MANISTIQUE - The Luce, Mackinac, Alger, Schoolcraft District Health Department is looking to secure a cooperative agreement from the Schoolcraft County Board of Commissioners.
An official from LMAS presented details of the "Urban Cooperation Act" during Tuesday's board meeting. According to Nick Derusha, LMAS health officer, the four counties currently have only an informal agreement with the health department. "The health department was formed through the four counties in 1972 - essentially on a handshake," he said. "We have not had the benefit of a formal agreement since that time."
Derusha explained the department and LMAS Board of Health determined a formal agreement would be appropriate, and formed subcommittees to explore options. Using cooperative agreements from other area health departments, the subcommittee was able to develop one "tailored" to LMAS, he added.
"The Urban Cooperation Act provides an avenue for us to formalize the agreement between the counties," said Derusha. "Most of the agreement simply reinforces the arrangements that are already in place for the health department; there are a few sections that the agreement provides some clarification."
Some sections that have been clarified include financial support, since the counties are giving larger contributions than they did when LMAS was first formed. Determining how much each county contributes was changed from a yearly population review to a sounder five-year, census-based calculation, said Derusha.
"What we've done for the previous two years is simply looked at census data," he explained. "The problem is, when the county experienced a small fluctuation in census population or even in an estimate in that year, it could impact the amount that county would need to contribute to the department by a few thousand dollars."
With the new cooperative, the department will still use census data, but fix appropriation amounts for five years. The appropriations will continue to be reevaluated every five years, based on either estimated or actual census data. This, said Derusha, will give the counties a set number for their budgets for five year blocks - reducing the number of unexpected fluctuations.
The cooperative will also be taking into consideration the prison populations of certain counties using the department's services.
"A couple of our counties have prison populations that are factored in to that census data, and the department doesn't provide our full range of services to those prisoners," explained Derusha. "It was decided by the committee and the board that each county would equally share 25 percent of that prison population."
While this move increased the amount each county will pay, Derusha noted LMAS also reduced its budget to lessen the overall burden for each cooperative participant.
Other cooperative provisions include the ability for any of the four counties: to request an appropriation evaluation due to a significant population change; to opt out of the department's services by either waiting until the end of a five-year period or giving the board of health 180 days notice; and to request that LMAS administer a county ordinance, as long as a county funding mechanism is provided. If one of the counties fails to meet their required appropriations, Derusha said the cooperative ensures the remaining counties will not be saddled with the financial burden.
"The first thing (disciplinary action) is environmental health fees would be raised in that county only - enough to make up the difference of their shortfall," he said. "We could also look at reducing services only in that county or the board may decide just to dissolve the health department (in that county)."
Derusha pointed out Luce County has already approved the cooperative, and Alger and Mackinac are expected to do the same.
Commissioner George Ecclesine explained the cooperative has been needed since a recent eye-opening experience. "The main thing that became the driving force on this was when one of the counties, about two years ago, was seriously looking at pulling out of the health department," he said. "We were all kind of shooting in the wind there was nothing, no perimeter as to how this would take effect or what would happen if that did occur."
The logistics of the possible county exit from LMAS, however, didn't pan out, added Commissioner Dan LaFoille. "What happened with that one county is they came, very quickly, to the realization that they could not afford to go by themselves," he said. "This is a good way to solidify things and give everybody a little better feeling about it."
Commissioners unanimously agreed to have the Schoolcraft County prosecuting attorney review cooperative, and possibly approve it in the last board meeting of the month.