Lewis County’s qualms with health board legislation arise during volunteer appointments

After the 2021 law, the county chose to maintain the fully elected health board structure rather than add medical professionals

To Isabel Vander Stoep / [email protected]

To meet state requirements for its Health Advisory Board — a group of citizen volunteers who provide recommendations to commissioners — the Lewis County Health Board moved to appoint two new members last week.

In a January 9 meeting, Meja Handlen, director of public health and social services, explained to the commissioners to maintain what they see as “local control” of the health board, the composition of the advisory board must meet “fairly clear criteria”. he has declared. The law states that advisory representatives must be selected based on community or health sector backgrounds, including tribal members, health care workers, physicians, and housing service providers. Seven people have applied for the openings, Handlen said.

One of the new appointees, Deb Mizner, is of the Cowlitz Indian tribe, a quality Commissioner Lindsey Pollock said was important to southern county representation because the Cowlitzes are very active near Winlock and Toledo. Commissioner Sean Swope said he has worked with Mizner at the Lewis-Mason-Thurston area agency on aging and that he would be happy to have her on the advisory board. The other new member, Dr. David Ellis, is a Chehalis family doctor. The same two commissioners expressed their support for his candidacy. Both new members were nominated by unanimous vote.

Swope and Pollock’s new seatmate, however, Commissioner Scott Brummer, argued for reappointing the previous seat holder on the advisory committee rather than Mizner, saying he believed the state’s guidelines were discriminatory. He said Mizner was a good candidate in a later interview with The Chronicle.

“Washington state, simply put, is very clear that it opposes discrimination against anyone for any reason. And then, however, they like dating RCW which to me says otherwise. That, ‘We’re going to give preference to someone based solely on that particular issue,’” Brummer said at the meeting. “This is a concern, of course. I don’t know Miss Mizner and I kind of miss the full appreciation of the advice itself.”

The previous holder of the seat that Brummer has claimed to reappoint, Elizabeth Rohr, was among those campaigning for Brummer and his supporters in the 2022 election. She and Greg Rohr, both from Toledo, have donated a total of $400 to Brummer’s campaign. Brummer, according to the Public Disclosure Commission.

Lewis County One of “Less Than Five”

The advisory board’s membership requirements come from legislation Lewis County has watched — and avoided — since 2021. Over the past two years, most Washington counties have been required to add medical professionals to their boards of health, which previously consisted of elected officials. But not in Lewis County.

House Bill 1152, first read on January 12, 2021, made structural changes to county health boards. A provision in the bill — a last-minute addition in the final draft of the Senate legislation — allows counties with health advisory boards to keep the health board all-elected. According to Handlen, Lewis County is one of “fewer than five” in Washington currently operating under this health board structure.

Originally, HB 1152 proposed the creation of various health districts throughout the state, which advocates argued would centralize health resources and expedite funding for county health crises. Many were against it, however, including the Lewis County Board of Health and, at the time, its health department director JP Anderson and health officer, Dr. Alan Melnick, who was based out of Clark County and represented several other health boards at the time.

County officials argued the bill would eliminate local control. Pollock said this week, regarding health policy, “you have to have local management, local buy-in.”

The only change required of Lewis County by the bill was that the advisory board meet certain criteria intended to ensure diverse representation.

Anderson told The Chronicle this week, “Lewis County had the advisory board before the bill, as did many other counties. … We advocated maintaining that structure with advisory boards.

In earlier Board of Health meeting minutes, Anderson discussed the bill as it passed through the Legislature. Pollock said he did not recall a specific request for lawmakers in 2021 to add the provision on advisory boards, but he did recall the bill as a cause for concern.

In last week’s meeting, Pollock and Handlen referred to Spokane County, which has seen backlash in the past two years for restructuring its board of directors to make it smaller and include a naturopath, rather than expanding and adding doctors. . In The Spokesman Review report, Democratic Spokane Representative Marcus Riccelli said the commissioners were violating the original spirit of the bill.

When asked why Lewis County commissioners were reluctant to add medical professionals to the healthcare decision-making board, Pollock said there was already broad representation on the advisory board. In the past year, the Board of Health has not adopted the volunteer group’s proposals for new appointees to the committee or hired its preferred county health officer candidates.

“Our main concern is not to be put under the microscope by the state,” Pollock told The Chronicle. “We have to prove that it works.”

Pollock said he has a “neutral” feel about the advisory board structure in place.

In an interview later in the week, Brummer said he had done more “homework” on RCW since the January 9 meeting.

“I certainly have no problem with tribal representation. We had a good candidate who was selected. It was a good thing,” he told The Chronicle.

However, he doubled down on the position that criteria based on someone’s background was “inherently discriminatory”.

She said she supports having diverse representation on the advisory board, but believes diversity should be defined at the local, rather than state, level.

Ultimately, Brummer said he believes the state’s ultimate goal is to regionalize health services, removing local representation in the process.

The Commissioner also withdrew his comment on the lack of appreciation for the Advisory Board, saying: ‘I just haven’t had the opportunity to work with them and see what happens… I just don’t have the full appreciation for everything they do for Lewis County.”

Why have an advisory board?

While the Board of Health may not have adopted the advisory committee’s proposals of late, former advisory chair Jami Lund said the group still plays a valuable role. Especially, she said, considering the volunteers only meet once a month for an hour.

The group may not have the time to review every single public health contract, Lund said, but it can provide high-level information on best practices for the board and the department. Additionally, as a citizen volunteer group, council members bring a variety of skills, which may include outreach and other duties to support health care efforts in Lewis County.

He disagreed with the suggestion that the group had been “ignored” by the Board of Health.

“These groups are useful,” Lund said. “They can stop the county from making mistakes.”

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