By The Herald Editorial Board
To the silver linings of covid-19’s more than two years of clouds, add the expected integration of the stand-alone Snohomish Health District as its own department within the Snohomish County government.
The Snohomish County Council is expected to approve a resolution at its regular meeting today that will formalize a closer relationship that was deemed necessary during the pandemic, placing the health district and its employees under the county’s umbrella. The council’s action follows a unanimous vote May 31 by the district’s board of health, agreeing to the integration.
Even as the pandemic continues its post-surge simmer with slight increases in case rates but lower hospitalization counts in the county, the consensus view among local officials and the district’s own board of health is that a close working relationship between the health district and the county has been successful throughout the response to the pandemic in assuring delivery of the health service needs to the county’s more than 800,000 residents.
“Obviously, that team approach worked well,” said County Executive Dave Somers during an interview Monday. The close coordination of county leadership, health district staff and county and city representatives on the district’s board of health necessary during the pandemic essentially served as a pilot project for the integration of the district and county, a relationship that had been discussed and explored for several years but not acted on until now.
The six-month plan for integration, as discussed by Somers and others, is expected to continue a record of delivering on the mandate of assuring high quality public health services while improving efficiency, streamlining services and increasing opportunities for funding, particularly through grants. The district’s 135 full- and part-time employees will become county employees and the new county health department would be overseen — as the health district is currently — by a health officer and administrative director.
Among the remaining tasks for the current district and its board will be the hiring of a successor to the current health officer, Dr. Chris Spitters, who announced in December that he would step down from his position later this month.
The last two years of coordination have confirmed the advantages for the district’s delivery of health services by improving coordination and minimizing bureaucratic obstacles. What contributed to the collaboration’s success, Somers and other officials said, was a happy accident in the mix of personalities involved, committed to public health and not prone to disagreements. That wasn’t the case for other counties in Washington state during the pandemic, especially where health officials and elected representatives clashed, leading to firings and resignations elsewhere.
Another significant change — and one that was dictated by the state Legislature this year — is an adjustment to the board of health’s membership, which currently includes 15 elected officials; all five members of the county council and 10 representatives of the cities. The new state law for countywide boards of health requires equal numbers of elected officials and non-elected representatives, including those from public health, health care facilities and medical providers; public health consumers; and other communities.
The inclusion of unelected representatives on the board should serve the board and the new county health department well by diversifying the board and strengthening its base of knowledge. Among the findings of a 2016 report from the Seattle-based Ruckleshaus Center, which was asked to review the health district’s management and funding and recommend changes, was a finding that of the 73 people interviewed, including board of health members, many cited a lack of confidence in the breadth of knowledge on public health issues of some board members and the group’s ability to make informed decisions.
The integration into the county also is expected to facilitate a renewed focus on the ongoing opioid and fentanyl crisis, which has been overshadowed by the pandemic; continued work to strengthen disease control and prevention and prepare for the next pandemic; coordination of the county’s work with the homeless population and delivery of public health services to that community; the potential for a mental health unit in the department; streamlined permitting for environmental health and more opportunities for grant funding through the county’s existing Human Services department.
Regarding the new department’s funding, Somers said that state funds now provided to the health district won’t go to the county’s general fund to be distributed back to the health department, but will remain in a dedicated fund for that department.
In the past, the county’s cities have been asked to contribute to the district’s funding on a per capita basis. But state and grant funding shouldn’t be the only sources of support. As cities will be keeping some representation on the board, regular funding from the cities should be discussed with the county in the future.
The move to a county-run health department in lieu of the current stand-alone health district should not be seen as a slight against the district’s current leadership or its record of accomplishments in protecting and promoting public health since it was first formed in 1959.
As the county continues its growth to a million residents, however, this move to a county health department should help assure more stable funding, efficient coordination of services and diverse representation of public health needs throughout Snohomish County.
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