Board of Health looks at reorganization, impacts of new law

The Hill County Board of Health held a lengthy discussion Wednesday during its quarterly meeting about reorganizing the board and determining what body would have authority over it, a discussion largely stemming from a law passed by the 2021 Legislature.

The bill, pushed due to mandates issued to protect public health during the COVID-19 pandemic, strips health boards of their authority, requiring health proposals from the boards be approved by elected officials in a body overseeing the health board decisions.

Hill County Health Officer Kim Berg, also the Hill County Health Department public health director, said the reorganizations of health boards due to the legislation is something counties throughout Montana are trying to to figure out.

She said the boards in Gallatin County Missoula County and Flathead counties all have been working on this for some time.

“They’re all going about it different ways,” Berg said.

Hill County Attorney Lacey Lincoln said the process of restructuring the board and deciding what body would oversee it is very complex, involving planning the restructure, working on the interlocal agreement with the city as well as changing any applicable parts of the bylaws of the board.

“It’s a massive overhaul,” Lincoln said. “There’s a lot of moving parts.”

The agreement in place since 1981 has the city agreeing that the Hill County Commission appoints two members of the five-member board and the three commissioners take the remaining positions.

The board now is looking at setting up a commission appointed by both the city and the county governments.

Lincoln said the law requires a board to have one member appointed by the county, one appointed by the city and three members appointed by both. She said that is a minimum, the board could have more than five members.

Another question was what body would have to approve recommendations by the the health board, whether that would be the commission or the Havre mayor or city council or a mixed group with members from both jurisdictions.

Lincoln said how that is set up would be up to how the board is restructured, although it was noted that if the Hill County Commission was the governing body, it would be inappropriate for the commissioners also to be members of the health board.

Lincoln said another issue that would be fairly simple to resolves is the duration of the interlocal agreement. The agreement in effect has not been renewed since it was implemented in 1981, but the law requires it to be reviewed and approved every five years, she said. The bylaws need to be amended to put that into place.

The group agreed to move forward to contact the city and start working on how the new agreement and bylaws should be set up.

The board also discussed repairing the health department’s refrigerator or replacing it.

Berg said the 7-year-old pharmaceutical refrigerator failed in March, with a fail-safe warning letting the department save all vaccine stored in it except one batch of influenza vaccine, which actually was saved but had to be thrown out after a problem with the cooler to which it was moved.

She said right now, the health department’s vaccines are being stored at Northern Montana Health Care, which Berg said has been very helpful in dealing with the problem.

She said she is told the county maintenance department has been having problems getting the parts it needs to repair the refrigerator, with the vendor that supplied the unit putting up requirements making its repair difficult.

Hill County Commissioner Mark Peterson told Berg to document the problems and what it would cost to completely replace the refrigerator.

Hill County Health Department WIC coordinator Nicole Hungerford gave an update on that department including a pull of Similac infant formula, the company with which WIC contracts.

Hungerford said it has added to an already-existing shortage of formula, but WIC has approved a lengthy list of substitutes.

Hungerford said it is very important that people use approved infant formula, which is reinforced with vitamins and minerals and so on, rather than making their own or buying a substitute.

Brandi Williams said she recently underwent training as an instructor in the use of narcan, used to reverse the impacts of opioid drug overdoses. She said she would like to start doing training sessions in the community and wants to gauge the interest in doing so, with groups of people and private individuals who may be around drug overdoses.