Local County Government and the Board of Health Relationship

County Board Functions Involve, represent, and be accountable to the public Provide services Make budget and levy taxes Set policies Strategic planning (mission, purpose, vision) Collaborate to ensure the needs of the population are met Cooperate with other governments Focus on long-term rather than past or short-term Todd

Committee Functions Complete the preliminary work on policies before taken up by the full board Collaborative policy oversight for departments Review and make budget recommendations Draft ordinances and resolutions Todd

Committee Chair Appointed Set the agenda Presides at meetings Makes reports and recommendations Todd

How the Board Makes Policy Plans Budgets Ordinances and Resolutions Todd/Bonnie

Plans: Comprehensive plan Other common plans Strategic Plans Capital improvement plans A parks plan Transportation plan Etc. Todd

Budget What services will be funded How will they be funded What level will they be funded Todd/Bonnie

Ordinances Local law Enforced by the officials of the governmental body Intended to be a permanent part of the governmental code Ordinances can also be regulatory: Licensing Zoning Peace and Order Todd

Resolutions Usually less permanent, temporary in character Used to grant special privileges, state policy, express opinions, or communicate with other governmental bodies Resolution may be used to adopt a budget WOTFV Resolution, Health in All Policies

Forms of County Government County Executive County Administrator County Administrative Coordinator Bonnie

County Executive Chief executive officer Elected by the citizens “Coordinates and directs all administrative and management functions” Appoints and supervises department heads subject to county board confirmation Appoints members to boards and commissions subject to board confirmation Submits the annual budget Todd

County Executive Veto Ordinances and resolutions Appropriation in whole or part County board can override with 2/3 vote Todd

County Administrator Counties having a population of < 500,000 may create the office of County Administrator By resolution of the board, or By petition and referendum and Appointed by the majority vote of the board Todd

County Administrator Chief administrative offer of the county Coordinate and direct all administrative and management functions of the county government Appoints and supervises department heads Appoints members to boards and commissions, where statutes give this authority. Answers to the county board of supervisors Submits annual budget Appointed solely on merit, no weight given to residence, political affiliation, etc. Todd

Administrative Coordinator Similar to county administrator but does not have appointment authority and “responsible for coordinating” rather than “coordinates and directs” County must designate an Administrative Coordinator Todd

Staff vs. County Board Vastly different responsibilities Board supervisors serve in a primarily legislative role Officials, department heads and staff serve in an operational and advisory role Staff: Education, experience, background checked, professionally current Board: Elected by the citizens, local connection Bonnie

Staff Roles and Responsibilities Staff has an obligation to carry out their duties in a manner consistent with the policy direction of the board and executive/administrator Staff makes recommendations and give professional advice. They generally do NOT make policy other than internal department policies as authorized Staff’s primary duty during meetings is to be prepared to answer professional questions and present professional reports to enable elected officials to make informed decisions Staff should be prepared to offer alternatives and recommendations as needed A key to staff success is to remain “politically savvy while politically neutral” Bonnie

Board of Health Consists of not more than 9 members County board members along with some non-county citizens At least three of the members not elected officials or employees; have a demonstrated interest or competence in the field of public health or community health Good faith effort made to appoint a registered nurse and a physician Shall reflect the diversity of the community Members confirmed by the governing body Bonnie

Local Boards of Health Powers and Duties Govern the city or county health department Assure the enforcement of state public health statutes and public health rules of the department as prescribed for a Level I local health department Assure that its local health department is a Level I, Level II, or Level III local health department May adopt those regulations, for its own guidance and for the governance of the local health department, that it considers necessary to protect and improve public health Bonnie

Local Boards of Health-Power and Duties May be no less stringent than, and may not conflict with, state statute and rules of the department Meet at least quarterly Assess public health needs and advocate for the provision of reasonable and necessary public health services Assure that measures are taken to provide an environment in which individuals can be healthy Review and make budget recommendations Bonnie

Local Boards of Health-Powers and Duties Develop policy and provide leadership that fosters local involvement and commitment, that emphasizes public health needs and that advocates for equitable distribution of public health resources and complementary private activities commensurate with public health needs In counties with a single county health department the County Executive or County Administrator may assume powers and duties of the board of health Board of Health shall be only a policy-making body Bonnie

Other State Statutes Open Meetings Law Advanced notice of meetings; meetings open and accessible to the public; limited closed sessions Definition of meetings; walking quorum Public Record Laws “presumption of complete public access, consistent with the conduct of government business. State and Local Codes of Ethics/Conflicts of Interest Todd

Health Officer Roles Provide leadership during a public health threat or emergency Notifying the public about health risks Taking necessary legal actions that may include isolating those carrying infectious diseases Charged with administration of local health department Responsible for hiring employees to carry out agency functions Bonnie/Todd

Health Officer Role Public health resource for the county Quarantining people or places when a health threat is suspected Establish relationships with key entities: Board of Health Medical Community Media General public Bonnie

Communication between Health Officer and Board Members Keep the board members informed and engaged (example-invite them to regional WALHDAB meetings, explain things one on one to them, send them correspondence when something is new or changed) Keep in contact with the chairperson to keep her informed on anything new and emerging in public health New board members, establish one on one meetings with them if your governmental structure allows for this. Board of Health of the Year in 2018

Communication Between Health Officer and Board of Health Chairperson Agenda items for board meeting (ask for chairperson’s input for the agenda) Be quick to respond Be thorough in your response and give the chair evidence-based facts Typically touch base once a month— depends on that person’s preference Add about Mary’s role on state WALHDAB board. She is a retired RN

When all members of the county structure function within their roles, it is like a well-oiled machine. (Talk about our structure and how it works well—and sometimes not so well)