Adverse selection is an inherent factor, but I feel that the role of public health systems is to figure out how to deal effectively with these so-called adverse populations. The default models of providing services are adverse, not the people. If you provide home-based alternatives, case management alternatives, and prevention, the population does not have to become adverse in a financial sense. It has been reported that you want to see public health departments put more emphasis on wellness, not just care. We will start with the adolescent wellness initiative.
Adolescence is an important time to intervene and try to support healthy behaviors.
I am concerned that default public policy for high-risk adolescents is the criminal justice system. That is not the public policy objective that we should have. We are thinking about what we should be doing for even younger children to set healthy behaviors and trajectories. We will do a lot of community work and involve peer leaders in programs. We are continuing our fantastic partnerships with the Seattle school district, and increasing partnerships with communities throughout the county.