Commission hears about health department grants

After a tense meeting Monday morning, the Hill County Commission met with employees of the Hill County Health Department Wednesday to look at their grants as part of their efforts to raise the department's wages.

Commissioner Mark Peterson said the commission will likely take action on the matter sometime in the next two weeks.

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 four meetings on the subject with 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 and has repeatedly said the department can't attract new people or keep their current staff on the wages they have.

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.

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.

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.

Monday's meeting ended with the Hill County Commission requesting to look at the departments grant, a request that they've made several times over the last few weeks despite Berg saying she already uses as much of the grants as possible for wages and Hill County Clerk and Recorder Lexis Dixon saying such a meeting is a waste of time.

At the beginning of Wednesday's meeting Peterson said it is a stressful time for everyone and requested that everyone there be mindful of their "tone of voice."

Berg, as she has done in the last four meetings, repeated that she uses grants to pay wages as much as possible and resorts to using county funds only when absolutely necessary.

She presented reports to the commission on each individual grant contract and explaining them, but wondered why she couldn't have just sent them a task order, which would have provided all the information they needed.

There was some confusion regarding the signature process for the department but Berg said they can always get in touch with the state for clarification and if there were any significant problems they wouldn't be able to use the funds they would know, since it would prevent them from using their grants.

The group discussed the department's finances overall, including how the department is and has utilized $100,000 of American Rescue Plan Act funding for COVID-19 mitigation work.

Berg said they have $72,000 left and intend to use it for ongoing COVID-19 relief.

After much discussion, Health Department Nurse Susan Somers asked the commissioners what information they've seen today that hasn't already been provided to them.

Commissioner Jake Strissel answered "nothing."

Peterson then said he wants to start seeing monthly reports from all departments about their expenditures, a subject that came up at Monday's meeting which he said reminded him to start requesting them.

Somers asked why the commission is asking for such a thing and if it's because they don't trust their departments.

Peterson said the commission is responsible for the money that gets spent in the county and they want to prevent missteps, pointing to an incident several years ago when a department had spent its entire budget well before the end of the fiscal year the commission had to step in.

That was in the 2017-18 fiscal year, when the commission ended up furloughing the fairgrounds manager due to department's spending going overbudget. The manager resigned and the grounds went without a manager, with fair board members volunteering to run operations, until Frank English was hired as fairgrounds manager in 2019.

Strissel said in Wedenesday's meeting that he wants these reports so that he can better understand how department expenses all fit together when budget season comes around, which he said can be confusing.

Hill County Commissioner Sheri Williams said reports could also give them an idea of how inflation is affecting department operations.

Hill County Treasurer Sandy Brown, who was also at the meeting, said if the commission wants to see the big picture, expenditure reports aren't a good way to do that, and she'd be happy to provide more comprehensive information to them whenever they want, something, she said, she has offered many times.

She said the reports she can create might be a bit more difficult to parse, but they are much better for getting an idea of where the various departments stand, and she can teach the commissioners how to read the reports properly.

The commissioners were asked if they were ready to take action on the issue of wages now that they've had a meeting about grants and Strissel said he was.

Peterson said he would like to take action on the matter sometime in the next two weeks.

"I think we need to get this solved," Peterson said.

Strissel said they would make sure to post a public notice at least 48 hours before any vote on the matter and Williams said she would be happy to have the department call into any conversations the commission has on the matter between then and now.

Somers said they would rather be there in person.

Other issues discussed

During the meeting, the department and commission discussed a few state level issues not directly connected to the matter of wages, particularly bills in the Legislature weakening vaccination requirements in schools and daycares.

Berg said the prospect of these bills, which will only lead to communicable disease outbreaks, is incredibly frightening, especially when it comes to measles in particular.

She said the disease can linger airborne in a space for up to two hours and anyone in that space has a 90 percent chance of contracting it if they are unvaccinated, making it incredibly dangerous.

Members of the department also talked about diseases like whooping cough, which is horrific for everyone, but especially children.

Berg said she thinks any legislator considering supporting these bills should have to listen to a recording of a child with whooping cough.

"It is the worst sound," she said.

Strissel said he's incredibly concerned about these bills, especially since the children who would potentially no longer need to be vaccinated would be cleared to go to day care and potentially spread it to others.

Berg said it's especially concerning now since they don't have the staff to do their normal day care inspection, to make sure everyone's vaccination records meet state requirements.

Srissel said the commission has been trying to arrange for someone from out of the county to come help with that.

He asked if the county could potentially handle the costs of a severe outbreak of mosquito-carried viruses like zika or west Nile.

Berg said that, at this point, the answer is probably no.

She said the county can declare a public health emergency if they get overwhelmed, which will allow them to receive assistance from the state or federal government, but the county is still on the hook for the upfront costs, as fighting communicable disease is an unfunded mandate.

They also talked about the CONNECT Referral System, which the state has been increasingly trying to make use of.

Berg said the system is a good one, but wide-spread implementation has been difficult.

She said one group it would be really beneficial for is students suffering from suicidal thoughts or depression.

She said a student can go to the ER suffering from these issues one day and be in school the next and no one there will know how badly they are hurting.

With CONNECT, she said, emergency rooms can keep counselors informed and let them know if a student needs some extra attention or help.

She said this is something that area schools are interested in and, before his unexpected death last year, then-Havre Public School Superintendent Craig Mueller was a big proponent of the system, but actually implementing it hasn't gone as well as she hoped.