The city is continuing work on its agreement with the county for the joint operation of the City-County Health Department.

During their Aug. 3 work session, commissioners reviewed a draft of edits by city staff to the draft from the county.

State law requires both cities and counties to have health departments, but allows for cities and counties to combine and operate jointly, as is the case for Cascade County.

City, county discuss operation of joint health department

CCHD has been operated as a joint city-county venture under a 1975 interlocal that has not been updated since and officials said there are many provisions of that agreement that haven’t been followed for years.

The city and county commissioners met jointly July 28 to discuss the recent law changes that require a designated governing body to oversee a health department with the ability to overrule some decisions by a local health board, which previously had autonomy and authority to issue health related rules during a health emergency.

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During that meeting, County Commissioner Joe Briggs said that he believed the intent of the law was that the body be an elected body and that it should be the County Commission since CCHD employees fall under the county currently and the county funds the lionshare of CCHD currently.

During the joint meeting, several City Commissioners asked if they could designate the existing health board for that function and it appeared to them that the new law allowed for that.

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Briggs said that was being attempted in Lewis and Clark County and that the Montana Attorney General had said no, but he didn’t have formal documentation of such a decision.

The AG’s office told The Electric “there’s no formal opinion in relation to HB 121.”

Sara Sexe, city attorney, said she didn’t agree with the county’s argument that it couldn’t designate the Board of Health as the governing body.

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The city and county are working to draft an addendum to the existing 1975 agreement to address the law change and establish an interim governing body while a working group explores options for updating the operating agreement.

The county’s draft named the county commission as the interim governing body, but the city’s proposed edits add one city commissioner serving as a non-voting liaison member.

Commissioner Mary Moe said they are “not at all in agreement” with the county on how to structure the joint operation going forward.

She said, “I disagree with a lot of things that were said in that meeting,” of the joint meeting on July 28 and that this law change further limited local control.

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The new law requires that the governor declare a state of emergency and local rules can’t be more strict than those of the state, and health boards can issue health orders related to an emergency, but the local governing body can hold a public hearing to amend or override them if there’s opposition to those rules.

She said that the local health board made tough decisions during the COVID-19 pandemic that were “based on local facts. So we’ve lost some ground. It’s a good example of why local control is so important.”

Commissioner Rick Tryon said local control is a matter for the Legislature to decide, but he’s concerned about the local control they have over areas they have authority and responsibility for. He said that a majority of people in the county live within the city limits so they need to represent them in the operation of the health department.

“We’re not going to get rolled over here on this,” he said.

During the joint meeting, city officials said they wanted to ensure they had some oversight of the health department going forward, particularly if they were going to provide additional funding.

Briggs said the county felt the same way about the operation of the 911 dispatch center, which is also a joint operation but managed by the city.

City Manager Greg Doyon said during the Aug. 3 meeting that if necessary, once the CCHD agreement is done, they can review other partnerships with the county such as the 911 center, as well as the free parking the city provides for jurors at the county courthouse.

The city is proposing that the interim agreement, which will require public hearings and approval by both commissioners, run through Dec. 1 in the hope that by then the working group will have drafted a new operating agreement,