By Marcy Stamper
After considering the composition of the county’s Board of Health, which has had two vacancies for several months, the Okanogan County commissioners are proposing a smaller board with five members — the three commissioners, a mayor or city council member, and a representative from the medical or environmental health community.
The current board charter, in effect since 1992, provides for six members — the commissioners and three elected city officials. When the Board of Health was first established in 1986, it had just five members — the commissioners and two city officials.
In a draft resolution accompanying the proposed charter, the commissioners say that restructuring the board would recognize that accountability for the cost of public health services has been assigned exclusively to the counties.
The commissioners point to a change to state law in the mid-1990s that eliminated direct financial contributions from cities and towns to Public Health, instead requiring the county to pay that portion of the budget.
At a meeting about the charter on Sept. 14, Commissioner Jim DeTro raised the issue of financial accountability. Since cities no longer contribute to Public Health, DeTro said it was important to ensure that the board members “have skin in the game.”
In addition to the county contribution, the Public Health district receives state and federal dollars and license fees. In 2014, the largest chunk of the district’s $1.25 million budget — 42 percent — came from license and permit fees (for programs such as restaurant inspections and septic permits), according to Ella Robbins, administrative coordinator for the health district.
Another 28 percent of the health budget came from the state, 20 percent from the federal government, and about 10 percent from the county, according to Robbins. A portion of that is returned to the county for rent and accounting services. The 2016 budget is $1.16 million.
Washington’s contribution to public health districts across the state was increased in the 1990s to make up for a drop in city revenue after voters approved an initiative that lowered car-registration fees, according to Ralph Malone, who served on the Okanogan County Board of Health from 2002 until July of this year.
Malone’s seat is one of the vacancies that has to be filled. He had to step down from the board after a review of the current charter determined that, as Omak city administrator, he was no longer eligible to serve. Malone first joined the board when he was the clerk for the city of Okanogan, which was an eligible position. (The current charter allows city clerks to be on the board; the proposed charter would restrict membership to mayors and council members.)
As a district and not a county department, Public Health has a status similar to junior taxing districts such as fire or hospital districts, but no taxes are levied expressly for public health — instead, the county’s contribution comes out of its current-expense budget, said Malone.
The current-expense fund receives property-tax revenue from all county residents, regardless of where they live, said Malone. In addition to public health, the current-expense budget pays for county functions such as the sheriff and the court.
The Board of Health has administrative and fiscal oversight of the Public Health district. The board approves the Public Health budget and fee-for-service contracts with state agencies. Oversight of medical matters, such as quarantines, is handled by the district’s health officer.
Under the amended charter, the county commissioners would serve as long as they are in office. The representatives from the cities and the medical community would have four-year terms. Any elected official would be removed from the board immediately if he or she vacated the office.
A countywide coalition of mayors would select the city representatives; the commissioners would appoint the medical representative. The board meets at least once a month.
The commissioners are holding a public hearing on the proposed charter on Monday (Oct. 5) at 1:30 p.m. in their hearing room in Okanogan. People can testify at the hearing or submit comments in advance to Laleña Johns at email@example.com.
For a copy of the amended charter, contact Perry Huston at (509) 422-7118 or firstname.lastname@example.org.