Health board requesting additional funding from city for CCHD operations
The Cascade County health board drafted a letter to the City of Great Falls during their Feb. 4 meeting asking the city to increase its annual contribution to the City-County Health Department.
The division of CCHD’s costs between the city and county has long been a point of contention between the two entities, along with operations of other joint entities, including the Great Falls Public Library and the 911 dispatch center.
The health board is a joint city-county board that governs the joint city-county health department, but CCHD employees are county employees.
For the current budget year, total CCHD revenues are projected as $1,649,424 and total expenses are $2,257,383 with a projected $607,959 deficit, according to Trista Besich, county finance officer.
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The city contributed $250,000 toward operations, with the county contributing $478,306 through rural mills, general funds, entitlement revenue and permissive medical funds. CCHD also receives state and federal grants and generates revenues for services such as inspections, licenses and immunization fees.
The city’s contribution has remained the same since at least 2015, county officials said, while the county contribution has made up the balance depending on revenues and expenses annually.
For the Feb. 4 meeting, county staff gathered historical data for environmental health and communicable disease activities to compare those within the city limits versus the remainder of the county.
Environmental health data from 2015 through 2025 included primarily inspections required by law for restaurants, hotels, tattoo shops and other facilities.
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For those years, the services provided within the city limits totaled 9,329, of a countywide total of 10,918, or 85.77 percent, according to the county.
Within the communicable disease division, staff reviewed data from 2021 through 2025 identifying Great Falls versus county for communicable disease investigation, tracking and reporting.
Of the total 31,910 activities, 29,857, or 93.3 percent, were within the city, and the remaining 2,053 were in the county areas outside the Great Falls city boundary.
Shannon Wilson, a health board member and city commissioner, said she checked with the state’s local government trainer whether she could sign the letter since she’s a member of both bodies and was told it was okay.
She said she had no problem signing the letter, but finding money in the city budget would be tougher.
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County Commissioner Joe Briggs, health board member, said the county’s contribution to CCHD had been “significantly higher” than the city’s and that CCHD was operating under a 1970s management agreement with the city that is “not legally up to snuff.”
The city and county disagreed about the makeup of a governing body that was established by the Legislature in 2021 as a reaction to COVID and had a temporary updated management agreement that has since expired and the two local governments have made no progress on negotiating a new agreement.
Heather Hoyer, health board member and Great Falls Public Schools superintendent, said that 10 years is a long time to see a stagnant contribution as operational costs have increased.
During the Jan. 28 city commission retreat, City Manager Greg Doyon briefly mentioned CCHD funding and that it was on a bit of a “crash course” with the county’s seemingly reluctance to name a representative for the city’s new TIF review board after city commissioners opted not to appoint Briggs to the seat.
“I wish we had a better relationship with the county,” Doyon said.
The county made significant cuts to CCHD over the last year in an effort to reduce expenses as grant funding has been cut and revenues haven’t kept up with costs.
After working with commissioners to make those budget adjustments over the last year, former county health officer Abigail Hill resigned, effective Dec. 5.
The county has been operating without a health officer since and the interim administrator for the department quit the week after Hill.
Briggs told The Electric in December that the county can operate for up to 30 days without a designated public health officer, “although that is not our plan or desire. The county is currently in contract negotiations with an individual that is qualified to be the interim public health officer. We are hopeful of having that individual aboard shortly.”
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State law includes a provision that if a local health board fails to appoint a health officer within 30 days, the Montana Department of Health and Human Services may step in and appoint a health officer.
During Jan. 2 meeting, commissioners voted to approve agreement with Gladys Young for her to serve as interim public health officer from Jan. 1 through June 30 at $500 monthly rate, plus time for Young’s services onsite or electronically at $150 per hour with the minimum incremental charge for services of 15 minutes.
The county will reimburse Young for six months of medical malpractice insurance coverage beginning Jan. 1.
Young is a licensed and certified medical doctor in Montana with previous public health officer experience in Liberty County during the pandemic, according to the county.
In late December, commissioners interviewed two candidates for health officer, but weren’t satisfied with the options, so with approval from the health board, opted to readvertise the position and seek more candidates.
During the Feb. 4 health board meeting, Briggs said that county human resources had notified commissions that 11 applications had been received so they closed the position. HR is reviewing those applications, which will be sent to the health board for scoring and the top three will be scheduled for interviews.
Briggs said he was told it was a strong candidate pool and the number of applicants was improved from the first round.
For the first round, the county had received five applications with some withdrawals after scoring, so interviews were scheduled with the three remaining candidates.
One candidate didn’t appear on Zoom for her scheduled slot or answer phone calls.
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During the Jan. 7 health board meeting, Briggs said he’d initially had a level of confidence that they had someone in that pool with the experience needed to take CCHD forward, but after interviewing the two remaining candidates, “I was not personally excited by their actual experience.”
In reposting the position, Briggs said he didn’t want to exclude those who’d previously interviewed but “I really think we need some experience at the health department.”
During the January meeting, Wilson said both interviewed candidates had good points but “not the experience our department needs to move forward.”
