At a legislative roundtable on Oct. 21, Lewis County commissioners and staff outlined multiple statewide policy priorities they said are pressing for the county's fiscal health and service delivery.

Foundational public health: Misha, director of public health and social services, asked legislators to allow greater flexibility in the Commerce/Department of Health contract and contract guidance that governs foundational public‑health dollars for small, rural jurisdictions. She described a recurring problem: local jurisdictions can be unable to hire staff paid at the same rate as larger counties, face "underspend" penalties, and then see those dollars redirected to larger jurisdictions. Misha proposed contract language allowing the county to submit an alternate use of underspent categories to state oversight bodies for approval so funds can address locally prioritized activities such as diabetes education or slips/trips/falls outreach.

Tort liability and risk pools: Commissioners reported dramatic increases in general liability insurance costs; one speaker said the county's general liability premium rose from about $766,000 in 2018 to a projected $2.3 million for 2026. Commissioners asked legislators to work with the county risk pool and state partners on reforms to manage exposure and stabilize premiums.

Jail medical reimbursement and malpractice access: County staff said jail medical costs exceed $2 million annually and that efforts to obtain Medicaid reimbursement for inmate medical services have been slow at the state level despite authorizations to allow Medicaid coverage near release. Staff also said local medical providers face prohibitive malpractice insurance costs that limit the pool of providers willing to serve jails; the county asked for state solutions to lower malpractice barriers or provide backup coverage.

Public defense funding: County budget staff and commissioners described rising public‑defense costs and the limitations of a fully contracted defender model. Lewis County presently receives about $200,000 in state public‑defense support while incurring roughly $2 million in local costs; commissioners urged returning more funds to counties rather than centralizing dollars at the state level and requested statutory or budgetary remedies.

Legislators acknowledged the complexity of the issues, suggested statutory and contract language changes where appropriate, and encouraged counties to supply draft language and prioritization to guide short‑session action. Several legislators cautioned that the short supplemental session, limited revenues and competing priorities mean changes will likely be incremental and phased.