Approval of Resolution NO. 21-041 authorizing an interlocal agreement between multiple governmental entities in Galveston County regarding the Galveston County Health District.

Galveston County Commissioners Court is updating the interlocal agreement governing the Galveston County Health District (GCHD). These improvements come from lessons learned over the past year as Galveston County to the COVID-19 pandemic. Notably, the County intends to modify the United Board of Health, the governing body over the Galveston County Health District to a five-member board verses the current thirteen-member board.

The Health District operates a coordinated public health program providing essential services throughout Galveston County, which its member cities and the County would otherwise need to provide for themselves, ranging from restaurant permitting to pandemic responses. Though the Health District does provide some services like EMS and animal control on a fee basis, the bulk of the Health District's functions are funded solely by the County.

The Galveston County United Board of Health is the governing body of the Health District. It is authorized under Section 121. 002 of the Texas Health and Safety Code and includes fourteen (14) local governments: Galveston County, Bayou Vista, Clear Lake Shores, Dickinson, Friendswood, City of Galveston, Hitchcock, Jamaica Beach, Kemah, La Marque, League City, Santa Fe, Texas City, and Tiki Island. The Board was established by the same aforementioned interlocal agreement establishing the Health District.

The current interlocal agreement requires that the make-up of the Board meet stringent selection criteria, which have posed significant challenges for the Commissioners Court. Presently, the Agreement requires that the Board have thirteen (13) members, with both geographical as well as professional specialty requirements. The Board must have one licensed physician, one representative from University of Texas Medical Branch, one representative from Mainland Medical Center, one licensed veterinarian, one registered nurse, one licensed dentist, one member of the food service or food sales industry, one professional engineer (or, instead, an individual with particular higher education requirements with at least ten years of experience in the petrochemical industry field), and three interested citizens of Galveston County.

Under the current selection process, the Commissioners Court nominates candidates to the member governments. The member governments then vote to confirm or deny the nomination. If a candidate does not receive a majority vote, the Commissioners Court must try again. Because of the large size of the Board and the constraints on eligibility, it has been challenging for the Commissioners Court to identify a sufficient pool of qualified applicants to nominate for the Board's vacancies. Currently, all Board members are holdovers from expired terms.
Proposed Modifications to the Galveston County United Board of Health: The County proposes modifying the interlocal agreement to allow for the restructuring of the United Board of Health. The Commissioners Court proposes that the Agreement eliminate the professional specialty qualification requirements for the Board and that the number of Board positions decrease from thirteen to five, which are to be exclusively appointed by the Commissioners Court.

These changes will allow the County to continue to support the Health District in efficiently providing services which alleviate burdens on the County and the cities. If the above-suggested modifications are not made, the County cannot continue to exclusively fund and support the Health District without greater financial oversight.

Simplifying the board will allow for greater public health accountability, transparency, and improved financial oversight of the County Health District. These improvements will allow the County to continue to contribute over $8 million annually to Health District operations.

Staff recommends approval of the proposed agreement.