When Washington County Health Commissioner Kathleen Meckstroth's contract was not renewed by a vote of the members of the Washington County Health Board Dec. 13, Meckstroth said she was taken completely by surprise.
"I did not know it was happening," she said. "I was sort of numb. I did not think that they would have made that move at that time."
Discussing their reasons for non renewal of Meckstroth's contract, health board members initially said the vote was based on the department's building financial woes and the need for a restructuring plan.
However, budgetary issues at the Washington County Health Department have been common knowledge-and cause for growing concern-for at least three years.
"Financially, we've been struggling for several years," said Richard Daniell, health board president.
For her part, Meckstroth said she had been working toward bringing in more departmental funding.
Meckstroth, whose salary was $65,508 annually, had received no salary increase since January 2008. Her staff has had no raises since July 2008, she said.
When three positions at the Washington County Health Department recently became vacant, one was not filled, another one (director of nursing) was held, to be filled in 2013, and the third, a grant-funded position, was changed from full-time to part-time.
"We were making strides to realign the staff and so forth to cover some of the loss of funding," said Meckstroth.
The idea of restructuring the department was also a surprise for Meckstroth, she said.
"At one time we (Meckstroth and health board members) had talked about some other potential options but there were never any other options offered to me when the board made the motion not to renew my contract at that time," said Meckstroth. "I did not know that they were considering departmental restructuring."
Trying to maintain the level of health services that members are charged with providing county residents, the health board has "cut down on the cost of supplies and other non-essential items to the point that there's just no meat left on the bone," Daniell said.
According to Daniell, operation of the county health department is highly labor intensive.
"We pay about 75 percent of our income out for employment costs," he said.
"In the past year, we've had trouble making employee payroll," he added. "I hate to admit it, but we've even had trouble getting money for postage. That's pretty bad."
Dwindling funding, grant monies and changes in health care have all contributed to this budget crisis at the Washington County Health Department.
"The budget has been $1.3 million (annually), and has not varied very much for the last two or three years," said Daniell.
One source of funding for the county health department are the assessments that each Washington County township receives annually.
"Each township is assessed a certain amount," said Gene Morris, Washington County Township Trustees Association president.
The amount "is figured on a township's budget. Not all townships are assessed the same," he said.
For 2012, that assessment totaled $235,000, or 18 percent of the health department's budget, said Daniell. It is likely there will be no change to that amount in 2013, he added.
Approximately $10,000 to $12,000 of the health department's budget come from the Ohio Department of Health, Meckstroth said.
County service fees for services like environmental health programs and immunization fees are an additional funding source.
"Those sources are what runs most of the department," Meckstroth said.
Grant monies are a separate source of health department funding.
The department's largest grant, around $150,000, represents 14 percent of the health department's budget, Daniell said.
Called a Public Health Emergency Preparedness grant, a portion of the monies allow for a part-time local planner that helps review disaster preparedness plans, said Meckstroth.
To help create healthy community lifestyles, the county health department received a $78,000 or $79,000 grant, she added.
The health department received a $59,000 grant to help subsidize the department's dental clinic, Meckstroth said.
A $32,000 grant was awarded for the department's dental sealant program that is directed at schools in Washington, Noble and Monroe counties, she added.
"Those grants do give us some funding but are regulated. They have specific purposes and are allowed to have only certain expenses," said Daniell.
Until members of the Washington County Health Board decide how they'll proceed with restructuring in the new year, those having a question for the county health department will be directed to various representatives.
"If it's a nursing problem, they'll be referred to the nursing department," Daniell said. "...Each department is running and has been assigned representatives, with duties of that section."
"It'll be operating the same as before except not answering to a health commissioner at this point," he added.
Members of the Washington County Health Board are Daniell, president; Kenneth Leopold, president pro-tempore; Wilbert Antill; Jim Rodgers; Floyd Drake; and Mike Abbott, said Gene Morris, president of the Washington County Township Trustees Association.
Four of the health board members are elected to five-year terms by a health advisory council that is part of the 66-member township trustees association, said Daniell.
The fifth board member is elected by the Washington County licensing board, a group of license holders whose licenses are issued by the county health department. License holders include water haulers, septic system installers and food preparers in the county.
Daniell said he is not aware of special qualifications for serving as a county health board member.
However, he added, "You would have to be recognized as having some talent in order to be nominated and be supported by the township trustees association."
The Washington County Township Trustees Association will have no say in staffing or financial decisions the health board makes, said Morris.
"The health department will take care of all appointments, like if anybody was appointed to take (Meckstroth's) place," he said.
Meckstroth said she did not decline the board's offer to serve out a two-week notice and decided to leave immediately, as Daniell had previously said.
"I would never have abandoned my position," she said. "I was not given that option."
Eligible for retirement, Meckstroth had planned at some point to announce to the county health board that she would retire Nov. 13, 2013.
"I planned to announce, say that I would stay with the board, help them get through this and find a good replacement for them, if that was their desire," she said.
Despite the fact that a decision not to renew her contract was made, Meckstroth said she is hopeful about the health department's future.
"I think with appropriate, strong leadership in there that department can be turned around," said Meckstroth. "I don't know if they're at that point now."