MORGANTOWN — Throughout his decade-long tenure as Monongalia County’s health officer, Dr. Lee Smith has consistently excoriated Charleston over its attitude toward and support for the state’s local health departments.
Fitting then that the issue came up Thursday, during Smith’s final Monongalia County Board of Health meeting before his July 1 retirement.
Monongalia County Health Department Executive Director Anthony DeFelice said MCHD is bracing for a cut in state support after leadership with the West Virginia Department of Health explained they may or may not share any of the $5 million allocated during the recent special legislative session with the counties.
Smith said it’s ultimately easier to just hold the money in Charleston than face the legislative oversight of distributing it.
“My concern, and this is Lee Smith private citizen speaking here, my concern is that sometimes what the bureau for public health does is not in the interest of public health, but in the interest of the bureau of public health,” he said.
In the 2022-’23 fiscal year, $15.5 million in state funding was distributed to local health departments using a formula concocted of various data points including population, poverty rate and access to health care, among others.
That number jumped to $17.2 million for the current fiscal year.
MCHD receives the fourth highest allocation behind Kanawha-Charleston, Martinsburg and Mid-Ohio Valley. This year, that number was about $810,000.
It was anticipated the pie would grow again, to $19 million, in the upcoming 2025 fiscal year, but the threat of a $465 million clawback of federal COVID relief dollars halted that plan. The WV Department of Health was included in an across-the-board budget cut and the state aid number dropped back down to $15.5 million.
When the state learned the clawback had been averted, legislators headed back to Charleston to undo those cuts.
“We were confident, based on what our senators and delegates were telling us, that they were going to restore it to at least the $17.2 million, and they thought they did when they passed it. Unfortunately, once the Senate and Delegates conferenced, they put the money so basically the funding goes to the Cabinet Secretary,” DeFelice said.
Ultimately, he continued, without additional action from lawmakers, it’ll be up to Cabinet Secretary Sherri Young if local health departments are made whole.
“I can tell you there is interest from the governor’s office and also from the legislature that they want to fix this. From me talking to the governor’s office and talking to our senators and some of our delegates, they were shocked that this money is not going to filter down.”
Because MCHD anticipated a 10% increase in state aid, DeFelice said the hit to the 2025 budget would be about $120,000 if nothing changes.
Smith pointed out that the state distributed $16 million to local health departments in 2016, just before former WV Health Department Cabinet Secretary Rahul Gupta cut that number by 25%.
“So, from 2016, we’d clawed our way back up from $12 million to $15.5 million to $17.2 (million),” Smith said. “If you do the conversion between 2016 dollars and 2024 dollars, we’re going backwards.”
Smith said he believes there is a deliberate effort to weaken local health departments.
“They have always had in the back room the plan to centralize public health in the state of West Virginia,” he said. “I have been eternally opposed to it because none of the people down there have ever worked in a health department, much less know how to run one, much less be able to centralize all public health. But that’s where they want to go. And this, to me, is if I break you financially, then somebody gets to ride up over the horizon and bail everybody out.”
