Commissioners share public health outlooks

LUVERNE -- One day after Nobles County Commissioners agreed to release Rock County from a joint powers agreement for shared public health services, commissioners from both counties had an open dialogue about the changes coming forth for Nobles-Rock Community Health Services. The public health agency has been shared between the two counties for more than 40 years.

Rock County Administrator Kyle Oldre told NRCHS board members during a meeting Wednesday afternoon in Luverne that after reading the story in the Daily Globe, he believed all NRCHS employees and its administrator Brad Meyer would remain in their current positions through 2011.

"It allows people time to plan and do whatever actions they want to do," Oldre said. "Rock County wants to move forward with Southwest Health and Human Services. We've laid that card on the table, and it will just happen a year later."

Oldre said Nobles County's lack of a decision to join SWHHS presents some pros and cons -- the biggest pro being that it allows both counties to do some planning. He said Rock County's decision had nothing to do with the level of service provided by the agency and, in fact, commended NRCHS and its administrator for the work that has been done.

"A lot of the decision is based on economics," Oldre said, adding that the rate SWHHS quoted the county, in addition to the long-term viability of a multi-county collaboration, steered Rock County Commissioners toward the move.

"Having the ability to reach into a bigger mass makes some sense," he said. "We need to leverage our dollars to provide a same or similar service."

Oldre said the reasons Rock County wants to partner with Lincoln-Lyon-Murray-Pipestone Public Health in the new SWHHS agency are no different from the discussions taking place in joint dispatch. He said as budgets get tighter, counties will look to share services in other areas, such as human services and engineering.

"The state's looking at regionalizing everything," added Meyer. "Something's going to happen in public health. The state is looking to cut it back, and it will be interesting to see what happens next year."

NRCHS board chair Karen Pfeifer asked if Nobles County would be penalized by the state if it chose to operate an independent public health agency with human services and community corrections, though no one seemed to know the answer.

"My dear friends in Nobles County will need to make the decision that's best for them," Oldre said.

It was pointed out Wednesday that Rock County is only looking at merging its public health agency with SWHHS, while its human services agency will remain a stand-alone entity. Oldre said SWHHS, with the addition of Rock County, would include five counties for public health and three counties for human services.

"There are going to be issues -- it's going to be a little bumpy -- but it will work out," Oldre said. "As long as we remember the focus is on the public, it will all fall into place."

Meyer has supported the SWHHS collaboration since shortly after the idea was presented to him, even though it means he will be out of a job. He said the working model is population-based, and counties like Nobles and Lyon, with larger populations, would have more representation on the board.

"I was kind of frustrated with the process -- that no one really cared what I thought," said Meyer. "I think I've got more insight on the happenings than anyone else. ... I just think there's a lot of information that didn't get back to the county board."

Pfeifer told Meyer she applauded his decision to stick with the agency through the process.

"You always have turmoil before you get things settled out," said Rock County Commissioner Richard Bakken. "I've been on the health board for eight years, and it's been a rocky road. I would like to see you get in a more stable organization where you (employees) didn't have to go through this all the time."

"There's other ways to do things, and if you don't look at them once in a while, then you're neglecting your duties also," added Jarchow.

In other action, the board:

* Decided that Nobles County must remain the fiscal agent for the public health agency through 2011 as Nobles and Rock counties begin the process of parting ways at the end of next year. Nobles County had previously decided not to provide health insurance coverage for employees of the agency. As Oldre pointed out in the bylaws, Nobles County agreed to be the fiscal host, providing health insurance and other services to the employees of the agency.

* Received an update on influenza immunizations. This year, the seasonal and H1N1 vaccine are combined in one immunization. All individuals older than the age of 6 months are encouraged to get the flu shot this year, which is a new guideline. Also, individuals older than age 65 will have access to a higher dose of the vaccine.

* Learned that tuberculosis numbers are steady in the two counties. There are now two individuals receiving direct observational therapy for active TB, and 25 to 30 cases of latent TB.

* Approved interpreter contracts at $20 per hour for Than Than Cho, Hser Naditha and Naw Play Say for Burmese and Karen translation; and Wendy Dela Rose Gaeke and Violeta Cota for Spanish.

l Approved a contract for a $36,000 public health preparedness grant. The contract dollars are split evenly between Rock and Nobles