🏥 Skamania Public Health Update – Vaccines & Winter Readiness, Fall 2025

🩺 How Skamania County Public Health Operates

Before we dig into this update, we wanted to share about the small team, regional partnerships, and shared services that contextualize why meetings include ex: folks who may seem to work outside the county.

• Skamania is one of the smallest public-health departments in Washington.
The county has only a handful of full-time Community Health staff. Much of the mandated “health jurisdiction” work is handled through formal partnerships with Clark County and Klickitat County.

• Environmental Health is shared with Clark County Public Health.
Clark County provides Skamania with:

• Health Officer services (Dr. Melnick / Dr. da Silva Bhatia)
• Epidemiology consultation
• Communicable-disease investigation
• Foodborne illness investigations
• Certain environmental-health reviews

Skamania does not employ its own health officer.

• On-site septic and some inspections use Klickitat County assistance.
Because Skamania doesn’t have a full in-house EH team, Klickitat County staff complete portions of:

• Septic permitting and soil evaluations
• Water-sampling support
• Limited environmental inspections (as needed)

• WIC is operated locally but backed by regional support.
Skamania Community Health administers WIC directly, but receives federal compliance, nutritionist oversight, and training from the State DOH & Clark County Public Health.

• Public Health nursing is extremely limited.
The county does not have a large clinical nursing team. Vaccinations, outbreak follow-up, and homebound outreach are done by a very small staff with Clark County clinical backup.

• Emergency preparedness planning is regional.
Skamania partners with:

• SWACH (SW Washington Accountable Community of Health)
• Regional Emergency Operations Centers
• Washington Gorge Action Programs (WAGAP)
  for extreme weather response, wildfire smoke outreach, cooling/warming center coordination, and vulnerable-population communication.

• The county’s vital records office is part of Public Health.
Birth and death certificate services are handled through the Community Health office rather than the Auditor.

• Some state-mandated programs are “opt-in” only because of staffing.
As a result Skamania does not have:

• A dedicated tobacco prevention program
• A local chronic-disease prevention division
• Air-quality enforcement
• A county mental-health division (this is handled through Southwest Washington Behavioral Health / Lifeline Connections)

With that, let's get into our Fall Board of Health update.

🏥 Skamania County Board of Health - October 14, 2025
Flu shots, vaccine access, and planning for 2026

The Board of Health met Tuesday afternoon for its final meeting of the year, reviewing community-health updates, environmental-health coordination, and vaccine access for local residents and veterans.

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🗣 Public Comment
A resident of Stevenson raised concerns that the VA’s Vancouver clinic was not offering COVID-19 vaccines to veterans, even as flu shots were available. She urged county officials to ensure residents, particularly seniors and veterans, can access both vaccines locally.
She also promoted an upcoming community hospice education series titled “Speaking About Death and Dying,” organized by a retired nurse to encourage open discussion of end-of-life care and hospice coverage.

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🌿 Environmental Health Report - David Waymire
Waymire reported progress addressing food-safety enforcement issues and said the county is revising procedures in coordination with Clark County Public Health to streamline environmental-health oversight.
He noted staffing changes under the interlocal agreement with Klickitat County, which continues to assist Skamania with on-site sewage inspections and other environmental-health services.

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💉 Community Health Report - Tamara Cissell (Clinical Supervisor at Skamania County)
Cissell summarized fall vaccination outreach, reporting that the county has administered 43 high-dose flu shots, 15 standard-dose flu shots, and 12 COVID-19 doses, with additional clinics scheduled at senior centers and assisted-living facilities. She confirmed that the department maintains adequate vaccine supply and is expanding outreach to homebound residents.
Cissell also briefed the board on potential federal shutdown impacts on WIC (Women, Infants & Children) benefits, noting that temporary state funds would cover October but that longer-term disruptions could affect families if federal funding lapses.

Editorial note, Skamania County WIC Update: Washington DOH has secured USDA emergency funds to keep WIC food benefits active through mid-late November. Skamania County reports 48 local participants, with clinics and nutrition services continuing as normal. Public Health is monitoring federal funding closely and coordinating with local food banks in case additional support is needed. Families can continue using WIC benefits without interruption at this time.

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🧬 Health Officer Report – Dr. Brianna da Silva Bhatia (Clark County Public Health)
Dr. da Silva Bhatia joined remotely, addressing vaccine accessibility and clarifying that the Portland VA continues offering COVID vaccines, though coverage and availability vary between VA sites.
She explained that the CDC’s 2025-26 vaccine schedule now classifies COVID-19 vaccination as a “shared decision-making” recommendation rather than a universal one. This means insurers may no longer be required to cover it at no cost. Her presentation compared U.S. and European Union vaccination policies, highlighting that many EU countries continue to offer free or subsidized vaccines for all age groups, while U.S. access is increasingly dependent on insurance coverage.
She also reviewed current data showing low flu and COVID activity statewide and fewer than ten pertussis (whooping cough) cases in the county this year.

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📅 Scheduling & 2026 Planning
The board welcomed a new clerk who will begin in November and agreed to shift to quarterly meetings in 2026, typically held in March, June, September, and November.

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🗓 Next Steps

• Winter vaccine clinics will continue through December.
• The health department will monitor WIC funding and coordinate with local food banks if federal benefits lapse.
• Next Board of Health meeting: March 2026 (TBD)

💻 Join online: us02web.zoom.us/j/88906321210
✉️ Comments: commiss@co.skamania.wa.us

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🔎 Related News & Further Reading

🍼 WIC Funding Uncertainty & Local Response
Uplift Local reports on how Gorge-area food banks and health providers coordinated when federal WIC and SNAP funding faced temporary disruption. Skamania partners were included in the regional response.
🔗 https://upliftlocal.news/federal-shutdown-spurred-coordinated-local-response-to-food-shortages/

🏥 Skamania County Public Health Services Overview
A helpful refresher on what county Public Health covers: immunizations, WIC, environmental health, vital records, and disease prevention.
🔗 https://www.skamaniacounty.org/services/public-health

💉 Local COVID-19 & Flu Vaccine Information
The county maintains updated guidance on COVID-19 and seasonal illnesses, including local vaccine availability and public-health advisories.
🔗 https://www.skamaniacounty.org/departments-offices/community-health/public-health/covid-19

🌡 Extreme Weather, Air Quality & Local Preparedness
Public Health’s emergency management page outlines cooling/warming shelters, smoke guidance, and what residents can expect during heat waves or wildfire events.
🔗 https://www.skamaniacounty.org/services/public-health/emergency-preparedness

🌾 Food Access & Rural Health Gaps (Gorge-wide)
A two-part Uplift Local series looks at food insecurity and gaps in rural health access across the Gorge—issues echoed during recent county discussions of WIC, WGAP, and outreach to homebound residents.
🔗 https://upliftlocal.news (search “food insecurity” or “health access”)