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Public health poses more questions than answers

County Commissioner Tony Hyde voices concern over health district's approach to public relations

As the Columbia Health District and Columbia County look at new ways to move forward with administering public health services countywide, a state-level plan in its early stages may affect how much control the county programs have after the 2011 legislative session.

Meanwhile, County Commissioner Tony Hyde believes the Columbia Health District has overstepped its authority.

These are just the latest wrinkles in an increasingly confusing public health saga.

At the state level, the Health System Transformation Team, which is expected to have legislation prepared shortly, is looking at ways to redesign the delivery of Medicare and Medicaid benefits.

The implication at the county level is that public health will have less of a role in administering those services, which has local representatives nervous.

'We're very concerned about public health because a little nibble here and a little nibble there can affect everything,' said Mark Nystrom, the policy manager for public health at the Association of Oregon Counties, which is wary of the changes. 'And these are not nibbles, they're big bites.'

Hyde said he opposed state-level changes to public health, adding that he thought it was 'strange that the state's way of cutting the budgets would be to centralize services.'

Even without the state's work, there are questions about how the county's public health services will be administered in the future.

The county has begun looking at signing a contract with a different agency as a way to provide public health services. Murmurs of dissolving the district completely have also started, two months before an election that will likely alter the complexion of the health district's elected board.

Tammy Maygra, one of a handful of health district opponents running for an open board position, said she thought dissolving the district was a way of silencing the health district's opponents, such as herself.

For his part, Hyde has become frustrated with decisions made by health district officials, taking particular issue with a press release the district released on March 22, which stated that the health district had begun work to move public health to a public nonprofit.

'Sorry, they don't make announcements like that,' Hyde said. 'We do.'

Public Health and the county have had many closed-door discussions over the past year and message management has come up. The latest flap may signify how the two boards are not completely on the same page.

Hyde said the latest information released by the health district, 'really pisses [him] off.'