Hill County Board of Health meets

The Hill County Health Board at its quarterly meeting Wednesday discussed recent developments at the local and state level and how they are affecting local public health.

Hill County Public Health Director Kim Berg, who is also the county’s health officer, said the wage for the Hill County Sanitarian position has been raised and looks like it will be put back under the health department.

Berg said she’s hoping the increase in the wage will draw in applicants.

She said Clay Vincent, the county’s current sanitarian, who has been trying to retire for years, is performing inspections for businesses in dire need, and she’s been handling some of the environmental health work associated with that position, but they need someone to take over.

She said the department has recently created applications that spell out the environmental health and sanitation requirements for establishments looking to do business in Hill County, which she’s been told has been helpful, particularly for temporary food vendors who still need to follow county rules.

She also said the WIC Coordinator position has been filled by Tami Schoen, and her previous position of WIC assistant is going to be posted soon.

Berg also provided an update on the recent restructuring of the health department, but not before Hill County Commissioner and Health Board Chair Mark Peterson objected, saying he doesn’t think the matter is relevant to the board.

Berg and board member Kyndra Hall said the board isn’t taking any action on the matter; they just want to make sure everyone is up to speed on the change.

Berg said the board is responsible for overseeing public health in Hill County, so a reorganization of the Hill County Health Department is absolutely relevant to the board, but Peterson was unconvinced.

“I don’t see that being a part of this board,” he said. “… I’m struggling over whether this is the place to talk about the adjustment.”

Peterson’s objection was ultimately ignored with Berg asking Hill County Commissioner and Health Board member Jake Strissel if she should talk about it, to which he said yes.

Hill County Commission and Health Board member Sheri Williams was absent from the meeting.

Berg said the commission approved a plan to reorganize the health department, eliminating positions so they can offer a wage in line with the rest of the state.

Wages at the Hill County Health Department have been significantly lower than the state average for a long time, which Berg said has made retaining department employees difficult and made hiring practically impossible, and after years of requests from the department and a slew of tense meetings the commission finally agreed to allow Berg to restructure the department last month.

Berg originally asked the commission to raise the wages of the department’s 11 employees without restructuring, which would have required $30,000 more for her department, but the commission said that was impossible.

Berg then suggested a plan to restructure the department, a plan that would require no additional investment from the county, but this proposal encountered significant resistance as well.

After a few contentious meetings, had at the commission’s request, some of which were criticized by the department and other county officials as unnecessary, the commission eventually agreed to Berg’s plan.

At Wednesday’s Board of Health meeting Berg said under this new structure the department would have six essential positions, plus whatever other positions the state was willing to fund through grants.

About 80 percent of the department’s funding comes through grants, the majority of those coming from the state.

Berg said the six essential positions are health officer/public health director, public health nurse, lead public health nurse, WIC coordinator, WIC assistant and program assistant/vaccine manager, which Berg said are absolutely critical to the department’s function, but, depending on the Legislature in any given year, they often get funding for more positions.

This year, for example, they are going to have funding for a disease intervention specialist which will lighten the load on members of the department, which has increased in the wake of the restructuring, she said.

Funding for that position, she said, is guaranteed through 2027.

Board member Erica McKeon-Hanson, who attended remotely due to illness, thanked Berg for the explanation, saying the only info she’d been given until now had come through the Havre Daily News, and she was glad to hear about the restructuring more directly.

McKeon-Hanson thanked the health department for being willing to restructure and find a solution to this ongoing problem, and the commission for approving the plan.

Berg also provided an update on legislation relevant to the department.

She said they are worried about House Bill 364 which would allow independent subdivision reviews for past due applications.

She said a section of the bill would allow applicants to be certified to do their reviews that would allow approval documents to bypass review by the health officer, meaning they could be approved despite there being serious issues.

“(These documents) could show septic systems that are not sized or designed properly, wells could be too close,” she said.

Berg said proponents say it would decrease costs to homeowners, which she thinks is inaccurate, but it will increase liability to the county.

She said she understands this process of approving these kinds of things can be long, but this change will only serve to threaten environmental health.

On a more positive note, she said, most of the vaccine-related bills seem to be dead, with the exception of HB 715, which is the least harmful.

HB 715, she said, would require exemption information and forms to be included whenever school districts share state requirements for vaccination.

Of all the vaccine-related bills up for debate this session, she said, this is one the public health world doesn’t really have much issue with.

Many of the other bills would have significantly loosened vaccine requirements for schools and day cares, which Berg has said would put a lot of young people at risk.

Outside of these bills there have been a few relating to indoor vaping laws, but many of them have been tabled so she doesn’t anticipate much change.

Berg also provided an update on her department’s recent activities and the state of public health in Hill County generally.

She said the state has seen an increase in syphilis cases but an abnormally high number of these cases have been asymptomatic, which is very unusual for syphilis.

She said she’s hoping the department will get some funding to help address this increase, funding that will give them access to rapid testing and help them treat it more effectively as well as educate people on the disease.

Berg said syphilis is complicated since treatment varies greatly based on what stage the disease is in so having some extra help would be great for the department.

As for other STDs like chlamydia and gonorrhea, she said these have been at normal levels statewide so far.

On the COVID-19 front, she said, the department has only seen a handful of them recently, but they have started a new program to test local wastewater for the virus once a week, which will be helpful.

She said they are hoping to add the ability to detect other viruses and diseases and the findings will be made available to the public on a website once everything gets up and running.

She said they also haven’t had any recent flu cases, which is great, but they have had a bunch of cases of norovirus, which causes vomiting and diarrhea.

She said the disease is contagious for at least two weeks and anyone who catches it should stay home and refrain from handling other people’s food.

“Trust me, you don’t want to get this,” Berg said.

She also talked about the department’s continued success with their electronic data collection system, which will be getting new features soon and is seeing increasing use by other departments across the state.

She said the system has been great for COVID-19 contact tracing but is also being used around the state for STD contact tracing.

Berg said it seems like people are often more likely to respond electronically through this system than talk directly to the department, and because the system is HIPAA compliant it’s becoming an increasingly useful tool that the state has been smoothly transitioning into using more widely.

She also talked about the department’s family planning program, which has been seeing an increase in walk-ins, which she said is great.

Berg and the board also briefly discussed progress on drawing up an interlocal agreement to and new bylaws that would allow them to restructure the health board into a city-county health board.

Berg said she is so swamped with work she just doesn’t have the time to work on this and McKeon-Hanson offered to reach out to the state to see if they have anyone who would be able to lend a hand finishing the documents.

She said she thinks House Bill 215 would affect the makeup of a theoretical city-county board, but as far as she understands all the bill does is specify that officials on the board must be elected officials.

At the end of the meeting Berg and the board also discussed changing the schedule of their meeting, shifting them ahead or behind by a month, since they so often conflict with the Great Northern Fair in July and the Havre Area Chamber of Commerce Annual Meeting in January.

Peterson asked Berg and members of the board to get in touch with him and let him know what schedule works better for them so a decision can be made.

Before the meeting adjourned, McKeon-Hanson said she wanted to take a moment to acknowledge the department and their work.

She said it was National Public Health Week not long ago and the county has been well-served by the people at the department for a very long time.

“We’re lucky that we’ve had them, most of them for many years,” she said.