LISBON - Proposals in the state budget, including one attempting to force health departments to file for accreditation through the Public Health Accreditation Board (PHAB), have been creating concerns for Columbiana County Health Commissioner Wes Vins and others across the state in his position.
Vins explained some of his concerns to the County Board of Health on Wednesday.
One of the changes would allow the state director of health to withhold funding from those not accredited. Vins said there are currently no accredited health departments in Ohio, although some larger ones are in the process of applying.
"Accreditation does not make us a better health department," Vins said. "We are already a good health department."
Vins said he sees filing the paperwork to the PHAB, which is located in Virginia, as taking valuable local tax dollars and sending them away from the area. The health department will not be able to use food service fees or septic fees to cover the $20,000 application fee. It will have to come from local taxes. Additionally, he estimates it will take another $60,000 in man hours just to complete the application.
The estimates came from contacting 15 health departments who have already gone through the application process. Statewide, Vins said the cost of complying with the accreditation requirement would be $2.2 million in applications fees and $11 million in staff costs.
"For us to allocate dollars we could use for public health care for accreditation does not make any sense," Vins said.
Another concern for Vins is a requirement for health commissioners to do a two-year community health evaluation. Currently, Vins and others in the area including the local hospitals, join together to provide one for the area every three years.
Another change would be a requirement for someone from the local health board to be from the largest medical facility served by the local health district. In the case of Columbiana County, both hospitals are served by their city's health departments.
The new requirements encourage shared services, requiring local health departments to move toward regionalization in order to qualify for grants or funding. For instance regional grants will be awarded instead of state grants to local health departments, which Vins points out will only create additional administration. Additionally, local health departments will be required to enter into more agreements with other health departments. In the near future, 180 separate grants will be merged into 47 regional awards.
Another requirement would be for food sanitarians to obtain accreditation through the Food and Drug Administration in order to perform inspections of food service establishments. Vins said there are currently only three FDA certified sanitarians in the state.
The new requirements would force those on the local board of health to obtain eight hours of continuing education each year. Dr. Jack Amato pointed out additional education is good for everyone when possible. He plans to go to a state conference soon at his own expense. Vins said it is often valuable to talk to other health departments facing similar issues. However, after the meeting he pointed out most health board members have other jobs, and the requirement could make it more difficult to get people interested in serving on the board.
Finally, $14,000 in state subsidies currently being received by the local health department to address community issues such as dog bites, will be taken from the money the health department submits to the state for vital statistics and later returned.
Vins said he has expressed his concerns to local state Rep. Nick Barborak and Sen. Joe Schiavoni, both of whom listened to him and asked him to keep them up to date.
In other matters before the board:
- Vins said he has had discussions with Salem's mayor and others about the possibility of the county health department taking over services there. Vins has estimated it would cost $40,000 and would not allow Salem to continue having an office within the city.
At this point, Salem has not made a decision Vins said, although he said if they plan to combine the services in the next 12 months he would like to bring it up at the district advisory meeting next Monday.
- After no one responded to a request from the board seeking a physician willing to serve as an on-call doctor in case the health department's regular doctor is unavailable during an emergency, Amato offered to take the position for $1 a month. His only request was for the health department to cover his liability, because he is retired. The board approved the action.