MOUNT VERNON — Knox Public Health is seeking approval of a 1-mill operating levy on the Nov. 8 general election ballot.
The proposed health levy is a replacement of the current .8-mill levy with a .2-mill increase. The current levy expires next year.
The increase equals an additional $7 a year for every $100,000 of property value. The replacement levy is for five years, with tax collection beginning in 2024, based on 2023 property values.
The proposed levy will generate approximately $1.6 million a year.
“The levy is an important part of the agency’s funding, accounting for nearly 20 percent of the public health budget and helping to fund a variety of essential services,” Knox County Health Commissioner Zach Green said in a press release.
“And while it’s important to understand what levy dollars go for, it’s also important to know what they can’t be used for.”
That includes operation of the Community Health Center, which is part of Knox Public Health, and to purchase property.
What levy dollars can’t be used for
KPH’s Community Health Center has grown in the past five years, the press release stated. The Center opened offices in Danville in 2019 and acquired the Moore Family Practice and The Walk-In Clinic in 2021.
Green explained that all of the Community Health Center locations are funded through federal grants, and Moore Family Practice and The Walk-In Clinic were purchased using local funding from the American Rescue Plan Act (ARPA).
“We applaud the success of the Health Center and work hand-in-hand with the Center staff to address health inequities, but it is important that people know that the Health Center has its own funding stream,” Green said in the press release. “It does not use local tax dollars.”
With the growth in Health Center staff, as well as staffing for public health programs and services, there is a shortage of office space at the main facility on Upper Gilchrist Road, the press release stated. The health department moved into that building in 2001.
While the health department is actively looking for a new home,” the press release stated, Green said the requested increase in levy funding is strictly for programs and services, and cannot be used to purchase or build a new facility.
What levy dollars can be used for
The services and programs that levy dollars fund are numerous and multifaceted, according to KPH. They include immunizations for children and adults; health services such as community flu clinics and on-site school clinics; investigation and control of communicable diseases such as TB, Chlamydia, Hepatitis, Pertussis and Lyme disease.
The levy also funds mosquito surveillance and control; public health nuisance abatement; school facility inspections; investigation of animal bites and rabies prevention; maintaining birth and death records; health education including student programs on hygiene, puberty and hand-washing; and community education on health issues.
Green said that while the agency charges fees for some services and receives state and local grants for some programs, the grants and fees only partially fund what it costs to provide these services and programs.
“The health levy covers the remaining costs,” Green said in the press release, “including those for radon awareness, tobacco cessation, newborn home visiting, safe sleep program for infants, child car seat distribution, many environmental health programs and senior health and wellness.”
Green explained that for some service fees, part of the fee goes to the state. For example, of the $25 fee for birth and death certificates, more than half goes to the state where the funds are distributed among other state programs.
“For mandated environmental health programs, such as inspections for food service operations, campgrounds, public pools, beaches, septic systems and water wells, we are restricted on how much can be charged for fees which means local tax dollars pick up the uncovered costs for these mandated services,” Green said.
What’s at stake
The Knox County Board of Health voted in May to place the 1-mill replacement levy on the ballot.
Green said the decision followed research by the health department’s levy committee, which examined the agency’s financial outlook over the next five years.
“We have a levy committee, made up of community stakeholders and some friends of public health across our community, and we did a five-year financial trend of those unfunded, mandated programs in particular, that are core, public health essential services,” Green told Knox Pages.
“And we determined that, based off of what we’re generating in revenue for levy dollars, looking at the year 2025, those programs would be in the red and we would have to cut programming essentially, is what that would come down to.”
Green stressed that Knox Public Health does not profit off of these programs. It is not allowed to, by Ohio law. However, the law also requires local health departments to maintain these programs, in order to meet basic environmental health needs.
“Unfortunately, these are government-mandated programs. So if we start losing the ability to really inspect and investigate and ensure prevention measures are in-place to those facilities that we are expected to inspect – and the community expects us to inspect those types of facilities, when they want to go enjoy an evening out with their family, friends, etc. That is just an expectation – and potentially, quite frankly, an assumption – of where we are after 100 years of public health,” Green said.
“So in order to maintain those types of programs, those are local dollars that help offset our loss.”
If Knox County voters do not pass the levy on Nov. 8, the health department would have to cut programming, Green said. This would limit access to care for residents, as they would have to go outside the community for the aforementioned health services.
“How do we continue to provide that access to a rural community without this levy? …” Green asked. “It’s imperative that we move forward with providing core public health, to eliminate or begin to address social determinants of health in our community, and access to care is one of those things.”
Failure to pass the levy would also set Knox County back in its effort to prepare for population growth, Green said.
“With all the building that’s going on in our community, and the expectation of growth in the coming years, with what’s going on surrounding us, all those are expectations – that we can provide efficient services,” said Green, noting the importance of building and septic system inspections in the years to come.
“But without supplemental funding, (those services won’t be available).”
In order to recruit and retain a state-certified staff to execute these services locally, Green said, the health department needs local funding. This levy is designed to provide just that.
“We can charge (for these services) to some degree, but we can’t make money off them. So how do we continue to have high-qualified staff to be able to do that, and retain them? It’s no different than any other business right now – it’s difficult to recruit and retain,” Green said.
“But you want to talk about individuals that have to be state-certified to be able to conduct these investigations, with an undergrad degree? And no one over there’s getting rich – no one in public health is getting rich. So how do we continue to provide the services, understanding that we’re gonna be in the red in these programs?”
“At the end of the day, being a local government entity, we look to have those prevention measures for our community members (with) boots on the ground. Well, in order to achieve that, some local, in-kind dollars (are needed) for those programs.”
Knox Public Health over the years
Every five years since 1988, voters have approved a tax levy for the Knox County General Health District, KPH said in its press release. The levy has covered unfunded, mandated services, plus essential services that are not fully funded by fees and grants.
Since passage of the last levy in 2017, Knox Public Health achieved national accreditation, at the time an achievement only attained by a handful of health departments in Ohio.
Working with other community partners, the agency also conducted two Community Health Assessments and implemented two Community Improvement Plans.
The latest plan includes steps to improve transportation to health care locations, address behavioral health issues and increase awareness of available resources.
Other accomplishments during the past five years include development of an ongoing quality improvement program and expansion of communication efforts such as an increased social media presence; the introduction of an online newsletter; a new outside digital sign; and agency rebranding that included a new name, logo, and tagline.
Knox Public Health also became a drop site for the OhioHealth Mothers’ Milk Bank to collect human milk for medically-fragile infants.
Most recently, Knox Public Health has been a leader in COVID-19 prevention, conducting testing clinics, administering over 23,000 doses of vaccine and documenting over 12,000 cases.
Public health services have been a part of Knox County since the mid-1850s when the city of Mount Vernon created a board of health. A county health department was formed in 1919 as a result of the 1918 Influenza Pandemic and passage of the Hughes-Griswold Act, which established the modern-day organization of local health departments in Ohio.
After more than 60 years of co-existence, in 1983 the county and city health departments were combined to form the Knox County General Health District which became known as the Knox County Health Department. In 2019, the agency changed its name to Knox Public Health
The Committee for Public Health is coordinating promotion for the levy with the theme of “Public Health Is Wherever You Are: Home, Work or Play.” Rochelle Shackle is the committee treasurer. For more information about the levy or to schedule a presentation, contact Pam Palm at 740-399-8002 or ppalm@knoxhealth.com.
