Los Alamos County Councilor Morrie Pongratz, left, and Paul Jaramillo, Pastor of Open Door Bible Ministry chat during a break at the Dec. 4 County Council meeting. Photo by Maire O’Neill/losalamosreporter.com

Healthy Schools Initiative Director for Los Alamos Public Schools Kristine Coblentz answers questions for Los Alamos County Council Dec. 4 as Superintendent Dr. Kurt Steinhaus and Board Member Andrea Cunningham look on. Photo by Maire O’Neill/losalamosreporter.com

Note: A landmark panel discussion was held at the Dec. 4 Los Alamos County Council meeting on Promoting a Healthy Community which resulted in a very extensive and comprehensive discussion of issues of concern in the community particularly for youth and the efforts being made to address those issues as well as available resources.  The Los Alamos Reporter has published a series of stories based on the meeting. This is the final story in a series of four. 

BY MAIRE O’NEILL

Los Alamos County Council members weighed in Dec. 4 following presentations related to Promoting a Healthy Community in a “panel discussion” placed on the Council agenda by Councilor Morrie Pongratz.

Councilor Pete Sheehy said he has been the liaison to the Community Health Council of Los Alamos for a long time, is aware of many programs discussed and certainly supports them.

“I feel a little guilty that one thing that I have not done is to make it known both to Council and to the community that all these things are going on. There are so many County-funded efforts and independent non-profit efforts. Independent of the $2 million that goes into Medicaid, the County puts $1.5 million into social services of all kinds” he said, adding that the organizations supported by the County leverage that and bring in another $1 million with state and other sources to enhance their work.

Sheehy said it is the job of councilors to get the word out and let people know that not only when someone has a problem, there are many resources which can be accessed for help before problem begin.

“Resources we have don’t matter if they don’t get to the people. Get the word out. If you see people with a problem try to gently communicate and see if you can connect them to some help,” he said.

Councilor Antonio Maggiore said he is the only councilor that went to high school in Los Alamos and that he has been acutely aware firsthand of all the issues and concerns raised.

“I think that gives me a different perspective from previous people who have sat up here on the dais,” he said. He asked Kristine Coblentz, director of Los Alamos Public Schools Healthy Schools Initiative some questions about the Youth Risk and Resiliency Survey results she had presented earlier in the evening. (See separate story). He asked if there was a reason the last time the YRRS was given to the entire student body was 2015. Coblentz responded mostly because of the expense to survey an entire school. She said students involved in reviewing the survey data have asked a similar question because they would prefer that everyone be surveyed.

“Last year we chose to do all students in second period so that it would hit students across all types of classes and all different ages and that is one reason why it looks a little funny – there are fewer older students I believe than younger students surveyed,” Coblentz said. Maggiore said the fact that that there are fewer older students lead him to be rather suspect of some of the data that’s provided.

“One of the students brought this up at the data roadshow. They weigh the responses to try to make it more representative. A student brought up that the older students could be lower than what was surveyed because many of those older students who are in jobs at Los Alamos National Laboratory or in internships in the community weren’t surveyed and that they would have less likelihood of having risky behaviors because they have security or other reasons to prohibit them from use. But we have no way of validating what that difference would be,” Coblentz responded.

Councilor Maggiore asked to what Coblentz attributes the doubling of the unprotected sex rate not having a public health office across the street from the high school is a factor. Coblentz said that absolutely could be a contributor students were accessing free condoms at that location. When Councilor asked where students access free condoms now, Coblentz said there isn’t a location that she is aware of.

“We’ve been in conversation with other community locations that would be close to the high school where they might be able to be made available on a neutral location but we haven’t been able to have an agreement on that yet,” Coblentz said.

Councilor Maggiore asked LAPS Superintendent Dr. Kurt Steinhaus who was in the audience why there are no condom machines in the high school.

“Why don’t we have bowls of condoms in the high school? What does it take to get them there?,” he asked. Steinhaus responded that he doesn’t know. He said what he does know is that the last time the issue was brought to the school board was several years ago and the board’s decision was “not to do this”. He said there might be some people in the room who are more knowledgeable about this than he is.

School board member and former public health nurse Andrea Cunningham said going back 15 years there was an initiative where they were looking into bringing in services, more family planning, that were linked in a school-based health.

“At the same time the public-parent reaction (that was two superintendents ago) was that it was not considered to be an issue at that time. It was also not considered to be welcome from a community standpoint. There was real discussion of offering birth control, condoms, family-planning related to the school so the attitude at that time was that the school was for education and public health was something was different and that there was an office located across the street which was available and a separate entity. Again this is many years ago. At that time that just sort of ended that discussion,” Cunningham said. “As far as coming back around, the funding for the health office has fluctuated greatly – staffing as well. I truly believe that the increase in unprotected sex is due to lack of resources and I know that as a council we are very grateful that you have been discussing funding, bringing in service.”

Councilor Maggiore said it’s a huge concern for him and asked Los Alamos Teen Center director Sylvan Argo if the Teen Center hands out condoms. Argo responded that certain staff are able to hand out condoms.

“The caveat – and this was voted on by our Y board and we adhere to our Y board’s decision – is at this time that the educational piece  is really important. So we make sure that with the resources that those teens have access to education, information and also ongoing support in that circumstance. That’s the other piece of it – we want to make sure that we’re connecting into a broader network of resource,” she said.

Councilor Maggiore asked if it is widely known that kids can come to the Teen Center and get condoms. Argo responded that she does not believe so. Councilor Maggiore asked if the Council is having a big discussion on promoting a healthy community , why that piece of knowledge is being withheld from the student body. He asked where were the students and Coblentz responded saying that the presenters were invited to attend the meeting less than a week beforehand and that with jobs, finals and other commitments she had not invited them to come. She said the students would love to come and that she could arrange it.

“You weren’t able to see their root causes and solutions because we don’t feel ready to release that to the public and I didn’t feel I should be presenting their work. The schools are ready and willing to partner with the County on a community health clinic to provide for these health care needs. We have pledged funding for that and the County has pledged funding. We just need to move forward as a community. We are gravely concerned and our student advocates would speak to that, that they help each other. We’d even like to train them to be peer counselors for each other in this way so that they would tell each other where the access is,” she said.

Coblentz said there have been conversations with Los Alamos Medical Center about the issue.

“We are on it. We all just need to move collaboratively and leverage our resources in a public health setting where they can receive counseling support because often these issues come with disclosures of sexual assault, disclosures of multiple partners. To have that person like we had in our former public health nurse is a really important component and honestly our school nurse – I think that is not a role that we have in our setting at this time right now in the school system. We are short staffed in both the nursing and counseling arena,” she said.

Councilor Maggiore said he would formally like to extend an extended invite for students to come and present because the numbers in the survey and some of the ways the survey is put together is designed to gloss over some of the seriousness of the issues. He said the survey is broken down in ways that he doesn’t think bear much on the real problems.

Coblentz told the Council that the students would welcome strongly participation in a community dialog event where there would be a more collaborative solution-focused setting.

“Sometimes this setting feels like they get to present and then answer questions and then it doesn’t always go towards solutions,” she said.

Cunningham said in most other places the state provides many of the services Los Alamos County is not eligible for.

“Being dependent on that funding, that fluctuating of services has been one of the reasons for the creation of JJAB in the way that it is. Many of the service organizations that have sprung up are to meet a need that has been presented by the community where we have to have a local response because we don’t have a state or federal response. So for the County to step forward and take all this as seriously as it has by funding Social Services, funding the clinic, you’ve taken the appropriate steps and I very much appreciate that. I think this emphasizes that we have to provide services for our own community because it’s not coming from outside, she said. She added that the wheels of change in government are very slow.

“We have been working on the clinic for two years and we’re still in that process,” Cunningham said.

Maggiore said the one thing that occurs to him is that the County has in recent years partnered every other year with the schools to the tune of about half a million dollars and that has been sort of limited to work on structures.

“I would be happy and I would hope that fellow councilors would share the view that next time that comes around that we dedicate that towards getting some serious programs up and running. And I’m going to go on record and say the next time the Teen Center contract comes up, I want to see condom distribution in that contract. Absolutely, no ifs ands or buts,” he said.

Councilor Rick Reiss said he appreciated the information that was shared, that it reminds everyone out there that good things are being done in the community. He said the number of programs already in place makes you wonder if there is really anything else that can be done.

“We’re swinging at just every baseball that’s being thrown at us. The problem is we never know where the baseball throwing machine is moved to. Maybe we do need to have a middle school space. Some of the stuff is pretty obvious that we might be able to do but with our environment changing so quickly it’s like about the time you get one problem solved a new one comes up. A perfect example is we’ve been tracking smoking for years and now all of a sudden we’ve got vaping.,” he said.

Reiss said the Department of Health’s office closing has really aggravated some of the processes.

“And now we’re seeing an uptick in unprotected sex and there’s less testing going on because what 15 or 16 year old is going to drive to Espanola to take care of those kinds of things…Hopefully we’re going to get that solved one of these days. We’ve been working on it for way too long and I didn’t make a very good impression with the Secretary that was here from the Department of Health when I just flat told them they were cheating us out of what we were due and that it was silly to think people were going to drive 30 miles to a state-driven health department,” he said.

Reiss said the JJAB scenarios presented by coordinator Lisa Zuhn were sobering.

“It’s kind of hard to imagine them in Los Alamos. The statistics show us we’ve always had some sobering scenarios but we tend to gloss over them. The case management is really important because you can kind of see if we’re making any progress and I think in the County that we even do case management though I’m not sure how much we do now. It could be that we are helping people get on Medicaid which is kind of a specialty as opposed to resolving an issue that perhaps almost got them into court and came to JJAB’s attention, he said.

Councilor Pongratz said that he wanted to bring up that Paul Jaramillo surfaced three issues – behavioral health, substance abuse and homelessness. He said homelessness had been touched upon but that the meeting would go on until the new year if everything was addressed. He asked Assistant County Manager Steve Lynn what the County is doing on homelessness and Section 8 housing. Lynne said the most recent activities really related to the affordable housing projects. He said the County recently closed on A-9 and that introduced an ordinance for a second affordable potential project with a public hearing to be held at the Dec. 18 Council meeting.

“In terms of homelessness, there is not an established, robust, singular program for that in the County but I do know that when those instances occur a lot of the people that have been up here speaking work with each other to do outreach to the resources that are out there to try and place people. That’s more of a case by case situation,” Lynne said.

Asked why the County doesn’t have a public health office here, Lynne responded that there was one organization that was qualified but they couldn’t get their board to agree to come to Los Alamos. He said that with the original expectation for developing the replacement service, some of the assumptions had turned out to be incorrect.

“So there’s been a more recent effort to restart that as a more typical procurement for services and that is underway and we’re hoping to see that out the door quickly because we know the need is urgent,” he said.

Councilor Susan O’Leary, attending by phone, said taking care of our youth is a responsibility of adults and that she believe it’s a responsibility of the County to make sure that there are programs in place that support healthy environment, healthy living and a system that produces healthy, productive high school graduates that go on to serve our community and our country.

“It’s not trivial, it’s central to the role of government in my opinion and frankly trying to help the youth in our community is why I decided to run for County Council,” she said.

She said children under 18 represent 25 percent of the County population and yet they can’t advocate for themselves and their parents really aren’t in a position to talk about issues on a more global level’

“Frankly the parents are too busy to come and advocate for the community overall. The only time we’ve seen parents show up was when we were discussing recreation bond projects and that was because those parents knew how important those projects would be to their children and they were willing to make that effort. We haven’t seen that in any other case in the four years that I’ve been on the Council. So it’s really incumbent to the professionals who are here tonight and who are working in our community to be fierce advocates for our children.” O’Leary said. “I’m terming out at the end of this month and in January no one’s going to care what I think about this. What I want to do tonight is to help the professionals in the room to understand that it’s incumbent upon you to find solutions and then to come to the Council and ask for the funding to support and deliver those solutions.”

She said one of the disappointments she has had in her four years as a councilor is a lack of support for youth.

“I hear some councilors talking about how much we’re doing and in my opinion, we don’t do anywhere near enough for our children and I think the example of the public health nurse position not being fixed and provided to our youth – it’s been two years now – is an example of how our youth do not get the attention and resources that they need. We don’t hear from the public apart from the few of you in the room about the need for a public health nurse. We need to acknowledge our responsibilities to get that position filled and do it as quickly as possible because I share Councilor Maggiore’s frustration. Two years ago I could have predicted that the survey results would show an increased unprotected sex and here we are and that shouldn’t be a surprise to anybody,” O’Leary said.

She said she didn’t hear in four years on the Council from public health professionals about public health programs and ways the County could fund.

“I don’t hear enough from the school board about the needs and ways the Council could support with more funding and I just encourage you to become more aggressive,” O’Leary said.

She said money has gone to public works and not to community service.

“If aliens came down and with a financial expert looked at our budget and made conclusions about our values, they would say this is a community that really likes to have nicely paved roads but it’s not a community that spends as much on its people and particularly its youth,” O’Leary said.

Council Chair David Izraelevitz asked about the RFP status for the health nurse. The response was that the RFP would go out this month and it would take three months before the process finished. Izraelevitz asked that the Council receive regular communication on status of the process.

Izraelevitz asked whether or not economic security is a root cause for kids for at risk behavior,  or if access to health care, mental illness, home environment, home education and parenting are factors. Coblentz responded that Izraelevitz’s question strikes to the very heart of what she is passionate about which is being very strategic about what’s being done.

“On the topic of economic advantage or disadvantage situation, we see risk behaviors happening across all social classes and situations. In fact there is some evidence that high risk behaviors occur in affluent communities. While that can be a factor, feeling economic insecurity or food insecurity absolutely creates increased stress, adverse childhood events which can affect development – yes – but I don’t want to limit those behaviors to those populations because that’s not what we see in the data,” she said. “We do see with students with more protective factors the risk behaviors are less. Students who have more of those have lower risk behaviors. So if they have secure housing, if they have a parent who’s home in the evening, a parent who knows where they are in the evening, many of those protective factors if you crosscut them with the risk behaviors they’ll be lower. Students with insecure housing will have the highest risk behaviors often.”

Coblentz said it’s easy to get lost in the weeds and when data comes out and be attracted to the scary ones and worry about what’s being done.

“That’s the reason why we’re moving to more strategic prevention framework approach because if we build the foundation of relationships, connectedness, safe spaces, adults who care, the ability to manage myself and read others, that will move all the needles on all the behaviors. We won’t have to be looking at every baseball that’s flying at us. We will know that our students have a more secure base from which to operate and will then have lower risk behaviors. This is a long-term exercise and it does speak to home environments,” she said. “We as adults have to model the positive, healthy, resilient behaviors and we don’t see that. We see a lot of youth modeling the behaviors we’re showing them. Bullying in particular. We see bullying in all environments in our community, in work environments, from parents to coaches to students to students to employers to their supervisees. That’s a cultural problem we see, not just a problem that we see in the schools. We have to model a different way.”