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County commissioners review budget for Lake Region health unit
August 1, 2020

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Lake Region District Health Unit Administrator Allen McKay met with Pierce County commissioners Monday morning at the Pierce County courthouse to present a preliminary budget for review.

McKay called the proposal a "hold even" budget, emphasizing most expenses would stay the same, except for a salary increase for employees. He also noted the district health unit received extra federal funds to combat the COVID-19 outbreak in the area.

Lake Region District Health Unit serves Pierce, Benson, Ramsey, and Eddy Counties. The federal funds, which amount to $1.1 million, will help the health unit's pandemic efforts in its normal service area plus Rolette, Towner and Cavalier Counties, which McKay called "our emergency preparedness region."

McKay also gave credit to the National Guard at Camp Grafton for help with mobilizing supplies for the COVID effort, adding the district health unit was purchasing a trailer to help with distribution once the mission at Camp Grafton ends.

"The other big push is to help keep our kids immunized," McKay said. "They had a good idea here in Rugby. They had (immunizations) in the park, but it just didn't turn out. People had vacations; they had other things to worry about, so they just didn't get a very good turnout. But, we'll keep trying."

McKay suggested drive-through immunizations, noting a program to immunize children using an auto mechanic building at Lake Region State College worked well due to the building's layout.

"They don't want the kids getting a measles outbreak or pertussis with the COVID outbreak," McKay said.

McKay said finding retired nurses to return temporarily for COVID testing efforts poses a challenge.

"There's a nursing shortage anyway, and when I call up the few who retired to convince them to help for just a few hours, they're not interested. They don't want to be near anything to do with COVID. They're higher risk," he said.

"We mask up; we're fully gowned and have gloves when we do the testing. We protect ourselves, but stuff happens," McKay added.

However, he added, testing efforts are "wearing on our staff. We have a very small staff."

Pierce County Commissioners Michael Christenson, Terry Hoffert and David Migler questioned line items in the budget, particularly a proposed salary increase amounting to approximately seven percent.

McKay told the commissioners financial analysts used a market survey to develop budget for salaries.

McKay said the budget was developed with a goal of setting salaries at 90 percent of the salaries from other health units in North Dakota, plus the private healthcare provider Altru.

"We took five years to get up to 95 percent of the old (salary numbers) you did, and we kind of fell behind everybody else over five years, too," McKay said of previous budgeted salary raises.

Christenson raised the issue of benefit increases for health district unit employees.

"The benefit plan you guys have is unbelievable. You have to work 20 hours a week to get full benefits," he said.

Commissioners estimated full monthly health benefits cost $1,500 per month per employee.

"The hospital doesn't pay that kind of benefits. They might have better wages, but they don't have the same benefits," Migler said.

Hoffert said, "Here at the county, we're taking a cut as commissioners. I haven't had a raise in four years. I don't understand how you give someone a six or seven dollar an hour raise. It doesn't balance out to me, especially the way the economy is. I understand the state is giving us COVID money at the federal level, and that's great. I don't know what's going to happen when that's done, but I have a very hard time looking at seven percent to get to the ninety percent (salary level) in the budget."

The commissioners questioned what the raise would mean for McKay's salary.

McKay estimated his current salary of approximately $81,000 would increase to about $103,000 per year.

McKay also talked about grant-funded and other positions that have gone away due to budget shortfalls in the past.

Employees paid by grants and regular salaries deliver regular services and implement outreach programs, he said.

"That's for kids and people that come into their (clinics); that's mental health and family planning; that's tobacco and alcohol cessation; that's all that stuff. We have a big program to train bartenders on how to handle people when they come in to ID them," McKay said, listing some of the programs the health unit offers.

Addressing how the salary increases would be justified in uncertain economic times, McKay asked, "Can I tell you what's going to happen in three years? No. I think we're going to stay fairly steady (on property tax and other revenues). I don't believe we will lose our core people. But, when things go to heck and you start losing money and land values go backwards, that means there's less money per mill."

Downturns would mean cutbacks, McKay told the board.

McKay also told the commissioners Lake Region District Health Unit has 18 employees.

Both Christenson and Hoffert voiced opposition to the proposed salary increase.

"I will not vote for it," Christenson said.

"I can't go along with that salary," Hoffert agreed.

The commission will revisit the salary increases and budget in a conference call at 8:30 a.m. on Oct. 6.

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