County waiting to make health board appointment until discussions with city settled

The city filled its vacancy on the joint city-county health board this week and during the discussion on Dec. 21, Commissioner Owen Robinson said the county had a vacancy that it had not filled since April.

Robinson said that two of the three county commissioners weren’t aware of the vacancy until he spoke with them about it recently. Robinson sits on the health board as a city representative, but will be coming off as his commission term expires at the end of the month.

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The Electric followed up with the county commissioners and Commissioner Joe Briggs said that they haven’t filled the seat for several reasons. Briggs serves as a county representative to the health board.

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Briggs said recent changes to state laws regarding the authority of local health boards “have lessened the time sensitivity to fill the position and more importantly depending on the outcome of the discussions between the city and county commissions, the make up or even the existence of the Board of Health is in question.”

The legislature made several changes impacting local health boards, one of which requiring a designated governing body over the health department and the health board. The makeup of that governing body has been a point of contention between the city and county for several months and is part of their ongoing discussions.

City considering temporary agreement for joint health department

The city and county have an agreement governing the operation of the Cascade County City-County Health Department that has not been modified since 1975.

This fall, the city and county approved a temporary agreement to make the county commission, with one city commissioner as a nonvoting member, the designated governing body.

That agreement is in place through June while the city and county continue work on a new agreement for operation of CCHD.

City, county nearing temporary agreement on governing body for joint health department

The city has indicated a plan to file in District Court asking a judge to make the determination on the law whether the governing body can be the existing health board or if it must be an elected body such as the county commission.

Briggs said that those discussions could potentially result in the city and county each having their own health departments and then each entity would need to define their own board membership requirements.

“An appointment made based on the current BOH structure may or may not be a good fit for the new structure of a county health department should that occur,” Briggs told The Electric in an email.

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The operation may continue as a joint agency, but there could be other changes to the membership requirement for the board, as the 1975 agreement requires a doctor, dentist and the superintendent of Great Falls Public Schools, as well a city and county commissioner, and one person appointed by the city and one appointed by the county.

Briggs said that could remain the same, but there could be changes to the appointment process. He said that the appointment of one city commissioner, one county commissioner and another person appointed by each body “is no longer inherent in the law.”

If the governing body for the local health board includes a county commissioner, it may not be appropriate to have one on the health board, he said.

City seeking legal opinion on joint operation of city-county health department

Another possibility is that the combined health department could be expanded to include other incorporated communities in the county, which are Belt, Cascade and Neihart, Briggs said. If that were to happen, then they would also get an appointment to the health board and possibly reduce the number of appointments for the county and city.

City, county discuss operation of joint health department

“Until some fundamental structural decisions are made by the city and county commissions regarding the City County Health Department, any appointment made to the current board of health would be a conditional appointment that may or may not exist at the end of fiscal year. Given the lack of a clear direction and description of the role that a new appointee would fill, it does not seem prudent to fill the position until we have some clarity,” Briggs said.