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County health looking at joining collaborative

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Nine years after it pulled out of Multi-County Nursing Service to go it alone, Becker County is poised to join three neighboring counties in a collaborative public health system.

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The move would go beyond the cross jurisdictional sharing that Otter Tail, Clay and Wilkin counties have done in the past few years; it would establish a joint powers agreement and a joint powers board.

But unlike the former Multi-County Nursing Service, the new organization would be structured so that each county board retains its authority over its county health department.

Each county health department will retain its own budget and employees, and will continue to be responsible for things like infectious disease control, health promotion, access to services, environmental health issues and e-prep duties.

Benefits will come in the potential for shared staffing, shared grant writing and avoiding the duplication of effort in several areas: writing strategic plans; community health assessments, community health improvement plans; quality improvement planning and preparations for accreditation.

Becker County Administrator Jack Ingstad said he was skeptical at first, but changed his mind after looking into the matter and talking to Clay County Administrator Brian Berg.

“The only concern that I had was control of our destiny,” Ingstad said. “It’s now very clear that the budget of the entity and the budget of the county will remain very separate … our employees will remain county employees. I’m very comfortable with what Brian Berg is saying, we will  not lose control of our health department.”

Both Community Health Supervisor Ronda Stock and Becker County Human Services Director Nancy Nelson told commissioners Tuesday that they support the plan.

Commissioner Larry Knutson expressed concerns. “What if the new entity doesn’t agree with the county budgeting process,” he wondered. “Who prevails?”

The joint powers agreement will be designed by the four member counties, and it’s important for Becker County to get in on the ground floor to make sure it’s designed in a way that works for Becker County, Ingstad said.

Requiring stand-alone counties to join together with other counties to establish public health departments isn’t mandatory — yet, Ingstad said. But it seems to be the direction the State Health Department is taking, he added.

Public health departments are most effective when they serve populations of 50,000 to 500,000, according to a “blueprint for success” developed by the State Community Health Services Advisory Committee.

Becker County pulled out of the Multi-County Nursing Service joint powers agreement with Mahnomen and Norman counties when Becker County’s population hit 30,000, the minimum  size for a stand-alone public health department.

The county’s population is now at about 32,500.

As of the 2010 Census, Otter Tail County’s population is 57,300, Clay County’s population is about 59,000 and Wilkin County’s population is about 6,500.

The total for all four counties is 155,300.

“I think it (a multi-county health cooperative) is the future,” Ingstad said.

“I’m just worried about the dollars and cents of this thing,” Knutson said.

Board Chairman Don Skarie said he was ‘initially quite skeptical,” but after digging into the proposal now believes “it’s a very good plan for Becker County.”

Commissioner John Okeson agreed. “I’m ready to move forward with it and give it a try.”

Commissioner Barry Nelson also voiced support for the plan.

“From what I’ve heard today, there’s no reason not to (support it),” added Commissioner Ben Grimsley. But the devil is in the details, and he said he will remain uncommitted until he sees the proposed bylaws and joint powers agreement.

Diane Thorson, public health director for Otter Tail County, appeared at Tuesday’s Becker County Board meeting to answer questions. She said Grimsley would be a good candidate to help develop the bylaws.

The proposal calls for each of the four county boards to approve a resolution merging the county health boards into one health board by mid-October.

A planning committee will reconvene this fall to develop bylaws and operating procedures.

By Dec. 1 a notice will be sent to the State Health Department regarding the intent to merge the county health departments, with the aim to be fully operational by Jan. 1, 2015.

The proposal calls for a five-year commitment to the joint program, and a year’s notice if a county wants to pull out.

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