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Report: Health District needs to look inward first to survive

EVERETT — The Snohomish Health District should do some soul searching first to get on solid footing for its future, an important report on its situation summarizes.
One of the first steps the report calls for is that the district should evaluate the composition of how it’s governed.
The 41-page report released Sept. 9 by the William D. Ruckelshaus Center also found that employees are passionate about the district’s well-being, but uncertain on not only the health district’s role to the public but also quiver about their job stability after years of employee cutbacks.
The Snohomish Health District is not a division of the county, although there’s been a recent push to make it one. It is an independent, special purpose agency, and unlike other local districts, it lacks any authority to tax the public to raise money for itself.
The health district instead gets most of its money from federal, state and county contributions. Those contributions diminished during the Great Recession. As a result, in the past 10 years the health district’s headcount shrunk, and some services, such as on-site immunization clinics, closed.
The board of elected officials who help guide the county’s health
agency discussed the report at the last week.
Perhaps punctuating the issue on governance, a little less than half of its 15-member board showed up for the meeting. The lack of quorum prevented voting on action items at the monthly mid-afternoon board meeting such as signing a contract with a new law firm.
The operational problems are so detrimental, it’s “like trying to tackle things with one hand behind your back because of the structural issues,” Ruckelshaus Center director Michael Kern told the board.
The Ruckelshaus Center is a neutral party assessment group run jointly by the University of Washington and Washington State University. Health district leaders commissioned Ruckelshaus to take stock of the health district and relay recommendations given from its board members, its staff and community leaders. The group interviewed 73 people to base its report.
Perhaps most striking is that the report writers heard most from the people interviewed was the governance and roles need to be cleared up before talking about funding or strategic direction.
At the same time, the district is asking cities
to each contribute a $2 per resident pot of cash. Some city leaders are responsive to the request; City of Snohomish leadership was waiting for the center’s report to come out before making a commitment.
The report also relayed concerns that the health district appears under-recognized and unclear on its highest purpose. People recall the Health District from its vaccination clinics, but can’t pinpoint what it does now.
The district closed its immunization clinics on June 30 last year because it found it was duplicating services available at neighborhood clinics and at an increasing number of drug store chains.
The district is the agency that conducts restaurant inspections and dispenses food handler’s cards. It’s also the agency that responds to outbreaks such as whooping cough by buying vaccine stocks in bulk to administer to the public at low cost.
And it is taking steps to be a strong contributor in curtailing the county’s heroin epidemic; as of this summer, it was working on a plan to require hospitals to make mandatory reports on patients who overdose on heroin and other opioids in the name of data gathering. By making the reports mandatory, the health district can connect the dots to the doctors who prescribed the pills to inform doctors about opioid abuses.

Will it blend?
Talks about integrating the independent health district into the county began last year. Many of the report’s interviewees, which included a large number of staff, said they’re against the idea.
Many people interviewed said they think the county neither can afford to do it
nor would place public health as a high priority among all of the county’s functions.
County Councilman Ken Klein appeared to bristle at a comment that there is no sure thing to fix funding.
“There is a silver bullet,” he said, and that is absorbing the health district as a branch of county government. He has firmly held this position since last year when he put it forward as an agenda item.
“Everyone in this room needs to understand the status quo cannot continue … we are in a dire financial situation,” Klein said.
But until a decision is made, it’s put a metaphorical axe hanging over the district.
District communications strategist Heather Thomas, who’s also the district’s media spokeswoman, said at the meeting that the district is experiencing staff turnover because of unease on the county proposal.
“Staff have been waiting with bated breath on whether we’re going to the county or not,” Thomas said. “It’s impacting our day-to-day work.”
The conversation turned among the board members there last week to complaining that colleagues skipping out on meetings is occurring too often. The board is made of 10 elected city officials and all five County Council members.
A string of meetings in March, April, June, July and August 2015 had votes delayed for lack of a quorum until some board members arrived late to form a quorum. The December 2015 meeting lacked a quorum altogether.


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