[{"_1":2,"_104":-5,"_105":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,74,84,94],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":-5,"_54":55,"_56":57,"_58":59,"_60":61,"_62":63,"_64":65,"_66":67,"_68":69,"_70":67,"_71":72,"_73":72},"mediaId",6056811,"mediaKeyId","3308816-eacf755d95cb13d07dc6cdfbc424ab54","parentId",3308816,"title","Cascade County health department ramps measles preparedness after out-of-county cases; pertussis increase noted","audioSeconds",266,"startMs",2212000,"endMs",2478000,"viewUrl","/Search/View?dp=1&key=3308816-eacf755d95cb13d07dc6cdfbc424ab54&start=2212&end=2478","thumbnailUrl","https://d352y6ypj4mjo3.cloudfront.net/AudioPlaceholder.png","articleUrl","/articles/6056811/Cascade-County/Montana/Cascade-County-health-department-ramps-measles-preparedness-after-out-of-county-cases-pertussis-increase-noted","mediaUrl","author","MT / Cascade County","date","2025-05-07T00:00:00Z","article","Cascade County Public Health staff told the Board of Health on May 7 they are monitoring vaccine-preventable illnesses and have taken steps to coordinate testing, outreach and partner response after recent out-of-county measles cases.

Abigail (Family Health Services and Prevention Services staff) described a Gallatin County cluster that included travel-associated cases and said there was \"no exposures in schools\" in that incident. She said public-health partners there used advance screening and coordination to limit exposures and that Cascade County has opened a measles phone line to funnel questions from providers and the public and to provide consistent guidance on testing, treatment and immunization eligibility.

Preparedness steps: Abigail said the department has scripted phone routing (providers press 1; testing questions press 2, and so on) and is coordinating with benefits/clinic partners about testing sites. She said the Alluviant mobile units have been offered as an option so testing can occur outside indoor clinical settings. The department also said it has worked with hospitals to arrange mobile mammography and other mobile services previously.

Other surveillance notes: the department reported a rise in pertussis cases this year and is reminding providers about testing and reporting. Abigail said the gonorrhea total this year appears lower, but staff will follow up to determine whether the decrease reflects less screening or a true decrease in cases.

Respiratory surveillance and immunization: board members noted that RSV and flu reporting can be affected by home tests and underreporting. Abigail said the RSV immunization for infants appears to have been effective in lowering cases this season, and staff are tracking respiratory positives reported from PCR testing.

Ending: staff asked partners to use the measles phone line and said they will continue surveillance and partner coordination to limit spread and to set up mobile testing if needed.","mediaType","Audio","parentTitle","Cascade County Board of Health Meeting May 7, 2025","oneSentenceSummary","Staff reported a measles cluster in Gallatin County and described steps the department has taken to prepare local response, including a dedicated measles phone line, coordination with partners and options for mobile testing; department also reported an increase in pertussis cases this year.","taxTitle","Cascade County, Montana","taxId",5060,"location","headline","","shortSummary",{"_33":75,"_35":36,"_37":38,"_39":76,"_41":77,"_43":78,"_45":79,"_47":80,"_49":50,"_51":81,"_53":-5,"_54":55,"_56":57,"_58":82,"_60":61,"_62":63,"_64":83,"_66":67,"_68":69,"_70":67,"_71":72,"_73":72},6056817,"Cascade County environmental health staff shortage, new septic appeals law and raw-milk complaints complicate permitting",417,779000,1196000,"/Search/View?dp=1&key=3308816-eacf755d95cb13d07dc6cdfbc424ab54&start=779&end=1196","/articles/6056817/Cascade-County/Montana/Cascade-County-environmental-health-staff-shortage-new-septic-appeals-law-and-raw-milk-complaints-complicate-permitting","Rhonda, who presented the environmental health report to the Board of Health on May 7, said the department is handling a heavier workload in permitting and inspections and will be short-staffed after a sanitarians\u0000resignation.

Rhonda said permitting has slowed because of recent legislative changes that require additional nondegradation water testing and because many new properties are in difficult locations; she said, \"We have about 36% of our routine inspections done up to date. That's 254 inspections so far this year.\" She told the board that a sanitarian, Colton, has given notice and his last day will be May 16, reducing the staff able to perform septic work.

Appeals process for septic permits: Rhonda said new legislation signed by the governor now requires an appeals process for septic permits; she said she is scheduling a meeting with the county attorney's office to discuss how that appeals process will work locally and to get legal guidance.

Raw milk complaints and enforcement: Rhonda said the department is tracking complaints about unattended raw milk sales from small, unmanned refrigerators where customers leave payment in a coffee can. She said face-to-face sales are allowed under the Montana Local Food Choice Act but that the current sales model may not meet the law's requirement for an \"informed end consumer\" and that the county has reached out to the Montana Department of Livestock for guidance. Rhonda said, if the Department of Livestock does not pursue enforcement, she will consult the county attorney's office about local options.

Other items: the department is preparing for the fair and reported it had completed 20 plan reviews and 254 inspections year to date; Rhonda said a contract for an HS GovTech migration has cleared legal review and is slated to appear on the county commission work session agenda. She also said the board will later consider language to grant certain authority to an environmental health technician; that item was tabled until the next meeting for further review.

Ending: Rhonda said she would post the open sanitarian position as soon as possible and work with the county attorney's office on the septic appeals process; the board will revisit technician authority at the next meeting.","Environmental health staff reported a resignation that will cut septic permitting capacity, described a recent legislative change that creates an appeals process for septic permits, and said the department is tracking sales of raw milk and will follow up with the state Department of Livestock or county attorney if needed.",{"_33":85,"_35":36,"_37":38,"_39":86,"_41":87,"_43":88,"_45":89,"_47":90,"_49":50,"_51":91,"_53":-5,"_54":55,"_56":57,"_58":92,"_60":61,"_62":63,"_64":93,"_66":67,"_68":69,"_70":67,"_71":72,"_73":72},6056822,"On-site clinic provider to leave Cascade County health department; screenings and specialty care ending",306,2894000,3200000,"/Search/View?dp=1&key=3308816-eacf755d95cb13d07dc6cdfbc424ab54&start=2894&end=3200","/articles/6056822/Cascade-County/Montana/On-site-clinic-provider-to-leave-Cascade-County-health-department-screenings-and-specialty-care-ending","The Cascade County health department told the Board of Health on May 7 that it will end its on-site provider clinic, affecting diabetes care, some sexually transmitted infection treatment and specialized screenings.

Abigail (Family Health Services and Prevention Services staff) said the department determined the clinic model was not financially sustainable: \"It was determined that it's just not sustainable at our health department.\" She said the program\u0000\u0000which provided diabetes care and some STI/HIV services\u0000will end June 30 and that staff have begun notifying patients.

Why it matters: the provider\u0000model had included chronic disease management (Abigail said the diabetes panel numbered in the hundreds) and on-site capacity to diagnose and treat STIs; losing the provider reduces the department\u0000capacity to perform some exams and in-person treatment.

Services affected and alternatives: Abigail said diabetes care, STI treatment and Hep C/HIV care capacity will be reduced. Some aspects of screening will continue through referral partners; for example, the department will route patients to community providers such as Benefits clinic and other partner organizations. A state-funded retinopathy screening contract will be terminated because the department no longer has a provider to operate the camera-based clinic.

Medical director and standing orders: staff said the health department must operate under a medical director. Abigail said an interim medical director exists through the Department of Emergency Services if needed, but the county must complete credentialing and standing orders for that arrangement.

Board questions: Board members asked about the size of the diabetes patient panel and what would happen to STI exams that formerly were treated on-site. Abigail said she would follow up with precise patient counts and that core communicable disease functions (reporting, partner tracing, medication ordering under public health authority) would continue through the department even if clinical services shift to partners.

Ending: The department will send patient notices, refer patients to other providers and seek credentialing for interim medical oversight while it works to ensure continuity of care.","The county\u0000run clinic's on-site provider will depart and the department will end or refer out specialty services including diabetes care, some STI/HIV care and retinopathy screening; staff said patient letters are being sent and partners will be asked to absorb care where possible.",{"_33":95,"_35":36,"_37":38,"_39":96,"_41":97,"_43":98,"_45":99,"_47":100,"_49":50,"_51":101,"_53":-5,"_54":55,"_56":57,"_58":102,"_60":61,"_62":63,"_64":103,"_66":67,"_68":69,"_70":67,"_71":72,"_73":72},6056827,"Cascade County health department pulls vacancies, cuts programs amid grant uncertainty",848,2532000,3380000,"/Search/View?dp=1&key=3308816-eacf755d95cb13d07dc6cdfbc424ab54&start=2532&end=3380","/articles/6056827/Cascade-County/Montana/Cascade-County-health-department-pulls-vacancies-cuts-programs-amid-grant-uncertainty","Cascade County health department officials told the Board of Health on May 7 that uncertainty about state and federal grant awards is forcing the department to pause hiring, reduce full-time equivalents and end some grant-funded services.

The department\u0000administration report delivered by Abigail (Family Health Services and Prevention Services staff) said the county has \"heard everything from programs being cut or anticipating level funding or only funding ... three months, and then we'll reassess.\" Abigail said the department has pulled several job postings and in some cases reduced positions from full time to part time while it awaits contract letters.

Why it matters: several of the services affected are grant-funded and were not matched to current costs. Abigail said the department has to prioritize mandated services and programs that can be self-sustaining; where grant funds do not cover inflationary increases, the department has reduced or paused roles.

What was cut or changed: Abigail said the department will no longer fund an on-the-ground position for the connect referral system that helped onboard local agencies to the referral platform; that role will be discontinued when current funding ends. She also said the clinic-based HIV/provider services program will end (program end date given elsewhere as June 30), and the department has reduced WIC staffing by one dietitian. A retinopathy camera contract tied to a state grant will be terminated because the department will no longer have an on-site provider to run the screening clinic.

County finance context: Trista Vestich, Cascade County chief financial officer, told the board the county is surveying departments for balanced budgets after ARPA and other temporary funds have been exhausted. Vestich said several collective bargaining agreements and inflation have increased operating costs, and the county\u0000\u0000forecast shows a potential long-term negative impact to levied mill values. She said some departments are already operating with budgeted shortfalls and that further cuts are possible.

Discussion and next steps: Abigail said staff are analyzing which vacancies to pause and which programs to preserve, and that May would be pivotal as the department waits for grant contract letters from state partners. She said the department is also exploring whether partner agencies might absorb some services if the health department can no longer sustain them.

Board members questioned service continuity and asked for follow-up on specific programs and staffing levels. Abigail said she would provide more detail as contracts arrive.

Ending: The board heard the administrative and finance reports and asked staff to return with specifics in the next meeting once grant award letters are received.","Cascade County Public Health officials told the Board of Health on May 7 that uncertainty in state and federal grant funding has prompted the department to pause hiring, reduce staffing lines and wind down several grant-funded programs including the connect referral position and a local HIV provider program.","actionData","errors"]

Article not found

Cascade County health department ramps measles preparedness after out-of-county cases; pertussis increase noted

Cascade County environmental health staff shortage, new septic appeals law and raw-milk complaints complicate permitting

On-site clinic provider to leave Cascade County health department; screenings and specialty care ending

Cascade County health department pulls vacancies, cuts programs amid grant uncertainty