County, city still have no agreement over management of CCHD
After nearly a year of discussions, disagreement and apparent lack of communication, the Cascade County Commission voted unanimously during their June 21 meeting to reject an amendment by the city to their joint agreement for management of the City-County Health Department.
They instead approved an amendment proposed by the deputy county attorney that is identical to the existing agreement but extends the term of the agreement to December 2022.
The interim agreement is set to expire June 30.
The city and county operate a joint health department that service both entities and have been under an operating agreement that was signed in 1975 and not updated since.
When the Legislature approved changes to local health departments and health boards as a reaction to health protocols and restrictions implemented during the COVID pandemic, they created a requirement that health departments must have a designated “governing body,” instead of the Board of Health, which previously oversaw the health department and had the authority to implement health protocols during emergencies such as COVID.
The fundamental disagreement between the city and county is who can be on the governing body.
The county contends that it must be an elected body and that it should be the County Commission since they fund the majority of CCHD.
The city has argued that the elected bodies could designate the health board as the governing body and essentially maintain the status quo, or that the governing body could be comprised of the county commissioners with a city commissioner serving as a voting member.
The current interim agreement has a city commissioner serving in a non-voting capacity with the county commissioners who have voting rights.
Cary Ann Haight, the deputy county attorney, said during the county commission’s June 21 meeting that she disputes the legality of having a city commissioner serving in a voting capacity on the governing body.
The city has filed a lawsuit in district court to ask a judge to make a determination on the makeup of the governing body.
A scheduling conference has been scheduled for June 22 in that matter, but that case is unlikely to be resolved in the near future.
Earlier in June, the City Commission voted to approve an amendment to the current operating agreement that would allow a city commissioner to serve in a voting capacity on the governing body.
Haight said during a June 15 work session that, “I don’t find their proposed amendment acceptable.”
County Commissioner Don Ryan asked if there decision during the June 21 meeting gave the city enough time to react to the county’s action.
Haight said she didn’t know the city’s agenda and “that’s not a conversation I’ve had with the city.”
Mayor Bob Kelly sits on the health board currently, as does County Commissioner Joe Briggs and during their June 1 health board meeting, Kelly said that the city was considering an amendment during their June 7 meeting and that document was transmitted to the county on June 8, according to city officials.
City officials told The Electric on June 21 that they hadn’t been aware of where the matter stood at the county as of this morning.
The city commission meets every first and third Tuesdays of the month and posts their agendas the Thursday before the meetings.
The county commission typically meets on the second and fourth Tuesday of the month and their agenda is usually posted the Friday before the meeting.
Ryan asked if the health board had the authority to enforce regulations without a governing body and Commissioner Joe Briggs said, “we don’t really know.”
Under the state law and the current joint agreement, the basic operation of the CCHD remains unchanged and the governing body would formally employ the health officer, formally adopt wastewater regulations as proposed by the health board; and would conduct a public hearing, seek public comment and be able to amend, rescind or otherwise change any directive, mandate or order issued by the health board in response to an emergency/disaster declaration from the governor.
Briggs said that the larger discussion about the management of CCHD is the funding.
He’s brought up the issue multiple times over the last year and said that the county funds the majority of the health department to the tune of about $1.5 million. from its rural mills.
The city contributes $250,000 annually.
Briggs brought up funding during a June 2021 joint city-county meeting about CCHD and city officials said that the city funds the majority of the Great Falls Public Library and the 911 dispatch center, both of which are joint city-county operations.
City Commissioner Joe McKenney has been meeting with Briggs for months about the governing body agreement and told The Electric on June 21 that he and city officials have told the county multiple times that they’re willing to discuss the funding issues, but that it’s not connected to the immediate need of establishing the governing body, which is required under state law.
“They just want to tie those things together. We thought it would be a good ice breaker to take care of this very simple agreement and then move on to the harder ones,” McKenney said. “We want to talk about [the funding issues]. We just wanted to do the easy one first, build good faith, then tackle the hard ones.”
During the meeting last summer, city officials said they didn’t feel comfortable increasing their contribution without more city oversight of CCHD.
Briggs said at that time he felt the same way about the dispatch center.
In recent year, under the county’s management, CCHD had financial issues after Alluvion Health split from the county.
In late 2019, the county determined that Alluvion owed the county $480,961 in billing revenues, back rent and phones and computers that the county had allowed Alluvion to retain.
Around the same time, the county treasurer’s office also discovered that $580,747.61 meant for the city had been sitting in a fund and hadn’t been distributed to the city since August 2016 from the local option tax vehicle tax for online registration renewals that the county and city split.
Briggs said during the June 15 work session that “the city has been unwilling to have substantive discussions about this.”
He said that he believes the 1975 agreement was designed for equitable cost sharing, though it does not specify those details.
Briggs said the county funds the bulk of CCHD’s budget and that’s “an inequity that in my opinion should not stand. To me, the real issue is the city needs to start paying its fair share of this.”
Briggs said as an example that the fees for restaurant inspections, most of which are in the city, is not enough to cover CCHD’s costs. Those fees are set by the Legislature, he said.
Under state law, the city is required to operate a health department and can do so as a joint venture or on its own.
Briggs said that the joint city-county operation is the best, but that they need to address funding.