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Public health check

Lewiston Morning Tribune - 1/20/2019

Jan. 20--ASOTIN -- Several major changes have taken place at the Asotin County Health District in recent years, including moving the office from Clarkston to Asotin, a $24,000 pay raise for the top administrator and shutting the doors on Fridays.

Ten years ago the district employed 15 people, including eight public health nurses, and operated with an annual budget of about $1.3 million. Today, the nurses are gone, only six people work for the department, and the budget has been cut in half.

Despite the challenges, officials said the number of clients served through the Women, Infants and Children Nutrition Program has been rebounding, and the district is benefiting from the expertise of its contracted health officer, Dr. Robert Lutz of the Spokane Regional Health District.

So far, the WIC program has remained open during the federal government shutdown. The program serves about 460 low-income pregnant women and children younger than 5 in Asotin County and roughly 275,000 people statewide. Almost half of all babies in the state are on WIC.

In Asotin County, clients can access the federally funded services at Asotin, or once a month at a satellite office in downtown Clarkston. Most of the clients reside inside Clarkston's city limits and prefer the once-a-month option over the 6-mile trip to Asotin.

Melissa Daggett, 26, and her infant son, George, were among the steady stream of women and children who showed up for health assessments, food vouchers and support on the second Wednesday of the month in downtown Clarkston.

"For me, it wasn't difficult to go to Asotin, but having the satellite option has helped a lot, especially since I only live two blocks away," Daggett said. "I really appreciate the services. The staff is very nice and helpful."

Joy Maynard, 56, is on disability and doesn't own a vehicle. She said riding the bus to Asotin with a baby carrier and kids isn't a realistic option, so she paid a friend to drive her to the Clarkston site earlier this month to get infant formula.

"I'm raising three grandkids on my own," Maynard said. "Asotin is way too far out for the people who live in Clarkston, and you can quote me on that."

Samantha Gortsema, 26, brought her 6-month-old baby Shylynn, to Asotin in December to visit the WIC coordinator. Because she and her fiance live in Clarkston, Gortsema typically uses the satellite office.

"I think every woman should take advantage of this program," Gortsema said. "It helps grow happy, healthy, chubby babies like her. It encourages you to choose healthier options when you're pregnant. It's been great, and I absolutely love getting to visit with everyone in the office. They've been very helpful."

Over the past eight years, the Asotin County Health District served a high of 649 WIC clients in 2012 and a low of 384 in February 2018. The numbers followed statewide and nationwide patterns, said Administrator Brady Woodbury. That started to change last spring.

"We've increased every month since May," Woodbury said. "We're the only program in the state of Washington showing this trend of growth in the past six months."

Woodbury credited the current WIC staff, including coordinator Lora Gittins and receptionist Maurine Nicholson, for the recent upswing. They work well together and are connecting with the women and children, he said.

Gittins said the program is available for any caregiver, including single fathers, grandparents or foster parents. As soon as a woman finds out she's pregnant, she can begin receiving services if she meets the income requirements.

Office now closed on Fridays

Woodbury said the hours were changed at the first of the year to "maximize efficiency" and better serve the public by opening earlier and working through the lunch hour on the four days the office is open to accommodate working clients.

"With six staff members, it was really hard to have full coverage on Fridays, and we were having zero walk-ins and very few calls to our main line," Woodbury said. "Many of our WIC (and other) clients ... wanted the extended hours, and we're trying to accommodate the public."

The decision to change the hours was approved by the Board of Health, although Asotin County Commissioner Brian Shinn objected at the time, saying five-day access is important. In meeting minutes approved last month, Shinn said the administrator's salary increase in 2018 and closing on Fridays could be perceived by the public as "paying more and getting less."

Shinn also went on record saying his comments were not a negative reflection on the administrator.

Asotin County Commissioner Chris Seubert said he missed the November meeting when the decision was made, but probably would have objected to the change.

"County offices should be open five days a week," Seubert said at the December meeting.

Move from Clarkston to Asotin

After three decades on Elm Street, the public health office was uprooted in 2014 over a rent increase. The move shifted the office from the dense hub of people who depend on the district's services to the county seat several miles away.

According to the latest figures from Twin County United Way, 61 percent of Clarkston's population is struggling to make ends meet, compared to 32 percent in the city of Asotin and 24 percent in the Clarkston Heights.

Officials said leaving the longtime office near Clarkston City Hall boiled down to finances. The rent in Clarkston was $2,100 per month, and utilities averaged $515 per month. The mortgage payment on the Asotin building is $1,241 per month, and the utilities average $258.

"We looked at over 10 options that didn't work because of size, safety, cost, etc., and seriously considered the two buildings that are now Canna4Life and Sativa Sisters, but both would have been beyond our means to renovate," Woodbury said. "We found this building out here and made what we thought was a low offer, and it was accepted. Fiscally speaking, it was a great move for our office."

However, the new location has its challenges, the administrator said, because of limited office space and the longer distance for Clarkston WIC clients to travel. But in the long run, the move is saving money, and the health district will own the building in 15 more years.

"There are also other factors that we weighed in deciding to move out here," Woodbury said. "The trend was a shrinking number of employees, we didn't have even close to the number of programs that we formerly had, and the same trend was occurring at every local health jurisdiction in the state. We had to find a sustainable location. We also are close to several of the county departments that we work closely with, so there is some benefit there, too."

He said if the public health funding situation improves at the state level, the district may be able to have more of a presence inside Clarkston city limits.

"In an ideal world, with ample funding, it would make more sense to be in Clarkston where the majority of our clients live," Woodbury said. "Eventually, depending on how public health is funded in the future, we may be able to have a more permanent branch or portion of our office in Clarkston, but for now we make it work from out here in Asotin."

Administrator salary increased by almost $25,000

The Asotin CountyBoard of Health unanimously approved a hefty pay hike for Woodbury that went into effect last year. He was making $70,180 and now is paid $94,146 a year.

The increase was based on a salary study conducted by Shannon Jones, fiscal administrator and head of human resources at the Asotin County agency.

Woodbury said all of the district's salaries were adjusted to match counterparts across the state. Some went up and others remained nearly the same.

According to information obtained by the Lewiston Tribune, Woodbury is at the high end of public health administrator salaries in eastern Washington.

The top public health official in Whitman County is paid $71,156, and the person overseeing Garfield and Columbia counties makes $77,718. In Adams County, the administrator is paid $88,524, and the person overseeing Ferry, Pend Oreille and Stevens counties makes $79,512. In Okanogan County, the highest public health salary is $76,893.

In an email exchange with the Tribune, Woodbury said every local health jurisdiction is different, and the numbers cannot be easily compared. Levels of education and duties were taken into consideration, along with experience.

In Asotin County, the vast majority of funding comes from state and federal programs rather than significant contributions from local governments.

"Because of this, we have less flexibility to hire additional staff to run other programs, and I end up doing a lot," Woodbury said. "In addition to administration duties, I also do all of our public health preparedness. Of all the counties you mentioned, I am the only administrator doing emergency preparedness; the others hire staff to do that."

In addition, he said he has worked in public health for 20 years and has a master's degree, unlike some administrators across the state.

"The bottom line is the Asotin CountyBoard of Health, consisting of six elected officials, voted to support (my salary) at its current rate. While there was some discussion and 'blowback' by a board member, the board determines my salary and voted in favor of it."

Woodbury was referring to meeting minutes that show Shinn questioning the raise in late 2017.

At the time, Shinn said he was "ashamed" he did not review changes to the handbook, the new salary schedule and fiscal impacts more thoroughly before agreeing to approve the items at a previous meeting. If the public knew the administrator was receiving a $24,000 salary increase in one year, they wouldn't be happy, Shinn warned the board at the time.

According to the health district minutes, the board agreed district personnel need to make fiscal changes more "blatant" in the future.

Last week, Clarkston City Councilor Skate Pierce defended the board's decision to raise Woodbury's wages by 34 percent.

"We have an outstanding administrator in Brady," Pierce said. "A replacement with his education and expertise would be nearly impossible to find and attract to this area."

Public health funding changes

In Asotin County, more than 80 percent of the budget is from federal programs that pass through the Washington Department of Health. Another 12 percent or so comes from fees for services, such as permits for septic systems, licenses and restaurants. The remainder is made up of contributions from Asotin County and the cities of Clarkston and Asotin.

Ten years ago, Asotin County contributed $225,000 to the district on an annual basis. When the economy tanked, the amount was reduced to $28,000. In addition, state and federal funding for several large programs, such as immunizations, sexually transmitted disease prevention, family planning and emergency preparedness, was cut. Public health has been redefined across the state, officials said.

In addition to the budget cuts, the Asotin County Health District has experienced a fair share of turnover in recent years, including the environmental health officer position, which is now filled by Jeff Hagen. As a registered sanitarian, Hagen oversees inspections for septic systems, swimming pools, food establishments and solid waste.

To fill staffing gaps, Woodbury is studying for certification to conduct on-site septic system inspections. He plans to take the test this spring.

The district's health educator, Sundie Hoffman, handles issues related to food safety, vital statistics, maternal child health, vital statistics and communicable diseases.

Thanks to Hoffman's efforts, Woodbury said the public health department has a "much more pronounced presence in the community, working with schools and coalitions regarding marijuana, tobacco, vaping prevention and education."

Board of Health Chairman Jim Jeffords said having Dr. Lutz on contract as the health officer has been another good addition. The Spokane physician is committed to Asotin County and plans to attend at least six meetings a year.

Lutz and Jeffords also work together on the state board of health.

"It's been really fascinating to learn the process," Jeffords said. "Right now we are looking for additional funding from the state to meet the core responsibilities of public health."

Jeffords, who has served on the county health board for eight years, is pleased with how the local district is functioning.

"Everyone in the office wears multiple hats," he said. "It's a real team effort, and everyone works well together."

Sandaine may be contacted at kerris@lmtribune.com or (208) 848-2264. Follow her on Twitter @newsfromkerri.

Board of Health times, places & faces

The Asotin CountyBoard of Health is made up of all three county commissioners, the mayors of Clarkston and Asotin and Clarkston Councilor Skate Pierce. Commissioner Jim Jeffords serves as chairman and on the state board of health.

Board meetings are open to the public and conducted at 1 p.m. on the fourth Monday of the month at the annex, located at 095 Second St. in Asotin. Meeting agendas and minutes are available online at http://www.asotincountypublichealth.org/

As of Jan. 1, the new hours at the Asotin office are 7:30 a.m. to 5:30 p.m. Monday through Thursday. A satellite site for WIC is available on the second Wednesday of the month at 935 Sixth St. in Clarkston.

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