Health departments across the county have come out against a provision in a bill before the Ohio Senate that could lead to health departments in Ashtabula and Conneaut being forced to merge with the Ashtabula County Health Department.
The language in Substitute House Bill 110, which was passed by the Ohio House on April 21, requires the Director of Health and Auditor of State to create criteria to be used by a city to determine if it would be more efficient and effective to have health departments in cities with populations of less than 50,000 merge with the county health department. The evaluation would be required within 18 months of the announcement of federal census results, including the 2020 census, according to the legislation.
The exact criteria are not laid out in the legislation. If it is found to be more efficient and effective to merge with the county department, city departments must do so within two and a half years of the announcement of federal census results.
The language in the version that was passed by the Ohio House is somewhat watered down from its original form, which required the elimination of all health departments in cities with less than 50,000 residents.
The legislation was referred to the Senate Finance Committee on Wednesday. The bill contains appropriations for 2022 and 2023.
Conneaut Health Commissioner Nichele Blood disagreed with the move.
“If anything, I think we need more health departments in the state of Ohio,” she said. "I don't think they should be trying to get rid of the smaller health departments."
Transportation is an issue in Ashtabula County, Blood said. A number of Conneaut residents would be unable to be get down to Jefferson, she said.
"I feel that us, as a health department, we provide a variety of different services, including vaccinations and immunizations, obviously, with COVID, especially," Blood said.
The Conneaut Health Department had administered more than 5,000 COVID-19 vaccinations, Blood said.
"If Ashtabula city, Conneaut city and Ashtabula County all became one, it might have been a little bit harder for Conneaut residents to be vaccinated," Blood said. "Not to say that the county isn't doing a fabulous job, because they are."
Blood said the Conneaut Health Department would work to have the language removed.
Ashtabula City Health Commissioner Christine Hill said the city health department was horrified and opposed to the proposed language.
Centralizing services is not a good fit for the area, Hill said.
"I worry that, this is a local service that is being taken away, and that decision is being made in Columbus," she said. The decision should be made locally.
There is a package of work that needs to be done by health departments, and merging departments doesn't make that work go away, Hill said.
"Bigger is not always better, and one size does not always fit all," Hill said.
A lot of people have supported the Ashtabula City Health Department, sending letters to Columbus, Hill said. She encouraged people to reach out to the county's state-level representatives and share their feelings on the bill.
"I don't think it's the right fit for here," Hill said.
The timing of the move, in the middle of a pandemic, is hard to understand, Hill said.
"It's not the time to dismantle our public health system," she said. "It's the time to support our public health system."
Both city health departments are in the process of being accredited, which Blood said examined the efficiency and effectiveness of the department.
"I feel that the study they have would be the exact same thing as the accreditation," she said.
Hill said the accreditation process is time-consuming and expensive.
"Just prior to COVID hitting, it was our main focus," Hill said. The accreditation process seems similar to the requirements set forth in the current version of the legislation, Hill said.
Ashtabula County Health Administrator Jay Becker said he couldn't imagine what would have happened if the county's two city health departments hadn't existed during COVID.
"I don't understand the whole timing of this," Becker said.
If the county health department had to merge with the other health departments, the impact to the county health department would be tremendous, Becker said.
"This is the largest county in the state," Becker said. "It would be an unbelievable task."
Becker said the provision of the bill was motivated by money concerns.
Becker praised the Ashtabula and Conneaut city health departments.
"I can't say enough about what their partnership has meant to us over the years," Becker said. "They know their population better than what we do. I realize we're in the same county, but they know their businesses, they know their political figures, their school administrators, they know their residents, they know their communities.
If the health departments were forced to merge, it would take resources away from other parts of the county to provide services for Ashtabula and Conneaut, Becker said.
If the health departments are forced to merge, it will not save money, Becker said.
State Rep. Sarah Fowler Arthur, whose district includes most of Ashtabula County and parts of Geauga County, voted in favor of the bill. She said the change from the initial proposed language to the language that was in the version passed out of the house was positive.
Fowler Arthur said the intent of the language, as she understood it, was that health departments that had gone through the accreditation process would not have to merge with the county health department.
Because the bill includes the budget for the coming two years, it is difficult to base a vote on one item. She said she will be looking at the language on health departments when she makes her decision when the bill comes back from the Senate.
"My goal in voting on the final version is to hopefully have a preponderance of things that I support and that we feel are benefiting the district and the state as a whole, and to limit the situations that we feel like are going to have to be revised in the future," Fowler Arthur said.
State Senator Sandra O'Brien could not be reached for comment.