A countywide fluoridation mandate will go before voters in Lakewood this fall.

The Lakewood Water District’s Board of Commissioners unanimously has agreed to let ratepayers vote whether the district should fluoridate its water, a directive from the Tacoma-Pierce County Health Department.

The health board in April decided to require all county water systems serving 5,000 or more people to add fluoride to their water. The 14 affected water providers have until 2004 to comply or risk a fine of up to $250 each day.

Lakewood Water District officials estimate fluoridation could cost as much as $713,000 to retrofit their 31 wells, plus $125,000 each year in operating costs. The district has about 15,800 connections, serving nearly 63,000 people.

The vote has sparked debate over who has ultimate control over fluoridation matters.

Some say the vote is futile and will only confuse water customers into thinking that they have the ability to make public-health decisions.

Health department officials maintain that their jurisdiction supersedes all others when making such decisions, including fluoridation.

“The vote basically has no effect,” said Paul Lawrence, an attorney representing the health department. “It’s a waste of time and taxpayer money. It is absolutely misleading to voters that (a vote) would have an effect.”

District officials disagree. According to their interpretation of state law, the health department does not have the final say.

The district realizes “that our legal opinion differs and that it could lead to a court determination,” said Larry Ghilarducci Jr., Lakewood Water District Board of Commissioners president.

The district will move forward with election plans, despite the health department’s decision last week to study the environmental impacts of fluoride before continuing with plans to mandate water fluoridation.

District officials estimate the special election will cost about $25,000. It’s a small price to pay, considering district officials will learn what their ratepayers want, said Randy Black, Lakewood Water District manager.

But vocal fluoridation opponent Jean Jamison said she doesn’t think a vote is necessarily the appropriate solution.

Jamison, who considers fluoride to be a form of medication, said ratepayers shouldn’t decide whether their neighbors get medicated or not.

Instead, Jamison would rather see Lakewood city officials follow Edgewood’s lead – even though the City of Lakewood has no authority over the water district.

The Edgewood City Council is considering making it illegal for someone to add substances, including fluoride, to the public water supply. Edgewood residents get their water from Mt. View-Edgewood Water Co., which is a separate entity from the city.

So far, nine water providers have agreed to comply. Any water provider that does not agree to comply with the mandate by June 30 could lose a chance at grant money to help pay for fluoridation costs.

The Washington Dental Service Foundation and the health department together are offering $840,000 in grants to help affected water suppliers pay for some of the fluoridation equipment.

Lakewood Water District, for example, was supposed to get $186,000 as its share.

The money earmarked for the district likely will be distributed among the compliant water providers, the health department’s Steve Marek said. Ghilarducci said the district is willing to risk losing the grant money.

If voters approve fluoridation, the district will immediately begin installing the necessary equipment to its water system, Black said.