Months-long rumors and accusations of unethical decision-making came to a head this week during a Clay County Health Department report to the County Board of Supervisors.
The county board met for its regular session Jan. 23 at the courthouse in Clay Center.
Laurie Kohmetscher, of Fairfield, opened discussion on the health department’s future during the public input portion of Tuesday’s county board meeting. As president of the health department board, she requested that the county board include her board in decision-making about the Health Department.
“That’s why we’re here,” Kohmetscher said, “so we can keep airways open.”
Hearsay has circulated around Clay Center and social media, speculating that the county board has been moving toward closing the health department without discussing this in its public meetings and without the express knowledge of the health department board.
By law, any discussion or decisions of the county board regarding the possible closure of the health department must be done within meetings open to the public and the public must be given prior notice of those meetings in its designated news outlet: the Clay County News. Informal gatherings of all or a portion of the county board members, outside of these publicized open-to-the-public meetings, are illegal.
During her report to the county board on Tuesday, health department director Donna Jensen stated that the health department board has plans to interview three candidates to succeed her; she has resigned due to personal reasons. However, Jensen explained that she felt duty-bound to inform these applicants on the status of their potential employment, given the rumors that the county board intends to close the department.
County Board chair L. Wayne Johnson, of Clay Center, didn’t directly answer Jensen but reminded her and the county board that only six of Nebraska’s 93 counties continue to have a local health department: Clay, Dakota, Douglas, Polk, Red Willow, and Scotts-Bluff. Regardless, all of the state’s counties, with or without a local health department, are covered by multi-county health districts. Clay County is included in the South Heartland District Health Department, based in Hastings. Some services, such as immunizations, overlap.
“We have to ask ourselves why we have a department?” Johnson said.
He was quick to point out that the county board is looking at the viability of all county services, such as the jail or planning and zoning— weighing the pros and cons of following the trends of other small Nebraska counties that have decided to combine services to save their taxpayers’ money.
“Certainly no snap decisions are being made on anything,” Johnson said.
Jensen interjected that the county board hasn’t given clear expectations to her as to what the Clay County Health Department must do to remain open.
“We have to be working Johnson replied that the county board is looking at the health department’s costs and whether its services are necessary. He assured that the health department has not been singled out; for example, the same process is applied to a request for new machinery by the roads department or a new building on the fairgrounds.
Johnson clarified to Jensen that if the county board definitively decided to move toward closing the health department, state law requires that the county board first schedules a public hearing before its vote. However, Jensen circled back to the director candidates and the quandary of continuing with interviews and selection of a new director if there’s a possibility that the health department may be closed in a few months. Each of the applicants would be leaving an existing job to accept the director position, she quipped.
County board member Ivan Fintel, of Sutton, remarked that Jensen’s periodic reports on the health department’s services need to include clearer data to point to the department’s efficiency.
“I want to see number of bodies you took care of this last year based on the 6,000 population,” Johnson agreed, referring to Clay County’s number of residents. “I talked to someone the other day who didn’t know we had a health department. He was from Fairfield.”
Jensen remarked that the worth of the health department should not be based on how many people know about or use it.
“I know there are people in the county who want this service,” she said, “even if they don’t use it. It’s just like having a public library. Not everyone uses it.”
County board member Dick Shaw, of Edgar, interrupted with a repeat of Jensen’s question about what to tell the interviewing candidates for the health department director position. Shaw sits on the hiring committee.
Shaw and Johnson argued about whether the county board had publicly discussed the possibility of closing the health department.
“I thought we talked about that,” Johnson said, to which Shaw replied, “No, we didn’t.”
“I can’t sit there and interview someone,” Shaw added, “knowing they may not have a job in six months.”
Jensen reiterated that the director candidates deserve honesty about the future of a position with the health department.
Johnson referred to the importance of Jensen’s reports to best evaluate the health department’s efficiency, counting 700 to 1,000 people who use the department’s services.
“What if none of the schools had a lunch program but Sandy Creek, but only 15 percent of the kids there used it?” he said, using a metaphor for the health department’s seemingly low public engagement. “Is that a program they should keep?”
Jensen re-referenced the public library system.
Shaw interjected again to bring the discussion back on track.
“I want, I need to know where we stand in our future,” he said. “I need to know today.”
County Board members began to call their positions on the future of the Health Department, beginning with Johnson.
“In my opinion,” he said, “the Health Department is not cost-effective.”
County board member Eric Samuelson, of Trumbull, agreed. County board member Glen Becker, of Harvard, remarked that he was not ready to commit either way. Johnson then reminded the board that this would not be the official vote, and no one else offered their position.
Shaw then asked again what he should tell the director candidates during their upcoming interviews. Some discussion among the county board members ensued, with a general consensus that the future of the health department was uncertain.
At this point, Jensen made a plea to the county board to see value in the health department’s services, among which are home health, adult and child vaccinations, foot care for the elderly and disabled, and medical equipment checkout such as walkers, bath chairs, and commodes. To illustrate her point that the health department’s role in the community is to make basic health care accessible, Jensen shared about parents who couldn’t afford to take their children to a private medical clinic for their immunizations and chose to use the health department instead.
“If it comes down to that choice,” she said, “we have people who are not going to vaccinate their kids.”
At this point, Johnson stated that it was time to set a public hearing. Shaw disagreed, replying that during the 14 years that he’s been on the county board, he’s not heard once from a constituent wanting to close the health department. Samuelson countered, saying that he doesn’t think most people in Clay County know that the health department exists.
