The Wahkiakum County Eagle - Established as The Skamokawa Eagle in 1891

Wahkiakum County Commissioners heard some good advice Tuesday about replacing retired Health and Human Services Department Administrator Judy Bright, who announced her resignation in December for health reasons.

Commissioners heard from the administrators of health and human services departments in Skamania, Clark and Cowlitz counties from Dr. Alan Melnick, health officer for Clark and Wahkiakum counties, and Wahkiakum's deputy directors weighed in also.

Commissioner Lisa Marsyla invited the officials to offer input and insights, saying that the political and financial changes in public health demand the right kind of leadership.

"You know us and our county," she said. "What scares me is health care reform. I want to make sure we are at the table and are making good decisions for our county."

Commissioner Blair Brady invited the visitors to raise any worthwhile suggestions; these could include options such as combining departments with another county or privatizing management.

A nurse practitioner, Bright could perform both clinical and administrative roles, and some speakers said that was valuable.

Skamania County's health and human services coordinator, Kirby Richards, said that with a small staff in a small county, she has had to do some of the clinical work at times.

"It's hard for me to imagine, in a small county, how you can have just an administrator," she said.

"In Judy Bright, you had an administrator and a leader," said John Wiesman, manager of Clark County's Health Department. "The leadership piece is absolutely critical."

The group agreed that the new director would need to be part of the group forming a regional health care alliance to implement mandates of the federal Health Care Reform Act. This act will encourage public and private health care agencies and providers to work together, and Bright has already been involved in that work, they said.

If the county were to combine services with another county, the board of commissioners would need to take an active role, said Wiesman. "As a board, you need to make sure you have a voice," he said. "The political discussion role is important."

Brady commented that it would take a long time to develop an agreement with another county to combine departments, and the department could suffer from a lack of leadership in that time.

"My biggest concern is having an overworked staff," said commission Chair Dan Cothren.

Department staff, who have been assuming Bright's responsibilities while she was on medical leave, echoed Cothren's comments.

"We have to take care of ourselves, to do what we can do with what we have," said Deputy Director Chris Wieler. "We need to prepare to do more with less. I just don't want us to lose momentum and that we de-leverage how well we work together."

Chris Holmes, director of the county's Human Services Department, said the department has a strong reputation for developing strong programs with little resources and that will have to continue.

"We can't leave the position open," he added, "but it would be an error to rush to fill a vacancy with a person less than qualified for the position."

Marsyla commented she doesn't want the department to go backward into an unwelcome merger because of funding problems. Both state and federal governments are reducing their funding of public health, leaving counties to pick up the difference or to cut services.

Carlos Carreon, director of Cowlitz Health and Human Services, said his department would do what ever it could to support Wahkiakum.

"Wahkiakum's success is our success," he said. "Disease has no respect for political boundaries at all."

Wiesman commented that he wouldn't split the department and that he would look for a person capable of navigating the waters of the changing health care stream.

"It is critical that you can get a leader who can work through these transitions," he said.

"We need to find someone with the leadership skills as soon as possible," Brady said.