MORGANTOWN — Monongalia County Health Officer Dr. Lee Smith said there are foundational changes in the works for how West Virginia organizes and allocates funding for county health departments.
During the January meeting of the Monongalia County Health Department Board of Health, Smith explained the West Virginia Bureau for Public Health is mulling over a map that would divide the state into public health regions.
According to Smith, there are multiple reasons for doing so — one is efficiency.
“If you’re in the DHHR, you’ve got 20 maps. You’ve got the EMS map. You’ve got the hospital map. You’ve got a homeland security map. Everybody and their brother has got a different map and they’re wanting to consolidate these maps into a particular easy format,” Smith said. “Unfortunately, there’s no easy way to divide the state.”
There are six regions in the proposed map’s current iteration. Monongalia County would be the lead county for Region 4, which would also include: Barbour, Harrison, Marion, Randolph, Upshur, Preston, Taylor, Tucker, Lewis, Doddridge and Gilmer counties.
By moving to a regional model, the state could work directly with six lead counties instead of 48 individual health departments. Those lead counties would then be responsible for their respective regions.
Smith said a regional footprint would also open grant opportunities that are not available to individual counties due to population requirements.
Lastly, he said the regional setup would allow others within the region to provide guidance or even peer pressure if departments are under-performing.
“Presuming, as we move forward, if there’s a county that’s not performing or if there’s some issues with funding, you look to the lead county to try to help with any issues that may arise,” he said.
This leads to another significant change in the works for county health departments — performance-based funding.
Currently, health departments are funded using a formula that considers a wide range of factors, including population, poverty levels and the various programs the department provides, among other things.
Smith said the state is rolling out new performance standards this year and looking at where the state’s departments stand.
“Then, in 2025, the state intends on actually measuring performance of each of the health departments so they can then give you a ranking,” he said, explaining it’s not yet clear how below-standard performance will impact funding allocations.
In the event the regional model is adopted, performance-based funding would make the role of the lead county even more critical to ensure adequate funds are coming to the region.
And more expensive.
Taking on the responsibility to handle the accounting, track the money, ensure deliverables are met in a timely manner and grant policies and procedures are being implemented across a 12-county region would be an additional strain on the MCHD.
“We understand the state has agreed those additional responsibilities are going to require some additional funding,” Smith said. “So, there should be some additional dollars coming towards that.”
