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Public health merger is a go

With a “yes” vote from the Douglas County Board on Tuesday, Horizon Community Health Board (HCHB) is a go.

HCHB is the integration of three public health departments – Douglas, Pope and Stevens/Traverse/Grant’s already combined department – into one entity.

After two years of preparing and planning and the approval of all five county boards, HCHB is set to launch on January 1, 2015.

The formation of a new community health board will separate the public health departments from the counties.

HCHB will become its own entity with a governing board, budget and staff.

The major changes will be administrative and organizational in nature, according to Sandy Tubbs, director of Douglas County Public Health and Stevens/Traverse/Grant Public Health.

She said she wants to assure public health clients that their services will remain the same.

“From their perspective, how they receive services, they will see no change. It’s not that we’re moving anywhere or relocating. All the staff will be in the same building [they’re in now]. They will see the same people. This will be seamless for people in the community,” Tubbs said.

Current public health staff will move from county employees to HCHB employees on January 1, 2015.

Tubbs said, “We’re not certain where everybody will go, but everybody will have a place; many will stay in their current position.”

There are other community health boards in the state, but they also operate separate public health departments, as well.

Tubbs said, to her knowledge, HCHB is the first of its kind in Minnesota.

Neighboring Otter Tail County will join Clay, Wilkin and Becker counties on January 1, 2015 to form a new community health board, but they will still operate separate public health departments.


Why bring five public health departments together into one?

Tubbs said maintaining a strong public health infrastructure in the future can best be assured by integrating staff and resources of the three public health departments.

Tubbs explained that as rural Minnesota populations have changed and there’s more local government cooperation, it’s becoming more and more obvious that public health departments need to join together.

She said, “We’re still vulnerable to different changes in financing and public health emergencies… all things that when you’re smaller can have much more significant impact.”

She explained that a community health board is the legal entity that the Minnesota Department of Health communicates with and considers a local partner.

The HCHB has been in place for several years, but the public health departments also operated separately. Now, they’re coming together to operate as one.

“The other thing looming is national encouragement to become an accredited public health department. There are standards in measures that are pretty demanding. Now, our counties can collectively become accredited as a single entity.”

HCBH will be a service available to approximately 66,000 people in the five-county area.


Now that HCHB will become reality, Tubbs said the first order of business is development of the official joint powers agreement and terms of the new partnership.

Work will also begin to finalize the HCHB governing board, organizational structure, personnel policies and other items that will need to be adopted by the new HCHB of directors.

The 13-person governing board will likely include two elected officials from each county with the largest county having a third appointee that may or may not be an elected official, and the board will also include two community members recommended by county commissioners.

Tubbs said they hope to have the HCHB board in place by July.

HCBH would reportedly have an operating budget of about $7.5 million, which is approximately the total of all three public health departments’ current budgets. Currently, the combined tax levy for public health for all five counties is about $995,000; 55 percent of that is Douglas County tax dollars.

Tubbs said, “Certainly it is our hope that after three years of operation… that total tax levy would at least stay the same or at least go down. At that point we could go to a population-based tax levy.”

How funding of HCHB will be divided among the five counties has yet to be determined.


The board passed the resolution supporting HCHB integration with a 3-2 vote Tuesday. Commissioners Jim Stratton and Jerry Johnson voted “no.”

After the meeting, when asked why they voted no, Johnson said he has concerns about hospice services and, overall, “It’s the expense. Is it going to cost us more? Do they have revenue that exceeds expenses? There are too many unanswered questions.”

Stratton echoed Johnson’s concern with expense, but said there’s been a lack of communication with the public about HCHB.

“There’s a lot of my constituents who have questions. They don’t even know what the Horizon thing is about. The fact of the matter is that I don’t think the communication has been adequate throughout the county to let them know what the purpose is for this and what are the pros and what are the cons? Just because this is not going to take place until January, we’re looking at it in April – what’s the rush?”

He said he would have liked to have seen more community meetings to share information about HCHB.

Immediately after the HCHB vote, commissioners voted 5-0 to remove the county’s Senior Services department as a division of public health and put it under the direction of the county coordinator, as of January 1, 2015.

Amy Chaffins

Amy Chaffins is a journalist working for the Echo Press newspaper in Alexandria, Minnesota.

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