County adopts version of CCHD management agreement without city’s proposed member

Cascade County Commissioners voted 3-0 during their Aug. 24 meeting to approve a memorandum of understanding to adjust the 1975 agreement with the City of Great Falls regarding the operation of the City-County Health Department.

The commission adopted a version that does not include a non-voting member of the City Commission, as proposed by the City Commission.

City, county continuing discussion on management of CCHD

Since it’s a joint agreement, the version adopted by the county is not in force until approved by the City Commission, which has not yet formally considered the version of the document as adopted by the county this week.

The update is needed due to several law changes this year related to the oversight of public health agencies and the authority of local health boards.

Previously, local health boards had the authority to enact emergency health protocols, including those stricter than state rules.

City, county discuss operation of joint health department

The law change requires a governing body to oversee the health board and that measures in response to a health emergency can only be issued by a local health board when the governor has declared a state of emergency or disaster and those rules only remain in effect until the governing body holds a public meeting to affirm, modify or rescind those rules.

The county has interpreted the rule to mean a governing body must be an elected body, so either the county or city commission, and the county has said it believes that should remain within county control, since it’s larger geographically, the CCHD employees are currently under the county and the county carries the liability as well as funds 75 percent of the department.

Lawmakers consider limiting authority of local health officials

City officials disagree with that interpretation and believe that the city and county could create a local body that is essentially the existing board of health.

The law includes an option for a governing body to be “the entity identified as the governing body as established in the bylaws, interlocal agreement, or memorandum of understanding creating a city-county local board of health or a local district board of health.”

During a July 28 joint meeting of the city and county, Commissioner Joe Briggs said that Helena had tried that and the Montana Attorney General’s office had said it was not allowed.

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

Carey Ann Haight, deputy county attorney, said during the Aug. 24 county commission meeting that her office has concerns about the legality of creating a joint body by agreement.

She mentioned that CCHD needed a clear governing body so that people would be clear on the authority of the health board in dealing with variances.

The law as signed by the governor, states that, “it is a purpose of this chapter to address ongoing issues or conditions created during a declared state of emergency as a result of orders, directives, or mandates issued by the governor as allowed under Title 10, chapter 3, for a state of emergency acting longer than 7 days. It is not a purpose of this chapter to hinder, slow, or remove non-emergency-related powers granted to a local board of health.”

Certain types of variances are the normal operation of the health department and board of health, though the law has added that the board may propose for adoption by the local governing body rules related to variances that would be used to make those decisions.

During the Aug. 24 county commission meeting, Haight said that the city had discussed a modified version of the county’s draft without further communication to the county.

City Attorney Sara Sexe sent the city’s draft to Haight on Aug. 5, after city commissioners had discussed the matter with staff during a public work session.

The draft adopted by the county commission this week incorporated most of the edits from city staff, with the exception of the added city member to the governing body.