August 23, 2018

August 23, 2018
Commissioners Robert ‘Pits’ DeArmond, Scott Blain, and Bill Bullock, and Administrative Officer Angela Newell were present.
8:30 Pledge of Allegiance
Commissioner Blain moved to approve Commissioners Proceedings for August 2, 6, and the special meeting on August 6; Commissioner DeArmond seconded; motion carried.
Commissioners approved the Memorandum of Understanding between Carbon County and the Montana Department of Transportation for the Planning and Construction of the Clarks Fork Bridge UPN 9523000; STPB 9005(54) (AKA Chance Bridge).
Commissioners approved the Fair Board’s request to provide a gift certificate to Danny Mydland for his volunteer time at the County Fair.
Commissioner Blain noted the Dept. of Transportation has confirmed they will be paving the portion of Farewell Rd they realigned for the approach to the new Highway 212 alignment.
10:00 Deputy County Attorney Shannon Foley met with Commissioners. Regarding the Industrial Communications and Electronics lawsuit, Shannon will be meeting with Jacque Papez to discuss discovery and then file for a motions schedule.
10:30 Beartooth Billings Clinic CAO Kelly Evans and Public Health Nurse Roberta Cady met with Commissioners regarding the Public Health Service Agreement. Beartooth requested at 5-7% increase for their preliminary budget. Commissioners are proposing a 3.25% increase tying the increase to the cost of living increase for County Employees. Kelly noted the cost for information systems has raised significantly over the last few years far outpacing inflation rates. Commissioners agreed that not having an increase last year and trying to catch up is harder for County budgeting than a steady increase from year to year. Roberta noted the department’s increased work load, including School Nurse Sheila Boggio acting as a per-diem nurse for immunization clinics and to assist Roberta when needed. The State pushes for a 10% increase in immunization rates every year under the immunization grant. Roberta noted there will also be additional nursing staff required to comply with the requirements of the Point if Dispensing exercise later this year; Public Health will rely on staff paid by Beartooth Billings Clinic to comply. Kelly noted when the department studied the feasibility of delivering cross jurisdictional Public Health services with Riverstone Health, the cost of delivering public health in Yellowstone Co. and the City of Billings was $14.48/person. The cost for almost identical services in Carbon Co. was about $7.50/person.

The conclusion of that study was that Riverstone Health was unwilling to take on Carbon County at a lower capita rate. Kelly also reiterated that Beartooth Billings Clinic has moved Carbon County to the 4th healthiest county in in the State.
Beartooth Billings Clinic Representatives and Commissioners also discussed Medicaid expansion and I-185. Kelly noted Medicaid expansion resulted in an $82,000 increase to Beartooth’s revenues from patients who became Medicaid eligible. I-185 proposes a tobacco tax that would also apply to vape products to support Medicaid expansion costs with Federal funding being reduced. They asked if the Commissioners or the Montana Association of Counties (MACo) planned to take a position on the initiative. Commissioners noted MACo has a resolution they will present at their annual conference in September supporting I-185. Beartooth representatives and Commissioners expressed concerns with lack of contact from the state legislative delegation. Kelly noted she has been trying to schedule a meeting with Seth Berglee regarding the Children’s Center as he is the chair of the education committee; Representative Berglee has been non-responsive to those meeting requests.
After a review of the budget, Commissioners decided they were comfortable with a 4% increase to the Public Health Services Agreement. Commissioner Blain moved to renew the agreement with Beartooth Billings Clinic for Public Health services with a 4% increase; Commissioner DeArmond seconded; motion carried.
11:00 No asphalt bids were received.
Commissioner Blain moved to accept the Justice Court End of period Disbursement for July 2018; Commissioner DeArmond seconded; motion carried.
12:00 Lunch – Board of health meeting. Dr. Bill George, Jean Atherly, Tom Kohley, Sheriff Josh McQuillan, Lori Kane, Josh Juarez, Dick Nolan, Roberta Cady, and Sheila Boggio were present. Red Lodge Community Foundation representative Stephen Kalb-Koenigsfeob was also present.

Respectfully submitted: Angela Newell, Administrative Officer