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Township and villages have oversight of county health operations

Fiscal and directional oversight of the Washington County Health Department is set up by state law to allow those governed to have representation in how the funds are spent within state-mandated health services.

Washington County townships and villages semi-annually contribute to the county health department budget through an assessment by the county auditor, but then retain some fiscal oversight as defined by state law through appointing power to the Washington County Board of Health.

Washington County Auditor Matthew Livengood and Fiscal Deputy Tori Wells explained Wednesday that the disbursements land in the health department’s account twice each year.

“We withhold a percentage of the property tax gathered in the townships and villages in two settlements,” said Wells. “Usually, then in March and in August, those are paid to the health department.”

Wells explained that each township’s portion of withholding is based on the percentage of land that township occupies within the county’s total taxable acreage.

“The total to the health department has been the same since 2014 and will be the same again in 2020,” she added, explaining that annually the health department receives $258,000 each year in increments of $129,250.

Those funds are then spent by authorization of the Washington County Board of Health, as appointed by the township trustees each year.

“Typically the township trustees hold a health meeting right before my annual dinner with the County Township Association,” explained Washington County Engineer Roger Wright. “Usually in May we’ll hold that dinner at 7 p.m. and they’ll hold that meeting at 6:30 right before it. This last one they had to call their meeting back to order during the dinner to take a vote to remove a member of the health board.”

The District Advisory Council, by state law, is made up of the president or chairman of each township trustee board (22 in Washington County), the president of the board of county commissioners (David White) and the president of the county township trustees.

This would in practice place 24 voting members on the DAC in Washington County.

Any and all meetings of the District Advisory Council must, as written by state law, be attended by the county health commissioner.

State law also dictates that if a board member to the board of health must be appointed at an annual or special DAC meeting, that the appointment must be made by either the majority of the DAC members or by executive committee which “shall consist of five council members including the president of the board of county commissioners, council chair, council secretary, and two additional council members selected by [a] majority affirmative vote of the council members present at the meeting.”

According to the Ohio Revised Code, the DAC is required to adopt bylaws to govern its meetings, the transaction of public business and voting procedures.

According to state law, the board of health is also required to participate in accreditation interviews, to demonstrate its understanding of state-mandated services.

These interviews are anticipated to occur on Dec. 4 and 5, during the site visit scheduled and blessed by the board of health last week.

These interviews would also be taking place two workdays after the intended start date of the new health administrator and at the onset of the health department’s county-mandated move from 342 Muskingum Drive across the Muskingum River to 1115 Gilman Ave.

State-mandated Services

The Ohio Revised Code and the Ohio Administrative Code outline the state-mandated services each health district is required to provide and the services it may charge for within its jurisdiction.

“Many of the ‘shalls’ outlined in the ORC we can’t charge for, they’re unfunded mandates, but the ‘mays’ the board of health can set fees for which then help pay for the services we can’t charge for,” explained Washington County Health Department Fiscal Officer Jeannie Farnsworth. ‘There is a required cost methodology for those services too, and for the other mandated services outlined by the OAC.”

The Ohio Administrative Code also requires that all health districts (county, regional and municipal) apply for and become nationally accredited by June 30, 2020.

National accreditation standards are set by the Public Health Accreditation Board under the realms of:

• Environmental public health.

• Health education.

• Health promotion.

• Community health.

• Chronic disease prevention and control.

• Infectious disease.

• Injury prevention.

• Maternal and child health.

• Public health emergency preparedness.

• Access to clinical services.

• Public health laboratory services.

• Vital records and health statistics.

• Management /administration.

• Governance.

Those standards are measured by 12 domains outlined in a 264-page “standards and measures for accreditation” document.

“And we have to provide through this accreditation process, proof via documentation that we meet all of those standards,” said Farnsworth.

In the case of the Washington County Health Department’s accreditation application, the board of health will be measured by:

• Maintaining current operational definitions and statements of public health roles, responsibilities and authority.

• Clear, open and documented dialogue between the department and the board concerning official responsibilities of both the board and the departments.

• The board’s engagement with obligations and liabilities.

According to Accreditation Coordinator Amy Nahley, the scheduled visit of the health department to review accreditation compliance will occur Dec. 4 and 5.

Nahley reminded the board of health during its regular meeting last week that each member will be subject to interview by the PHAB visitors to ensure understanding and support of the required services the health department must perform by state law.

Janelle Patterson can be reached at jpatterson@mariettatimes.com.

Timeline:

• July 9: Washington County Board of Health Regular Meeting:

• Wittberg ousted from office by vote of Washington County Board of Health.

• July 16: Washington County Board of Health special meeting.

• Board Member Jim Rodgers resigns.

• Board Member Dr. Kenneth Leopold resigns and then reinstated.

• July 18: Washington County Board of Health special meeting:

• Board discusses in executive session potential lawsuit from Wittberg.

• July 21: Letter to board from Leopold, intent to resign on or before Oct. 31. “Due to philosophical concerns about the direction the Washington County Board of Health,” penned Leopold.

• July 25: Washington County Board of Health special meeting

• Wittberg reinstated as part-time health commissioner.

• Aug. 13: Washington County Board of Health regular business meeting.

• Board approves the job posting for health administrator following the resignation of Director of Population Health Court Witschey.

• Sept. 10:

• District Advisory Council holds a special meeting in the parking lot of the Washington County Health Department, no known minutes exist of this meeting to appoint Jeff Jones to the Board of Health.

• Washington County Board of Health regular business meeting.

• Appointment of Roger Kauffman as administrator of the health department, start date Nov. 30.

• Sept. 11: Public announcement of resignation from the board by Board Member Joe Mills.

• Sept. 20: District Advisory Council has scheduled a special meeting at 10 a.m. at the Washington County Engineer’s Office, 103 Westview Ave., Marietta.

• Oct. 8: Next regular business meeting of the Washington County Board of Health, 6:30 p.m., 342 Muskingum Drive, Marietta.

Sources: Washington County Health Board, Department, Township Trustees, County Commissioners and Times research.

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