Lewis County Finalizes Deal for New Health Officer Services

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Dr. Alan Melnick and Dr. Steven Krager — who are currently providing public health officer services to five Southwest Washington counties — will take over for Lewis County’s Dr. Rachel Wood, who announced her retirement last September.

Although negotiations began months ago, with outgoing county commissioners signaling their approval for Melnick and Krager, the transition this week was rockier.

Newly-elected Commissioner Sean Swope argued that hiring a health officer responsible for several counties embodies the same regional approach that the county is fighting against with the state. County officials — including Public Health Director J.P. Anderson — have been objecting to a bill proposed by the governor to replace local boards of health with regionalized public health jurisdictions, a move they see as stripping away local control.

Like most counties, Lewis County commissioners serve on the local board of health.

“We are about to have to fight legislation about regionalized health, and now what we’re doing is we’re about to hire someone that’s sitting in that same manner,” Swope said Monday. “Why are we not pursuing someone to focus completely, entirely on Lewis County?”

Currently, Melnick and Krager serve Clark, Pacific, Cowlitz, Skamania and Wahkiakum counties. 

Swope called for the county to open a public application process in order to hire someone locally. 

But according to Anderson, who was directed to scope out a replacement last year, it’s not that simple. He was joined by Wood in contending that the county is lucky to have Krager and Melnick considering how few health officers are available. News reports last year highlighted the increasing number of health officers retiring, stepping down or being terminated during the pandemic.

“Given what I know about the availability of qualified, competent and quite frankly rockstar health officers that we have now in Clark County, it’s very limited,” Anderson told commissioners. 

Anderson warned that if the county were to open up an application instead of hiring Krager and Melnick, it could find itself without a health officer in the throes of a pandemic. If an application was launched later on, and Clark County “decided not to stay for that,” Anderson said the state would likely step in as Lewis County’s health officer. 

Wood also chimed in, telling Swope that “it’s not like health officers are a dime a dozen.”

She cited Thurston County, which was without a health officer for months after Wood departed. 

“They were fortunate to get a retired health officer to step in,” Wood said, referencing Dr. Diana Yu, who has since re-entered retirement.

Wood also pointed to Mason County, whose health officer planned to depart the state at the end of 2020, but is staying put as the county struggles to find a replacement. 

Anderson also said that while Melnick and Krager do operate, to some degree, on a regional level, they are also champions for local control. He contended that regional partnerships and local control are not mutually exclusive. 

“I do think that part of local control is cleverly leveraging regional partnerships to reach your needs,” he said. “And the most important thing is we decide when to leverage those regional resources.”

While commissioners voted unanimously to approve the agreement with Clark County, Commissioner Gary Stamper also expressed support for looking for a new health officer at some point. 

Regarding the transition, Pollock said her biggest concern was how new health officers would navigate Lewis County’s schools — the aggressive reopening of which, despite state guidelines, has been commended by local officials. 

Krager said that he and Melnick would largely take a hands-off approach. 

“We will support them kind of in any decision they make. So we haven’t made strong recommendations, is how I would put it,” Krager said. “We generally said we recommend following the state’s guidance, but also recognize that there are different circumstances within the districts.”

Commissioners also questioned whether working for multiple counties would spread Krager thin in his efforts to attend to local needs. During a pandemic, Krager said, most public health workers are working around the clock anyway. 

Per the new agreement, Krager will act as Lewis County’s primary health officer, and will work eight hours per week solely with Lewis County. But Anderson said a large chunk of a health officer’s work is keeping up to date with state guidance and research — hours of work that benefits each county.

The contract begins March 1, and ends at the end of December, with an option to extend. Lewis County will pay $6,775 per month for services, or $67,750 by the end of December.

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