Having navigated a once-in-a-century pandemic without the aid of a full-time public health chief since July, Flathead County’s health board voted Thursday to authorize another round of hiring negotiations to fill the critical leadership position, urging swift action as personnel demands become dire and the rate of new COVID-19 cases accelerates well beyond the department’s control.
The Flathead City-County Health Department has been attempting to hire a qualified candidate for the vacant position since the former chief public health officer, Hillary Hanson, stepped down at the end of June. Since then, Tamalee St. James Robinson, the former health board chair, has been serving as interim health officer, leaving her seat on the county’s public health board empty.
Meanwhile, the beleaguered health department is struggling to keep pace with the county’s surging COVID-19 caseload, and a pervasive climate of skepticism surrounding the pandemic has driven a deeper wedge into an ideologically divided health board, whose members have repeatedly drawn to a 4-4 stalemate when pressed to consider enacting even modest proposals to curb the spread of the novel coronavirus.
Because a tie vote on the county health board amounts to taking no action, inking a contract with a new chief health officer would place St. James Robinson, who in her capacity as interim health chief has been unsuccessful in convincing the board to enact new community-wide restrictions, back on the board as a tie-breaking member.
More importantly, hiring a public health officer would bring new leadership to a department that has been under immense strain as case numbers reach unprecedented highs and morale plummets within the agency’s ranks.
According to Kalispell City Councilor Kyle Waterman, a health board member who chairs the personnel committee, the department has encountered numerous stumbling blocks in its search for a new chief health officer, including having a finalist withdraw from the process in July. However, Waterman said he was enthusiastic about the two applicants at the center of the most recent round of hiring negotiations, which the board approved Thursday.
The newest candidate, Brian Hanft, is the current chief public health officer of Cerro Gordo County, Iowa. In its vote on Thursday, the Flathead City-County Health Board gave the personnel committee approval to offer Hanft a contract and begin negotiating a compensation package, as well as relocation logistics.
The other candidate is David Windham, who the personnel committee proposed hiring at an emergency board of health meeting on Nov. 13, with the board voting 8-0 to begin negotiations. The candidates are the second and third finalists, respectively, to enter negotiations with the county, which has reached multiple hiring impasses due to the consequences of the pandemic.
“These are difficult times to be recruiting for this position,” Waterman said, noting that the public health crisis has hindered recruitment efforts on multiple levels, including by making it difficult to enlist a qualified health official whose services are in high demand.
“We are trying to recruit qualified candidates, and our finalists are dedicated to their communities, and to the public health departments they’re currently running,” Waterman said, adding that Flathead Valley’s skyrocketing housing prices have added another degree of complexity to the process. “Negotiations are always a poker game, and during a pandemic, with the housing prices as prohibitive as they are, the chips are really stacked against us.”
Although the next health board meeting isn’t until Dec. 17, Waterman said he hoped to convene a special board meeting to approve a finalist much sooner.
“This isn’t over until it’s over, but I am pleased that we have entered this phase with two qualified candidates,” he said. “My goal would be to let the public know and the rest of the board know as soon as we come to a mutual agreement with one of the individuals. We have already gone through multiple rounds of negotiations and we have been searching for someone in this round since July. So it is a top priority to get this done soon.”
Prior to approving the hiring negotiations Thursday, the health board heard impassioned pleas from community members, who testified via Zoom video conference and urged the board to act quickly. Some of the public testimony came from frustrated health care professionals who implored the board to root out COVID-19 skeptics from the pool of candidates.
“As a frontline RN [Registered Nurse], I want to make sure that the new health officer supports science and public safety and not the anti-mask rhetoric that continues to be peddled in this community,” said Tara Lee, a nurse at Kalispell Regional Medical Center who referenced the board’s repeated past failure to enact any new health measures to curb community spread of the virus.
“As a health care worker I feel like I am getting stabbed in the back by my local community and the health board,” Lee said, singling out the four health board members who have opposed new restrictive measures to slow the spread of COVID-19, as well as the three county commissioners who were responsible for appointing them. “The other day I was at work, and I was told that our pediatric unit was being turned into a COVID unit. The virus is here and we are in the fire. We needed help two steps ago. Please.”
Indeed, officials from Washington D.C. to Helena down to the Flathead City-County Health Department itself have, for nearly two months, pointed specifically to Flathead County as a COVID-19 hot spot, an unwanted distinction that doesn’t appear to be abating.
The county reported 2,217 new cases in October, and so far November has been worse, with 2,321 new cases reported as of Nov. 19, representing a stunning 38% of Flathead County’s total number of cases (6,089) since the pandemic began.
After two days in a row this week of reporting 160-plus new cases, St. James Robinson said the county had confirmed an additional 218 cases on Thursday.
Adding to the pressure of the case growth, St. James Robinson said the virus is taking a literal toll on her staff, some of whom are in quarantine, either because they came into contact with a COVID-19 positive patient or tested positive themselves.
“That’s cutting us really short,” she said.
The health department said it has abandoned contact tracing except for high-risk contacts, and with case investigations sometimes starting two days after a positive test, the effectiveness of those efforts was already limited.
The degree of community spread has so overwhelmed the county’s ability to perform effective contact tracing that St. James Robinson said the department has begun training school administrators and teachers to conduct the case investigations themselves.
“We had 36 new school cases today alone,” St. James Robinson told the board on Thursday. “We’re training school staff to help with contact tracing, but it’s a hard job.”
In spite of public health officials’ desperation, the county’s elected leaders have dismissed their recommendations at every turn, and the health board has even rejected watered-down proposals to limit the size of public gatherings indoors. In the last month and a half, the county commission has come out in support of residents who refuse to wear masks in public, the county attorney has declined to prosecute any businesses that violate directives from the governor’s office, questioning their legality, and law enforcement has said it is unable to enforce widespread mask violations.
In the most recent blow to morale at the health department, according to public health officials, a Flathead County District Court judge rebuffed a request by the Montana Department of Public Health and Human Services (DPHHS) to take legal action against five local businesses that the department claims were operating in violation of the statewide mask directive aimed at slowing the spread of COVID-19.
Those businesses in turn filed counterclaims against the state of Montana and Gov. Bullock, seeking damages and attorneys’ fees, as well as a formal declaration that the mask requirement is not enforceable.
News of the court’s decision came as a shock to Bill Burg, chair of the Flathead City-County Board of Health, who has publicly aired his frustration over the repeated inaction by the county’s elected leaders.
“So we’re not getting support from the commissioners, the sheriff, the county attorney, and now one of the judges,” Burg said at Thursday’s meeting. “Okay then.”
On Nov. 18, Gov. Steve Bullock did what the county has been unable to do for months when he enacted new statewide health directives, issuing an executive order further limiting the capacities in bars, restaurants, breweries, distilleries, and casinos, while restricting public gatherings to 25 people or fewer when social distancing is not possible, including outdoor settings.
The governor’s order, which went into effect at 5 a.m. on Friday, also extends a mandate requiring face coverings in public settings to include all counties regardless of case numbers.
At Thursday’s board meeting, other health care professionals pointed to the devastating toll COVID-19 is taking on the Flathead Valley’s most vulnerable populations, including seniors.
Last week, health care officials announced an outbreak at Kalispell Regional Healthcare’s Brendan House, a 110-bed nursing facility. As of the morning of Nov. 20, 50 residents have tested positive for COVID-19.
Erica Lengacher, a critical care nurse at Kalispell Regional Medical Center, said she works with the hospital’s sickest patients, offering them bedside support in their lowest moments.
“As a nurse I will continue to be the person at their bedside, talking to patients right up until the moment they are intubated, which is a picture I wish I could paint for you because it is a horrifying, excruciating experience for the patient,” she said, referring to a procedure that involves a tube being surgically inserted into a patient’s trachea for ventilation. “There are thoughtful, reasonable and medically based steps that we can take to slow the spread, and evidence has shown that they work. Please take them.”