GREAT FALLS — Cascade County health leaders say tough choices are ahead as rising costs and flat city funding put early-intervention programs at risk.
At Wednesday’s Board of Health meeting, the board approved a letter asking the City Commission of Great Falls to reconsider its annual contribution, while Family Health Services Division manager Jo-Viviane Jones delivered her final report before retiring after 15 years, highlighting the critical role her division plays in supporting children and families.
Aneesa Coomer reports - watch the video here:
The letter asks the city to review its $250,000 annual contribution, a figure that has remained flat since at least 2015, even as the health department’s operating costs increased from $1.4 million pre-pandemic to over $2.15 million today.
“The county has been continuously subsidizing the health department, adding more and more money every year just to meet its operating requirements,” says Joe Briggs, Cascade County Commissioner and chairman of the Board of Health. “85 percent of the services delivered by the health department are to residents of the city of Great Falls, and yet they pay only 30 percent of the cost of that health department.”
With federal COVID funding gone, Briggs says the department must prioritize state-mandated services first, including communicable disease control, restaurant inspections, and immunizations.
“We have to focus on doing what we are legally required to do first and then assess how much we have to subsidize these other grants to do other things which are important,” Briggs says. “Nobody’s saying they’re not, but they’re not required.”
That conversation took on added weight as Jones delivered her final report, taking the opportunity to emphasize the importance of Family Health Services programs.
“I would like to ask you to be supportive and see the big picture and what these programs really do,” Jones says.
Family Health Services is entirely grant-funded, with a division budget of roughly $1.1 million. Only the Maternal Child Health Block Grant requires a county match of about $69,000 per year to support public health home visiting and oral health education in schools. Programs overseen by Jones include WIC, home visiting, nutrition support, developmental screenings, and early-intervention programs for children ages zero to five.
Jones says these programs are already effective, and recent discussions about moving them to other agencies would be disruptive.
“It would take years before you would even be able to restart a program,” Jones says. “And I’m thinking, why reinvent the wheel when we already have one that’s working?”
She highlighted the direct impact on families if the programs were moved or cut:
- Over 5,000 children would no longer receive oral health education in schools
- Nearly 3,000 children would miss dental screenings
- Close to 150 children would not receive evidence-based home visiting
- Almost 400 medical referrals would go unmonitored
- More than 1,100 WIC participants could lose access to specialized formula, nutrition support, and breastfeeding guidance
Jones stressed that most other agencies in the community lack the capacity to absorb these programs, making relocation highly impractical. She also voiced concerns about staff morale and workforce stability, noting that uncertainty about program sustainability could discourage employees from staying or joining the department. According to Jones, more than 20 employees have been either cut, not backfilled, or left on their own accord in 2025.
“Our employees are the glue holding this agency together,” Jones says. “They need stability, support, and clear communication, not uncertainty.”
Briggs acknowledged these concerns but emphasized the importance of balancing program needs with financial realities. He noted that department spending has already started trending in the right direction.
“Spending has drastically decreased, and it’s not enough to right the ship,” Briggs says. “But there is definitely an expense trend that is in the right direction.”
Briggs said the board’s goal is to protect core public health services while exploring sustainable ways to deliver other programs, including Family Health Services.
“We’re not trying to compromise public health,” Briggs says. “It may look different, but we want a system that’s sustainable and meets legal obligations while keeping as many programs as possible.”
County leaders say discussions with the City of Great Falls and ongoing program reviews will continue in the coming months as they work to balance budgets, stabilize staffing, and protect essential public health services for children and families.
