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Health board discusses concerns about state budget proposal

February 13, 2013

Auglaize County Health Department members expressed concerns Tuesday about how Gov. John Kasich’s budget proposals could affect local health departments.

“There is a lot of contention across the state about this, especially from smaller health departments, who are under stress already and don’t have the financial resources to make this happen,” county Health Commissioner Charlotte Parsons said.

Reviewing reports by the Association of Ohio Health Commissioners (AOHC) and the Ohio Department of Health (ODH), Parsons said several proposals are concerning, but since those proposals still have to go before the Legislature, the proposals could look very different by the time the new state fiscal year begins on July 1.

Being discussed is the regionalization of grants, with Ohio’s 88 counties possibly condensing into eight statewide recipient groups.

“There would probably be 18 to 20 counties per grant,” Parsons said. “That would require a lot of work to figure out how to do that.”

While some counties, such as Auglaize, partner with neighboring counties now for the distribution of grants, Parsons said a lot of the work is done in-kind with no administration fee, something that wouldn’t be possible under the proposals because of the magnitude of the work required.

“Whoever would be administering grants for 18 to 20 counties would need to charge some kind of fee,” Parsons said. “It would be a lot more work.”

A grant administrator most likely would be necessary to perform the work and Parsons said how money would be allocated through such a system also would be a concern.

Parsons said while she understood why the idea was being proposed, there doesn’t seem to be a good understanding of how things work at the local level, that county health departments operate on different fiscal years and have cash flow issues.

Parsons said the new state budget proposal would zero out state subsidies for local health departments. As funds have continued to decrease, Auglaize County received just $500 last year.

Kasich proposed that health board members from each county would need to have eight hours of continuing education annually.  As it is now, there is no set training schedule in place for health board members.

Parsons said years ago trainings were held annually, but they were poorly attended and eventually eliminated.

“We will see how it works out,” Parsons said, explaining that the hours would have to be specific for the members’ jobs as health board members, not hours required to maintain their licensure.

The governor’s proposed budget requires the inclusion of the director of a hospital on the board.

“I don’t think they checked with the administrators on that,” Parsons said. “I’m not sure that will make it through.”

Kasich also wants health departments to be public health accredited.

“That is controversial and very expensive as no funding is attached to the proposal,” Parsons said.

She said right now, no local health departments in the country are accredited and no studies have been done determining that if they were they would be better run or lead to healthier communities.

The governor also is proposing the standardization of food sanitarian inspections.

“I have no problems with standardization, but it should be more about training versus punishment,” county Environmental Health Director Curt Anderson said.

He expressed concerns that it could even get done with a lack of a manpower at the state level to follow through.

Shared health services among counties could be a possibility under the new budget proposal, but Parsons said even though county health departments work together, they are different, and this would just add more work to the administrative process.

“It would require the repeal of some laws,” Parsons said, explaining it also would allow for the sharing of administrators between noncontiguous counties.

One part of the governor’s budget proposal Auglaize County is already doing — community health assessments.

Auglaize County has conducted such assessments for several years, although Kasich wants to see more done with their results.

“It would require we go further with it,” Parsons said of plans to use the assessments to develop community health improvement and internal strategic plans.

Parsons said the AOHC has drafted a letter with concerns about state budget proposals to present to Kasich’s office and she asked health board members who feel strongly about the proposals to contact their government representatives, who are in leadership positions.

“It raised a lot of questions and concerns for me,” Parsons said.

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