBTQ organizations receive only 0.17% of all charitable giving in the United States.

That's less than $1 for every $500 donated. At the same time, our costs are rising nearly twice as fast as our funding is coming in. Yet, at this moment, our communities are in need, are most in need. Every day, we hear from trans non-binary people who are afraid and afraid of losing their health care, housing, legal protections, and simply freedom of living to live by themselves, live for themselves.

I'm going to skip a bunch of stuff, but I've heard that 95 people have moved to Seattle,

and over 10 youth and young adults have come from other states to seek safety. And this is the minimum number that we know have moved here.

Thank you, Taylor. I'm going to read the next five names here. We have Chloe Shapiro, Magdalena Warr, Lydia O'Taylor, and Alex Goss, and Eden Qua.

Good afternoon, counsel. I am Chloe Shapiro. I'm a veteran of the United States Army, National Guard, Texas. I served 12 years. I am now a refugee for the same country that I defended for 12 years because I lived in Texas, and it was getting dangerous. and now I'm here, homeless, sleeping in my car, and we need actual support. Me and almost 40,000 other trans refugees, all escaping from Texas, Florida, Oklahoma, Georgia, Alabama, Mississippi.

We are struggling.

There are multiple states that have called special sessions and have turned us into a protected class.

For instance, Hawaii a couple months ago have just signed in a legislation as trans people, as a protected class.

So I called upon the city council to help.

Thank you, Chloe. Next we have Magdalena.

I'm ready. Council President Hollingsworth, esteemed members of this body, and Councilwoman Rink, and Councilmember Kettle, whose solidarity with trans people is a laurel to their crown. Her name was Juniper Blessing, and her blood cries out from the floor of this chamber. She did not have to die. Bigotry killed her and this city's mild-mannered efforts to combat it.

Your first duty as inheritors of a genocide, the one committed against the Duwamish and others, is to return legal and natural stewardship to their descendants. You have no higher or more eminent duty. If this place had not been

colonized, the nations of the regions would have opened their arms to us. You have no right to do anything less. The Lemkin Institute has identified ongoing political violence against trans people as a genocide. No one here is qualified to refute that statement. We will take it on faith that you understand that. Stand by us and declare a civil emergency and say it in the text. Stop transgenocide. We are not a crisis. We are constituency. How many of us are here? More than the 2,000 people that Mayor Wilson won by. Stand by us or we will send you home.

Thank you, Carolina. Next, we have Lydia. And then folLod by Lydia, we have Alex.

Hello? Hello?

You have to eat the mic a little bit.

What? Eat the... Oh, like this?

Yes, that's perfect.

Hi, I'm Lydia Taylor, and I have met with several of you before,

either with Youth Care or with Mockingbird. and it's nice and validating to have a list of points.

But those of you who've met me before would know that I have already been saying this for years

at the times that we have met face to face.

Thank you, Lydia.

Next we have Alex Goss, folLod by Eden Kwa.

Hi, my name is Alex Goss. I fled here from New Hampshire last year, as the state had become increasingly hostile to trans people.

Just after I left, they passed a trans bathroom bill, and we're already in the process of stripping away trans healthcare. first for minors and hopefully with the intention of taking away from adults as

well and not long before I left New Hampshire neo-Nazis walked through the street of the capital conquered New Hampshire and the police there did

nothing it is becoming increasingly hostile for many people across this

country but especially trans people and the only reason I didn't go to Massachusetts is because I have an ex there who wants me dead so we seriously

We seriously need to take this seriously because we are targets of what is effectively agenda

and we need to declare a civil emergency now.

Thank you, Alex. Next we'll hear from Eden.

и.иииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииии slurs were frequently yelled at me in the hallway. And then because I had to have a summer job, slurs were yelled at me when I was working at a gas station. I came here and I didn't have enough money and I was afraid I was going to be homeless. So I took out $62,000 in debt to attend a graduate program here, which I've now graduated and know that I will spend the rest of my life paying off that money. I don't want other people to have to take out $62,000 of debt to have a chance at getting a job somewhere where they're not under threat of hate crime constantly. Although Jennifer Blessing's death was tragic, there are many, there are dozens of other trans people who have posters up in Cal-An talking about how they're missing and who will never see again.

I'm reading a statement on behalf of a refugee anonymous AQ. I moved to Seattle in February 2025 and moved in with a couple other trans folks I knew from the internet. Luckily, I work from home, so I didn't have to find a job immediately after moving, so that was a huge plus. If I didn't have that, I for sure wouldn't have been able to do this, as saving up was out of a question. I already sold my most valuable and prized possession

to move here. The truck my dad gave me after he died, which he bought a month after I was born. I had fully restored it and put so much money and love into it over the years and had to sell it to

move here. I reached out to a few LGBTQ orgs like LGBT Center in Cap Hill and Cap Hill Medical. The LGBT Center assigned me a caseworker and they were incredible. Cap Hill Medical was full and not

taking any patients, but the caseworker I was assigned worked to recommend me doctors I could go to to get an HRT prescription because I was running out. Getting in with friendly doctors was almost impossible, but I got lucky and found a country doctor in Cap Hill because of a friend's recommendation. Living in Seattle has been life-changing for me, actually being

around people who accept me for who I am or at least just don't care. I don't get stares when I go out and I have some... I've never experienced this living in a small town in Kentucky, just where in front of me.

Thank you.

Now we have Tobias.

Hello. There we go.

My name is Tobias Girl. I'm a trans man and a teacher here in Seattle. I moved here for the second time in December of 2024.

I fled Seattle in 2022 because I saw the direction the city was going and I tried to make it to Canada. Unfortunately, I wasn't able to stay after my graduate program concluded, so I came back here.

With all love and respect to Seattle, many of us would not be here if we had other places to go because we still live under the threat of the federal government.

We do not have other options. We're playing the floor is lava on top of an active volcano. If I didn't already know people when I got here, I would have been homeless again,

because you can't get a job if you don't have a home, and you can't get a home if you don't have a job. Help us avoid all of that and fund our organizations. Thank you.

Thank you, Tobias. Ayo?

Hello, my name is Ayo. Thank you, council members, for being here. I am currently 23. I moved to Seattle five years ago, hoping to escape some of the cruelty of the American Southwest. Since then, I have spent most of these five years doing my best to uplift the city and the people that have helped surround me. Since then, I have spent most of my time volunteering at food banks and educating Seattle's youth. Right now I would like to iterate like everyone like many people here today that trans people need help and we would we are asking you to declare a state of civil emergency

so that way more of us may build a life here and help build in Seattle into the city that we all know that it can be. Thank you.

Thank you, Ayo. Next up, I have Mante and then Akaris. Apologies if I'm mispronouncing that.

Mante? Hi, you may call me Mante. I am a spiritual leader of the trans community here in Seattle. I read this on behalf of another trans person. I cannot attend this meeting, but if someone can highlight how many trans people we are losing, whether it's to mental health outcomes, physical

disability, homelessness, etc., and largely in part because we are so fucking poor and being systematically discriminated against. 95% of employers have said a trans person would not fit

into our workplace. On behalf of my trans siblings' request, I now read aloud the names of all the trans people I am aware of who have died or gone missing in Seattle since Katie Wilson was elected

Mayor. Vanessa, refugee from Georgia, 19, missing. Alex Juniper Gilbert, Seattle local, age 12, suicide. Livy, refugee, 20, missing. Ellie Schmidt, 22, missing. Juniper Blessing, 19, college student, murder. Fable, 27, suicide. 27, refugee from Kansas, accident. Toy, early 20s, missing. Gwendolyn, 24, suicide. Amy, age unknown, unknown if dead or missing. Amy Koyama, local activist, 51 natural causes. Stop the death, declare a civil emergency now.

Thank you, Monti. Thank you. Very powerful. And yes, please, if people want to submit their testimony into the written comments box, that would be great. I have Akharas, and then I'm going to read the next names here. We have Lou, Brandon, Allison, then Friday.

day. Good afternoon. Good afternoon, Council. I'm Noah here on behalf of a car as a transmasculine man and refugee and Washington resident who couldn't be here today. He relocated from New Orleans, leaving the city because not because he wanted to, but because it wasn't safe to stay. Medicaid didn't cover his hormones and he was physically unsafe in a place where you kept your head down because you knew you could be beaten or worse. A translate rights organization like the one here helped pay for his plane ticket to Washington, but that was just one of the many substantial costs, financial, social, and emotional. He's been pushed out of jobs with no warning or justification, and he also speaks of a friend of his in a more rural place in Louisiana who didn't get the help she needed and is now actively suicidal, having been hospitalized more than once. Nothing about this is an abstract policy question. The southern trans crisis you're discussing is the reason he lives in Washington today instead of New Orleans. More and more trans people are coming to Washington because this isn't a choice for them at all. Organizations that help cover his hormones and his plane ticket need stabilization funding. It's the difference between them being able to turn people away or say yes to their organizations and read his full statement. Thank you.

Thank you, Akaris. Next we have Lou.

Hey, I'd like to speak here not as a person who fled a red state but as a helper. Um, most of us don't have a lot of money. A lot of us are unemployed.

Um, a lot of us are super overwhelmed and it's like a person does a bunch of work.

They collapse. They give it to another person. They collapse.

And that's kind of, um, like there's some stability here and there, but we need money. We gotta like actually be able to take care of our rent.

We actually need to be able to bring in the people here into housing.

Like a motel would be amazing if we could just put people in a motel. That would be insane. But we need money to do that. Please fund organizations like COI. Thank you.

Next we have Brandon. Thank you for the time you've given today to address the crisis of transgender refugees who faced persecution within their own home states. For years, the LGBTQIA community has warned of escalating attacks on trans rights as part of a coordinated and callous political strategy by the right. It has become undeniable that the violence done against trans individuals is real, including the disruption or elimination of necessary medical services. But Seattleites are welcoming, and Seattleites are generous, and Seattleites have made it clear that the genocide against trans people stops at our border. So the question today is not will Seattle welcome trans refugees from across the country. Our neighbors have made it abundantly clear that we are willing to accept them. Now we need to back it up with action. We need more homes to place people in. We need meal assistance and financial assistance.

We need health care that won't drop coverage for trans children when the Trump administration threatens their funding. Organizations that aid trans refugees to resettle in blue states have thousands of applicants but don't have a hundredth of the resources they need to make a scale. I call on you as our representatives and I call on our neighbors to have our trans community pass.

Thank you.

Thank you, Brandon. Next, I see Allison Everest.

Check. Check. Sorry. Okay. Check. Dear Council, my name is Allison E. Efferist, Mississippian by birth, and my pronouns are they, she, it. I'm here to present an electoral angle on this matter. The trans community has done extensive legwork to elect the current municipal administration.

We are supposed to be a government for and by the people, and as long as there is a government to do our bidding, they should. We are the people, and our private mutual aid networks have been stretched beyond their

means to provide for our embattled siblings who are fleeing from across the nation from imminent threat to their lives. We urgently implore the city of Seattle to hear our collective voice

and do its part to live up to its reputation as a safe haven for trans refugees. Too many have been martyred for the current state of affairs to continue. Thank you.

Next up we'll have Friday and then I'm going to read the next handful of names. I have Clinton, Darren, Marie, and Ernest. All right. Hello. Hello. Hello. There we go. Hello, members. Two of my

friends have died by suicide in the past year, one of which died after harassment from another group became too much for her to handle. She had recently moved here from her abusive family situation in California and fell in with our group shortly before the harassment began. This group uses the lure of a fun party space with sex, drugs, and most importantly, beds and shelter. They pressure girls to cut ties with other girls, use their position as stability gatekeepers to keep them alive or keep them in line. There is a crisis in Seattle. There are over 40,000 trans people here that have moved to the state seeking stability as the Trump administration and co. continues to use trans people as scapegoats to distract from their pederasty. We must not allow these people to come into Seattle sans support. By doing so, we breathe air into these abuse networks. Before, people used to rely on queer support groups, but this is a temporary measure at best, as these groups face overcapacity and budget cuts during the Trump administration. We must rapidly expand our housing.

Declare civil mercy.

Clinton.

Good afternoon, council members.

My name is Clinton Attaway. I'm in District 2. Shout out to Council Member Lynn.

I am cisgender, straight, and I'm just aware of this crisis through opening my home up to refugees who are coming up from Texas and from other places where they're just being culturally extinguished. The council members here are all savvy political minds and are surely aware of the cliche Bible quote of, You are the light of the world. A city on a hill cannot be hidden. This gets worse. More people are going to be coming. We need resources now, and that's going to only be accomplished through declaring a civil emergency. Thank you.

Thank you, Clinton. Next up, I have Darren.

All right, and as Darren's coming up, just a reminder, we have Marie, Ernest, and then

we'll have Nina, and I believe I see Sam, folLod by Simon.

Hello, my name's Darren.

I moved here from Florida back in 2024, recently after Rhonda Sanchez enacted a bill that would allow healthcare professionals to decline to treat transgender patients.

It has only gotten worse for people back in Florida since then.

I worry about my friends there, what they're going through, who couldn't afford to move up here like I did. I was very fortunate. And I asked the city of Seattle to please help fund our programs to help move other transgender people up here.

ии.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и. for keeping our meeting rolling. So if we can have Ernest, Nina, Sam, and Simon start lining up for public comment, that'd be great. Wonderful. Please, Marie.

Hello, my name is Marie. It really seems like every time that I go to a gay bar these days, I always meet somebody who tells me that they came to the city of Seattle because they're fleeing some horrible situation or some horrible new law that was cooked up in another place. And it always comes from a new face every time. And I call upon the city to declare a state of emergency on the trans refugee crisis so that funds can be freed up to support the mutual aid organizations, which already exist and which help to resettle trans immigrants like the people I meet in these bars. Thank you.

Thank you. Next we have Ernest folLod by Nina.

Hello there. Oh, goodness, this is very tall. My name is Ernest Wallace, and I am a refugee success story. I fled here in 2019 where I lived in Georgia, and I had the privilege of having a support to stand on, of having a solid foundation.

We are taking efforts, us, the trans community, to bring our people to safety. But as trans people ourselves, we are already at a disadvantage. It is clear on our streets, in our homes, and in our hearts.

40,000 people arrived here in 2024 and more flee here every day. It's time for the city to acknowledge this as well. If you're not prepared to welcome us, you're actively complicit in the violence that is chasing us here. It'll be clear what the side of history, Seattle, and the current administration has decided to stand on. What's happening right in front of you, the people who are dying on your watch, throw the lifelines to the rafts we are building from the bones we rip from our still-beating chests. Thank you for listening.

Thank you very much. Next, we have Nina, folLod by Sam, Simon, and then Ari.

Thank you for the opportunity to speak today on the topic of the transvipity crisis. I mean, so many here have said it so much better than anything that I could come up with.

We need funding. We need help.

I'm so tired of seeing just the fear in my siblings' eyes when they have to think about going back to places that want them dead.

that want them erased. We cannot be erased.

Sorry, just...

We need funding. We need funding to go

to these community efforts. That will help.

There's no other option. Thank you.

Sam? Sam? Hello, I'm Samyaza, local activist. In the past year, I counted, I have had at least 12 different trans people crash on my couch and I live in a studio. This is not enough. These people are effectively orphans. They are fleeing both from states and from parents that they would rather be homeless

than live with.

Just yesterday, I was at a gathering for homeless trans people and all trans people to share music together.

That was that right wing agitators came to and started a fight in. We need more resources so that people can get housing and don't have to be dependent on the lucky few who can get employment. Thank you.

Also, those wings are incredible.

Next we'll have Simon, and then I'm just going to read the next couple of names so folks can start queuing up. We have Ori, Gabby, and then Vincent, and then we're going to move to our online public commenters. Simon, please proceed.

Hi, I'm Simon Thornton. I'm reading a statement today by CI, who's not able to be here. They're at work. I did not know as late as the end of February that I was moving here. When Kansas passed SB 244, I still wanted to stay there. I had a stable roof, friends, and supportive co-workers. The job went first. They did not want a bus driver if my license was going to be revoked. Then my friends stopped providing support, scared at being seen with a transgender person. When I was folLod home by someone who threatened to shoot me, I immediately made arrangements to move. I found out later that someone the next week had broken into my home with a firearm. KOI, who evacuated me, saved my life. These stories happen every day, most end badly. I'm blessed to have mine end well. People are going to move here no matter what. Thank you.

Thank you, Simon. Next we have Ari.

Hello. My name is Ari Chihomsky. I am a high school educator with Seattle Public Schools.

I absolutely love my job, and I know that I would not be able to do it in my home state of Arizona and increasingly would not be able to do it in many, many states across this country.

I have good relationships with most of my students, but my relationships with my trans students are especially wonderful because they get to see that a future for them is possible. I've had trans students tell me that I am the first trans adult they have ever met. Not a lot of them. As we know, Seattle has a lot of trans folks around. So I'm not the first many I've met, but for some of them it is.

And it gives them hope that a future is possible. So I'm just here to say, please remember trans youth, trans teachers, we're here.

Please declare a civil emergency, especially as states like Texas try to push an increasingly hostile narrative for trans people in education.

Thank you, Ari.

Now we have Gabby, Vincent, and then Michaela.

Hello. My name is Gabby Dinep. I moved here from Virginia back in 2021. Prior to moving here, I had attempted suicide three times, and now I'm basically an unlicensed therapist for my friends who were suicidal and can't get any help because there's just no good place to go to it it's if you go to an any institution it feels like prison and there's just no safe place for trans people so now I have to I have to worry every day that one of my friends might kill themselves and there's just like barely anything I can do because I am not trained for any

of this. Thank you. Vincent and Michaela. Good afternoon. My name is Vincent Avi

Stormfelt and I am an Epstein survivor. Y'all missed the Montana tentacle in the files because the people in this ring run the world and they are accusing my community. I as an intersex masculine, they are accusing my community of what

they do. I shouldn't have lived past six because someone ordered a snuff series of videos from my father who is a marine who is the best friend of Bill Clinton's

marine security detail. I don't know who ordered it. I know the KKK chased us out of Arkansas before dad could finish filming those videos because they didn't want to see a little white girl get hurt. They didn't care about the dead black babies they forced me to eat off of in the video. The people making these accusations are the thing they accuse us of.

Declare a civil emergency. You are on the menu if you're not at the table with these people.

My name is Michaela Helsley. I've been a resident here in Seattle for about two years now.

When I first got here, I was extremely fortunate to have many friends who were able to lend me housing in spaces where I could take care of myself in the beginning of my transition. I know that that is not an opportunity that most people are lended, and there are many voices who could not make it here simply because they are looking for places to survive.

We are in a very terrifying time to be anything that is considered different or out of the ordinary, and we are already trying to be marginalized and pushed away into the cracks and crevices of the street where we can be forgotten and left for dead. If you need any kind of evidence for why we need a trans state of emergency, you just need to walk through any street of Capitol Hill, go into Cal Anderson Park. On the very large pump house on the back, there is a door. There is a message that has over 20 names of individuals who are gone, missing or dead. Please go into the streets. We need an emergency.

Thank you, Michaela.

And those were all of our in-person public commenters.

Now we're going to move to remote public commenters.

The first remote speaker is Alberto Alvarez.

Please press star six when you hear the prompt of you have been unmuted.

Thank you. dollars not declarations reports out of ucla and other population studies show more more than half

of trans and queer kids teens and families are fleeing their home cities and states you are

hearing about the oppressive laws and dangerous policies driving so many to seek help and acceptance here in our communities. We all have been witnessing the chaos, violence, and turmoil brought by this fascist storm. As with any large-scale disaster,

council has the legal responsibility and moral duty to provide funding and build up community services that will ensure a healthy arrival for anyone seeking help. Dollars, not declarations. will get you fed, housed, work-trained, and ready to stabilize their new life in our town.

Thank you all, and have a good day.

All right, there are no additional registered speakers, so now we'll be proceeding to our items of business.

But before we go into our first item of business, I want to take just a personal point of privilege to address everyone who's come out for public comment today and to thank you for your powerful testimony. I know before the meeting I chatted with a few of you. I understand there's some people who are here giving their first public comment in City Hall for the first time,

and I want to thank you for that. This is the people's house, and I also want to thank you and welcome you to Seattle. I know we have a lot of new neighbors here, and I know we'll be getting

to the item that you're speaking to later in our agenda for today, but just wanted to touch on that point and also affirm. I know at the beginning of the meeting I said happy Pride Month, but to honor

truly the history behind Pride Month, I think it's important to note that we would not have a Pride Month if it was not for trans people, if it was not for trans women of color. I think that's important to get into the record. So again, I want to thank you all for being here. Thank you.

And with that, we are now going to move on to our first item of business. Will the clerk please read

item one into the record. Item one, one big beautiful bill act, HR1,

impact on health care in Seattle and Washington State, briefing and discussion.

Wonderful. So at this point, I'm going to invite our presenters to come up to the table.

Colleagues, while our presenters are coming up to the table, I'm really excited to have this

discussion today. Maybe excited is not the right word. This discussion is really important. City

of Seattle and particularly city government does not necessarily cover health care, yet

Congress has made some major changes to health care for our residents.

And I think given that these changes are imminent and will have immediate impacts to our neighbors, having this discussion today felt particularly important.

So I'd like to welcome our colleagues from Healthier here and the Washington State Health

Care Authority. And with that, if you could take a moment to introduce yourself by stating your name into the microphone for the record and then start the presentation, that would be fantastic. Good afternoon. I'm Trinity Wilson. I'm the state Medicaid director with the Washington State Health Care Authority. And thank you, council members, for the opportunity to come and speak with you today. I'll be providing an overview of the state's implementation of what we're calling HR1, also known as the One Big Beautiful Bill. As a reminder, Medicaid is a state and federal partnership program that provides free and low-cost health insurance to Washingtonians. Right now, it covers 1.9 million Washingtonians. So I'm going to provide a statewide overview of the impacts of H.R.1 and then pass it to my colleague John for more of a centralized King County and Seattle impact. But the impacts of H.R.1 on Medicaid are significant. и.иииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииииии

and then also what we are doing as a state in terms of outreach and communication to our communities and the individuals that are impacted by these provisions.

I've lost it.

There we go.

So at a high level overview, I mentioned those two different categories.

The first bullet point that you see here is really the eligibility provisions that are coming from H.R.1. The first being an impact to the definition of a qualified, lawfully present non-citizen. And those are the most immediate near-term impacts that will come into effect on October 1st. Then we have several impacts on specifically the adult expansion population.

So these are individuals in our state who are newly eligible for Medicaid as a result of the Affordable Care Act.

And in our state, that's about 600,000 individuals who are currently receiving coverage. HR1 introduces an increase in the number of times these individuals need to redetermine their eligibility. Right now, it's an annual recertification, and come January 1 of 2027, that reduces to six months.

So twice a year, those adults will need to recertify their eligibility.

HR1 also introduces work requirements for this adult population and a cost-sharing provision,

so a sort of co-pay for certain services that are rendered.

HR1 also impacts retroactive coverage.

So today on Medicaid, an individual could be eligible for up to three months of retroactive coverage if there were unpaid medical bills during that time. beginning January 1 of next year, that coverage period reduces to one month for the adult population and two months for the rest of the population, including children. And then the second bullet that you see here is really around those provider payment provisions that I mentioned. So HR1 does invest considerably into rural health transformation, but then also restricts the use of what we call state-directed payments, so Loring the federal share of money going directly to providers in our community. This is a sort of overarching timeline of the Medicaid provisions.

You can see on the top here, we're currently at the end of that graph. The green boxes are all of the provisions of H.R.1 on the top, and then the gray boxes are other various CMS federal-led eligibility initiatives that we're also undertaking. So you can see we are entering a period of significant change between October and January of next year. I do want to mention the health care authorities approach to implementation. We acknowledge that we would never have implemented some of these policies that were passed by the federal government. So we are really building upon four principles as we implement HR1. One being building the least burdensome processes for our clients. So as much as possible, we are leveraging automation and information that we already

have access to so that the customers do not need to provide us additional information to prove that they remain eligible. Our second principle really building on and advancing the customer experience,

so we want this to be easy for our customers to access care and we want continuity of coverage

and to mitigate coverage loss. So where there are other state-funded options available to individuals, we will be moving them into other programs to maintain coverage. And then administrative

efficiencies. So this is a considerable amount of work for the state and the providers. We want to

reduce the amount of work that it takes to implement these provisions and really again

leverage systems and processes that we already have access to today. And then finally, we've been

co-building a communications plan and strategy with our partner agencies,

providers, our tribes across the state, hospitals, and community-based

organizations to ensure that we are communicating in languages that are appropriate for the individuals that we serve and communicating in methods that

will reach them. So letters, mail, text messaging, robocalls, etc. So I'll dive a little deeper into some of these eligibility provisions, the first being

the change to the definition of qualified lawfully present non-citizen. I do want to emphasize these

individuals are lawfully present. Beginning October 1st, we anticipate that roughly 14,000

individuals who are currently receiving Medicaid will no longer be eligible, as the definition of a qualified non-citizen is restricted to lawfully permanent residents, Kofa Islanders, and then certain Cuban and Haitian entrants. Of the 14,000 individuals who will be impacted, roughly 1,700 of those individuals are currently receiving long-term care or developmental disability

services. So as a state, we are currently evaluating, again, other state-funded options that could be available to these individuals and maximizing the funds that are available to us to

do so. We originally thought we were going to be able to implement this provision over time based

on an individual's renewal dates. We did hear from our partners at the Centers for Medicare and Medicaid Services in April of this year that this provision does take effect October 1st. And so those 14,000 individuals coverage, their last day of coverage would be September

30th. I'll move into the work requirements and just emphasizing again that this is only applicable to the adult expansion population. So about 600,000 individuals in our state. Beginning on January 1st, HR1 introduces a new eligibility criteria that individuals must meet a work or community engagement requirement or qualify for an exemption to a work requirement.

We did get a rule published by CMS just on June 1st, so the agency is working very fast to implement the rule by January 1st.

So several criteria to meet the work requirement. It does include having an average monthly family income of at least $580 per month. That is 80 hours at the federal minimum wage. An individual could also be enrolled in an educational program at least half time. They could participate in a work program for at least 80 hours per month, complete at least 80 hours of community service, or have any combination of those factors to meet the work requirement. There are several exclusions and exemptions to the work requirement. I won't read through all of them, but it does include individuals who are foster care or former foster care youth,

individuals who are parents or caretakers of children under the age of 14 or of individuals that have a disability. Tribal members are also excluded from work requirement.

individuals who are considered medically frail, and or individuals who are receiving treatment in an alcohol or substance use facility. In combination with the work requirement, I mentioned the changes to the redetermination period. So beginning January 1st, this adult population will need to recertify their coverage every six months.

I am happy to report that as a state we are able to today automatically renew 78% of our Medicaid population using information that we already have from them. So we are leaning on that high rate of renewal moving into six-month eligibility reviews.

But I want to emphasize that approximately 20% of the population will still need to manually renew their coverage every six months.

We expect that this is going to drive calls to our community-based organizations, our state agencies, as this is definitely a change.

It's also a change as compared to other household members. So for a family who's receiving Medicaid coverage, there's going to be several different certification periods to track. Moving away from the eligibility provisions, I mentioned some of the state-directed payment provisions of HR1, which really impact the provider payments in the healthcare delivery

system.

So it does prohibit new state-directed payments and for existing state-directed payments reduces the payments to a Medicare payment level.

In our state, we expect that over time, this could be a $1.5 billion reduction in federal funds into the provider community.

Customer outreach. I want to share with this group that we do have established a community connectors forum.

This is a monthly forum. We invite anyone in the community, navigators, assisters,

community members to tune in and learn about the changes

that are forthcoming over the next several months.

We have also just recently finalized a communications toolkit for our partners

to use in their social media campaigns, for our health care providers to use in their clinics to share about the changes that are coming.

This is a timeline of what individuals should expect over the next six months. We will begin sending notices to the 14,000 individuals who are losing coverage due to the definition of a lawfully present non-citizen next month. So in July, those notices will be sent. They'll be sent by mail or email. We'll also be running text messaging campaigns. and we are translating these notices into our customers preferred language. We'll begin correspondence on work requirements and the changes to the redetermination period in the month of September and that will be ongoing for the next 18 months as individuals are as it applies to individuals in that coverage group. And then retroactive coverages in December and most of these provisions take effect in January. So just emphasizing a lot of changes coming in the next six months for our Medicaid population. My contact information if there are questions and then I will pass it over to John. My contact information if there are questions, and then I will pass it over to John.

While we're switching over, hello, my name is John Kim. I'm the CEO of Healthier Here, accountable community of health for King County. I want to thank council for attending and focusing on this opportunity to protect the health of Seattleites into 2027 and beyond. I also want to extend thanks to HCA for this amazing work that is already ongoing and has been going for as soon as we heard that this was going to happen.

And as you can see, it's a ton of work and it's very complex. And that has to happen at that level in order for us to really bring it home to the people on the ground. And so without that, it's really challenging for us to even imagine what our response is going to be locally.

So thanks for that.

I'm here to encourage us in this moment to think holistically about family and friends, neighbors, and about busting the silos in our care delivery systems that can do a better job of ensuring that all of us have access to the resources that we need to thrive.

Healthier Here is a cross-sector collaborator and convener

with a network of community partners able to meet people where they are

with language and cultural sensitivity.

Our community care hub is built as a no-wrong-door hub

and it's a backbone for community-based organizations providing case management and navigation to social care services. And you can see here that we have 85 community-based workers speaking 40 different languages across 21 partner organizations,

some of whom are here in the room and will be speaking to you during the roundtable.

Our firm belief is that high-quality, whole-person care coordination matches what people actually need to thrive and not just survive.

And you can see from all of the services that are laid out here, people need a lot of different services, and they need a lot of help.

And so built on the trusted relationships that our partners have created with the communities that they serve, we empower and assist people to access a wide variety of needed services.

And we see the barriers around access to Medicaid being yet another challenge that we will have to address.

We are focused on servicing communities that have... Let me say that again. We are focused on serving communities that have traditionally been...

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not only to reduce their access to services, but to also intimidate. It is targeting.

And here you can see, based on the data that we're collecting on people that we're serving,

that it is a very diverse group.

I put this up here not because you don't know statistics about King County and about Seattle, but to say that in the work that we're doing, we are collecting data. And we're really trying to be sensitive about what data is telling us. And I really want you to focus on what we see as the highest community needs. And this is coming direct from clients to our case managers. And we're seeing that housing and shelter services, no surprise, are top of the list.

but closely folLod by financial assistance, food access, employment, and utilities.

And I also want to note that oftentimes folks come into the hub seeking assistance with one stated reason. But because of the trusted relationships, they are able to become more vulnerable over time

and to share the full extent of their needs. and the intersectionality is a little surprising. Maybe it's not so surprising, actually, but it is rare that someone shows up with only one need.

They may present with one need and end up having four or five, and then as we remove barriers and help attach people to services, other needs emerge. I just want to say life is not linear and it's messy, And so being in a position to work closely with folks in a trusting relationship is absolutely key. It is not transactional.

I put the Seattle information up here, and I just want to note that according to the data we're seeing,

in Seattle, the neighborhoods that we're serving the most folks from are Chinatown International District to South and East Seattle.

And as you can imagine, as folks move further south to find affordability into South King County, we are seeing a migration of folks that are needing services moving to the south.

And I want to highlight that with a 10.5% population in Seattle on Medicaid, a profoundly negative impact on Medicaid is a very large number within Seattle.

I'm almost embarrassed to put this slide up here with six blocks because the true impact of HR1 goes far beyond this.

And I don't think we're going to see what the true impacts are going to be until time unfolds and we see the implementation.

But what I can say is that based on the diversity of impacts that we can imagine, it's going to take stakeholders from every walk of life to really take note and come together to address this crisis.

And the harms, potential harms from HR1 aren't necessarily completely new. Because it wasn't as if the system was really working perfectly before the passage of HR1.

And based on our input from our partners in the community, I can say that the issues around capacity, enough bodies in place to work with clients is going to get worse. And the training that they need to be able to provide the services that are going to be needed is going to get worse. And then this idea that if we are not breaking down silos and sharing information in a way that enables our workers to actually provide whole person care coordination, it's going to get worse.

So, being able to share data in a meaningful way to make the tools more effective, to have trainings that are current and that are accurate and that equip our case managers to be able to work with clients, and just having more case managers available to work with the increased volume of folks needing services. These are areas that we can address.

Healthier here is in a place to see some of the early warnings around the issues with systems and the need for capacity.

And we are doing it by being close with community, paying attention to what people with lived experience are actually offering,

because that's where a lot of the special sauce is happening.

These are resilient communities, and the value of their lived experience sometimes is not recognized in conversations about systems. But without it, I don't know how we're going to do better.

So as I mentioned, Healthier Here is operating a community hub in King County, serving Seattleites as well as folks throughout King County to address people's social needs. We also are operating information exchange, which is a powerful tool in the hands of case managers, which allows them access to resource directories, to closed-loop referrals, to being able to exchange information with other organizations so that more providers of services have a clearer picture of the comprehensive needs of their clients. And in the course of this work, we've been so fortunate to already be working with Seattle-King County Public Health, who have been working very hard ahead of implementation around understanding the impacts of HR1. They have shared really comprehensive trainings that we are adopting and using to train our partners. And then working with our AAA in town has also been incredibly important as we implement health-related social needs services and creating strength between organizations that are serving overlapping populations.

You've heard a lot about, like, the worst of what could happen with HR1. And I just want to say, if we do nothing, this will come to pass.

But not us, because we have an opportunity.

And by coming together and thinking about the ways that we can really coordinate the effort across organizations,

across silos, so that we're not duplicating expensive infrastructure, but are really creating a comprehensive coverage of all the many things that need to be done

to prevent people from getting unnecessarily disenrolled from a service that they need so badly.

Thank you.

Thank you, Bill, for this tremendously informative presentation.

Colleagues, I want to open it up to you first for questions you have for our presenters.

Councilmember Foster.

Thank you so much, Councilmember Rink, Chair Rink, and thank you so much to our presenters. I'm going to first start off with a comment, and then I'll just come back around with a question. But I'll just say I really appreciate this and the presentation, as well as the focus on re-enrollment and the work that you're doing to make sure that folks are trained so that we can minimize as much as possible the impacts from HR1. And it's important to me, not just as an elected official, but also somebody, I talk about this occasionally, but I was on Apple Health when I gave birth to my son.

And it was like a lifeline, literally. It was the way that we accessed health care. And so that access for myself and for him to have a strong start was so important.

And so when I think about the potential for families to lose that access, it's just devastating.

So I just want to say that how much I appreciate this sort of both professionally and personally. And I want to thank Healthier here for having me yesterday.

I got a chance to sit down with the team and with some fantastic folks from Via Communitaria in South Park

and learn about their work and what they're doing, again, on the prevention side and trying to keep people enrolled. And I just want to express my appreciation again to the folks who are having me on that site visit and that tour.

It was a really helpful opportunity to understand how these networks are trying to work together, again, to sort of stem the worst. Having said that, I'm wondering if you can just speak a little bit more.

I know you had this on, I think, both of your slides around the role of the community navigators and the trainings that you're doing. But I wonder if we have an understanding of, you know, how many folks we think are actually eligible for re-enrollment, if we're able to reach them adequately. Do we have a number there or sort of a sense of scale to your point of minimizing the worst?

Yeah, thank you so much for sharing your story, Council Member Foster. I really appreciate that. So I mentioned, excuse me, the 600,000 individuals, adults who will be impacted by most of these provisions. We did have 1,300 individuals sign up for our and attend our very first webinar on HR1. So we are acknowledging that the health care authority is not the right messenger in a lot of these forums. Individuals who are receiving Apple Health trust their providers. They trust Healthier Here. They trust the navigators that they work with to access their coverage. And we have a lot of learnings from the COVID-19 public health emergency. And when we unwound that, there were hundreds of thousands of individuals who had to recertify coverage over a period of 12 months. And our outreach strategy that we used during the unwind is much of what we'd adopted for implementation of HR1. So leaning on the assistance from community and those provider networks to help communicate. I think in terms of the impact and the number of individuals, we know today that we're able to automatically renew up to 78% every month. But we do also know that up to 200,000 of those adults could lose coverage due to the work requirement and six-month eligibility requirements alone. So it's a significant impact. And the more people that we can reach in the community to share those impacts and the requirements, I think the better that we'll do at mitigating the coverage loss.

Thanks for the question. And so for a level set, right, when we're talking about the total Medicaid population across the state of Washington, King County is 22 plus percent of the total Medicaid population, which translates to many thousands.

And Healthier Here is only one of the players that's involved in King County.

And when Trinity mentioned sort of the impacts across not just the Medicaid enrollees, but also the reduced payments and other things that apply to providers, what we are seeing is a huge amount of interest from hospital systems, healthcare insurers, and the folks that do the navigation for the healthcare benefit exchange. So there are a lot of people, I think, who have their own interests. But when it's combined, that actually looks like better coverage for reaching the number of Medicaid enrollees in King County and in Seattle. Between all of us, we have different touch points and different ways of reaching them.

So I think we're looking for as comprehensive coverage as possible, and we can't do it alone. And by linking arms with folks that have similar interests in terms of ensuring that people on Medicaid stay on Medicaid,

I think we'll actually have a chance of approaching that number. And I'll just also throw out there that over 50 percent of the Medicaid population in King County are young people. I mean, and thanks for aggressive CHIPS program and the ability to get folks on coverage. But these are large numbers amongst the population that we are seeking.

Thank you for that. And just one follow-up question. And I really appreciate your mention of both the impact to young people as well as their reference to sort of lessons learned from COVID. I maybe this is too simplistic of a question, but as I think about our community based organizations and the folks who you mentioned as trusted providers, what are what is the best way for those folks to have up to date information on redetermination? If we want to make sure as a city that we're getting we're doing our part to help get that information to folks.

Yeah, the Community Connector Forum that I mentioned is a fantastic opportunity for folks to tune in. We're also doing quarterly webinars and happy to share that information with the Council after this meeting. And then the toolkit that I just mentioned, we just published it this week. ! We just published it this week, but it has a lot of fact sheets and social media campaigns that ! folks can use rebrand and share within their networks. ! So I think from the state's perspective, that would be the best opportunity for folks to get involved. ! Thank you.

That encourages the ACHs across the state to work together. encourages the ACHs across the state to work together with HCA on implementation. So there's specific call out for us to be working together. And so I'm happy to say that we are in conversation about how best to deploy resources between the local and the state in order to ensure that we're really at once providing accurate and helpful information, but also delivering it in a way that's language-sensitive, cultural-sensitive, and coming from folks that are from the communities that they're actually working with.

Thank you so much. Thank you, Chair.

Thank you for those questions, Council Member Foster. Vice Chair Kettle.

Thank you, Chair. I want to thank Ms. Wilson and Mr. Kemp for being here in your presentations. I like your last slide.

We're not going to go second to last slide. It says, together we can support a healthy, safe, and thriving Seattle.

I think that highlights the we.

One thing I've been noticing that we, be it state, county, or city, need to work together better. And this shows up in a whole host of different policy issues. But in this one, this is an area where we do have to have everything in sync. I think we need to have the state, the county, and the city with the various pieces and the responsibilities. Because the challenges do show here in Seattle in a way that doesn't happen in other parts of the state.

But the responsibilities for the areas of responsibility require the county, require the state to do its part. And so I thank you for being here and kind of in a way representing that. But that's something that we need to reinforce because partly we're all in fiscally difficult straits.

And so this idea, you know, and it's made worse by what the federal government's doing, but this idea that city of Seattle can do it alone is obviously not possible. And so we do need the county and its responsibility in public health or the state's responsibilities in different areas, Medicaid, to do its pieces as well.

And so I bring that up because at the end of the day, and I thank all the public commenters who have come here, the fact is that we are a welcoming city, exampled by all the public comment that we received today.

So thank you for being here. And I think messaging this and also messaging it in a way that is reflective of the founding documents.

This is our 250th year, and I'm old enough to remember the 1976 bicentennial as well.

Yes, Council President. But the point being is that we need to build on these pieces and to remind ourselves. And this is why it's important to come to public comments and to be seen and be heard. I carry around the U.S. Constitution, partly even more so now under the Trump administration,

But it's a reminder, you know, with the freedom plane coming here soon, next month, as part of the 250th celebrations, that we, the people of the United States, in the preamble, it goes on, says,

in order to form a more perfect union, establish justice, ensure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, and do ordain and establish this Constitution for the United States of America. this is supposed to be for all of America. And obviously in our history, it hasn't been. It hasn't been for African-American, our black communities, particularly in the age of slavery, but also for our women in terms of the right to vote. And this arc of this history, with the idea of promoting general welfare, it applies, too, to the LGBTQ plus community. And the idea that it doesn't is wrong. And I think it's important, too, with my colleagues that are sitting here on the dais, that somebody who comes from another jurisdiction around the country, so I've been around the country in my term in the military, so I know all these states that have been mentioned. And oftentimes it's people like me who are passing these laws in these states. And I think it's important for us as a city, as a county, and the state to say that publicly. Go back to what is the foundation and then make the point that what is happening today is part of this arc of the history. It's that creating the more perfect union. Because if we stopped 10 years ago, that's not right. that we should be building on Juneteenth. We should be building on, I come from near Rochester, New York, Susan B. Anthony and the suffragettes and the right to vote, but then throughout the period of the 60s, 70s, and 80s, and now in the 2020s, and what we're seeing with reaction to the Trump administration. And so I'm saying this to say it's important to be here and it's important to see yourselves as part of this process. And I think we should be linking it to that process because at the end of the day, I think that's where we get success. But that success cannot be City of Seattle alone. It's got to be in partnership with the county and the state in our case, but really in also partnership with Oregon, California, and other states as well. So, Chair, I just wanted to make that note. I think it's important to kind of ground ourselves in that way. And to be frank, I think it's important for people like me, because, again, in so many of these states, it's people that look like me, that have my background and the like, that are passing these laws in these various states,

often, nearly all the time, in ignorance.

And so, Chair, I just wanted to take the opportunity to say that I don't have a question specifically,

but I think it's important to say that.

Thank you for those remarks, Vice Chair Kettle. And I think that was a good grounding, too, and I wanted to build on some of those remarks that you just made to kind of tee up a question for our presenters today.

And part of how we structured this discussion, too, is to really have a presentation first, kind of talking through the mechanics of H.R.1 and some of the structures that exist around health care policy across the state. And I think with everything that has just been walked through, it really begs a question about how can we do our work better together and kind of work through these silos.

And so I wanted to pose the question to you, too. If you can speak to what are actions you're aware of on the state level that are happening, whether it be by state agencies, the legislature, or governor's office that we're aware of,

and what kind of recommendations would you have for us as Seattle City Council to be a better partner or ways that we can work on improving our convening and breaking down some of these silos as we navigate this together?

Thank you for that question.

I'm tempted to just, you know, borrow a line that I heard earlier, which was so powerful,

and it was like, dollars, not declarations. But I don't think that actually tells the full story.

In a system, when we address a really impossible problem, like the size of it is impossible, the complexity of it is impossible,

the notion that anyone can do it by themselves really

it's false, right?

But to have everyone crowd in, you know, in a panicked reaction

and just dive in and everyone trying to do it

that's also not an answer.

And Seattle's council has a unique opportunity, I think, to be a convener.

Because the force of council is different than the force of any other convener. And the way that I see it is there are really powerful players that are tied into the system and are necessary parts of the answer. And then there are small little grassroots organizations that are barely scraping by, that are just as important. And to be able to equalize the power of these two incredibly valuable and important players is something that I feel like you're in a position to do.

With the right convening, the right facilitation, I think the possibility of actually avoiding duplication and covering gaps so that people are doing what they're really great at and not trying to cover all of the other ground.

People staying in their lane with the faith that somebody is going to be standing next to them

is something that can be intentionally created and planned. I also, you know, mention the three graphs that we see already.

additional resources to make sure that there are enough people who are able to work directly with clients. We know that folks are afraid of government.

We know that they're afraid of being targeted.

And so who better, right, than to invest in the workforce that looks like them, that maybe they come from the same street. They speak the same language. They share the same foods, right? This is the kind of connection that creates safety and the ability, I think, for people to be more effective. And hardly anyone wants to pay for that. So I think in the aspect of being able to bring people together to coordinate the effort

and to put some resources behind getting people onto the client-facing lines

are two really important things to consider.

I'm not sure if I could top that, John.

I think I'll just mention from the state perspective, I think awareness and education are a great first step.

I really appreciate the opportunity to come before you today just to share what's happening

at the federal level, at the state level. And I think as there are additional opportunities moving forward for us to share bilaterally

information, what's happening in King County and in Seattle with the state, and likewise

what is happening at the state. Those are opportunities that we would want to leverage and welcome the opportunity to participate.

Incredible. Thank you both. And hearing that charge too of being a convener,

I think our work as we navigate again, these changes will be continuing together. And colleagues, we are going to be continuing this discussion because as our two presenters here spoke to,

there are a number of provider partners that are doing the work on the ground and we are

going to be hearing from them next. So unless there's any final questions, last call. Wonderful.

I'm going to keep us moving and thank our presenters today. Thank you so much for being in committee.

And now we are going to move to item two. Could the clerk please read item two into the record?

Item two, roundtable conversation, one big beautiful bill act, HR1 impact on healthcare

providers in Seattle and Washington State briefing and discussion.

Fabulous. All right, colleagues, we have a few of the incredible provider partners that

were spoken about coming to the table today. So as folks get settled in, I know there's some

familiar faces coming before us for this. If you all could be on one side, that would actually be better. Otherwise, I'm looking at the back of your head. I'd rather see your face.

Wonderful. When you get settled in, if you can take a moment to introduce yourself before starting the presentation. Please proceed.

Good afternoon and thank you for the invitation to join the roundtable. My name is Mary Pearson and I'm the director of Aging and Disability Services.

G. Good afternoon. I'm G. DeCastro. He, him pronouns. I'm with Asian Counseling and Referral Service as Deputy Director.

Good afternoon. Summer Clavinowali. I'm the Chief Executive Officer at Harborview Medical Center.

Good afternoon, everyone. It's good to see you, Chair Rink, and other members of the Council. My name is Esther Lucero, and I'm Danette on my mom's side, Latina on my dad's side. and it's really important to be in solidarity at this moment. I also identify as two-spirit or in my language, Nathle, and I'm so proud of our trans relatives in here because the first step in creating change is identification and resistance, and I'm so proud of you. I know how intimidating environments like this can be, so keep raising your voice as we see you.

Oh, and I'm with Seattle and New Hillport. Sorry. I know you guys. I don't know them.

I'm like super proud of them, but I've, yeah. I love that grounding. Thank you. Wonderful. And I believe I'll be, we'll be hearing from Aging and Disability Services first. I'll just know if you need any tech support too. All right. Thank you. So as I stated, my name is Mary Pearson, the Division Director for Aging and Disability Services with the Human Services Department in the City of Seattle. ADS operates as the Area Agency on Aging for King County. and through federal, state, and local dollars, we fund a network of services that meet the needs of over 50,000 older adults, people with disabilities, and family caregivers each year. We also administer the Medicaid Long-Term Care Case Management Program, coordinating in-home care services for over 16,000 adults each month. Medicaid long-term services and supports provide in-home services and support for people who are assessed as financially and functionally eligible. The latter is defined as needing support with at least three activities of daily living, such as eating, bathing, or dressing. Washington State's Long-Term Services and Support Program is consistently ranked among the top two in the nation for high-quality and cost-effective care. Clients can receive care in their homes and community-based settings rather than in more costly institutional settings such as nursing homes and assisted living communities. Thank you.

Yeah, for Asian Counseling Referral Service, we provide behavioral health services and

also social services within the King County and wider state.

But primarily our services are within Seattle area, King County area, where most of our clients,

folks that we serve are Asian American, Native Hawaiian, and Pacific Islanders in the community.

Well, first of all, thank you so much for having me here. I am absolutely thrilled to be invited to a council meeting and am so pleased to be able to represent the institution of Harborview Medical Center.

And I'm also pleased to be here with such esteemed colleagues and everyone who is here. Thank you so much.

I wanted to take a minute to provide an oversight of who Harborview is.

I know most of us know who Harborview is, but who Harborview is in particular to the city and the county and the region we are in.

But more importantly, how federal changes like H.R.1 directly impact Harborview's mission and those that we are here to serve. So if we think about Harborview's mission being here to serve the most vulnerable of our region, always open to anyone and everyone regardless of payer status. Doesn't matter. Everyone is welcome into Harborview. So as you can imagine, HR1 will have a very large disproportionate impact on Harborview from a provider as an inpatient hospital and outpatient health services. If we think about where Harborview is right now, we really think about where health care is. Harborview is definitely a microcosm of what's happening federally to the health system across the country. Reimbursement cuts are set to hit with HR1. Harborview is estimating up to $700 million in reduced net revenue, revenue that we use to care for the most vulnerable in our community as H.R. 1 gets implemented over the next several years up until 2031. We will see coverage and service charges that will change. Just like Trinity talked about, the reality will be individuals will fall off Medicaid plans, will not be able to navigate the system. When we rolled out the Accountable Care Act, we had a federal government that definitely helped us

keep people on Medicaid and get people on Medicaid, we have the opposite now. It will be very hard to keep people on plans.

More importantly, we will have a difficulty with a large rise in individuals who will have no coverage at all, who will no longer be eligible.

Harborview, in addition to that, will also continue to see capacity constraints.

As you all know, we are so honored to have King County taxpayers give us a bond for new facilities. That is going to be an incredibly important project for us. And we remain in a state post-COVID of boarding and having way too many individuals in non-optimal space. These individuals are the individuals that we are all here to represent, right? We are here to talk about the most vulnerable in the community, and that's who Harborview serves. And we are working very hard to ensure we have the capacity and are able to execute on what the taxpayers provided us.

If I think about what Trinity presented, you guys, I can put it into a couple buckets for Harborview. If you think of the H.R.1, and I do not call it what its other name is, I will refer to it as H.R.1. First step for Harborview is that we will have the new Medicaid eligibility. There will be a lot more need for wraparound services and partnerships with individuals up here at the table with me to ensure we are all working together. So when individuals are seeking care, they are already on plans or we can get them on plans. Those that will not be on plans, obviously Harborview is the largest safety net, not

only in this area, but regionally.

Another big change that will be very catastrophic to our Medicaid population and those that will be seeking to try to stay on Medicaid is that they only have that 30-day window. Typically if you think about an individual that comes in with a catastrophic event or a very serious illness into a hospital, particularly Harborview, you have 90 days retro. So you are able, even if it's the day before, if it's the 89th day, we can still get them on a plan, which has been very important because oftentimes you think people are incapacitated. They're not able to do what they need to do to get on a Medicaid plan, right, from the paperwork perspective. And now we will only have 30 days.

That will not only be catastrophic to the individuals, it will result in a lot more charity care and uncompensated care to Harborview and other institutions.

We are already starting to see an impact to Harborview of more individuals who are either underinsured or uninsured Medicaid being transferred to Harborview from other health systems.

And I think that that will continue as there is a great deal of fear about health systems not having enough money to serve the most important that we have to serve.

The second step is, or the second piece of what Trinity talked about that is absolutely crucial to Harborview was this idea of these directed payment programs. These were made, these were created during the Accountable Care Act for hospitals like Harborview. These true super safety net hospitals that there are very few in the country left, but Harborview is one of.

The directed payment programs were made to provide a supplemental funding for Medicaid patient reimbursement.

It alLod providers like Harborview, who have large portions of Medicaid, to receive reimbursement that is somewhat closer to what hospitals who see a lot more commercial patients receive. Not equivalent to, but more. If you think about governmental payers like Medicare and Medicaid, they pay under what cost is.

So the ability for Medicaid, for a hospital like Harborview to receive these supplemental directed payment programs and to receive reimbursement to see all of these Medicaid patients and reinvest in these Medicaid patients, that's going away.

That is catastrophic to a hospital like Harborview.

Lastly, I would just say that we are incredibly committed at Harborview to continuing to serve the community we are here to serve.

We do not waive from our mission, we do not waive from our partnerships with all of the

other entities that are here to protect the most vulnerable, but we are ready to fight

the good fight and figure out ways to ensure that our individuals that we care the most

for are going to be taken care of and that we protect them from what's happening at the federal level.

Thank you, Summer. I have so much respect for my colleagues here at the table. And just for the public, the Seattle Indian Health Board is an urban Indian organization, meaning that we're part of the Indian Health Service system. So we do recognize that we have that carve out for American Indians, Alaska Natives for the work requirements. Just about 60% of the relatives we serve, we call our patients our relatives, identify as American Indian or Alaska Native. We also operate our Urban Indian Health Institute, which is one of 12 tribal epidemiology centers in the nation and acts as our public health arm. We are deemed a public health authority just like the county is. We are also a federally qualified health center, which means that we're part of the safety net that Summer was just talking about. We see everyone, regardless of their ability to pay. We see them in the native way. And so the conversation I want to have with you all today is because I know I have some creative thinkers up here, some brilliant policy minds. And something you said, Chair Rink, earlier is, oh, we don't pay for health care. You said, the city of Seattle doesn't pay for health care. And I'm going to tell you that you indirectly do. You just do it through the inter, what is it called, interlocal cooperative agreement or whatever it is with the county. So essentially what you've done is you've chosen to partner with one, one entity to provide health care services. And I'm bringing this up because you all actually funded Thunderbird Treatment Center because you recognize the value of inpatient treatment for the folks living on the streets here in Seattle. You recognize the intersection between mental health challenges, public safety, you know, Vice Chair Kettle, you really care about public safety and you know that we have to solve the substance use challenges to get through that problem. So I know you can think creatively. I also know that we distribute resources from the city of Seattle into the Regional Housing Authority, right? And these are funds that have been not used well.

So I'm going to challenge you all to really think about this Medicaid issue.

Here's why. How do you think we got a carve out for American Indian Falasca Natives? Well, we saw the Trump administration's initiatives to dismantle DEI programs. We had to get ahead of that conversation to help the Trump administration understand that American Indians and Alaska Natives are not just an ethnic identity, but also a political entity.

And we had to get ahead of that legislation. So when I hear rhetoric, right, and passion for communities that draw our people here,

They draw our people here because they're looking for safety and they're looking for resources and they're looking for protection.

We cannot stop at rhetoric. We cannot stop at a political position, but we have to really think about a plan and get our resources and our political strategies aligned so that we can get ahead of these initiatives that are designed to destroy us.

If the city of Seattle wants to be a leader, a true leader, you must have a plan, a vision, right?

Position and a plan. Without the plan, you're just dreaming.

Without the plan, you're making false promises to folks that are sitting here today. What I am telling you right now is that you have partners right here at this table that if you rethought the use of the funds,

If you rethought the use of the funds to supplement this Medicaid issue, you would have more impact.

You would have more impact. We're already sitting in a position for an urban Indian organization. We were promised Medicaid funds to supplement the underfunded system for Indian Health Service already.

When I think about things like this idea that all of a sudden, if you lose eligibility,

then you have to wait six months to even reapply? That's absolutely ridiculous. We have lawyers on this stage here.

Lawyers. You know, there's a new property theory by Charles Reich

that suggests that when you receive welfare or a sort of benefit, that it becomes a personal property right. Let's take a position on that.

I don't want to hear that we can't do anything, that we're going to sit here and talk about partnership or convening. I don't care about that. I care about resources and creativity and allocating resources.

So I'm here to ask you all to not just stand with us and, you know, give us looks that say, I'm so sorry you're dealing with this, but to really rise up and rethink the way we've always done things.

Only then.

an impact only then whoa I don't know creator said

Yes. Please listen. Thank you. Thank you. I just wanted to add to what my, um, our partners here have said, and to add to what I've, uh, introduced, ACRS, the services we provide, you know, the initial, uh, current, internal projections we have are that about 500 individuals that we're currently serving will lose Medicaid eligibility, um, 70 of them, as soon as October 1st, and we eagerly await the actual names and the folks who will actually lose those, the Medicaid coverage, come October and January 1st of 2027. But of that 500, about 220 of those are Seattle residents.

And for us, you know, what do we do? We're grateful for the information that's being shared through HCA, but for the actual

providers of behavioral health, their health care, behavioral health needs don't end when their coverage does.

And so we're left holding, like, we can't just like, oh, sorry, we can't serve you now. What's the plan? What's the guidance from state, local government of how we're going to handle all these folks

losing access to much needed primary and behavioral health care? It seems like the only door that will be left open will be emergency departments of our local hospitals, which is not an answer.

So what do we do? I mean, we've been thinking through this and have not heard any plan on how we transition care for those folks who will lose coverage. So that's one piece we're trying to think through. And for those folks who will have new work requirements, also we're thinking through how do we help them be compliant with the 80-hour-a-month work or volunteer requirement.

Are there opportunities to work with our city, county, state government on finding volunteer opportunities, like, for example, working or volunteering with our many, many parks in the city, in the county, in the state,

to maybe get those hours that they need so that they can keep on coverage? So those kinds of things are some of the things we're thinking through. And for a behavior health provider like ACRS providing linguistically and culturally responsive services, the loss of those folks that we serve will also mean a reduction in our workforce,

a loss in a specialized workforce that will be very hard for us to rebuild when the need rises again. So these are some of the things that we're working through, trying to hopefully partner with. our local government, like the City of Seattle, and with our partners in the area of how to address this.

Because as much as we want to provide services for free, our doors won't stay open that way.

We need resources to ensure that these vital services continue when those requirements hit in October and January. Thank you.

Thank you all, truly. And I want to specifically thank Esther just for that call to action and that challenge to all of us. This is exactly the reason why we wanted to at least have this committee meeting as really an inflection point to say we have to get serious around a plan and a strategy for the sake of our neighbors. And so I want to thank you for that call to action and definitely commit to a follow-up. I'm going to move next to Vice Chair Kettle.

Thank you, Chair. I just had, well, one statement, one comment, one question. Ms. Lucero, I hear you. Mission, vision, and plan. That's what we do with public safety. And having that construct is really important. And then doing the work that goes behind that as well is very important.

And like the chair, I'd love your passion with that as well. One question I had, you know, looking at this space, and again with our public commenters earlier today, is that health care in Washington State has changed dramatically. This changed dramatically since I retired from the Navy in 2012. For example, it's no longer Virginia Mason. It's no longer Swedish. And those changes have had really big impacts on our health care. And this is an instance where we definitely need an all-hands-on-deck kind of approach. But because of these changes, though, that's not really quite possible because of the changes in the health care system in our state. And there's a big difference now between which was once a secular system and now it's not. The secular system is basically King County, UW. And I don't think most satellites, I don't think most Washingtonians really understand the impact of this, and particularly when it comes to LGBTQ+, but some other areas as well. That could also be impacted with HB1. Yes, I don't call it the other name either. So, Ms. Whaley, can you speak to, like, some of those impacts? because that just puts extra pressure on you. And by the way, that impacts also impact rural Washington. So next thing you know it, not only do we have people coming from all over the country, but within the state we have this other type of health care-related migration, which then puts additional strain on the system. And can you speak to that, Ms. Whaley?

Very astute question. Thank you. The health care environment, it has drastically changed. and what you've seen is a lot of consolidations, mergers and acquisitions, particularly acquisitions of hospitals by larger systems, some from out of state and some from in-state. And so you're seeing a consolidation of the system into several large, you know, a few large systems. Public hospitals are different, as you pointed out, and in particular, UW Medicine, which operates Harborview in collaboration with King County, is very different as the largest public hospital, two hospitals in the state, right? What we are seeing, particularly at Harborview is already movement where others will make different choices around who will be seen for primary care, et cetera, which will then put additional need for an institution like Harborview. Most states don't rely on one single institution like Harborview, right? But we really are the standalone large safety net. If you look at how much Medicaid we do and Medicare together, it's well over 60%. That's typically what most hospitals do for commercial, right? If you think about how many Medicaid encounters we have a year, over 129, almost 130,000 of the 330,000 that we do, right? So very large population already here to serve the most vulnerable. However, as you pointed out, that takes a lot of resources. And as others begin to not be in that field as much, it is more stress on the safety net. When you have mostly governmental payers, governmental payers pay at less than cost. you will see a hospital like Harborview get into very serious financial constraints. When that happens, to your other point, it is the people that are most at risk are those in our community that are often the most vulnerable. Gender-affirming care, right? Gender-affirming care is at risk. Harborview remains a key site for gender-affirming care, but that is under attack.

women's rights, reproductive care, right? So as you see other entities come in to the state, you see a loss of that from a healthcare perspective, particularly when you already have rural hospitals that have difficulty providing that care. The other thing HR1 is doing is not only providing less resources to a place like Harborview with a very high Medicaid population, our rural hospitals have high Medicaid populations. Those rural hospitals will topple. When they topple, that does not mean you just don't have care for those that are poor or underinsured. You don't have care for anybody in the area. Often the services that go first are things like women's health, right? OB, that's what you're starting to see. People traveling well over an hour to get that. We are in a very precarious position as a health care system across the country. And unfortunately, what is currently happening at the federal level will exacerbate that crisis way faster than anybody could have ever imagined. Thank you.

Thank you for that. I'd also like to speak to the impacts to the paid and unpaid caregivers and their families.

And of course, right, fear and concern of the unknown, right, what's going to happen to their loved one

if they're not able to receive pay to continue to care for their family and having to make the difficult choice of providing care, right, or putting food on the table.

Sorry, I have loads of notes here. Right, and so services as far as such as like personal care, medication management, personal emergency response systems, home-delivered meals, and environmental modifications to ensure that the homes are safe and accessible. Also impacts to our partner agencies, and Carly G. is well positioned to speak about that, but at ADS we partner with four community-based agencies, Asian Counseling and Referral Services, Chinese Information Service Center, Lifelong, and Neighborhood House,

that help to provide the in-home case management care for clients that are at risk of losing services. Is there anything you want to add? Okay, well, one thing we did here from our contracted partners are there are a lot of the clients that are qualified for citizenship and have been on the waiting list for over a year.

So now they're going to be caught where they will have not received their citizenship status and will lose their coverage. And so we're really concerned about, you know, clients that are doing everything that they've been asked to do that are waiting.

But now we're just caught in the extended wait times. So that's another segment of the population that just want to make sure that we don't lose sight of.

Esther, did you have something to add to that point? I think I'd just like, I know we're talking about Medicaid reimbursement mostly, but I don't want to lose sight of the fact that HR1 also significantly impacts SNAP benefits. That's something that local communities can actually be responsive to. And we were speaking of workforce.

Here we are living in a very expensive city and getting our workforce to live here to

do their training, like our family medicine residents, for example, is already really challenging. So there are other ways that we can kind of support that work. I can tell you that the residency programs through Swedish Hospital, we're one of the sites that participate in that. They're going to be changing dramatically in the next three years because they just

can't afford to run. So I mean, we're talking about dismantling the healthcare system completely. And we can't go backwards. We just can't.

I want to invite you all to all of our committee meetings. I'm just appreciating the positivity and really connection with today's presentations.

And thank you for raising the point, too, on food access.

And we in this committee also had a focus session talking just about food access alone

and the impacts of all these, all the federal policy changes and cuts to SNAP and what's going on also currently with our food banks.

And so that's an encouragement to watch that committee meeting because we had some of our local providers also really unpack that component.

The impacts are profound and we can't go back. We simply can't. Colleagues additional questions?

I'm seeing Councilmember Foster. Thank you so much, Chair, and thank you again to our presenters. I really appreciate you all being here, as well as the work that you do day in and day out.

I wanted, my question I wanted to ask was for Harborview. I'm looking at and thinking about the $700 million in reimbursement loss that you mentioned through the end of 2031. And I know you also sort of you talked about the how the disenrollment, I'm like a more harsher word, but is going to make is going to end up with folks needing to access charity care and other components. And so I wanted to ask if that 700 million is inclusive of those other costs that Harborview expects to incur as people sort of shift how they are paying for their care.

и.ии.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и.и. we're looking at that we realized is we have thankfully provided a much more generous charity care ability. So we were actually at 300% of FPL, where back then we were at more like 200, 250, with a sliding scale up to 400% FPL. So many more individuals are able to access charity care, which means free care from Harborview. So I think that we don't have a good understanding yet of what that will look like. And that's a very daunting thing to think about, particularly since we know that that will be a population of individuals that may only have Harborview as a choice for their inpatient care. So that's a very, it's a big question mark to me. And I thank you for pointing that out.

Yeah, thank you for that. I mean, I think the number is staggering in and of itself. And then to know that that's not comprehensive. So thank you for that. Thank you, Chair.

Thank you, colleagues.

With that, I am going to keep us moving on this hearing some direct calls to say we have

some work to do together following this meeting. And I imagine I just heard a call from the audience.

I would humbly ask our presenters if you're available for questions from folks in the audience, perhaps after the presentation.

I think there's some interest.

We don't take questions from the audience during committee meetings, but my team will be available after the meeting to have these discussions.

But I want to thank you all for the work that you do and are doing and for your partnership and just a commitment to you that we're going to do this work together moving forward beyond this committee meeting.

So thank you. Thank you.

I'm going to move us to our third item of business for today and our final item. Will the clerk please read item three into the record?

Item three, civil rights and two-spirit lesbian, gay, bisexual, transgender, queer questioning,

intersex and asexual, 2SLGBTQIA plus communities in Seattle, briefing and discussion.

Thank you all. While we're going through the transition. Thank you.

! Wonderful, welcome to our final panel for the day. ! If you want to take a moment to introduce yourselves !

Thank you for having us.

Can you hear me now? Yeah, there it is. Thanks for having us, Councilmembers. Council Chair Ring, thank you for the invitation to speak. My name is Chris Correa. I am one of the chairs of the Seattle LGBTQ Commission. We're grateful to be here.

My name is Cody Allen. I use he, him pronouns, and I am another co-chair of the Seattle LGBTQ Commission.

Hi, Councilmembers. Ann Maher, Federal Affairs Director in our Office of Intergovernmental Relations.

Good afternoon. Dominique Stevens, she, her pronouns, special advisor on LGBTQ affairs for the mayor's office. Glad to be with you all.

Good afternoon. Dr. Hadjah Al-Faham, Seattle Office for Civil Rights Policy Director, she, her pronouns.

So, as the commission, we wanted to start off just by framing a little bit of our conversation

and what we have heard from community that even brought us to participate in some of the actions that we have here today.

So we've highlighted a few different things.

While we're talking about two-spirit LGBTQIA plus communities at large, we really wanted to center on transgender and gender nonconforming folks who are experiencing an onslaught of attacks. federally, legislation and the like to this, to their community, to their rights, to our rights. So escalating anti-trans legislation that's not just happening federally, but also happening at a local and state level is driving internal displacement that's happening where folks from other states are coming to our city, our region, our state and looking for

the protections that we have as a place of refuge. And this is placing a growing pressure on our

community-based organizations that are already providing the kind of wrap-around services, whether we're talking about food assistance, health care support, legal navigation,

those kinds of things who are feeling strapped to be able to help not just the people who identify as transgender, gender nonconforming in our community, but also those who are relocating to our region to call it home as a place of safety and refuge. So as the commission, we've been in conversation with some of these community-based organizations that have asked us,

you know, what can we do to help and the increased demand for services, the higher operating costs.

the shifting funding landscape and even the attacks at the federal level on some of these organizations have created some new and complex and challenging pressures that brought what was once and a critical issue into now being an urgent issue, a matter of crisis for not just our community-based organizations, but also those who are directly receiving their services. And so the community ask has been to really start with just immediate stabilization while all of these complex changes are happening, particularly by way of funding resources, to preserve the good work that is already happening within our community-based organizations and service providers while we're also working to create more long-term solutions through not just

looking at this budgetary cycle but also looking beyond into the kind of infrastructural support that will continue to reinforce our welcoming cities values and Cody's going to take a little bit of time to talk about what that has looked like at the more boots on the ground level in dealing directly with our NGOs and our community-based partners.

Yeah, so I just want to take a moment to frame what the commission is, what we do.

So we are a volunteer-based commission.

We are made up of community members, LGBT community members, many of whom work in nonprofit, but have also received services from these organizations ourselves.

And so one of our biggest roles is to be a bridge between our community and the city, this body. In the last six to eight months, what we have seen, what we have heard, is community organizations coming to us raising red flags.

That they do not have the funding and the resources needed to continue these really, really important services to our community.

queer-specific health care, trans-specific health care, wraparound community or case management,

housing and emergency shelter services.

And this isn't a, we don't have the funding for this year, but we can figure it out next year.

This is a, we don't have the funding to stay open until the end of the year emergency.

And so while these organizations are dealing with an increase in clientele, when they should

be increasing staffing and they should be increasing programming, they are instead doing

layoffs.

They are figuring out where to cut money from these little services just to keep their doors open.

and the impact that these organizations closing would have on our communities is almost impossible to quantify and is already creating a strain on other organizations that are not queer specific. In my day job, I am a program manager for a homeless shelter. We have seen a massive increase in trans specifically and queer young adults who are coming here from other states. And so that I can tell you 100% that 95 number that we heard earlier is a massive understatement. We have seen that in our shelter alone. We are turning away at least 10 young adults a night, and we are the biggest shelter in the city. And many, many, many of our clients are trans refugees who have come here. If these community-based organizations that are specifically for queer people close, the impact that would have obviously on the people who use those services, but also every other community-based organization in the city who are also experiencing decreased funding because of this federal administration,

would put a huge strain on the system.

And so what the commission, as Chris said, what we've been working on, what we are asking is both short-term and long-term solutions at the same time.

Long-term solutions are so important to set our community up for success.

But they don't matter if we don't have short-term solutions to ensure that these community-based organizations survive. We can talk about the future all we want, but if these community organizations don't have a future, then it's a new point.

So we are asking the city, the city council, the mayor, to continue. We need help.

our community needs help and

this is the only place

that we can get it from

so yeah do you have something to add? that's great yeah

awesome well I think as you all know and as we can tell today there is a lot happening around LGBTQIA and civil rights at the national level So per usual, could spend quite some time talking about it. So just for the sake of time, I'm really here to just provide a few concrete examples of

harmful actions the federal administration has taken, which I obviously will reiterate the need for the work of my colleagues here are discussing, and then also share some insights on what's happening, what happened during our last state legislative session. So starting with the federal administration, you may recall that when Trump first took office, there was a slew of executive orders, many of them focused on DEI and queer rights. One of the initial orders that came out was actually a rescinding of President Biden's orders, mainly focused around LGBTQIA equity. And included in that was the establishment of the White House

Gender Policy Council. So that no longer exists. We also saw some concerning orders like 14187

and 14190, which both targeted trans youth. And outside of those, we also saw executive orders that impact federal funding. So 14151 really aimed to put restrictions on local governments and federal funding recipients specifically around diversity, equity, and inclusion. And so while there has been extensive litigation on these orders, I just think it really demonstrates rights that the administration has and really will continue to attack equity and specifically trans rights.

We've also seen the Supreme Court here, a number of cases related to trans rights. Just earlier this year, oral arguments were held for West Virginia BPJ and Little Reese Hecocks, which are both focused on banning transgender youth from participating in sports. There was also a major decision around banning of conversion therapy, Chiles v. Salazar. And so these are both issues that remain incredibly important to our community members, so just wanted to highlight those.

And then before hopping over to the state side, I also wanted to flag a highly problematic

proposed rule coming from the Office of Management and Budget. Just last month, this rule is aimed to rework the federal funding process and would essentially give authority to halt grant awards based on national priorities, bar DEI policies and gender transition services, and also give the administration the authority to alter funding requirements based on national interest. So this remains a huge concern to cities along with national entities. Director of Public. And I imagine this will quickly elevate to a legal challenge if enacted. So with all that being said, the Washington State Legislature did take quite a few actions this past cycle to protect the queer community. Just a few to mention. Senate Bill 6081, which prevents Department of Health and Department of Licensing from disclosing records about sex designation changes. Senate Bill 6183, which will increase access to early treatment to prevent HIV. progression. And then we also saw House Bill 1604 pass, which provides parameters for conducting searches of transgender and intersex individuals combined in local jails, and will also allow individuals to express a preference for the gender staff conducting their search. So as you can see, obviously a lot happening around queer and civil rights, both on the national level and here at home. You know, this slide is truly the tip of the iceberg. I think as we've seen through the presentations and public comment today. So, you know, Council Member Rink, do appreciate you raising this issue today and happy to answer any questions. And just on a personal note, I want to thank everyone for their public comment today. Also a member of the queer community. And this is such a difficult time.

And I hope that folks can also find some time to celebrate and find some queer joy this weekend. So with that, I'll pass it to the Mayor's Office and Dominique.

So, again, good afternoon. Glad to be with you all. Really honored that, first, this role that I sit in has never existed in the City of Seattle. So, the mayor's office being intentional about having a special advisor on LGBTQ affairs is a big thing. And then the next step is that we recently stood up, which as you see on the screen, a trans and queer community stabilization interdepartmental team that also has never existed in the city and so here we are. So we understand the urgency of the matter of where we are right now, the call of action to folks moving into Seattle, welcome to Seattle, and the long-standing needs of our community as well. And so this IDT in partnership with Office of Civil Rights and the Commission and community members, which is great,

will be able to address the citywide immediate needs, right, fortified long-term services of questions and asks and demands, whether you're a community member and even folks who are queer identified and they work in the city of Seattle. There's been a bunch of requests from them as

well that's been unaddressed, unanswered. And so this will help us stabilize and start to operationalize across the board what would be immediate needs and long-term needs. So this also kind of goes to what Chris and Cody was talking about in terms of immediate funding, not just like in this year, but what can be done to be stabilized, ongoing. What does it look like to also have maybe low barrier access to some of this funding? Because we know some of these organizations, they work with very sensitive information. So we don't want to further harm community as we're also making the funds available. Simultaneously, this is community formed in terms of housing, behavioral health, food, transportation, legal navigation, survivor-centered violence prevention. And so part of that too would say we, as we're taking the community informed information, the questions, the facts, and we're trying to formalize what would happen next, we want to make sure that we're doing this in a very intentional way. So, for example, we can say, and this is, we can get into this deeper at another time, but we know that in our shelter expansion, there will be a trans-specific site

that will be stood up, right? That's something that we should be able to go ahead and say. Simultaneously, through this IDT, it also helps us figure out what we do in terms of folks who migrating here, right? Because you might be migrating here with some resources. So how do we, and something that I think I heard at the table too earlier, was that how do we make sure that you don't deplete all your resources to get services, right? Sometimes we have a bad habit of making people go to zero to get services, but I think that we can be on the precipice of making sure that we do not deplete someone's resources if they move to Seattle for their safety.

Um, and then ultimately we're going to do this as an intersectionalized approach, right? We're going to mean in all the identities that be able to talk about what you need in terms of whether you're a young person or old person, uh, older person, I should say, wisdom. I wasn't looking at you, council, council member Kettle. And I was like, how did I even get this? But we want to make sure that across the board, we stabilize and we're not always at the starting line. We want to make sure that this is ongoing for our folks and for our community members.

And as a proud L of the LGBTQ, yes, I had this conversation earlier too, Council President.

Yet we want to make sure that everyone is seen, identified, and lifted up in a non-harmful way to get the services and the needs that they want, so desire, as they live in Seattle, play in Seattle, work in Seattle. So more to come on this. This IDT has, we've only had a few meetings, and thank you to most of you all on the dais. You all have great representation in this IDT. And so we'll be adding more departments as it comes. And as our engagement rolls out, we'll have way more community engagement from our various community partners. And we're going to make sure that's a broad approach as well. So thank you.

Good afternoon. Today I'd like to cover an overview of how the Seattle Office for Civil Rights approaches civil rights promotion and protection, but with a special focus on two-spirit LGBTQIA

plus communities. The first area of work that we lead in is on civil rights policy and enforcement.

In this area, we enforce the all-gender restrooms ordinance, conversion therapy ban on minors. We also monitor and enforce 21 protected classes that include gender identity, sexual orientation,

marital status, and sex. In addition, when we conduct our policy analysis, we not only take a data-informed and scientific

approach, we apply an intentional intersectional lens so we pay close attention to how policies

impact folks, particularly those on the margins of society. and we consider very closely how a range of policies affect two-spirit LGBTQIA communities in particular. Along with our policy and enforcement, we engage communities directly through our commissions. Currently, we're collaborating with the LGBTQ Commission on the Trans and Queer Community Stabilization IDT. We also have our Women's Commission and our Disability Commission and our Human Rights Commission that we engage as well. Finally, I'd like to give a preview of what our race and social justice division will be rolling out in the very near future.

They will be working on trainings for city employees that consider how race, gender, sexual orientation, and gender identity overlap in significant ways and shape how we can better support the public.

Thank you all.

Thank you all for walking through all of this. Colleagues, I'm going to open it up to you all for questions first.

I know we've had a lot thrown at us today. Don't be shy.

Council President Hollingsworth. Thank you, Chair, and thank you for putting this together, and thank you all for your hard work on this. I know it takes a lot of coordination and effort, and then also getting information from the community, and then also bridging what we hear from community, and then figuring out how we're going to put it into policy and actually concrete pieces through whatever processes, whether it's the executive legislative process, is it a departmental piece? I know that takes a lot, the bureaucracy that often people don't see. However, trying to move with a sense of urgency to meet the need and also the moment in time as well, I know is like, it is a delicate dance. So just want to, number one, thank you all for that.

And the second thing I wanted to know, and I heard it from a lot of the people that spoke

today was about just like resources, immediate resources for community so we can stabilize what we've seen go on in our streets, whether it's housing, resources, food, mental health. I heard people talk about, hey, we need jobs, you know, just these pieces. And wanted to know from

your all's perspective if we are thinking, because I know there are immediate needs and then there's long-term pieces and what we're focusing on. I know what I'm trying to focus on as a council member particularly are like, what are the immediate needs right now to stabilize?

Because often when you're a moment of crisis, like, you know, it's hard to try to figure that out. But what I've heard is housing, food access, and then building up a lot of the groups that are here, that infrastructure piece. So could you all talk about like, hey, here are the immediate needs that we've seen and

And you all talked about them a little bit today, but like, hey, here's how we're approaching this for immediate needs right now that we've seen, you know, that community needs.

I think funding is the biggest one.

And many of our organizations have grown to be very scrappy with the wraparound care that they offer.

One-stop shops for all sorts of different types of resources.

and being able to provide some of that funding support to help keep them afloat, particularly at a time where they're experiencing a lot of trepidation from previous donors

who don't want to be flagged within the federal administration's crosshairs,

particularly in times that they are seeing legislation roll out from the Justice Department

that is calling community-based organizations supporting queer and trans folk domestic terrorists.

There's a lot of trepidation about...

There's a lot of understandable trepidation about what it means to support community organizations right now.

And we also want to endorse that they are doing the really good work out in community right now

and don't want to stop them in doing that good work. In fact, we want to build them up.

Yeah.

I think it's really important to highlight that Seattle does have a historic and really robust support system for LGBTQ communities.

It's just we don't have the funding in order for them to do what they need to do.

And so I don't think, obviously there's always more programs and there's always more growth that we can do. But I don't think the question is what more programming can we be doing right now?

The programming is there.

It's just it doesn't have the funding for it to reach the level that it needs to reach in order to help the community in the way that the community needs help.

So it's funding.

If I may, I think that one of the major barriers to a lot of these essential resources and services is discrimination.

And so for the Office of Civil Rights, we have a public-facing office, so we do intakes

with folks who have experienced discrimination, whether it's with employment or housing or contracting.

And so one of the things that we do is we do intakes, we investigate, and we do our best to mediate or come to a solution to remedy the discrimination.

So I just wanted to offer that up as something that the city does right now to try to help folks get equal access and equal opportunity. Yeah.

I think also the community and the commission as well is that we've heard a lot about having a system navigator.

someone or a community-based organization or a series of people, if you will, that can help our new neighbors navigate where the resources are. Sometimes it's just hard to find out where the basic resources are, if there's even accessibility for that.

And so we're really taking in the account of the ask for funding and the system navigator. We know that there's a question about an office as well, but we really want to focus on this short term, which is can we find the funding for 2026? Can we stabilize the funding into 2027, 2028? And then and simultaneously figure out this system navigator. So as people are moving to Seattle and the county and Washington, but specifically Seattle, that there's there's access for you to be able to find the needs that you that folks are looking for as they move here. Right. And I think through the IDT, what we can explore are models that we've used in other departments and other ways to be able to support folks. So, for example, we came up with a series of fundings that went to immigrant refugee affairs.

Then we were able to put that funding in a philanthropic group. So then they had low barrier access to those funds. What are how do we continue those kind of models? Similar to, I think someone else said it too in their public comment, you know, there's, while we're going, while we're taking care of the folks who are chronically unsheltered on the ground now, and then we have folks moving in, are there models that we can use hotel services and things like that? So, then, at least, it gives you, again, access to housing and being sheltered, while you figure out how to get on, get on your feet, while you move to Seattle, right? And so, and we're not putting you in further, further harm, as you're trying to find your footing. So, we're, we're trying to, those are the immediate things that we've heard, right off the bat. So, thank you, Council President, for the question. I'll also just offer that, um, part of the Office of Intergovernmental Relations work is around, um, advocacy, and policy, um, on the national level,

And so, you know, in hand with that, there's a lot on the legal side right now around protecting community. And so I'm happy to partner as we can around some national advocacy on these issues. And I think a continuation of just protecting from the legal side is needed right now outside of financial resources.

Awesome. Thank you for that. And then my last, and this is just a comment probably, because that's helpful to kind of just know like what you all have been hearing and kind of what the focus is, is I think there's a unique opportunity because of the group that's been stood up with all the departments and mayor's office and council to, because I hear resources. And then I also hear, let's have a plan. And I think being able to set up a plan and being very, very intentional about, okay, these groups are doing the housing. Then after that, these groups are doing the food access. These groups are doing the mental health, like resource mapping. So then when someone comes to Seattle or people that are here, they're able to figure out where to go in a system that is easily accessible with this instead of it just being like, okay, let's fund this, fund this. And it's just like, okay, what are we funding here? And I think there's an opportunity for that to plan out since it's the infancy stage. And a point of privilege I think is really cool because I did coach Annie. And so to see her here in high school, to see her, how she's grown up into a great young woman and advocating for this, and then you responding to these questions. I'm like, yo, this is a full circle moment for me. So I just wanted to say point of privilege. It's really great to see how well you've grown up and been able to advocate for this. So really proud. Thank you. Thank you, Councilmember.

I appreciate that. And just a shout out for Seattle's Youth Commission as well. I was on Seattle's Youth Commission. So it's quite a privilege to be at this table today. Thank you.

Such a wholesome note, Council President. Thank you. I wanted to build on a point and the question that Council President had as she was asking about the need. I want to put a finer point on that and just ask about scale, because we've talked a little bit about data today and the challenges around data. We heard some data points raised in public comment. We heard some additional data points raised by the panel before us right now.

And so data is a powerful thing, and data also can be really complicated in terms of how we collect data, who we collect data on, how that data is then framed. And particularly right now with such a concerted discrimination against trans people, I mean, there's real danger that comes with data collection as well. And so I'm wondering if the panel can speak to how are we trying to balance the need, knowing that understanding scale and the data behind scale is really important as we're shaping that plan. plan and looking at investing resources, but also what do we need to be mindful of when

it comes to data privacy and protection? Because a lot of people are getting by right now by

staying invisible. And I want us to ensure that as we are moving through this work we are being really mindful and careful about that reality.

I think that's a great question. I think for us right now, we really need the data points on folks who are actually moving to Seattle.

We've heard a lot of antidotes about how many folks are moving to Washington, but we haven't seen any real numbers on people moving to Seattle. So we really, we're kind of figuring that person

out too, so we can figure out how to scale up into this plan. I think that, and then for how we're,

I think I might have to table, let me think about the rest of your question for a second, because we also want to make sure that as we're getting information, we want to do it mindfully,

Right. Again, we've heard this time and time again, like some of our new organizations, they just became 501 C3s, you know, or again, this is why we're trying to figure out if we were able to find the funding, do we put the funding somewhere else?

So, again, it's like a low barrier situation. So they're not having to disclose a bunch of information that may not sit well with the organization or the clients that they serve.

So, we're being mindful of how we want to be able to collect that data. And again, we want to move ourselves out the way as government, because we're still government,

right? And so, as much as we want to move ourselves out the way, we don't, again, want to create

any more harm as we're trying to collect this data or what people need to be able to give to receive the funding. So we're mapping that out in IDT as well.

So there's a bunch more there, I will say.

Thank you, Dominique. Council member, I can share that as far as data collection with the IDT and community engagement goes, I think we're looking at a qualitative data approach, which allows us to learn more about folks' lived experience and do a version of user experience research, essentially. So we're learning directly from folks most impacted and the orgs that serve them what is it like to navigate the Seattle environment when it comes to accessing resources or services or potentially coming across barriers. One of the benefits of doing a qualitative approach, which is where we're headed, is privacy. You're not collecting sensitive data when you do qualitative research. You can anonymize the data. You can protect people and offer them a degree of cover while also learning from them and their experiences. So as far as IDT outreach and engagement goes, we will be taking a qualitative approach, which should offer a degree of protection around privacy. Thank you.

I really appreciate those thoughtful responses, understanding this is something we just are having to grapple with. So I look forward to continued discussions with the IDT and OCR on just how we do this right. And on that note, I want to thank the mayor for convening this IDT and bringing so many partners to the table to really start putting together this plan and taking this citywide approach on how we really tackle the challenges that we've heard about today. And in that same spirit, we've also heard articulated also by our vice-chair that Seattle can't do things alone. We never can and we I bring that up to the point that I'm wondering how we can really build up this work by thinking about partnering across jurisdictions as well knowing that Seattle is not alone in this and there's real opportunity to be partnering with other cities around the county. Looking to the county level and the state level and so I want to offer that and if there's any initial thinking too on this point. How are we thinking about engaging with our other jurisdictional

partners in this particular work? I'll let the commissioner speak some of it too, because they've done a lot of legwork already, but, and there's been a lot of great interest. I understand that there's interest from the port. We just started the conversation with the King

County Executive's Office about their interests and what their plans are in terms of stabilizing

and supporting LGBTQIA plus communities. Also in our engagement plan, it is extremely robust

on our regional partners of who we're going to be calling into the table on how we do this. And again,

this is, it's resources, specifically the resources is the funding part, right? So we really want people to come in and help us make sure that we can support our community-based organizations. So when we're at this stage, we will be able to call in as many organizations that align to this that make sense so we can do this in a more comprehensive way. So a bunch of folks are in this list of who we're going to be calling on to join us with this IDT and this stabilizing work.

And I think maybe just adding on to that or emphasizing Dominique's point that we have had really productive conversations with creative community partners across jurisdictions who also want to stay with us at the table. And I think that has been really encouraging to see, and I hope to see that snowball keep rolling, especially at a time where our community-based organizations are really feeling like the clock is ticking. Like we can come up with creative solutions with more people at the table to be able to do the things that help for just for the stabilization, not just now, but also thinking long term. So thank you for the question.

Thank you.

Colleagues, any additional questions for our panel today?

I'm not seeing any hands, and so I want to thank each of our panelists for this discussion today.

The work ahead of us is tremendously important, and so looking forward to continued updates

and work with the IDT and communicating out and really bringing more folks in.

So I really appreciated the last point around all of the folks that we can bring into this work.

So, thank you all so much for being here today and for your work. Thank you. Thank you, Councilmember. Thank you. Thank you. Thank you. Wonderful.

Colleagues, we have a standing ovation. Colleagues, we have reached the end of today's agenda.

A lot of information, I just want to get through at least two procedural notes. One, I want to just correct the record that Councilmember Rivera is excused from today's

meeting. I misspoke earlier, and I apologize for that error.

And finally, just as a quick update, tomorrow is Trans Pride.

So that feels particularly timely. Thank you, colleagues, for signing on to the Trans Pride Proclamation.

I'll be really excited to present in community and invite you all to come and present alongside as well. It's a really incredible event, and so I look forward to seeing you there.

We have reached the end of today's agenda. Does anyone have anything for good of the order?

All right. Hearing no further business to come before the committee, we are adjourned.

The next Select Committee on Federal Administration and Policy Changes is scheduled for September 10th.

Thank you, everyone. Please take care.

Happy Pride.