Tensions rise over health department wages issues

The fate of the Hill County Health Department's wages seems uncertain after a tense meeting between department employees and the county commission Monday morning.

After once again being asked about using grant funding to address the issue, Hill County Health Department Public Health Director and Hill County Public Health Officer Kim Berg said that can't solve the department's problem.

"I don't know what else I can give you," she said. "Our staff is down to half, I mean I don't even have a person at the front, I have a bell ... I'm not asking for a penny more from the county. I've told you it is sustainable and there is nothing else I can do."

At the end of the hour-long meeting Berg once again told the commission that the situation at her department is dire and if they don't get help soon it is only going to get worse, holding back tears as she said it.

Members of the Hill County Health Department have been requesting a raise in wages for a long time, arguing that while they believe county employees in general are long-overdue for an increase in compensation, their department's educational and training requirements make the issue especially important for them.

Department employees have argued that the wages for comparable positions in counties around the state are much higher and the wages Hill County is offering isn't just making recruitment difficult, but driving existing employees away.

Hill County's then-WIC Coordinator Nicole Hungerford resigned from the department last month, citing wages and a lack of support and respect from the commission during and after the pandemic as her primary reasons for leaving.

Since Hungerford announced her departure the department and commissioners have had three meetings on the subject department personnel but no action has been taken.

Hill County Public Health Director Kim Berg has expressed increasing concern about the commission's lack of action.

In Monday's meeting, as well as in a meeting last week, she repeatedly said the department can't attract new people or keep their current staff on the wages they have, and after months of asking the commission to help they have exhausted all their options.

During a meeting with Hill County Commissioner Jake Strissel last month, Berg, who is also Hill County's public health officer, said the average wage for a public health officer in Montana is more than $40 an hour, and after 13 years on the job, she is at $26, and everyone at the department is significantly lower than the state average wage for their positions.

Berg and the department have asked the commission to approve higher wages for the department, but the commission has argued that there is no money to spare, despite having recently awarded substantial raises to the Hill County Sheriff's Department after negotiations with their union.

The commission briefly considered holding a special election to see if they could raise taxes to sustain better health department wages, but decided against it after county officials raised concerns about the substantial price tag on holding such an election, as well as their own concerns about further burdening taxpayers during an ongoing inflation crisis.

Health department employees have said they only need $30,000 more a year to cover the requested wages, and given that relatively small sum within the context of the entire county's budget, it doesn't seem like an election is even necessary.

At last week's meeting Berg suggested a new possible solution, restructuring the health department and eliminating a few positions to pay for the increases, which would require no extra money from the county and would be sustainable on the department's current budget.

After that meeting Berg said she had sent the idea to the commission the previous week and at this Monday's meeting she and the department sat down to answer more questions about their department and plan.

Berg's proposal was to reduce their staff of 11 down to a minimum staff of six plus whatever positions can be funded with grants provided by the state, which tend to change dramatically every two years.

In a statement sent to the Havre Daily News Monday afternoon Berg said they need a minimum of a public health nurse, family planning coordinator, WIC coordinator, WIC aide, program assistant and health officer.

"We are down over half our employees, and the current employees are willing to step up and take on additional duties and responsibilities for an appropriate wage adjustment," she said in the statement. "... Only 20% of our overall budget comes from county dollars and revenue from my department, the rest is all grant funded. ... Our department is willing to step up and do the work for appropriate compensation, and since that comes at no extra cost to the county it seems like a clear decision to me."

Hill County Commissioner Sheri Williams, who led Monday's meeting, said restructuring makes sense since other comparable departments in the state get by with smaller staff, though there was some confusion between her and department employees about what the actual number of staff at said departments is.

Berg said it's sometimes difficult to make comparisons like that, not just because departments are different, but communities are different, as some have more local institutions that cover things like chronic disease programs and tobacco education and prevention than others, which affects how much work their respective departments have to do.

Similar to last week, department employees spent time answering the commission's questions about how specific positions work, how their grants work and how education and licensing is paid for.

Hill County Commissioner Jake Strissel said it sounds like much of these costs are covered by the grants that fund many of the department's positions, but Berg and others said while some costs are covered there are a lot of license renewals that they need to pay for out of pocket.

The matter of grants has been a contentious one in previous meetings. Williams said in last week's meeting that she wanted to sit down with the department to go over their grants and see if they could be used to alleviate the issue.

Berg has said repeatedly throughout months of meetings that she uses every last dollar that she can from the grants to pay for wages, and only resorts to using county funds when absolutely necessary.

At Monday's meeting Williams brought the issue up again, asking for more time to look at grants.

Hill County Clerk and Recorder Lexis Dixon confirmed Berg's accuracy and said that money from these grants cannot be reallocated.

During the discussions about grants Williams said when other departments get grants they come to the commission very early on to tell them about them.

Hill County Commissioner Mark Peterson said the health department's positions are much more heavily funded by grants than other departments so it's not really the same situation.

Berg said the commission is provided monthly expenditure reports on the vast majority of their grants, they give the commission the information they need during budget season and they write up regular reports on how they spend money.

Berg also suggested a few other things increase the efficiency of the department.

She said that, when hiring, the department puts out advertising for specialized positions like "immunization nurse" or "communicable disease nurse" but, in reality, as long as the person in that position is a public health nurse they can train to take on these specializations.

She said it would be more efficient for recruitment if they put out advertisements just for "public health nurse" and designate specializations after hiring, which would be more efficient considering the state's grant support for positions often changes every few years.

"It can drastically change," she said.

Berg said her plan brings employees of the department up to the average pay in the state, with the exception of her own position, which would still be much lower.

She said the average pay for a Public Health Officer in the state is $40 to $45 an hour, but she understands that the county might not be able to handle something like that, so it would only raise her wage to $33 per hour, still well-below average.

Williams expressed concern about the increases, saying Berg's wage would be raised 25 percent, much higher than the increase given to the sheriff's, which she thinks may be inappropriate.

Health Department Nurse and WIC CPA Tami Schoen said if the county had incrementally increased pay as time went on, such a drastic increase wouldn't be necessary, and these increases will not cost the county anything.

In Berg's statement later that day she said the proposed wages she gave the commission in her plan came directly from using the Montana Association of Counties Salary Survey that was done July 2022.

She also said that focusing on the percentage increase isn't a good way to assess the situation especially since it is still far below the average, and the other employees need this very badly.

"Our lead public health nurse has been here nearly 20 years and moving her up to the state average only seems appropriate," she said in the statement. "There are many other staff who have been with our department for years, and restructuring and providing a wage adjustment is necessary to continue being able to offer essential public health services to Hill County."

She said if anyone has questions about the department, how they are staffed and funded and what they do with each program they are more than welcome to call and ask or email them at [email protected].

When asked what the commission needs to move forward on the issue Williams once again said she wants to look at the grants.

Peterson said grant funding changes significantly every year and they don't know how that will affect the department's sustainability under this restructuring, but Berg said because it doesn't require any more money from the county that shouldn't be a problem.

Berg asked the commission what they needed from her to move forward on the issue and received little answer beyond the request to look more closely at their grants.

Berg once again said that looking at the grants isn't going to solve the issue and the department needs action.

Dixon agreed with Berg, saying any more meetings on the matter of grants is completely pointless.

"This is a waste of time," she said. "I have other (expletive) I could be doing. Another meeting is just a waste of another hour and a half of you guy's busy lives."

The next meeting on this issue was scheduled for 9 a.m. Wednesday morning. No action will be taken at that meeting.

When asked if the matter would be put on the agenda for this week's business meeting on Thursday, Strissel said he would contact the Havre Daily News so it could be noticed to the public with the legally required 48-hour notice if they decide to do that. The Havre Daily News has received no such communication.

Other issues discussed at meeting

During the meeting Williams also asked Berg about a pair of bills in the Legislature seeking to weaken immunization requirements in schools and daycares, which Berg said made it past the transmittal deadline on party-line votes and they are almost certain to pass.

She said these bills will cause an increase in communicable diseases among children in the community and cause outbreaks that the county will need to pay to address.

She said fighting outbreaks is an unfunded mandate by the state and the county is on the hook for those costs, but that isn't the main issue for her or her employees.

"The thought of children in this county having measles or polio," she said. "It's scary."

Berg also talked about the still open county sanitarian position, which she said needs to be addressed as well. She said the position is not technically under the health department, but really should be, and suffers from the same wage issue that their department does.

She said she's also concerned about a planning position at the county potentially being funded with money meant for the sanitarian position which she said is a huge problem if true.

Williams said she hasn't had a chance to look into the matter yet as she was occupied all last week, but it is on her radar.

Berg said because the previous sanitarian Clay Vincient was also a planner at the same time, calls for the sanitarian are now going to a planner's office and some of those calls contain private information, as do documents stored on that office, so that needs to be rectified as well.