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AGENDA CLARK COUNTY COMBINED HEALTH DISTRICT

BOARD OF HEALTH October 15, 2020

6:00 p.m.

1. Call Meeting to Order

2. Roll Call

3. Minutes of the September 17, 2020 Meeting

4. Activity Reports: A. Nursing Division (Christina Conover)

1) 3rd Quarter Communicable Disease Report B. Environmental Division (Larry Shaffer) C. Early Childhood (Lori Lambert) D. Women, Infants, & Children (Emily Hawke) E. Vital Statistics (Shannon Hackathorne) F. Financial Report (Lindsey Hardacre) G. Legislative Update (Charles Patterson)

5. Monthly Vouchers (Lindsey Hardacre) A. Payment Approval B. Transfers/Advances, if necessary

6. Special Report

7. Old Business

8. New Business A. Position Upgrades (Christina Conover)

1) Renee Steele 2) Alyssa Trass 3) Gracie Hemphill

B. First Reading – Environmental Health Fees (Larry Shaffer) C. Southern Village Flooring (Charles Patterson) D. Audit Report Acceptance (Lindsey Hardacre) E. Appropriations (Lindsey Hardacre)

9. Health Commissioner’s Comments

10. Executive Session – if necessary

11. Additional Business – if necessary

12. Next Meeting Date – Thursday, November 19, 2020

Adjournment

Clark County Combined Health District Board of Health Minutes

September 17, 2020 President Catherine Crompton called the September 17, 2020 Clark County Combined Health District Board of Health meeting to order at 6:00 p.m. Board members present: Catherine Crompton, Marianne Potina, Dala DeWitt, William Scarff and Valerie Moore. Board members absent: Bernadette deGuzman and Dana King. Staff present: Charles Patterson, Health Commissioner; Larry Shaffer, Director of Environmental Health; Christina Conover, Director of Nursing; Emily Hawke, WIC Director; Lori Lambert, Early Childhood Director; Shannon Hackathorne, Administrative Assistant to the Health Commissioner; Rick Holbrook, IT Technician and Kyle Trout, Communications Coordinator. Others present: Ms. Rositta Rice, citizen and Mr. Ronald Pasco, citizen. Minutes: The minutes of the August 20, 2020 Board of Health meeting were approved as submitted. Activity Reports: Nursing: Ms. Conover said that staff are doing a great job with alterations in programs, specifically Children with Medical Handicaps (CMH). She said this program is primarily home visiting without direct physical assessment, but case management and social support. She explained that this program is a subsidizing program for insurance, when insurance does not pay for some of the medical needs, this program can help. She said there is a need to help keep these families engaged, on the program and connect them to other resources available. She said that we made some changes with the program and were able to put a nurse in place with CMH being her primary focus, which allows her to be responsive to families. She said the other nurses still carry a caseload, however, they are much smaller. She said we are pleased to see this continue to be a successful model for that program. She thanked the nurses with cases, Ms. Renee Steele and support staff, Ms. Jan Walker and Ms. Sandy Miller for their work in making this a successful program. Ms. Conover said we are finally providing services at our Southern Village site and we are very thankful for that opportunity. She advised that we have successfully run a couple Monday clinics for reproductive health. She said we chose to do our longer day from 8:00 a.m. to 6:00 p.m. there because we need to have a certain number of appointments outside the 9:00 a.m. to 4:00 p.m. period. She said the immunization clinic has only been there once, however, Ms. Kristen Earley who was at the site shared how thankful people were to be able to come to the Southern Village site. Dr. Crompton asked how word is getting out that the clinic is there in Southern Village. Ms. Conover said it has been a soft start with offering the Southern Village location when people call in for appointments. She said we will be doing promotion through social media and we were able to do some canvasing this afternoon. She said we delivered packets to 500 households in the area for the pop up community testing clinic being held across from the Southern Village plaza and we included an additional note in the packet about services available at the Southern Village site. Ms. Conover said we were fortunate to engage with Kaleidoscope consultant, Ms. Kim Fish in regards to the Wittenberg COVID-19 outbreak. She said we reached out to Ms. Fish because Ms. Michelle Clements-Pitstick was moving to EMA and we knew we needed someone to serve as a liaison with the Health District and Wittenberg. She said we did not know there would be a large number of cases almost immediately after Ms. Clements-Pitstick left so this has proved to be very helpful. She advised the contract with Ms. Fish is under the contact tracing grant and we will have those funds until the end of December. She said the case counts have reached the triple digits with approximately 50 new and 100 resolved. She said Wittenberg had the opportunity thanks to Mr. Patterson to pull in some National Guard and State resources to come for a mass testing event on September 9, 2020, which resulted in about 45 cases. She said Wittenberg moved to virtual classes for a few weeks. She said working together has been beneficial and we want to continue that relationship.

Clark County Combined Health District Board of Health Minutes September 17, 2020 2

Ms. Conover said schools have returned to class and that has been interesting. She advised that every school board can make their own policy on how they will handle someone going out with COVID-19. She said there is a wide range on how it being handled. She said the Health District looks at CDC guidance which says many symptoms of COVID-19 look like other illnesses, allergies, flu and other things heading our way and would cause a lot of unnecessary out of school experiences if the full 10-14 days at home was required every time there is a symptom. She said the guidance suggests making sure the child is fever free for 24 hours and symptoms have resolved with no new symptoms before returning to school. She said the schools have the liberty to make that more restrictive as necessary. She said many schools have made it more restrictive and we want to support them as we don’t know which school will have the most success with their model policy. She said we have one (1) nurse we have asked to be primarily responsive to schools due to some rearrangements made pre-COVID-19 and that has been helpful in communications. Ms. Conover said nursing homes continue to be tested per the state system depending on what our positivity rate is in the county. She explained that the county is classified in a certain color based on positivity rate, which is different from the Governor’s color, and that color defines how much nursing homes must test and we try to support them as well. Environmental Health: Mr. Shaffer said we have completed mosquito surveillance for this year. He said due to improved bait and excellent work of the staff we were able to sample more than 17,000 mosquitos and have 21 West Nile positive samples. He said the rest of the state did not participate well in the mosquito sampling this year so we were a leader in that area. He said fortunately there have been no human cases of West Nile Virus. He said we have 50% more West Nile Virus in mosquitos this year than in past years and it has been countywide. He said we found West Nile Virus positive mosquitos in North Hampton, South Charleston, Park Layne and several areas of Springfield. He said the best benefit from our work continues to be in public awareness and early warning for the presence of the disease. Mr. Shaffer advised there is some discrepancy in the last page of report regarding the number of animal bites and we will get that corrected with an update to the Board before next month. Mr. Shaffer said that normally in September we would present revised Environmental Health fees to the Board for consideration, however, enforcement, consulting and fit testing related to the pandemic continues to make accomplishing regular work a challenge for staff. He said revised Environmental Health fees will be available for review next month, however, there is talk in process to freeze Environmental Health fees statewide for three (3) years. He explained that Environmental Health fees are calculated using costs for time and mileage to complete inspections in each program from the previous year. He said this year most health departments have decreased cumulative inspection time due to staff being pulled from regular duties and facilities we inspect not opening, which will result in significantly lower fees two (2) years from now and environmental fees will not be covered. He said if the freeze is implemented the health departments will be able to continue to cover costs until the pandemic and economic situation has stabilized. Mr. Shaffer said the U.S. EPA has solicited public comment for remediation plans for the closed landfill on the west side of Route 235, south of New Carlisle. He said this is in response to contamination of the ground water with volatile organic compounds. He said the plans include vapor intrusion remediation as well as providing safe water for homes that may be affected, re-grading the landfill gap to be impermeable and better drain water away from the landfill and treatment of the ground water on the east side of the site. He advised that we have submitted comments supporting moving forward with this work and expressing concerns in regard to some of the items such as who will be responsible for equipment installed for long term remediation. Mr. Patterson this is a project our staff has worked on compiling comments for the past six (6) weeks, which were submitted yesterday detailing our agreements and concerns with the remediation plan. Mr. Shaffer said it seems to be a solid plan, we just want to ensure the thought process is in place to maintain the equipment they want to install. He explained that this was one of the problems we faced in Donnelsville as the original fix the EPA had in people’s homes to get rid of the PCE from the water was putting in air strippers, but no one put money out for maintenance and when the systems started to fail the homeowners could not afford the repairs and started pulling them out. He said we want to make sure they have the thought process in place to ensure homeowners will not be responsible for maintenance of the equipment they want to install. Early Childhood: Ms. Lambert said we are happy to report that we received notice of award for the Cribs for Kids grant. She said even though we have had to be really creative with our program delivery we have strong numbers, with the exception of Mom & Babies First. She said we added a few new families in Help Me Grow today, however,


we still have approximately 20 on a waitlist. She said we participated in a webinar for Baby & Me Tobacco Free and in Ohio the birth weights for those enrolled in the program are 90% at 5.5 pounds or greater and 91% are 37 weeks or more gestational age. She said we also do a good job in Ohio and Clark County enrolling African American moms and are almost twice the amount of our surrounding states. She said Clark County Combined Health District received a shout out on the webinar as we had the most online portal referrals in the state when looking at two (2) years’ worth of data. She said we were early adopters and quickly started outreach in the community. She said we do not have everyone we would hope to have onboard, but we do have a good amount. She said we have shared what we do with others in the state which is exciting for our county. She said that in August we had 2 graduates, which means we met the moms when they were pregnant and smoking, helped them quit and kept them enrolled for twelve (12) months. She shared that one of the moms had twins and the other has adopted many other lifestyle changes we educated about and she has really taken a big turn. She said both moms smoked ½ to 1 pack per day when we met them. Ms. DeWitt asked what timeframe we anticipate for families on the waitlist. Ms. Lambert said some families change levels which allows us to bring more families on, however, it is typically thirty (30) days. WIC: Ms. Hawke said she wanted to share details from our Breastfeeding Awareness Month (BAM) event. She said they wanted to hold a celebration for our pregnant and breastfeeding moms this year, however, due to COVID-19 this was a challenge so we decided to try a drive thru event. She referred to the photo collage in the Board packet capturing the event. She said they had 67 total attendees, 30 were pregnant or breastfeeding moms and the other 37 were children or support members. She said moms who attended were registered, asked what breastfeeding questions they had and directed to the stations. She said during the stops moms were introduced to the agency’s Lead and Early Childhood programs and WIC breastfeeding staff. She said mom received bags provided by Caresource, COVID-19 kits from Paramount and infant bags from Second Harvest Food Bank. She said moms also received beneficial materials from the State WIC Office including nursing bras, washable breast pads, children’s books, breastfeeding support bags and human milk storage magnets. She said locally we gave out breastfeeding handouts, contact information for the 24 hour breastfeeding hotline, promotion pens, coloring books, stickers for siblings, bottles of water, snacks and cookies ordered from a local baker, D-Sweets that were decorated with the breastfeeding logo. She said there were seven (7) raffle items the moms could enter into a drawing for and Ms. Liz Stevens and Ms. Safiyyah Truss demonstrated and gave out moby wraps to breastfeeding moms. She said we were very pleased with the outcome and thanked Ms. Liz Stevens who planned the event and the entire team for working to make this a successful event. Dr. Crompton asked how many people drove thru. Ms. Hawke said 30 moms drove thru with the total number of attendees at 67, which included support members and children. Ms. Hawke said they are going through their State Management evaluation which is being done virtually. She said documents were scanned and the call to wrap up the evaluation is scheduled for tomorrow. She said overall it sounds like the evaluation is going well. Vital Statistics: Ms. Hackathorne said there is nothing new or unusual with the report this month. Financial Report: Mr. Patterson said we have been holding our own with COVID-19 being a major driver behind direct expenses. He said if you look at the cash summary we are not exactly where we want to be, but with some additional grant funding we will talk about later in the agenda we believe the bumps will smooth out. He said we have adjustments of appropriations that we will talk about later in the agenda as well. Legislative Update: Mr. Patterson said the Legislature is not in session right now so most of the work we are doing is based on the lame duck session to come after the election. He said we know that things will get wild at that point. He said one of the major points we continue to watch is the bills that affect the Director of Health and Governor and how much authority and power they have in times of emergency as we are in now. He said in addition to that the new Speaker of the House has told us not to expect the normal flurry of crazy activity in the lame duck session. He said they will be doing some things, but should not be doing anything crazy between now and the end of the year and this Speaker of the House has a little more steady approach. He said the Legislature is concerned about the amount of authority the executive branch currently has and they want to rein in some of that back in. He said those things can be vetoed by the Governor so it will be interesting to see how many of those powers he is willing to give away. Vouchers: Mr. Patterson presented the bills.


R 81-20 A resolution approving payment of the bills from August 1, 2020 through August 31, 2020. Motioned by: Ms. Potina Seconded by: Ms. Moore Dr. deGuzman Absent Mr. Scarff Yes Ms. Potina Yes Ms. Moore Yes Dr. Crompton Yes Ms. DeWitt Yes Dr. King Absent Motion carried. Transfers/Advances: Mr. Patterson said we are asking the Board to approve a budgeted transfer in the amount of $30,000.00 from the General Revenue Fund to the Environmental Services Fund. R 82-20 A resolution approving a budgeted transfer for $30,000.00 from the General Revenue Fund to the

Environmental Services Fund. Motioned by: Mr. Scarff Seconded by: Ms. DeWitt Ms. Potina Yes Ms. DeWitt Yes Dr. King Absent Ms. Moore Yes Mr. Scarff Yes Dr. deGuzman Absent Dr. Crompton Yes Motion carried. Special Report: none Old Business: none New Business: Dr. Crompton advised that we have two (2) variance requests this evening and with the Board’s approval moved items 8G1 and 8G2 forward in the agenda. Sewage Variance Request – 2900 Dogwood Drive: Mr. Shaffer said the property at 2900 Dogwood Drive is in German Township with the back side facing Route 41 which has right of way with public sewer. He said the homeowner has a real estate transaction in process and due to the cost of connection, the homeowner is asking for a variance from rule that prohibits an operation permit from being issued if the foundation of the home is within 200’ of a right of way containing public sewer. He said the current treatment system is an aerator and if the aerator requires replacement, the Environmental Protection Agency will not allow another aerator to be installed due to proximity of the sewer. He advised the Board granted this variance for a property with soil absorption treatment and located next to this property a few years ago. He said that as of noon today, we have not received any estimates of the cost of connection from the homeowner. He said the realtor called and said estimates were being sent to us from the contractors and we advised estimates should be sent to the homeowner and we can be carbon copied as the contractors are working for the homeowner and the homeowner should be aware of what the proposed costs are. He advised a diagram of the property and a public health ethics review are included in the Board packet. He said German Township Trustees have been advised of the request for variance and have not offered any comment. Ms. Rositta Rice said she has not received the estimates for cost to connect to sewer as of this afternoon. Dr. Crompton asked if she has a buyer for the home. Ms. Rice advised that she does have a buyer and they have already placed a down payment on the sale. Mr. Shaffer said Forest Hills is higher than Route 41 so the sewer line would have to go downhill across Route 41 and connect to the sewer on the other side of Route 41. He said his understanding from the neighbor was that a sewage pump would have to be installed to complete the connection which is not uncommon. He said he believes


it is feasible, however, we are looking at a matter of cost. Dr. Crompton said if she remembers correctly, the cost to connect on the property next door was significantly more than the Board thought was appropriate for the homeowner to undertake. Mr. Shaffer said he would agree with that, however, as he remembers the cost seemed significantly out of line. Mr. Patterson said boring under the road is one of the significant costs of the connection and he cannot imagine it would be different in this case, however, we do not have the paperwork that we would normally submit to the Board for consideration. Ms. DeWitt asked if we can go back to the minutes for the neighbor’s variance request to review the details. Dr. Crompton advised the Board would hear the next variance request while we pull details from the previous variance request next door to 2900 Dogwood Drive for further discussion. Sewage Variance Request - 3690 Randee Lane: Mr. Shaffer said 3690 Randee Lane is in Pike Township. He said the homeowner desires to install an in-ground swimming pool. He said a site review reveals that someone has installed a concrete patio around the septic tank that does not meet isolation distances. He said the homeowner is requesting a variance for isolation distances to the concrete patio. He advised this should not affect the operation or maintenance of either the patio or the septic tank. He referred to the Board packet for diagram and public health ethics review. He said the Pike Township Trustees have been advised of the request for variance and have offered any comment. Mr. Ronald Pasco said there is very little room for a pool and this was the only possible place so they bought the smallest pool they could find. Dr. Crompton asked Mr. Shaffer for staff recommendation. Mr. Shaffer said we do not see any adverse effects on public health in approving the variance. R 83-20 A resolution approving a household sewage treatment system rules variance at 3690 Randee Lane, Springfield, Ohio (Parcel # 2500100002204003) allowing a household sewage treatment system to be installed in a location that is less than 10 feet from a hardscape with the responsible party signing a Hold Harmless Agreement. Motioned by: Ms. DeWitt Seconded by: Ms. Potina Ms. Moore Yes Ms. Potina Yes Dr. King Absent Dr. deGuzman Absent Dr. Crompton Yes Ms. DeWitt Yes Mr. Scarff Yes Motion carried. Variance Request – 2900 Dogwood Drive – continued: Mr. Patterson pulled the minutes for the neighbor’s variance request. He said there were only two (2) estimates provided, one at $58,700.00 and the second at $167,256.00, which seems to be off a little. Dr. Crompton asked Ms. Rice if she was aware this was going to be an issue when listing the home. Mr. Rice she has lived in the home for seven (7) years and had no idea this would be an issue. Ms. Moore asked Ms. Rice if she was aware this was an issue for the neighbor when they sold. Ms. Rice advised that she was not aware the neighbor had this issue. Ms. Moore asked Ms. Rice when she requested the estimates for the cost to connect to sewer. Ms. Rice advised her realtor took care of that and said the contractors were advised of the deadline to submit the estimates. Ms. Moore asked Ms. Rice when the home was put on the market. Ms. Rice advised it was listed approximately three (3) weeks to one (1) month ago. Mr. Patterson asked Mr. Shaffer when we talked with the real estate agent. Mr. Shaffer advised the realtor called approximately three (3) to four (4) weeks ago to complain about the process


and we explained that the variance request had to be brought before the Board. Ms. Moore asked if the buyer has been made aware that if the variance is approved and the system fails, they will incur the cost to connect. Mr. Rice advised the buyers are now aware and asked why they were not notified about the process prior to the pending purchase. Dr. Crompton advised that we rely on the realtor to notify people when bringing them to the property. She said we educate them as we do not know when these transaction are occurring. Ms. Rice asked if homeowners are only notified when selling their properties. Dr. Crompton said that so many properties qualify and we are flagging them when they go on the marked or transactions are occurring. Mr. Shaffer added that we have reached out to the community as best we can to make them aware that operating permits are required for public septic system by attending Township Trustee meetings, newspaper articles and meeting with and educating realtors. He said eventually everyone will have to have an operations permit and unfortunately homes with foundations closer 200’ to the right of way containing sewer cannot get an operations permit because they must connect to sewer. Mr. Shaffer said this was a state law that became effective on January 1, 2015. Dr. Crompton asked Ms. Rice if her property is on a lower level compared to the neighbor. Ms. Rice advised that she is between with one neighbor at a higher level and one at a lower level. Ms. Moore asked about the value of the neighbor’s property. Mr. Patterson advised the neighbor’s home was listed at $228,900.00. He said the current property in question is listed at $130,000.00, which is significantly less. Ms. Moore said she is trying to determine what an acceptable cost is. Mr. Shaffer said we do not have estimates for this job, however, he does not believe it is out of line to compare this to one we had a few months ago on Home Road that was similar job and those estimates were around $20,000.00. Ms. Potina said if the variance is granted the seller must inform the buyer if the aerator fails they must connect to sewer. Mr. Rice advised they are aware. R 84-20 A resolution approving a household sewage treatment system rules variance at 2900 Dogwood

Drive, Springfield, Ohio (Parcel # 0500600018401005) allowing a household sewage treatment system to be permitted in a location that is accessible to sanitary sewer with the responsible party signing a Hold Harmless Agreement, with the following stipulation; any perspective buyer must be informed that following failure of the current system, the residence will be required to hook up to the public sewer.

Motioned by: Ms. DeWitt Seconded by: Mr. Scarff Ms. Moore Yes Ms. Potina Yes Dr. Crompton Yes Dr. deGuzman Absent Mr. Scarff Yes Dr. King Absent Ms. DeWitt Yes Motion carried. 2021 Tax Rates/Amounts Acceptance: Mr. Patterson said this is the annual requirement from the state auditor to take the county auditor assessments of taxes of the levy already passed and to approve that they can levy those taxes for next year. R 85-20 A resolution accepting the amounts and rates as determined by the Budget Commission and

authorizing the necessary tax levies and certifying them to the County Auditor for 2021. Motioned by: Ms. Potina Seconded by: Ms. Moore Ms. Moore Yes Ms. Potina Yes Dr. King Absent Dr. deGuzman Absent Dr. Crompton Yes


Ms. DeWitt Yes Mr. Scarff Yes Motion carried. University of Pittsburgh RODS/NRDM Agreement: Mr. Patterson said this is the retail real time outbreak and disease surveillance system. He said this is one of the systems we plug into that tells us if there are over the counter medications going out of control and helps us understand surveillance wise if something is out there we need to look into. He said this is for bio-terrorism and other outbreak surveillance. He advised there is no cost, this is just data sharing. R 86-20 A resolution authorizing the Health Commissioner to negotiate and execute the yearly renewal

agreement with the University of Pittsburgh for the Real-Time Outbreak and Disease Surveillance/National Retail Drug Monitoring project. This is a data sharing agreement with no monetary request of the Clark County Combined Health District.

Motioned by: Mr. Scarff Seconded by: Ms. DeWitt Dr. deGuzman Absent Ms. Moore Yes Ms. Potina Yes Dr. King Absent Dr. Crompton Yes Mr. Scarff Yes Ms. DeWitt Yes Motion carried. HDIS Maintenance Contract Renewal: Mr. Patterson said each year we have this renewal. He said we had hoped to not have to renew this year with our newer electronic medical record, however, we are still using this system for tracking and some other environmental health tracking and therefore asking to renew for another year. R 87-20 A resolution authorizing the Health Commissioner to negotiate and execute the yearly HDIS

Maintenance Contract renewal. Motioned by: Ms. Moore Seconded by: Ms. DeWitt Ms. DeWitt Yes Ms. Potina Yes Dr. Crompton Yes Dr. deGuzman Absent Mr. Scarff Yes Dr. King Absent Ms. Moore Yes Motion carried. Update to Temporary Leave Buyout Policy: Mr. Patterson referred to the temporary leave buyout policy included in the Board packet with the updates highlighted. He advised that we previously asked to approve vacation leave one (1) week (40 hours) at a time and some of our staff need to buyout a couple days, but do not want to buyout a whole week as they may be earning less so we are asking to modify the policy to allow staff to buyout vacation leave in eight (8) hour increments at time, up to the eighty (80) hours. R 88-20 A resolution approving the updated COVID-19 leave and temporary leave buyout policy as

submitted at the September 17, 2020 Board of Health meeting. Motioned by: Ms. Potina Seconded by: Mr. Scarff Mr. Scarff Yes Dr. deGuzman Absent Ms. Potina Yes Ms. Moore Yes Dr. Crompton Yes Ms. DeWitt Yes


Dr. King Absent Motion carried. Appropriations: Mr. Patterson said we have some changes to the appropriations and each of the changes is offset by a revenue increase that allows us to do that. He said in the general fund we are appropriating some of the carry over funds to keep that afloat because we spent so much money out of that fund, such as the $250,000.00 in overtime that we hope to get back and put in there. He said in many cases you will notice in grants we actually got additional funding so we have to increase those appropriations to take in the money. R 89-20 A resolution approving the budget appropriations submitted at the September 17, 2020 Clark

County Combined Health District Board of Health meeting. Motioned by: Ms. Moore Seconded by: Ms. DeWitt Ms. Potina Yes Ms. DeWitt Yes Dr. King Absent Ms. Moore Yes Mr. Scarff Yes Dr. Crompton Yes Dr. deGuzman Absent Motion carried. New Fund Creation & Grant Submission: Care Resource Coordination: Mr. Patterson said we are very proud of this grant. He said this is a grant from the State Department of Health for quarantine/isolation, housing and housing support, which is food, medication, etc. He said this is something we have been doing since day one and when the state came out with the grant and had a webinar to tell the other 15 counties selected for this funding they asked us to present to tell other counties what we were already doing. He said unfortunately this grant only goes back to August 1, 2020 and we have a short time to spend the money, but that will not be a problem with the work we have been doing. He thanked the staff and operations team including Ms. Christina Conover and Ms. Lori Lambert for the work they are doing. He explained that we are asking for approval to create the fund and appropriate money to go with the fund as well as apply for the grant and do all things necessary. R 90-20 A resolution approving the creation of a new fund for Care Resource Coordination and authorizing

the Health Commissioner to do all things necessary including submitting the grant and negotiating and executing all contracts for the Care Resource Coordination grant

Motioned by: Ms. Potina Seconded by: Ms. DeWitt Dr. deGuzman Absent Mr. Scarff Yes Ms. Potina Yes Ms. Moore Yes Dr. Crompton Yes Ms. DeWitt Yes Dr. King Absent Motion carried. Health Commissioner’s Comments: Mr. Patterson thanked the Board for being flexible over the past six (6) months. He said we know that not all of our reports have been on time and we appreciate the flexibility and trust put into having us do what we need to do and get the job done for the community. He reminded the Board that we have a testing clinic scheduled for tomorrow and encouraged them to stop by. The next regular Board of Health meeting will be held Thursday, October 15, 2020 at 6:00 p.m. at 529 E. Home Road, Springfield, Ohio. With no further business to come before the Board, meeting adjourned at 7:15 p.m.


_______________________________ _______________________________ Charles A. Patterson, Secretary Catherine Crompton, President Clark County Combined Health District Clark County Combined Health District Board of Health Board of Health

ENVIRONMENTAL HEALTH MONTHLY REPORT 41

PROGRAM: Sept'20 YTD '20 PROGRAM: Sept'20 YTD '20 Sept'20 YTD '20

C&DD-Active: DOMESTIC PREPAREDNESS: FOOD-MOBILE:

Consultations 3 15 Complaints/Consultations 0 53 Consultations 0 11

Enforcement 0 0 Field Activity Hours (Clinics, Etc.) 85.75 2913.25 Licenses Issued:

Licenses, Permits, Orders Issued 0 0 Inspections/Re-Inspections 0 0 Food Establishment 2 5

Inspections &/or Re-Inspections 1 7 Sample/Re-Sample 0 0 Food Service 2 68

C&DD-Closed: Sample or Specimen Pick-Up/Delivery 0 2 Inspections-Standard 3 92

Consultations 0 0 Training-Given 0 0 Notices of Critical Viol.-Standard Insp. 0 0

Enforcement 0 0 Training-Received 0 8 Follow-Up Inspections 0 3

Inspections &/or Re-Inspections 0 2 FOOD-RISK (144): Complaints Rec'd./Investigated/FU/Pend. 0 0

CAMPGROUNDS (182): PLAN REVIEW 7 50 FOOD-TEMPORARY:

Consultations 0 6 Consultations 7 67 Consultations 0 0

Licenses Issued 0 7 Licenses Issued: Licenses Issued:

Inspections-Standand 3 16 Food Establishment 1 198 Food Establishment 8 41

Licenses Issued-Temporary 1 3 Food Service 3 407 Food Service 11 51

Inspections-Temporary 1 2 Inspections-Food Establishment: Inspections-Standard 19 73

Notices of Critical Viol.-Standard Insp. 0 0 Standard Inspections 24 238 Notices of Critical Viol.-Standard Insp. 0 0

Re-Inspections 3 3 PR Inspections 4 17 Follow-Up Inspections 0 0

Complaints Pending-Beg. Of Month 2 Notices of Critical Viol.-Stand./PR 0 0 Complaints Rec'd./Investigated/FU/Pend. 0 0

Complaints Rec'd.-Current Month 0 2 Follow-Up Inspections 4 59 FOOD-VENDING:

Complaints Investigated: Outbreak Investigations: 0 0 Consultations 0 1

Valid Complaints 0 1 Sample or Specimen Pick-Up/Delivery 0 0 Licenses Issued 0 63

Notices of Violation Sent 0 0 Inspection/Sample 0 0 0 5

Summary Compliance Abated 0 0 Inspections-Food Service: Inspections - Misc 0 0

Non-Valid Abated 0 1 Standard Inspections 93 560 Notices of Critical Viol.-Standard Insp. 0 0

Complaint Re-Inspections 3 5 CCP Inspections 39 259 Follow-Up Inspections 0 0

Complaints Pending-End of Month 2 Notices of Critical Viol.-Stand./CCP 0 1 Complaints Rec'd./Investigated/FU/Pend. 0 0

Outbreak Investigations 0 0 Follow-Up Inspections 7 93 INDOOR AIR QUALITY:

Orders to Appear before CCCHD 0 0 Outbreak Investigations: 0 0 Consultations 8 128

BOH Orders Issued 0 0 Sample or Specimen Pick-Up/Delivery 0 0 Inspections &/or Re-Inspections 0 17

Citations to Appear before BOH 0 0 Inspection/Sample 0 0 INFECTIOUS WASTE:

Plan Review 0 0 Complaints Pending-Beg. Of Month 2 Consultations 0 6

CLEAN FILL OPERATION: Complaints Rec'd.-Current Month 8 102 Enforcement 0 0

Complaints 0 2 Complaints Investigated: Inspections &/or Re-Inspections 0 1

Consultations 1 23 Valid Complaints 0 17 INSECT/RODENT (146):

Enforcement 0 0 Notices of Violation Sent 0 1 Bed Bugs:

NOITF, Orders Issued 0 1 Summary Compliance Abated 0 11 Consultations 0 13

Inspections &/or Re-Inspections 0 15 Non-Valid Abated 8 74 Inspections &/or Re-Inspections 0 1

COMPOSTING FACILITY: Complaint Re-Inspections 0 6 Consultations-Insect/Rodent 0 0

Consultations 1 12 Complaints Pending-End of Month 4 Complaints Pending-Beg. Of Month 2

Enforcement 0 0 Orders to Appear before CCCHD 0 0 Complaints Rec'd.-Current Month 1 7

Licenses, Permits, Orders Issued 0 0 BOH Orders Issued 0 0 Complaints Investigated:

Inspections &/or Re-Inspections 3 20 Citations to Appear before BOH 0 0 Valid Complaints 0 5

Citations into Court 0 0 Notices of Violation Sent 0 4

PROGRAM:

Inspections-Standard



INSECT/RODENT (cont'd.): MERCURY (199):

Summary Compliance Abated 0 0 Consultations 2 15 Complaint Re-Inspections 0 0

Non-Valid Abated 1 2 Enforcement/NOV 0 1 Complaints Pending-End of Month 0

Complaint Re-Inspections 0 3 Inspections/Re-Inspections 0 12 Orders to Appear before CCCHD 0 0

Complaints Pending-End of Month Complaints Rec'd 0 1 BOH Orders Issued 0 0

Orders to Appear before CCCHD 0 0 MOLD: Citations to Appear before BOH 0 0

BOH Orders Issued 0 0 Consultations 13 97 Citations into Court 0 0

Citations to Appear before BOH 0 0 Inspections &/or Re-Inspections 0 2 NUISANCES-WATER/UTILITIES (160):

Citations into Court 0 0 MOTORCYCLE OHIO: Consultations 0 0

JAIL: # of Classes Conducted 2 13 Complaints Pending-Beg. Of Month 13

Complaints Rec'd./Investigated/FU/Pend. 0 0 # SUCCESSFULLY COMPLETED: MALE 10 63 Complaints Rec'd.-Current Month 3 22

Consultations 0 0 FEMALE 4 33 Complaints Investigated:

Enforcement 0 0 MINORS 0 1 Valid Complaints 3 19

Inspections 0 2 # DID NOT PASS: MALE 0 0 Notices of Violation Sent 2 15

Inspection/Sample 0 0 FEMALE 0 1 Summary Compliance Abated 0 0

Re-Inspections 0 0 MINORS 0 0 Non-Valid Abated 0 3

Sample or Specimen Pick-Up/Delivery 0 0 # DROPPED OUT: MALE 0 1 Complaint Re-Inspections 4 14

Outbreak Investigations 0 0 FEMALE 0 2 Complaints Pending-End of Month 9

LANDFILLS-CLOSED: MINORS 0 0 Orders to Appear before CCCHD 0 0

Consultations 8 12 NUISANCES-GENERAL ANIMAL (147): BOH Orders Issued 0 0

Enforcement 0 0 Consultations 0 1 Citations to Appear before BOH 0 0

Inspections &/or Re-Inspections 0 17 Complaints Pending-Beg. Of Month 2 Citations into Court 0 0

LEAD: Complaints Rec'd.-Current Month 3 23 PLUMBING (141):

Consultations 5 58 Complaints Investigated: PLAN REVIEW 17 58

MAN. HOME PARK (180): Valid Complaints 3 18 Inspections 35 311

Consultations 0 0 Notices of Violation Sent 0 8 Finals 38 309

Inspections-Standard 0 30 Summary Compliance Abated 0 0 Permits 81 585

Notices of Critical Viol.-Standard Insp. 0 0 Non-Valid Abated 0 5 Registrations 8 251

Re-Inspections 0 3 Complaint Re-Inspections 0 15 Backflow Certifications 217 1467

Complaints Pending-Beg. Of Month 1 Complaints Pending-End of Month 3 Consultations 2 29

Complaints Rec'd.-Current Month 0 5 Orders to Appear before CCCHD 0 0 Complaints Pending-Beg. Of Month 7

Complaints Investigated: BOH Orders Issued 0 0 Complaints Rec'd.-Current Month 1 8

Valid Complaints 0 3 Citations to Appear before BOH 0 0 Complaints Investigated:

Notices of Violation Sent 0 0 Citations into Court 0 0 Valid Complaints 0 4

Summary Compliance Abated 0 0 NUISANCES-OTHER (149): Notices of Violation Sent 0 0

Non-Valid Abated 0 2 Consultations 0 0 Summary Compliance Abated 0 1

Complaint Re-Inspections 0 1 Complaints Pending-Beg. Of Month 0 Non-Valid Abated 1 3

Complaints Pending-End of Month 1 Complaints Rec'd.-Current Month 0 1 Complaint Re-Inspections 2 2

Orders to Appear before CCCHD 0 0 Complaints Investigated: Complaints Pending-End of Month 6

BOH Orders Issued 0 0 Valid Complaints 0 0 Orders to Appear before CCCHD 0 0

Citations to Appear before BOH 0 0 Notices of Violation Sent 0 0 BOH Orders Issued 0 0

Citations into Court 0 0 Summary Compliance Abated 0 0 Citations to Appear before BOH 0 0

Non-Valid Abated 0 1 Citations into Court 0 0

PROGRAM:

NUISANCES-OTHER (cont'd.):



RABIES CONTROL: Mercury Spills 0 0 SMOKING:

Animal Bite Investigation 10 119 Orders to Appear before CCCHD 0 0 Administrative Review 0 0

Re-Inspections 0 0 BOH Orders Issued 0 0 Complaints 1 16

Consultations 0 4 Citations to Appear before BOH 0 0 Consultations 0 0

Sample or Specimen Pick-Up 0 40 Citations into Court 0 0 Fines 0 0

Sample or Specimen Delivery 0 11 SCRAP TIRE ADDRESS: 0 12

Citations into Court 0 0 Consultations 4 20 1 16

RADON: Enforcement 0 0 0 5

Consultations 3 27 Inspections 0 23 Letters Sent - Misc 0 0

REAL ESTATE: SEWAGE (143): SOLID WASTE (142):

Consultations 0 0 Consultations 24 171 Hauler Registrations 0 9

Inspections - Well Only 3 19 Inspections: Truck Registrations-w/Registration Fee 0 0

Inspections - Septic Only 3 32 Aerator Inspections 26 140 Truck Registrations-Additional Trucks 0 101

Inspections - Well & Septic 16 123 Dye Tests/Sampling 0 1 Truck Inspections 3 147

Re-Inspections 8 34 Finals (New/Repair) 13 74 Consultations 0 2

Sampling 16 161 1 Year Operation Inspections 17 134 Complaints Pending-Beg. Of Month 31

Resampling 4 25 Site Approvals 1 30 Complaints Rec'd.-Current Month 18 137

RECYCLING/TRANSFER STATION: Site Review Inspections 16 108 Complaints Investigated:

Inspections 0 3 Subdivision Review Inspections 2 17 Valid Complaints 10 90

ROUTINE WATER: Truck Inspections/Re-inspections 0 2 Notices of Violation Sent 8 81

Consultations 0 0 Licenses, Permits, Orders Issued: Summary Compliance Abated 0 1

Sampling by CCCHD Staff 14 147 Site Review Applications 17 118 Non-Valid Abated 8 45

Sampling by Owner (Self) 14 106 Subdivision Review Applications 2 17 Complaint Re-Inspections 24 186

Inspections 0 2 Installation (New, Replace or Alter Permits) 14 108 Complaints Pending-End of Month 24

Dye Tests 0 0 Operation Permits/Inspection Fees 41 423 Orders to Appear before CCCHD 0 0

SALVAGE YARD: Site Approval Applications 1 31 BOH Orders Issued 0 0

Consultations 3 11 Sewage Installer Registrations 1 15 Citations to Appear before BOH 0 0

Enforcement 0 0 Service Provider Registrations 0 10 Citations into Court 0 0

Inspections 0 9 Septage Hauler Registrations/Trucks 1 10 SWIMMING POOLS/SPAS (181):

SCHOOL/PLAYGROUND (145): Variance Applications 2 12 Consultations 0 7

Consultations 0 14 Complaints Pending-Beg. Of Month 22 Licenses Issued 0 37

Inspections-Standard 40 89 Complaints Rec'd.-Current Month 3 60 Inspections-Standard 19 171

Re-Inspections 0 0 Complaints Investigated: Notices of Critical Viol.-Standard Insp. 0 9

Complaints Pending-Beg. Of Month 0 Valid Complaints 1 39 Re-Inspections 0 11

Complaints Rec'd.-Current Month 0 1 Notices of Violation Sent 1 48 Complaints Pending-Beg. Of Month 0

Complaints Investigated: Summary Compliance Abated 0 4 Complaints Rec'd.-Current Month 0 0

Valid Complaints 0 1 Non-Valid Abated 2 17 Complaints Investigated:

Notices of Violation Sent 0 0 Complaint Re-Inspections 0 1 Valid Complaints 0 0

Summary Compliance Abated 0 0 Complaints Pending-End of Month 23 Notices of Violation Sent 0 0

Non-Valid Abated 0 0 Orders to Appear before CCCHD 0 0 Summary Compliance Abated 0 0

Complaint Re-Inspections 0 0 BOH Orders Issued 0 0 Non-Valid Abated 0 0

Complaints Pending-End of Month 0 Citations to Appear before BOH 0 0 Complaint Re-Inspections 0 0

Outbreak Investigations 0 0 Citations into Court 0 0 Complaints Pending-End of Month 0

Letters Sent - Notice of Report

Letters Sent - Violation Warning

PROGRAM:

Investigations



SWIMMING POOLS/SPAS (cont'd.): WEST NILE VIRUS (198): WEST NILE VIRUS (cont'd.):

Outbreak Investigations 0 0 Consultations 78 112 Orders to Appear before CCCHD 0 0

Orders to Appear before CCCHD 0 0 Complaints Pending-Beg. Of Month 0 BOH Orders Issued 0 0

BOH Orders Issued 0 0 Complaints Rec'd.-Current Month 0 20 Flyer/Information Distribution 2 190

Citations to Appear before BOH 0 0 Complaints Investigated: Treatments Applied 2 5

Citations into Court 0 0 Valid Complaints 0 8 MEETINGS/TRAINING:

TATTOO/BODY PIERCING (171): Notices of Violation Sent 0 7 Meetings 19 333

Consultations 0 0 Summary Compliance Abated 0 0 Training-Given 2 106

Licenses Issued/*Temporary 1 12 Non-Valid Abated 0 12 Training-Received 10 377

Inspections-Standand/*Temporary 2 14 Complaint Re-Inspections 0 4

Notices of Critical Viol.-Standard Insp. 0 0 Complaints Pending-End of Month 0

Re-Inspections 0 0 REPORTED ANIMAL BITES/ Sept'20 Sept'19 Sept'19

Complaints Pending-Beg. Of Month 2 RABIES EXPOSURE: OWNED UNOWNED YTD 2020 OWNED UNOWNED YTD 2019

Complaints Rec'd.-Current Month 0 4 DOG: Bite/Non-Bite/Other Events 14 3 187 12 0 161

Complaints Investigated: Total Persons Exposed 17 163 12 160

Valid Complaints 0 3 # People Rec. Post-Exposure 1 1 0 1

Notices of Violation Sent 0 1 # Vaccinated at Time of Incident 1 43 4 49

Summary Compliance Abated 0 1 # Sent to ODH-Negative 0 9 0 20

Non-Valid Abated 0 0 # Sent to ODH-Positive/*Unsat. 0 0 0 5

Complaint Re-Inspections 0 0 CAT: Bite/Non-Bite/Other Events 0 20 2 17

Complaints Pending-End of Month 2 Total Persons Exposed 0 21 2 16

Outbreak Investigations 0 0 # People Rec. Post-Exposure 0 0 0 2

Orders to Appear before CCCHD 0 0 # Vaccinated at Time of Incident 0 4 1 6

BOH Orders Issued 0 0 # Sent to ODH-Negative 0 4 1 3

Citations to Appear before BOH 0 0 # Sent to ODH-Positive/*Unsat. 0 0 0 0

Citations into Court (*Search Warr.) 0 0 RACCOON:

VECTOR-BORNE (TICKS): Bite/Non-Bite/Other Events 0 14 0 5

Consultations 0 2 Total Persons Exposed 0 9 0 1

# Ticks Received 0 2 # People Rec. Post-Exposure 0 3 0 0

# Ticks Identified 0 0 # Sent to ODH-Negative 0 8 0 5

# Ticks Sent to ODH 0 2 # Sent to ODH-Positive/*Unsat. 0 0 0 0

# Ticks Ident. by ODH/Pending 0 3 BAT: Bite/Non-Bite/Other Events 1 21 4 6

WELLS (PWS): Total Persons Exposed 0 16 0 1

Consultations 0 0 # People Rec. Post-Exposure 0 0 0 0

Licenses/Permits/Orders Issued: # Sent to ODH-Negative 1 16 4 7

Alterations 3 14 # Sent to ODH-Positive/*Unsat. 0 1 0 0

New 10 69 OTHER: 0 0

Sealing Permits 0 7 Bite/Non-Bite/Other Events 0 5 0 6

Inspections 12 71 Total Persons Exposed 0 4 0 5

PWS Contractor Inspections 0 0 # People Rec. Post-Exposure 0 0 0 1

Re-Inspections 0 0 # Sent to ODH-Negative 0 3 1 2

New Well Sampling 13 78 # Sent to ODH-Positive/*Unsat. 0 0 0 0

Dye Tests 0 0 Cases Pending: Dogs: 4 Cats: 0

PROGRAM:

Type of Referral Current FYTD Referral Sources Current

Help Me Grow-Home Visiting FY: July 1, 2020 - June 30, 2021

7 23 Health District 6

Federal Home Visiting (MIECHV) FY: October 1, 2019 - September 30, 2020

17 139 Primary Caregiver 9

Moms & Babies First FY: October 1, 2019 - September 30, 2020

5 48 7

Total Referrals For September 29 210 7

29

ProgramTotal

Served Target %

Home Visits

Current FYTD

Help Me Grow 87 91 96% HMG-HV 209 580

Federal (MIECHV) 126 132 95% MIECHV 190 2374

Moms & Babies First 32 65 49% MBF 26 242

Total 425 3196

Moms Quit For Two:

Activity Served Activity Enrolled

Safe Sleep Initiative 13 Baby & Me Tobacco Free 34

Activity Served

Safety items distributed this year 321

Division Programs:

Moms Quit For Two grant funds Baby & Me Tobacco Free: mom enrolls prenatally and can be served up to 1 year after birth of baby

Cribs For Kids: prenatal (last trimester) up to 1 year

WIC

Help Me Grow-Ohio Healthy Families: prenatal to age 3

Moms & Babies First: funded by Ohio's Black Infant Vitality Program: prenatal to age 1

Safety Initiative:

Clark County Combined Health DistrictEarly Childhood Division

September 2020

Cribs For Kids:

Referrals

Families Served in Home Visiting

Other

Total

mk 05/07/2020

Ohio Department of Health - Bureau of Health ServicesInitial Participation Report - Part B (Charts) - ODHWIC0407

Reporting Month - SEP 2020

Agency Monthly Initial Caseload Trend

600

700

800

900

1,000

1,100

1,200

OC

T 20

18N

OV

2018

DEC

201

8JA

N 2

019

FEB

2019

MAR

201

9AP

R 2

019

MAY

201

9JU

N 2

019

JUL

2019

AUG

201

9SE

P 20

19O

CT

2019

NO

V 20

19D

EC 2

019

JAN

202

0FE

B 20

20M

AR 2

020

APR

202

0M

AY 2

020

JUN

202

0JU

L 20

20AU

G 2

020

SEP

2020

Category CodeWomenInfantsChildren

CLARK COUNTY WIC PROGRAM

Oct 7, 2020 - 2 - 10:03:14 AM

4D



WIC Distribution of Women, Infants and Children Charts

Agency Distribution of Women, Infants and Children

Children40%

Infants36%

Women24%

Children40%

Infants36%

Women24%

CLARK COUNTY WIC PROGRAM

Oct 7, 2020 - 3 - 10:03:14 AM

4D



WIC Initial Participation by Participant Type Charts

Clinic Initial Participation by Participant Type

Children39%

Exclusively Bre...3%

Exclusively Br...3%

Other Infants31%

Partially Breast Fed Infants2% Partially Breastfeeding ...

4%Post-Partum Wo...8%

Pregnant Wo...10%

Children39%

Exclusively Bre...3%

Exclusively Br...3%

Other Infants31%

Partially Breast Fed Infants2% Partially Breastfeeding ...

4%Post-Partum Wo...8%

Pregnant Wo...10%

Clinic 01200

Children45%

Exclusively ...5%

Exclusively ...3%

Other Infants26%

Partially Breast Fed Infants2%

Partially Breastfee...3%

Post-Partum W...6%

Pregnant Wo...9%

Children45%

Exclusively ...5%

Exclusively ...3%

Other Infants26%

Partially Breast Fed Infants2%

Partially Breastfee...3%

Post-Partum W...6%

Pregnant Wo...9%

Clinic 01231

Oct 7, 2020 - 5 - 10:05:32 AM

4D

FY20

: Ju

ne c

lose

out

/ Jul

y &

Augu

st in

itial

Oct

-19

Nov

-19

Dec

-19

Jan-

20Fe

b-20

Mar

-20

Apr-2

0M

ay-2

0Ju

n-20

Jul-2

0Au

g-20

Sep-

20Av

erag

eW

omen

Tota

l74

574

873

674

071

969

366

365

166

866

866

369

9Pr

egna

nt31

130

529

629

029

128

126

924

426

327

026

528

0Ex

clus

ive

BF10

310

295

8989

9490

8783

7775

89Pa

rtial

ly B

F96

101

111

120

111

104

9910

111

111

511

610

8N

on-B

F23

524

023

424

122

821

420

521

921

120

620

722

2

Infa

ntTo

tal

1,04

31,

019

998

1,01

199

198

897

997

496

998

999

999

6Ex

clus

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BF12

912

411

811

710

510

610

610

198

9790

108

Parti

ally

BF

5053

5559

4946

4643

3645

4648

Non

-BF

864

842

825

835

837

836

827

830

835

847

863

840

Chi

ldre

nTo

tal

1,17

71,

169

1,14

41,

166

1,16

71,

170

1,16

41,

164

1,16

31,

138

1,14

51,

161

WIC

Tot

al C

asel

oad

2,96

52,

936

2,87

82,

917

2,87

72,

851

2,80

62,

789

2,80

02,

795

2,80

72,

856

% T

otal

Cas

eloa

d D

iffer

ence

Fisc

al Y

ear

Clar

k-Av

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e16

46.1

%17

47.7

%18

52.1

%19

52.2

%20

50.7

%(J

une

2020

50.

6%)

-4.0

8%

0.75

%

-17.

57%

1,20

4C

hild

ren

17-F

eb1,

210

Chi

ldre

n 18

-Feb

1,15

2

58.2

%59

.2%

7.87

%

2.53

%

60.6

%

60.0

%

Aver

age

Chi

ldre

n FY

201,

161

Chi

ldre

n 15

-Feb

1,40

8C

hild

ren

16-F

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.3%

Chi

ldre

n 19

-Feb

1,07

6

% C

hild

ren

Cas

eloa

d D

iffer

ence

-3.6

0%

Dis

trib

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n &

Cas

eloa

d of

Wom

en, I

nfan

t, an

d C

hild

ren

Act

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CC

HD

WIC

Pro

gram

CC B

reas

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ding

Initi

atio

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Cas

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d2,

786

Stat

e-Av

erag

e

4D

Total Births Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

Y-T-D

Total Previous 12

Month Avg

2020 84 91 103 93 81 97 99 98 86 832 93

2019 98 76 101 87 93 99 122 119 96 96 93 97 1,177 96

2018 83 88 104 91 116 85 108 80 89 84 95 85 1,108 95

No. of LBW Newborns

2020 11 13 9 4 5 12 9 7 6 76 9

2019 11 6 7 4 3 13 10 13 8 9 10 9 103 8

2018 2 14 9 7 7 7 11 4 6 7 13 5 92 8

2020 13.10% 14.29% 8.74% 4.30% 6.17% 12.37% 9.09% 7.14% 6.98% 9.13% 9.30%

2019 11.22% 7.89% 6.93% 4.60% 3.23% 13.13% 8.20% 10.92% 8.33% 9.38% 10.75% 9.28% 8.75% 8.66%

2018 2.41% 15.91% 8.65% 7.69% 6.03% 8.24% 10.19% 5.00% 6.74% 8.33% 13.68% 5.88% 8.30% 8.12%

Mothers' Ages

Age 0-14

2020 0 1 0 0 0 0 0 0 0 1 0.2

2019 0 0 0 0 0 0 0 0 0 0 1 0 1 -

2018 0 0 0 0 0 0 1 0 0 0 0 0 1 0.2

Age 15-19

2020 12 11 12 7 7 8 6 10 10 83 10

2019 8 10 7 10 9 6 8 10 8 8 13 11 108 9

2018 11 9 11 12 10 7 13 7 8 10 10 9 117 10

Age 20-24

2020 30 30 35 35 24 30 30 22 29 265 29

2019 39 18 33 27 32 37 37 47 30 27 27 27 381 31

2018 25 20 39 24 37 19 29 24 32 21 30 16 316 29

Age 25+

2020 42 47 56 51 50 59 63 66 47 481 54

2019 51 48 61 50 52 55 77 62 58 55 52 59 680 57

2018 47 48 54 55 69 59 65 48 49 53 55 58 660 55

Sept

3 YEAR COMPARATIVE

BIRTH DATABirth Certificates Issued In September - 804 4E

4E

Cause of Death - 2020 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

Y-T-D

Total

Heart Disease 40 38 45 33 44 33 38 37 41 349

Cancer 19 19 25 25 21 24 26 29 31 219

Chronic Lower

Respiratory Disease 15 13 13 10 10 7 15 3 3 89

Accidents 6 3 3 4 7 5 4 1 2 35

Cerebrovascular Disease 12 9 10 7 6 11 10 6 12 83

Alzheimer's Disease 11 14 14 13 9 9 11 11 8 100

Drug Intoxication 4 3 4 6 7 4 4 2 0 34

Diabetes 2 2 1 0 0 0 1 0 1 7

Influenza/Pneumonia 12 5 7 15 6 3 7 7 6 68

Kidney Related Disease 4 2 3 3 1 5 4 4 2 28

Septicemia 3 6 3 5 6 1 8 9 9 50

Suicide 3 0 1 4 3 3 1 0 0 15

Liver Disease/Cirrhosis 5 2 2 2 0 2 4 4 3 24

Hypertension 4 4 0 2 0 0 1 1 1 13

Parkinson's Disease 3 0 2 1 3 5 3 1 0 18

Other 12 8 15 11 18 14 15 22 27 142

Pending 0 0 1 1 1 1 0 10 12 26

Totals 155 128 149 142 142 127 152 147 158 0 0 0 1,300

Causes of Death - 2019 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

Y-T-D

Total

Heart Disease 38 46 29 31 40 30 34 28 27 28 27 45 403

Cancer 27 22 23 25 28 17 29 30 25 21 24 27 298

Chronic Lower

Respiratory Disease 15 4 13 15 9 15 14 6 8 7 8 7 121

Accidents 0 1 0 2 3 0 4 2 4 2 3 6 27

Cerebrovascular Disease 5 3 4 9 6 5 7 4 1 6 4 8 62

Alzheimer's Disease 18 7 5 6 9 3 9 4 6 5 9 12 93

Drug Intoxication 6 4 5 2 3 3 4 5 3 6 9 4 54

Diabetes 6 4 2 0 2 2 7 3 1 2 3 0 32

Influenza/Pneumonia 7 7 12 9 7 8 6 10 4 8 8 5 91

Kidney Related Disease 11 5 5 9 4 5 4 7 3 5 5 6 69

Septicemia 3 3 4 3 1 3 5 2 4 4 4 3 39

Suicide 5 1 1 0 4 1 1 2 2 1 5 1 24

Liver Disease/Cirrhosis 3 2 4 1 2 3 5 0 4 3 2 2 31

Hypertension 7 6 5 3 7 2 3 1 3 7 2 4 50

Parkinson's Disease 2 3 0 0 1 1 0 1 2 3 2 1 16

Other 20 15 12 12 11 5 9 9 15 9 19 11 147

Pending 0 0 0 0 0 0 0 0 0 0 0 0 0

Totals 173 133 124 127 137 103 141 114 112 117 134 142 1,557

"Other" Causes of Death - September - 2020

Covid-19 13Failure to Thrive 5GI Bleed 1Hematemis 1Infected Leg Ulcers 1Multiple Sclerosis 1Probable Covid-19 1Pulmonary Embolism 1Pulmonary Fibrosis 1Respiratory Failure 2

27

VITAL STATISTICS

2020 DEATH REPORT Death Certificates Issued in Sept - 609

10/09/2020 REVENUE AND EXPENDITURE REPORT FOR CLARK COUNTY

PERIOD ENDING 09/30/2020

*NOTE: Available Balance / Pct Budget Used does not reflect amounts encumbered.

ACTIVITY FOR

2020 YTD BALANCE MONTH % BDGT

GL NUMBER DESCRIPTION AMENDED BUDGET 09/30/2020 09/30/2020 USED

Fund 8201 - HEALTH DISTRICT

Revenues

Dept 810 - CCCHD

8201-810-411100 TAXES - REAL ESTATE 2,010,478.00 2,010,477.17 0.00 100%

8201-810-411300 TAXES - MANUFACTURED HOMES 4,136.00 4,135.55 0.00 100%

8201-810-421000 INTERGOVERNMENTAL 80,000.00 45,552.84 9,681.00 57%

8201-810-422110 INTERGOVERNMENTAL - H/R 278,000.00 271,789.25 136,754.64 98%

8201-810-431000 CHARGES FOR SERVICES 513,644.00 263,055.72 41,770.39 51%

8201-810-481000 OTHER REVENUE 444,000.00 377,258.94 41,504.00 85%

8201-810-520000 ADVANCES IN 376,000.00 255,096.00 0.00 68%

Total Dept 810 - CCCHD 3,706,258.00 3,227,365.47 229,710.03 87%

TOTAL REVENUES 3,706,258.00 3,227,365.47 229,710.03 87%

Expenditures

Dept 810 - CCCHD

8201-810-702000 SALARIES - EMPLOYEES 1,485,938.00 1,189,926.00 123,598.83 80%

8201-810-711000 PERS 208,031.00 171,859.07 16,700.12 83%

8201-810-712000 WORKERS COMPENSATION 29,719.00 0.00 0.00 0%

8201-810-714000 MEDICARE 21,546.00 16,664.67 1,719.30 77%

8201-810-715000 DENTAL INSURANCE 5,247.00 3,173.60 362.68 60%

8201-810-716000 LIFE INSURANCE 1,190.00 676.19 78.26 57%

8201-810-717000 HEALTH INSURANCE 400,000.00 295,131.64 32,151.99 74%

8201-810-718100 TRAINING & DEVELOPMENT 18,000.00 5,000.00 15.73 28%

8201-810-718400 TRAVEL 13,000.00 12,636.72 3,566.14 97%

8201-810-721000 OFFICE SUPPLIES 348,022.00 281,051.04 65,975.70 81%

8201-810-740000 CONTRACT SERVICES - REPAIRS 5,000.00 1,123.55 488.55 22%

8201-810-744000 CONTRACT SERVICES 121,565.00 95,464.98 15,181.29 79%

8201-810-745000 MAINTENANCE 45,000.00 28,182.85 1,434.05 63%

8201-810-746200 UTILITIES 65,000.00 47,168.42 6,474.05 73%

8201-810-751000 SMALL EQUIPMENT 15,000.00 10,556.23 0.00 70%

8201-810-790000 OTHER EXPENSES 2,000.00 1,663.00 0.00 83%

8201-810-797100 FEES - STATE 190,000.00 144,231.70 3,179.00 76%

8201-810-798000 COVID-19 EXPENDITURES 171,000.00 126,601.75 14,889.71 74%

8201-810-830000 ADVANCES OUT 376,000.00 264,000.00 40,000.00 70%

8201-810-850000 TRANSFERS OUT 185,000.00 270,000.00 30,000.00 146%

Total Dept 810 - CCCHD 3,706,258.00 2,967,562.90 356,410.40 80%

TOTAL EXPENDITURES 3,706,258.00 2,967,562.90 356,410.40 80%

Fund 8201 - HEALTH DISTRICT:

TOTAL REVENUES 3,706,258.00 3,227,365.47 229,710.03

TOTAL EXPENDITURES 3,706,258.00 2,967,562.90 356,410.40

NET OF REVENUES & EXPENDITURES 0.00 259,802.57 (126,700.37)

10/09/2020 CASH SUMMARY BY FUND FOR CLARK COUNTY

FROM 09/01/2020 TO 09/30/2020

FUND: ALL FUNDS

CASH AND INVESTMENT ACCOUNTS

Beginning Ending

Balance Total Total Balance

Fund Description 09/01/2020 Revenues Expenditures 09/30/2020

8201 HEALTH DISTRICT 2,363,560.35 237,275.72 363,976.09 2,236,859.98

8202 FOOD SERVICE 90,782.51 3,210.81 18,939.02 75,054.30

8203 SOLID WASTE 31,120.96 33,750.00 10,626.78 54,244.18

8204 RECREATION PARKS & CAMPS 10,202.27 0.00 0.00 10,202.27

8205 WATER SYSTEMS 5,861.70 5,773.88 9,432.69 2,202.89

8206 SWIMMING POOL 11,838.63 0.00 0.00 11,838.63

8207 MOSQUITO CONTROL GRANT 13,211.01 0.00 3,084.04 10,126.97

8208 MEDICAID ADMIN CLAIM 95,709.59 0.00 8,502.69 87,206.90

8209 HIV GRANT 4,808.16 6,113.55 4,510.87 6,410.84

8211 DRUG OVERDOSE PREVENTION 7,912.68 38,250.00 8,952.83 37,209.85

8212 EARLY START GRANT 504,579.42 41,263.84 53,814.42 492,028.84

8213 CRIBS FOR KIDS 8,162.04 0.00 2,135.75 6,026.29

8214 IMMUNIZATION GRANT 45,334.78 0.00 173.98 45,160.80

8217 PLUMBING 56,201.76 8,891.00 11,861.00 53,231.76

8220 WIC 54,042.70 40,000.00 62,065.63 31,977.07

8223 COVID-19 122,075.85 0.00 4,213.78 117,862.07

8224 OIMRI GRANT 22,018.08 0.00 19,418.75 2,599.33

8225 WATER POLLUTION CONTROL GRANT 41,879.29 16,463.52 15,984.00 42,358.81

8226 MOM QUIT FOR TWO 5,167.27 0.00 2,013.40 3,153.87

8227 SAFE COMMUNITIES GRANT 14,435.22 2,779.29 996.67 16,217.84

8228 TOBACCO USE PREVENTION 18,308.09 0.00 8,572.88 9,735.21

8229 CONTINGENCY 400,000.00 0.00 0.00 400,000.00

8233 HL PREVENTION GRANT 7,370.54 0.00 1,706.67 5,663.87

8237 PUBLIC INFRASTRUCTURE 33,001.80 350.00 11,718.02 21,633.78

8238 SW NON DIST 17,417.45 155.00 0.00 17,572.45

8239 LEAVE ACCRUAL 135,935.08 0.00 0.00 135,935.08

8240 ENVIRONMENTAL SERVICES 16,132.72 30,687.17 7,750.89 39,069.00

8244 CARE RESOURCE CONNRDINATION 0.00 0.00 0.00 0.00

8246 CD&D FUND 26,222.37 7,059.20 6,645.84 26,635.73

8248 SEWAGE TREATMENT SYSTEMS 21,795.43 7,609.00 8,832.16 20,572.27

8252 CONTACT TRACING 322,281.82 0.00 49,815.91 272,465.91

8257 FHV 41,631.92 0.00 7,671.03 33,960.89

8259 MSG GRANT 40,755.48 0.00 1,949.00 38,806.48

8260 HEALTH - CHC 35,199.28 0.00 12,320.90 22,878.38

8261 REPRODUCTIVE HEALTH AND WELLNESS (RHW) 82,652.57 33,256.07 17,534.41 98,374.23

8262 MATERNAL & CHILD HEALTH PROGRAM (MCHP) 16,187.08 0.00 6,048.27 10,138.81

TOTAL - ALL FUNDS 4,723,795.90 512,888.05 741,268.37 4,495,415.58

10/09/2020 INVOICE GL DISTRIBUTION REPORT FOR CLARK COUNTY

INVOICE ENTRY DATES 09/01/2020 - 09/30/2020

BOTH JOURNALIZED AND UNJOURNALIZED

PAID

GL Number Invoice Line Desc Vendor Amount

Fund 8201 HEALTH DISTRICT

Dept 810 CCCHD

8201-810-717000 EAP BILLINGS - JULY 2020 CCCHD POSITIVE PERSPECTIVES INC 340.00

8201-810-718100 NOVA TRAINING NATIONAL ORGANIZATION FOR 15.73

8201-810-718400.CCHD8100008 JULY - SEPT CELL REIMB SHANNON HACKATHORNE 75.00

8201-810-718400.CCHD8100008 AUG & CELL REIMB & DOWNING (KEYS) DOROTHY TOADVINE 102.37

8201-810-718400.CCHD8100009 NURSING MILEAGE - AUG & CELL REIMB JO WINDON 21.50

8201-810-718400.CCHD8100009 AUGUST CELL REIMB ALICIA SEHEN 30.00

8201-810-718400.CCHD8100009 NURSING MILEAGE - LAB TRIPS BETH DORSEY 80.50

8201-810-718400.CCHD8100009 NURSING MILEAGE - LAB TRIPS BETH DORSEY 53.00

8201-810-718400.CCHD8100009 NURSING MILEAGE - JULY & CELL REIMB TINA FISHER 41.50

8201-810-718400.CCHD8100009 LAB TRAVEL BETH DORSEY 53.50

8201-810-718400.CCHD8100009 MIELAGE 08/31 TO 09/16 JESSICA C TAYLOR 88.00

8201-810-718400.CCHD8100009 NOVA TRAINING NATIONAL ORGANIZATION FOR 2,994.27

8201-810-718400.CCHD8100009 NURSING MILEAGE - JUL - SEPT VIRGINIA ABSHEAR 18.00

8201-810-718400.CCHD8100009 NSG MILEAGE - SEPTEMBER JANNIFER WALKER 148.00

8201-810-718400.CCHD8100009 GAS PURCHASES- SUPERFLEET MASTERCARD PROGRAM 125.00

8201-810-718400.CCHD8100009 NURSING MILEAGE - JUL - SEPT JENNIE L ROHRER 22.50

8201-810-721000.CCHD8100008 LAMINATING SUPPLIES LAMINATOR.COM 55.48

8201-810-721000.CCHD8100008 ADMIN SUPPLIES - MISC IT SUPPLIES CARDMEMBER SERVICES 121.81

8201-810-721000.CCHD8100008 ADMIN SUPPLIES BILL MARINE AUTO CENTER INC 330.00

8201-810-721000.CCHD8100008 OCT - DEC RENEWAL LIVEVIEWGPS INC 89.85

8201-810-721000.CCHD8100008 REFUND OF FSO FEE JOHNSON CULINARY GROUP 58.00

8201-810-721000.CCHD8100008 REFUND OF FSO LICENSE FEE SPRINGFIELD COUNTRY CLUB 377.00

8201-810-721000.CCHD8100008 REFUND OF FSO FEE WRIGHT'S CONCESSION 377.00

8201-810-721000.CCHD8100008 MISC SUPPLIES CARDMEMBER SERVICES 8.93

8201-810-721000.CCHD8100008 COFFEE SUPPLIES SHEEHAN BROS VENDING SERVICE 144.00

8201-810-721000.CCHD8100008 D. LYNCH DRUG SCREEN CITRAN OCCUPATIONAL HEALTH LLC 113.50

8201-810-721000.CCHD8100008 ADMIN SUPPLIES STAPLES BUSINESS ADVANTAGE 178.90

8201-810-721000.CCHD8100008 ADMIN SUPPLIES STAPLES BUSINESS ADVANTAGE 558.34

8201-810-721000.CCHD8100009 CLINIC ROOM TABLES CARDMEMBER SERVICES 79.92

8201-810-721000.CCHD8100009 WALMART GIFT CARDS CARDMEMBER SERVICES 400.00

8201-810-721000.CCHD8100009 LEASE - SEPTEMBER HONDA FINANCIAL SERVICES 324.25

8201-810-721000.CCHD8100009 ONE2ONE SUPPLIES DAVE PURCHASE PROJECT/NASEN 241.72

8201-810-721000.CCHD8100009 ONE2ONE SUPPLIES DAVE PURCHASE PROJECT/NASEN 208.76

8201-810-721000.CCHD8100009 CLIENT MEDS HARDING ROAD PHARMACY 87.72

8201-810-721000.CCHD8100009 NSG SUPPLIES MCKESSON MEDICAL-SURGICAL 60.69




8201-810-721000.CCHD8100009 TB TESTING CHGS PATHOLOGY LABORTORIES INC 144.45

8201-810-721000.CCHD8100009 TB TESTING CHGS PATHOLOGY LABORTORIES INC 735.15

8201-810-721000.CCHD8100009 VACCINE TO MERCK UNITED PARCEL SERVICE INC 7.34

8201-810-721000.CCHD8100009 INFECTIOUS WASTE PICKUP STERICYCLE INC 189.76

8201-810-721000.CCHD8100009 RHW REIMBURSMENT CLARK COUNTY COMBINED HEALTH 11,858.47

8201-810-721000.CCHD8100009 HEADSETS - ACCT ENDING 9981 CARDMEMBER SERVICES 107.96

8201-810-721000.CCHD8100009 LEASE - OCTOBER HONDA FINANCIAL SERVICES 266.20

8201-810-721000.CCHD8100009 HONDA LEASE - OCTOBER HONDA FINANCIAL SERVICES 106.68

1

8201-810-721000.CCHD8100009 HONDA LEASE - OCTOBER HONDA FINANCIAL SERVICES 397.65

8201-810-721000.CCHD8100009 NSG SUPLIES - HEADSETS CARDMEMBER SERVICES 89.98

8201-810-721000.CCHD8100009 NSG SUPLIES - SOUTHERN VILLAGE MCKESSON MEDICAL-SURGICAL 140.24

8201-810-721000.CCHD8100009 NSG SUPLIES - MCKESSON MEDICAL-SURGICAL 32.88

8201-810-721000.CCHD8100009 NSG SUPPLIES - SYRINGES SMD WYNNE CORP 792.00

8201-810-721000.CCHD8100009 NSG SUPPLIES - TONER FOR CD PROSOURCE 60.58

8201-810-721000.CCHD8100036 VACCINE - RABIES VACCINE SANOFI PASTEUR INC 886.22

8201-810-721000.CCHD8100036 VACCINE - FLUZONE SANOFI PASTEUR INC 8,725.06

8201-810-721000.CCHD8100036 VACCINE - SANOFI PASTEUR INC 14,400.42

8201-810-721000.CCHD8100036 VACCINE - HAVRIX/ENGERIX GLAXO SMITH KLINE PHARMACEUTICALS 2,088.81

8201-810-721000.CCHD8100036 VACCINE - GARDASIL MERCK SHARP & DOHME CORP 13,002.52

8201-810-721000.CCHD8100036 VACCINE - CREDIT MERCK SHARP & DOHME CORP (825.11)

8201-810-721000.CCHD8100036 VACCINE - PNEUMOVAZ MERCK SHARP & DOHME CORP 1,899.63

8201-810-721000.CCHD8100036 VACCINE MERCK SHARP & DOHME CORP 98.53

8201-810-721000.CCHD8100036 VACCINE - PREVNAR/TRUMENBA PFIZER INC 2,650.18

8201-810-721000.CCHD8100036 VACCINE - CREDIT PFIZER INC (1,260.30)

8201-810-721000.CCHD8100036 VACCINE - PREVNAR/TRUMENBA PFIZER INC 3,832.65

8201-810-740000 INTERPRETER SERVICES MEE-TZE KU 50.00

8201-810-740000 INTERPRETER SERVICES - CHINA PALACE MEE-TZE KU 37.50

8201-810-740000 CONTRACT SERVICES - BLUEPRINT CYBER ENGINEERING 401.05

8201-810-744000 2019 AUDIT FEES WILSON SHANNON & SNOW INC 9,300.00

8201-810-744000 CONTRACT SERVICES - SEPT CAROL A WILLIAMS 1,125.00

8201-810-744000 CONTRACT SERVICES - SEP OFFICE 365 BLUEPRINT CYBER ENGINEERING 782.34

8201-810-744000 CONTRACT SERVICES - SEPTEMBER BLUEPRINT CYBER ENGINEERING 3,175.60

8201-810-744000.CCHD8100077 CONTRACT SERVICES - SEPT LAURA THOMPSON 600.00

8201-810-744000.CCHD8100077 CONTRACT SERVICES - SEPT SHAHID BASHIR SPFLD PULMONARY 1,100.00

8201-810-744000.CCHD8100077 CONTRACT SERVICES - SEPTEMBER BLUEPRINT CYBER ENGINEERING 223.35

8201-810-745000 MAINTENANCE - RUMPKE 131.96

8201-810-745000 MAINTENANCE - SILCO FIRE & SECURITY 115.80

8201-810-745000 MAINTENANCE - HAUCK BROS INC 54.01

8201-810-745000 MAINTENANCE A-1 ABLE PEST DOCTORS 32.10

8201-810-745000 MAINTENANCE MILLER'S TEXTILE SERVICE 33.36

8201-810-745000 MAINTENANCE GENERATOR SYSTEMS LLC 26.78

8201-810-745000 MAINTENANCE - GENERATOR SYSTEMS LLC 439.22

8201-810-746200 UTILITIES A T & T 1,101.02

8201-810-746200 UTILITIES A T & T MOBILITY 725.20

8201-810-746200 UTILITIES A T & T 77.00

8201-810-746200 UTILITIES OHIO EDISON 2,354.37

8201-810-746200 UTILITIES A T & T MOBILITY 899.64

8201-810-746200 UTILITIES COLUMBIA GAS OF OHIO 35.73

8201-810-746200 UTILITIES CITY OF SPRINGFIELD 364.17

8201-810-746200 UTILITIES TIME WARNER CABLE 374.65


8201-810-751000 LAPTOPS DELL MARKETING LP 405.20

8201-810-797100 - VITAL SECURITY PAPER TREASURER STATE OF OHIO 2,966.50

8201-810-797100 BURIAL PERMIT FEES - AUGUST OHIO DIVISION OF REAL ESTATE 212.50

8201-810-798000 QUARANTINE UTILITIES CARDMEMBER SERVICES 77.00

2



8201-810-798000 ELECTROSTATIC SPRAYER AND TABS CARDMEMBER SERVICES 1,590.22



8201-810-798000 COVID INTERPRETATION SERVICES DENA KRAMER 362.50

8201-810-798000 PRINTER CART MASS TESTING GARRIGAN'S INC 1,926.02

8201-810-798000 COVID INTERPRETATION SERVICES LUXON BELIZAIRE 550.00

8201-810-798000 M. OSBORNE QUARANTINE SIMON KENTON INN 1,400.00

8201-810-798000 CAMPER ELECTRIC/CABLE SPRINGFIELD ACME ELECTRIC CO 2,250.00

8201-810-798000 BURNETT RD TESTING SITE STORTS SANITATION SERVICE LLC 95.00

8201-810-798000 COVID EXPENSES ALYSSA TRASS 57.00

8201-810-798000 MASS TESTING SUPPLIES CARDMEMBER SERVICES 19.96

8201-810-798000 COVID MEETING SUPPLIES CARDMEMBER SERVICES 80.66

8201-810-798000 COURIER SERVICES CLIPPER COURIER LOGISTICS INC 39.37

8201-810-798000 COVID EXPENSES - MILEAGE LISA A ODAFE 24.00

8201-810-798000 AUGUST 2020 RENT- 319 E COLLEGE AVE NORTH HILL APARTMENTS 297.00

8201-810-798000 1515 W. HIGH ST RUMPKE 92.05

8201-810-798000 COVID EXPENSES - FLORY QUARANTINE KROGER 1.99

8201-810-798000 QUARANTINE SUPPLIES KROGER 70.63

8201-810-798000 QUARANTINE GROCERIES KROGER 7.95

8201-810-798000 QUARANTINE SUPPLIES KROGER 18.99

8201-810-798000 LUNCH - MASS TESTING EVENT 09/18 CARDMEMBER SERVICES 419.40

8201-810-798000 COVID EXPENSES - QUARANTINED CARDMEMBER SERVICES 124.75

8201-810-798000 DISINFECTANT / WIPES BUSINESS EQUIPMENT CO 60.81

8201-810-798000 COVID INTERPRETATION SERVICES MELISSA SANDOVAL 187.50

8201-810-798000 COVID 19 TRANSPORTATION DRIVER MICHAEL A SCHULSINGER 60.00

8201-810-798000 COVID INTERPRETATION SERVICES VIANGIE GIBSON 325.00

8201-810-798000 COVID INTERPRETATION SERVICES VIANGIE GIBSON 462.50

8201-810-798000 COVID EXPENSES LORI LAMBERT 76.35

8201-810-798000 COVID EXPENSES GRAINGER 414.40

8201-810-798000 COVID EXPENSES STAPLES BUSINESS ADVANTAGE 309.90

Total For Dept 810 CCCHD 108,387.49

Total For Fund 8201 HEALTH DISTRICT 108,387.49

Fund 8202 FOOD SERVICE

Dept 810 CCCHD

8202-810-718400.CCHD8100037 GAS PURCHASES - SUPERFLEET MASTERCARD PROGRAM 108.43

8202-810-718400.CCHD8100038 MILEAGE - AUGUST ANNE KAUP-FETT 22.00

8202-810-718400.CCHD8100038 MILEAGE - AUG & CELL REIMB EMILY GRIESER 69.00

8202-810-718400.CCHD8100038 MILEAGE - AUG & CELL REIMB JESSICA BEIKE 83.00

8202-810-718400.CCHD8100038 MILEAGE - AUG & CELL REIMB MEGAN DAVIS 30.00

8202-810-718400.CCHD8100038 MILEAGE - AUGUST STEPHANIE JOHNSON 7.50

8202-810-736500 CERTIFICATION FEES - FSO AUGUST TREASURER STATE OF OHIO 84.00

8202-810-736500 CERTIFICATION FEES - FE AUGUST TREASURER STATE OF OHIO 28.00

Total For Dept 810 CCCHD 431.93

Total For Fund 8202 FOOD SERVICE 431.93

Fund 8203 SOLID WASTE

Dept 810 CCCHD


8203-810-746000 LEASE - SEPTEMBER HONDA FINANCIAL SERVICES 244.50


Total For Fund 8203 SOLID WASTE 269.50

3

Fund 8205 WATER SYSTEMS

Dept 810 CCCHD


8205-810-718400.CCHD8100038 MILEAGE - AUG CELL REIMB DANIEL LYNCH 25.00

8205-810-718400.CCHD8100038 MILEAGE - CELL REIMB STEPHANIE JOHNSON 25.00

8205-810-721000 CIVIC TOWING DAN'S TOWING & RECOVERY 62.00

8205-810-721000 SUPPLIES - AUTO MAINT KOI ENTERPRISES INC 67.46

8205-810-744000.CCHD8100043 WATER TESTING MOBILE ANALYTICAL SERVICES INC 52.50



















8205-810-744000.CCHD8100043 WATER TESTING - ACCT 5175 MOBILE ANALYTICAL SERVICES INC 198.60

8205-810-744000.CCHD8100043 WATER TESTING - ACCT 5175 MOBILE ANALYTICAL SERVICES INC 64.20

8205-810-746000 LEASE - SEPTEMBER HONDA FINANCIAL SERVICES 324.01


Total For Fund 8205 WATER SYSTEMS 2,174.47

4

Fund 8207 MOSQUITO CONTROL GRANT

Dept 810 CCCHD

8207-810-718400 GAS PURCHASES SUPERFLEET MASTERCARD PROGRAM 106.93

8207-810-721000 MOSQUITO AWARENESS PROGRAM ALPHA MEDIA 800.00

8207-810-721000 MOSQUITO AWAREMENT CAMPAIGN ALPHA MEDIA 800.00

8207-810-721000 MOSQUITO AWARENENSS CAMPAIGN ALPHA MEDIA 800.00

8207-810-721000 MOSQUITO SUPPLIES CLARKE MOSQUITO CONTROL 2,600.00

8207-810-721000 MOSQUITO SUPPLIES CLARKE MOSQUITO CONTROL 4,257.52


Total For Fund 8207 MOSQUITO CONTROL GRANT 9,364.45

Fund 8208 MEDICAID ADMIN CLAIM

Dept 810 CCCHD

8208-810-721000 MOSQUITO SUPPLIES - REMAINING BALANCE CLARKE MOSQUITO CONTROL 224.30

8208-810-746000 SELMA ROAD RENT - OCTOBER ZEUS SHOPPING CENTER 400.00

8208-810-746200 SELMA RD UTILITIES CITY OF SPRINGFIELD 32.18

8208-810-746200 SELMA RD UTILITIES TIME WARNER CABLE 185.96

8208-810-746200 INITIAL TREATMENT A-1 ABLE PEST DOCTORS 213.43


Total For Fund 8208 MEDICAID ADMIN CLAIM 1,055.87

5

Fund 8212 EARLY START GRANT

Dept 810 CCCHD

8212-810-718400 MILEAGE - AUGUST AMANDA FANNON 18.45

8212-810-718400 MILEAGE - AUGUST AMY TAYLOR 41.30

8212-810-718400 MILEAGE - AUGUST CHARMAINE SIMONSON 28.75

8212-810-718400 MILEAGE - AUGUST AIMEE HAMILTON 61.53

8212-810-718400 MILEAGE - AUGUST AIMEE HAMILTON 41.77

8212-810-718400 MILEAGE - AUGUST ANTIONETTE PEREZ 23.05

8212-810-718400 MILEAGE - AUGUST DAWN STASAK 11.90

8212-810-718400 MILEAGE - AUGUST & CELL REIMB ESTHER KEYES 58.40

8212-810-718400 MILEAGE - AUGUST KAREN BRUBAKER 26.35

8212-810-718400 MILEAGE - AUGUST & CELL REIMB KRISTINA FULK 49.65

8212-810-718400 MILEAGE - AUG & CELL REIMB KRYSTAL COLEMAN 25.50

8212-810-718400 MILEAGE - AUGUST LORI LAMBERT 28.00

8212-810-718400 MILEAGE - AUGUST MICHELINE DRUGMAN-DEWITT 13.00

8212-810-718400 MILEAGE - JUNE - AUG MIRANDA EGGLESTON 32.60

8212-810-721000 REIMBURSMENT FOR THERMOMETERS CLARK COUNTY EMA 310.30

8212-810-745000 MAINTENANCE A T & T MOBILITY 45.17

8212-810-745000 MAINTENANCE RUMPKE 3.07

8212-810-745000 MAINT RUMPKE 9.62

8212-810-745000 REIMBURSMENT FOR THERMOMETERS CLARK COUNTY EMA 1,584.23

8212-810-745000.CCHD8100050 MAINTENANCE A T & T MOBILITY 45.17

8212-810-745000.CCHD8100050 MAINTENANCE HAUCK BROS INC 55.04

8212-810-745000.CCHD8100050 MAINTENANCE TIME WARNER CABLE 238.81

8212-810-745000.CCHD8100050 MAINTENANCE MILLER'S TEXTILE SERVICE 14.24

8212-810-745000.CCHD8100050 MAINTENANCE ABSOLUTE CLEAN 271.68


8212-810-745000.CCHD8100050 MAINTENANCE CITY OF SPRINGFIELD 16.37


8212-810-746000 LEASE - OCTOBER COMMUNITY HEALTH FOUNDATION 470.08

8212-810-746000 LEASE - COMMUNITY HEALTH FOUNDATION 22.20

8212-810-746200 UTILITIES SHIVER SECURITY SYSTEMS INC 14.93


8212-810-746200 UTILITY COLUMBIA GAS OF OHIO 22.48

8212-810-746200 UTILITY OHIO EDISON 112.99




Total For Fund 8212 EARLY START GRANT 3,750.44

6

Fund 8213 CRIBS FOR KIDS

Dept 810 CCCHD

8213-810-721000 SUPPLIES OHIO EDISON 22.60




8213-810-746200 MAINTENANCE RUMPKE 2.54


8213-810-746200 UTILITIES COLUMBIA GAS OF OHIO 4.50


8213-810-746200 UTILITY CITY OF SPRINGFIELD 2.55

8213-810-746200 UTILITIES CITY OF SPRINGFIELD 0.73


Total For Fund 8213 CRIBS FOR KIDS 140.66

Fund 8214 IMMUNIZATION GRANT

Dept 810 CCCHD

8214-810-718400 MILEAGE - JUL - SEPT JENNIE L ROHRER 42.00


Total For Fund 8214 IMMUNIZATION GRANT 42.00

Fund 8217 PLUMBING

Dept 810 CCCHD


8217-810-744000 CONTRACT SERVICES - AUGUST GREENE COUNTY PUBLIC HEALTH 449.44

8217-810-744000 CONTRACT SERVICES - AUGUST MIAMI COUNTY PUBLIC HEALTH 321.65

8217-810-744000.CCHD8100058 CONTRACT SERVICES - CHAMPAIGN CHAMPAIGN CO HEALTH DISTRICT 2,697.44


Total For Fund 8217 PLUMBING 3,541.32

7

Fund 8220 WIC

Dept 810 CCCHD

8220-810-718400 MILEAGE - AUG & CELL REIMB EMILY HAWKE 47.50

8220-810-721000 SCALE INSPECTION ACURA MEDICAL SYSTEMS INC 242.00


8220-810-721000 SUPPLIES - DOLLAR TREE CARDMEMBER SERVICES 31.00

8220-810-721000 SUPPLIES - EVENT SUPPLIES CARDMEMBER SERVICES 216.00

8220-810-721000 SUPPLIES - EVENT SUPPLIES KROGER 118.04

8220-810-721000 DIETITIAN CHP 2 JOB POSTING OHIO ACADEMY OF NUTRITION 100.00

8220-810-721000 SUPPLIES - ACCT ENDING 9981 CARDMEMBER SERVICES 172.30


8220-810-721000 STICKERS SMILEMAKERS 120.98

8220-810-721000 L. HOYING RESPIRATOR FILE CITRAN OCCUPATIONAL HEALTH LLC 35.00

8220-810-721000 SUPPLIES - QUILL CORPORATION 70.97



8220-810-721000 SUPPLIES - ABSOLUTE CLEAN 161.93

8220-810-721000 PPE GHA TECHNOLOGIES INC 1,480.68

8220-810-721000 PPE GHA TECHNOLOGIES INC 679.32

8220-810-721000 LAPTOPS DELL MARKETING LP 3,792.20

8220-810-721000 SUPPLIES QUILL CORPORATION 63.99



8220-810-745000 MAINTENANCE COLUMBIA GAS OF OHIO 144.68

8220-810-745000 MAINTENANCE HAUCK BROS INC 298.13

8220-810-745000 MAINTENANCE SHIVER SECURITY SYSTEMS INC 13.00

8220-810-745000 MAINTENANCE TIME WARNER CABLE 444.23

8220-810-745000 MAINTENANCE MILLER'S TEXTILE SERVICE 26.47

8220-810-745000 MAINTENANCE ABSOLUTE CLEAN 1,309.67


8220-810-745000 MAINTENANCE CITY OF SPRINGFIELD 24.19

8220-810-745000 SUPPLIES QUILL CORPORATION 1,116.96

8220-810-745000 SUPPLIES QUILL CORPORATION 4,986.96

8220-810-745000.CCHD8100048 MAINTENANCE RUMPKE 24.93

8220-810-745000.CCHD8100048 MAINT RUMPKE 57.58

8220-810-746000 LEASE - COMMUNITY HEALTH FOUNDATION 3,055.49



8220-810-746200.CCHD8100053 UTILITIES CITY OF SPRINGFIELD 82.21

8220-810-746200.CCHD8100054 UTILITIES SHIVER SECURITY SYSTEMS INC 97.05



8220-810-746200.CCHD8100055 UTILITY OHIO EDISON 734.45

8220-810-746200.CCHD8100065 UTILITIES A T & T 165.48


Total For Fund 8220 WIC 21,132.54

8

Fund 8224 OIMRI GRANT

Dept 810 CCCHD

8224-810-718100 TRAINING -M. JOHNSON/N. OLIVER CARDMEMBER SERVICES 30.00

8224-810-718100 OFFICE 365 BUSINESS BLUEPRINT CYBER ENGINEERING 1,989.00

8224-810-718400 MILEAGE - AUGUST MARCIA JOHNSON 35.50

8224-810-718400 MILEAGE - AUGUST & CELL REIMB NATALIE OLIVER 80.55

8224-810-721000 MOMS & BABY FIRST T-SHIRTS FLASHIONS LTD 506.00


8224-810-721000 DIGITAL SCALE GLOBAL EQUIPMENT CO 202.00

8224-810-721000 TRACFONE CARDS CARDMEMBER SERVICES 125.00


8224-810-721000 M. JOHNSON RESPIRATOR FILE CITRAN OCCUPATIONAL HEALTH LLC 35.00

8224-810-721000 SUPPLIES STAPLES BUSINESS ADVANTAGE 98.46



8224-810-721000 LAPTOPS - PURCHASE ID 2007015208856 DELL MARKETING LP 4,992.05

8224-810-721000 KEYBOARDS - PURCHASE ID 2007015208450 DELL MARKETING LP 168.95


8224-810-745000.CCHD8100050 MAINTENANCE HAUCK BROS INC 22.93


8224-810-745000.CCHD8100050 MAINTENANCE ABSOLUTE CLEAN 113.20




8224-810-746200.CCHD8100053 UTILITY CITY OF SPRINGFIELD 8.19






8224-810-746200.CCHD8100057 UTILITY COLUMBIA GAS OF OHIO 11.24


Total For Fund 8224 OIMRI GRANT 8,960.66

Fund 8225 WATER POLLUTION CONTROL GRANT

Dept 810 CCCHD

8225-810-744000 WPCLF - 4659 W. NATIONAL RD HARROD SEPTIC SOLUTIONS 15,984.00


Total For Fund 8225 WATER POLLUTION CONTROL GRANT 15,984.00

9

Fund 8226 MOM QUIT FOR TWO

Dept 810 CCCHD

8226-810-718400 MILEAGE - NATALIE OLIVER 17.45

8226-810-721000 SUPPLIES HAUCK BROS INC 9.18

8226-810-721000 SUPPLIES TIME WARNER CABLE 22.97

8226-810-721000 SUPPLIES ABSOLUTE CLEAN 45.28




8226-810-746200.CCHD8100053 UTILITY CITY OF SPRINGFIELD 2.55






8226-810-746200.CCHD8100055 UTILITIES OHIO EDISON 11.38



Total For Fund 8226 MOM QUIT FOR TWO 235.54

Fund 8228 TOBACCO USE PREVENTION

Dept 810 CCCHD

8228-810-718400 JUL - AUG CELL REIMB CASSIDY NICOL 50.00

8228-810-721000 SUPPLIES/FACEBOOK CARDMEMBER SERVICES 7.00




Total For Fund 8228 TOBACCO USE PREVENTION 1,117.18

Fund 8237 PUBLIC INFRASTRUCTURE

Dept 810 CCCHD

8237-810-718400 AUG CELL REIMB BRENNA HEINLE 30.00


Total For Fund 8237 PUBLIC INFRASTRUCTURE 30.00

Fund 8240 ENVIRONMENTAL SERVICES

Dept 810 CCCHD



Total For Fund 8240 ENVIRONMENTAL SERVICES 47.00

Fund 8246 CD&D FUND

Dept 810 CCCHD

8246-810-736500.CCHD8100072 CD&D FEES - JULY TREASURER STATE OF OHIO 4,676.72

8246-810-736500.CCHD8100073 CD&D FEES - JULY MOOREFIELD TOWNSHIP 29.00

8246-810-736500.CCHD8100073 CD&D FEES - JULY MOOREFIELD TOWNSHIP 323.96


Total For Fund 8246 CD&D FUND 5,029.68

10

Fund 8248 SEWAGE TREATMENT SYSTEMS

Dept 810 CCCHD

8248-810-718400.CCHD8100038 MILEAGE - AUG & CELL REIMB ELIZABETH DEWITT 59.00


Total For Fund 8248 SEWAGE TREATMENT SYSTEMS 59.00

Fund 8257 FHV

Dept 810 CCCHD

8257-810-718400.CCHD8100038 MILEAGE - AUGUST AMANDA FANNON 40.05

8257-810-718400.CCHD8100038 MILEAGE - AUGUST AMY TAYLOR 38.70

8257-810-718400.CCHD8100038 MILEAGE - AUGUST CHARMAINE SIMONSON 15.75

8257-810-718400.CCHD8100038 MILEAGE - AUG & CELL REIMB AIMEE HAMILTON 116.70

8257-810-718400.CCHD8100038 MILEAGE - AUGUST ANTIONETTE PEREZ 27.45

8257-810-718400.CCHD8100038 MILEAGE - AUGUST DAWN STASAK 8.10

8257-810-718400.CCHD8100038 MILEAGE - AUGUST ESTHER KEYES 26.10

8257-810-718400.CCHD8100038 MILEAGE - AUGUST KAREN BRUBAKER 16.65

8257-810-718400.CCHD8100038 MILEAGE - AUGUST KRISTINA FULK 14.85

8257-810-718400.CCHD8100038 MILEAGE - AUG 7 CELL REIMB MICHELINE DRUGMAN-DEWITT 82.50

8257-810-718400.CCHD8100038 MILEAGE - JUN - AUG & CELL REIMB MIRANDA EGGLESTON 194.40

8257-810-721000 SUPPLIES TIME WARNER CABLE 117.32

8257-810-745000 MAINTENANCE - HAUCK BROS INC 73.37


8257-810-745000 MAINTENANCE - ABSOLUTE CLEAN 362.24

8257-810-745000 MAINTENANCE - CITY OF SPRINGFIELD 7.96


8257-810-745000.CCHD8100048 MAINT RUMPKE 13.33








8257-810-746200.CCHD8100055 UTILITIES OHIO EDISON 85.34



Total For Fund 8257 FHV 2,288.79

Fund 8259 MSG GRANT

Dept 810 CCCHD

8259-810-721000 SUPPLIES SUPERFLEET MASTERCARD PROGRAM 35.45

8259-810-744000 CONTRACT SERVICES - BRS 125 CHRIS BARNETT 442.00

8259-810-744000 REFUND OF MOTORCYCLE LIABILITY INSURANCETREASURER STATE OF OHIO 181.00

8259-810-744000 BRS 2020 CCS10282 DOUGLAS ANDERSON 442.00

8259-810-744000 BRS CCS 10285 SETH KNAEBEL 442.00

8259-810-744000 BRS 10284 JAMES R FEE JR 442.00

8259-810-744000 BRS CCS 10284 RANDAL PARMENTER 442.00

8259-810-744000 CCS BRS 10285 RICARDO MEZA JR 442.00


Total For Fund 8259 MSG GRANT 2,868.45

Fund 8260 HEALTH - CHC

Dept 810 CCCHD

8260-810-718100 TRAINING - A SHEARER VIRTUAL OTEC CARDMEMBER SERVICES 50.00

8260-810-721000 L. STINE MEMBERSHIP RENEWAL OHIO SOCIETY FOR PUBLIC HEALTH 50.00

11


Total For Fund 8260 HEALTH - CHC 100.00

Fund 8261 REPRODUCTIVE HEALTH AND WELLNESS (RHW)

Dept 810 CCCHD

8261-810-721000 CDD FEES - PAST DUE BALANCE CARDMEMBER SERVICES 11.76

8261-810-721000.CCHD8100003 RHW SUPPLIES MCKESSON MEDICAL-SURGICAL 25.95

8261-810-721000.CCHD8100003 RHW SUPPLIES MCKESSON MEDICAL-SURGICAL 68.07

8261-810-721000.CCHD8100003 RHW SUPPLIES CARDMEMBER SERVICES 21.98

8261-810-721000.CCHD8100076 SELMA RD SUPPLIES CARDMEMBER SERVICES 402.56

8261-810-721000.CCHD8100076 SUPPLIES - CARDMEMBER SERVICES 328.00



8261-810-721000.CCHD8100076 SUPPLIES - CONTRACEPTIVES MCKESSON MEDICAL-SURGICAL 23.13



8261-810-721000.CCHD8100076 CDD FEES - PAST DUE BALANCE CARDMEMBER SERVICES 206.35

8261-810-721000.CCHD8100076 CDD FEES - PAST DUE BALANCE CARDMEMBER SERVICES 5.39


8261-810-744000.CCHD8100074 CDD FEES -RHW CENTER FOR DISEASE DETECTION LLC 517.00

8261-810-744000.CCHD8100074 RHW - CDD FEES CENTER FOR DISEASE DETECTION LLC 349.50


Total For Fund 8261 REPRODUCTIVE HEALTH AND WELLNESS (RHW)2,259.07

Fund 8262 MATERNAL & CHILD HEALTH PROGRAM (MCHP)

Dept 810 CCCHD

8262-810-718400.CCHD8100038 AUG CELL REIMB LESLIE STINE 25.00


Total For Fund 8262 MATERNAL & CHILD HEALTH PROGRAM (MCHP)25.00

12

Fund Totals:

108,387.49

431.93

269.50

2,174.47

9,364.45

1,055.87

3,750.44

140.66

42.00

3,541.32

21,132.54

8,960.66

15,984.00

235.54

1,117.18

30.00

47.00

5,029.68

59.00

2,288.79

2,868.45

100.00

2,259.07

25.00

189,295.04

13

The following advance was made before approval by the Board

of Health at the October 2020 Board meeting.

Advance: From the General Revenue Fund to the WIC

fund (unbudgeted). $40,000 retroactive to 09/30/20.

Please note, the FY20 WIC grant ended 09/30/20. There were remaining

monies left in the grant to be spent by 09/30, therefore, the cash balance was

depleted.

Clark County Combined Health DistrictProposed Program Fees for 2021Based on State of Ohio Required Cost Methodology using 2019 data

$145.90 $119.46 $128.40 $131.00 $157.00 $186.77 $173.00 $28.00 $201.00

Commercial Risk Level 2 less than 25,000 sq. ft. $166.86 $135.54 $145.92 $148.52 $178.00 $210.81 $196.00 $28.00 $224.00

Commercial Risk Level 3 less than 25,000 sq. ft. $337.16 $266.10 $288.12 $290.74 $349.00 $405.97 $384.00 $28.00 $412.00

Commercial Risk Level 4 less than 25 000 sq. ft. $432.80 $339.40 $367.98 $370.62 $445.00 $515.57 $489.00 $28.00 $517.00

$219.72 $176.06 $190.04 $192.66 $231.00 $271.37 $254.00 $28.00 $282.00

$232.30 $185.70 $200.56 $203.16 $244.00 $285.79 $268.00 $28.00 $296.00

$874.06 $677.68 $736.44 $739.12 $887.00 $1,021.27 $976.00 $28.00 $1,004.00

$927.74 $718.84 $781.28 $783.96 $941.00 $1,082.79 $1,035.00 $28.00 $1,063.00

$65.30 $72.95 $59.73 $64.20 $78.50 50% Com. $86.00 $14.00 $100.00

$72.14 $83.43 $67.77 $72.96 $89.00 50% Com. $98.00 $14.00 $112.00

$127.71 $168.58 $133.05 $144.06 $174.50 50% Com. $192.00 $14.00 $206.00

$158.91 $216.40 $169.70 $183.99 $222.50 50% Com. $244.00 $14.00 $258.00

$89.39 $109.86 $88.03 $95.02 $115.50 50% Com. $127.00 $14.00 $141.00

$93.49 $116.15 $92.85 $100.28 $122.00 50% Com. $134.00 $14.00 $148.00

$302.87 $437.03 $338.84 $368.20 $443.40 50% Com. $488.00 $14.00 $502.00

$320.39 $463.87 $359.42 $390.64 $470.50 50% Com. $517.00 $14.00 $531.00

$19.39 $19.52 $19.30 $12.20 $12.43 $15.34 $12.71 $6.00 $18.71

Temporary FSO's & RFE's

$36.00 $32.00 $29.80 $24.00 $29.00 $41.78 $36.00 $0.00 $36.00

$18.00 $16.00 $14.90 $12.00 $14.00 50% Com. $18.00 $0.00 $18.00

$119.68 $107.50 $96.09 $88.28 $99.89 $141.00 $125.00 $28.00 $153.00

Non-Commercial Risk Level 2 greater than 25,000 sq. ft.


Each Operation

Commercial Temporary FSO's and RFE's (per day)

Non Commercial Risk Level 4 greater than 25,000 sq. ft.

Vending Food Service

2018

CCCHD

Fees

2019

CCCHD

Fees

FOOD SERVICE OPERATIONS (FSO) / RETAIL FOOD ESTABLISHMENTS (RFE)

Food Facility Risk Level

State of

Ohio Fee

2021

Each Operation - CPI Increase 2.3% 2019

2016

CCCHD

Fees

2017

CCCHD

Fees

Non-Commercial Risk Level 1 less than 25,000 sq. ft.



Non Commercial Risk Level 4 less than 25,000 sq. ft.


Total

Proposed

Fee 2021

Proposed

2021

CCCHD

Fees

Commercial Risk Level 3 greater than 25,000 sq. ft.

Commercial Risk Level 1 less than 25,000 sq. ft.

CCCHD PROGRAM

2020

CCCHD

Fees

Maximum

2021 Fee

(per Cost

Method.)

Non-Commercial Temporary FSO's and RFE's (per day)

Mobile FSO's and RFE's


Commercial Risk Level 2 greater than 25 000 sq. ft.


$298.00

$149.00

$160.00

$ 80.00

$177.00

$88.50

$219.00

$109.50

$214.50

$107.25 $570.36

$298.00

$149.00 N/A

$298.00

$149.00

$596.00

$298.00

$320.00

$160.00

$354.00

$177.00

$438.00

$219.00

$429.00

$214.50 N/A

$596.00

$298.00 N/A

$596.00

$298.00

$150.00 $175.00 $185.00 $195.00 $234.00 $380.33 $255.00 $110.00 $365.00

$150.00 $175.00 $185.00

$75.00 $150.00 $185.00 $195.00 $234.00 $380.33 $255.00 N/A $255.00

$75.00 $150.00 $185.00 $195.00 $234.00 $380.33 $255.00 N/A $255.00

$1.50 $1.75 $1.75 $2.00 $1.50 N/A $1.50 N/A $1.50

$246.00 $339.00 $299.00 $265.44 $319.00 $596.70 $350.00 $80.00 $430.00

$135.00 $150.00 $150.00 $175.00 $175.00 $596.70 $175.00 $55.00 $230.00

$150.00 $175.00 $185.00 $195.00 $205.00 $380.33 $225.00 N/A $225.00

$40.00 $50.00 $75.00 $100.00 $100.00 $380.33 $100.00 N/A $100.00

Updated 10/7/2020

Recreational Vehicle Parks, Recreation Camps, Combined

Park-Camps

2019

CCCHD

Fees

2016

CCCHD

Fees

Proposed

2021

CCCHD

Fees

FSO/RFE Plan Review

$195.00

Maximum

2021 Fee

(per Cost

Method.)

2018

CCCHD

Fees

$380.33

Commercial & Non-Commercial greater than 25,000 sq. ft.

Commercial & Non-Commercial less than 25,000 sq. ft.

State Fee

2021

$110.00$255.00

Individual Public Swimming Pools; Individual Public Spas;

and,

2017

CCCHD

Fees

Temporary Recreational Vehicle Parks, Recreation Camps, or

Combined Park-Camps with Greater than 50 Sites

2020

CCCHD

Fees

$234.00 Temporary Recreational Vehicle Parks, Recreation Camps, or

Combined Park-Camps with 50 or Fewer Sites

Greater than 50 Sites, per Site Charge (Permanent and

Temporary)

Total

Proposed

Fee 2021

CCCHD PROGRAM

$365.00

Tattoo and/or Body Piercing

Temporary Perm. Tattoo and/or Body Piercing Establishments

Individual Public Swimming Pools; Individual Public Spas;

and, Individual Special Use Pools

Recreational Vehicle Parks, Recreation Camps, or Combined

Park-Camps with 50 or Fewer Sites

Recreational Vehicle Parks, Recreation Camps, or Combined

Park-Camps with Greater than 50 Sites

Permanent Tattoo and/or Body Piercing Establishments

Swimming Pools and Spas

Fazio Color Shop 1020 S. Limestone St

Springfield, Ohio 45505 Phone#937-323-9149

[email protected] 09-28-2020

Quote for: Clark County Health Dept. Southern Village Break room Shaw Commercial 20mil vinyl plank with glued direct installation 252sqft @ 5.00 1,260.00 Scrape and skim coat floor 252.00 Install customers 5’’ rubber cove base and transitions 64 linft @ 1.50 96.00 1,608.00 No tax Price does not include removal of existing flooring or moving furniture

mailto:%[email protected]

COMBINED HEALTH DISTRICT CLARK COUNTY

SINGLE AUDIT

JANUARY 1, 2019 – DECEMBER 31, 2019

Efficient Effective Transparent

Board of Directors Clark County Combined Health District 529 East Home Road Springfield, Ohio 45503 We have reviewed the Independent Auditor’s Report of the Clark County Combined Health District, Clark County, prepared by Wilson, Shannon & Snow, Inc., for the audit period January 1, 2019 through December 31, 2019. Based upon this review, we have accepted these reports in lieu of the audit required by Section 117.11, Revised Code. The Auditor of State did not audit the accompanying financial statements and, accordingly, we are unable to express, and do not express an opinion on them. Our review was made in reference to the applicable sections of legislative criteria, as reflected by the Ohio Constitution, and the Revised Code, policies, procedures and guidelines of the Auditor of State, regulations and grant requirements. The Clark County Combined Health District is responsible for compliance with these laws and regulations. Keith Faber Auditor of State Columbus, Ohio September 15, 2020

JRHelle

Keith Faber

This page intentionally left blank.


TABLE OF CONTENTS TITLE PAGE Independent Auditor’s Report ....................................................................................................................... 1 Combined Statement of Cash Receipts, Cash Disbursements, and Changes in Fund Balances – All Governmental Fund Types - For the Year Ended December 31, 2019 ..................................................................................................... 4 Notes to the Financial Statement .................................................................................................................. 5 Schedule of Expenditures of Federal Awards ............................................................................................. 12 Notes to the Schedule of Expenditures of Federal Awards -2 CFR 200.510(b)(6) ................................... 13 Independent Auditor’s Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Required by Government Auditing Standards ......................................................................................... 14 Independent Auditor’s Report on Compliance with Requirements Applicable to the Major Federal Program and on Internal Control Over Compliance Required by the Uniform Guidance ..................................................................................... 16 Schedule of Findings – 2 CFR § 200.515 ................................................................................................... 18 Summary Schedule of Prior Audit Findings ............................................................................................... 19

1

INDEPENDENT AUDITOR’S REPORT Combined Health District Clark County 529 East Home Road Springfield, Ohio 45503 To the Members of the Board: Report on the Financial Statement We have audited the accompanying financial statement of the cash balances, receipts and disbursements by fund type, and related notes of the Clark County Combined Health District, Ohio (the District) as of and for the year ended December 31, 2019. Management's Responsibility for the Financial Statement Management is responsible for preparing and fairly presenting this financial statement in accordance with the financial reporting provisions Ohio Revised Code Section 117.38 and Ohio Administrative Code Section 117-2-03(D) permit; this responsibility includes designing, implementing and maintaining internal control relevant to preparing and fairly presenting financial statements free from material misstatement, whether due to fraud or error. Auditor's Responsibility Our responsibility is to opine on this financial statement based on our audit. We audited in accordance with auditing standards generally accepted in the United States of America and the financial audit standards in the Comptroller General of the United States’ Government Auditing Standards. Those standards require us to plan and perform the audit to reasonably assure the financial statement is free from material misstatement. An audit requires obtaining evidence about financial statement amounts and disclosures. The procedures selected depend on our judgment, including assessing the risks of material financial statement misstatement, whether due to fraud or error. In assessing those risks, we consider internal control relevant to the District's preparation and fair presentation of the financial statement in order to design audit procedures that are appropriate in the circumstances, but not to the extent needed to opine on the effectiveness of the District's internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of management’s accounting policies and the reasonableness of their significant accounting estimates, as well as our evaluation of the overall financial statement presentation. We believe the audit evidence we obtained is sufficient and appropriate to support our audit opinions.

Combined Health District Clark County Independent Auditor’s Report

2

Basis for Adverse Opinion on U.S. Generally Accepted Accounting Principles As described in Note 1 of the financial statement, the District prepared this financial statement using the accounting basis permitted by the financial reporting provisions of Ohio Revised Code Section 117.38 and Ohio Administrative Code Section 117-2-03(D), which is an accounting basis other than accounting principles generally accepted in the United States of America (GAAP), to satisfy these requirements. Although the effects on the financial statement of the variances between the regulatory accounting basis and GAAP are not reasonably determinable, we presume they are material. Though the District does not intend these statements to conform to GAAP, auditing standards generally accepted in the United States of America require us to include an adverse opinion on GAAP. However, the adverse opinion does not imply the amounts reported are materially misstated under the accounting basis Ohio Revised Code Section 117.38 and Ohio Administrative Code Section 117-2-03(D) permit. Our opinion on this accounting basis is in the Opinion on Regulatory Basis of Accounting paragraph below. Adverse Opinion on U.S. Generally Accepted Accounting Principles In our opinion, because of the significance of the matter discussed in the Basis for Adverse Opinion on U.S. Generally Accepted Accounting Principles paragraph, the financial statements referred to above do not present fairly, in accordance with accounting principles generally accepted in the United States of America, the financial position of the District as of December 31, 2019, and the respective changes in financial position thereof for the year then ended. Opinion on Regulatory Basis of Accounting In our opinion, the financial statements referred to above present fairly, in all material respects, the cash balances, receipts and disbursements by fund type, and related notes of the Clark County Combined Health District, Ohio as of December 31, 2019, for the year then ended in accordance with the financial reporting provisions Ohio Revised Code Section 117.38 and Ohio Administrative Code Section 117-2-03(D) permit, described in Note 1. Emphasis of Matter As discussed in Note 10 to the financial statements, the financial impact of COVID-19 and the ensuing emergency measures will impact subsequent periods of the District. We did not modify our opinion regarding this matter. Other Matters Our audit was conducted to opine on the financial statements taken as a whole. The Schedule of Expenditures of Federal Awards presents additional analysis as required by Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards and is not a required part of the financial statements.

Combined Health District Clark County Independent Auditor’s Report

3

The schedule is management’s responsibility, and derives from and relates directly to the underlying accounting and other records used to prepare the financial statements. We subjected this schedule to the auditing procedures we applied to the financial statements. We also applied certain additional procedures, including comparing and reconciling the schedule directly to the underlying accounting and other records used to prepare the financial statements or to the financial statements themselves, in accordance with auditing standards generally accepted in the United States of America. In our opinion, this schedule is fairly stated in all material respects in relation to the financial statements taken as a whole. Other Reporting Required by Government Auditing Standards In accordance with Government Auditing Standards, we have also issued our report dated July 30, 2020 on our consideration of the District’s internal control over financial reporting and our tests of its compliance with certain provisions of laws, regulations, contracts and grant agreements and other matters. That report describes the scope of our internal control testing over financial reporting and compliance, and the results of that testing, and does not opine on internal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Auditing Standards in considering the City’s internal control over financial reporting and compliance.

Newark, Ohio July 30, 2020

4

SpecialGeneral Revenue Totals

Cash Receipts: Intergovernmental Revenue 257,818$ 2,536,752$ 2,794,570$ Property Taxes 2,028,995 - 2,028,995 Licenses, Permits, & Fees 553,353 632,276 1,185,629 Contractual services - 534,607 534,607 Medicaid 22,909 1,310 24,219 State Subsidy 44,417 - 44,417 Vital Statistics 336,942 - 336,942 Reimbursements 48,533 934 49,467 Other receipts 18,181 3,775 21,956 Total Cash Receipts 3,311,148 3,709,654 7,020,802

Cash Disbursements: Salaries 1,387,778 1,939,902 3,327,680 Benefits 231,851 294,327 526,178 Insurances 401,671 512,153 913,824 Workers Compensation 19,655 27,166 46,821 Supplies 403,305 165,580 568,885 State Remittance 196,180 90,425 286,605 Equipment 8,133 - 8,133 Contract Services 118,308 576,777 695,085 Travel & Training 12,313 64,708 77,021 Maintenance / Utilities 59,362 84,176 143,538 Rent/Leases 28,378 77,141 105,519 County Auditor Fees 36,105 - 36,105 Other 7,872 3,401 11,273 Total Cash Disbursements 2,910,911 3,835,756 6,746,667

Total Cash Receipts Over Cash Disbursements 400,237 (126,102) 274,135

Other Financing Cash Receipts/(Cash Disbursements) Transfers-In - 173,000 173,000 Advances-In 35,000 38,000 73,000 Transfers-Out (173,000) - (173,000) Advances-Out (38,000) (35,000) (73,000) Total Other Financing Cash Receipts/(Cash Disbursements) (176,000) 176,000 -

Net Change in Fund Balances 224,237 49,898 274,135

Fund Cash Balances, January 1, 2019 2,268,740 1,202,053 3,470,793

Fund Cash Balances, December 31, 2019 2,492,977$ 1,251,951$ 3,744,928$

Fund Cash Balances, December 31, 2019:Restricted -$ 1,052,445$ 1,052,445$ Committed 115,935 199,506 315,441Assigned 80,474 - 80,474Unassigned 2,296,568 - 2,296,568

Fund Cash Balances, December 31, 2019 2,492,977$ 1,251,951$ 3,744,928$

COMBINED HEALTH DISTRICT

Governmental Fund Types

COMBINED STATEMENT OF CASH RECEIPTS, CASH DISBURSEMENTS, AND

FOR THE YEAR ENDED DECEMBER 31, 2019ALL GOVERNMENTAL FUND TYPES

CHANGES IN FUND BALANCES

CLARK COUNTY


NOTES TO THE FINANCIAL STATEMENT DECEMBER 31, 2019

5

1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

A. Description of the Entity

The constitution and laws of the State of Ohio establish the rights and privileges of the Clark County Combined Health District, (the District) as a body corporate and politic. A seven-member Board and a Health Commissioner govern the District. The District’s services include prevention and control of diseases, sanitation, vital statistics, abatement and removal of nuisances, and air pollution control.

The District’s management believes these financial statements present all activities for which the District is financially accountable.

B. Basis of Accounting

The financial statement follows the basis of accounting the Auditor of State prescribes or permits. This basis is similar to the cash receipts and disbursements accounting basis. The District recognizes receipts when received in cash rather than when earned, and recognizes disbursements when paid rather than when a liability is incurred. Budgetary presentations report budgetary expenditures when a commitment is made (i.e., when an encumbrance is approved).

C. Deposits and Investments

As required by the Ohio Revised Code, the Clark County Treasurer is custodian for the District’s cash. The County’s cash and investment pool holds the District’s cash, valued at the County Treasurer’s carrying amount.

D. Fund Accounting

The District uses fund accounting to segregate cash that is restricted as to use. The District classifies its fund into the following type:

1. General Fund

The General Fund reports all financial resources except for restricted resources requiring a separate accounting. The General Fund balance is available for any purpose provided it is disbursed or transferred according to Ohio law.

2. Special Revenue Fund

These funds account for proceeds from specific sources (other than from private-purpose trusts or for capital projects) that are restricted to expenditure for specific purposes. The District had the following significant Special Revenue Fund:

Women, Infants, and Children (WIC) Fund - This is a Federal grant fund accounts for the Special Supplemental Nutrition Program.



6

1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Continued)

E. Budgetary Process

The Ohio Revised Code requires that its fund be budgeted annually (except Agency Funds).

1. Appropriations

Budgetary expenditures (that is, disbursements and encumbrances) may not exceed appropriations at the fund, function or object level of control, and appropriations may not exceed estimated resources. The District Board must annually approve appropriation measures and subsequent amendments. Unencumbered appropriations lapse at year end.

2. Estimated Resources

Estimated resources include estimates of cash to be received (budgeted receipts) plus unencumbered cash as of January 1. The County Budget Commission must approve estimated resources.

3. Encumbrances

The Ohio Revised Code requires the District to reserve (encumber) appropriations when individual commitments are made. Encumbrances outstanding at year end are carried over, and need not be re-appropriated.

A summary of the 2019 budgetary activity appears in Note 2.

F. Fund Balance

Fund balance is divided into five classifications based primarily on the extent to which the District must observe constraints imposed upon the use of its governmental-fund resources. The classifications are as follows:

1. Nonspendable

The District classifies assets as nonspendable when legally or contractually required to maintain the amounts intact.

2. Restricted

Fund balance is restricted when constraints placed on the use of resources are either externally imposed by creditors (such as through debt covenants), grantors, contributors, or laws or regulations of other governments; or is imposed by law through constitutional provisions.



7

1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Continued)

F. Fund Balance (Continued)

3. Committed

The Board can commit amounts via formal action (resolution). The District must adhere to these commitments unless the Board amends the resolution. Committed fund balance also incorporates contractual obligations to the extent that existing resources in the fund have been specifically committed to satisfy contractual requirements.

4. Assigned

Assigned fund balances are intended for specific purposes but do not meet the criteria to be classified as restricted or committed. Governmental funds other than the general fund report all fund balances as assigned unless they are restricted or committed. In the general fund, assigned amounts represent intended uses established by the Board or a District official delegated that authority by resolution, or by State Statute.

5. Unassigned

Unassigned fund balance is the residual classification for the general fund and includes amounts not included in the other classifications. In other governmental funds, the unassigned classification is used only to report a deficit balance.

The District applies restricted resources first when expenditures are incurred for purposes for which either restricted or unrestricted (committed, assigned, and unassigned) amounts are available. Similarly, within unrestricted fund balance, committed amounts are reduced first followed by assigned, and then unassigned amounts when expenditures are incurred for purposes for which amounts in any of the unrestricted fund balance classifications could be used.

G. Property, Plant, and Equipment

The District records cash disbursements for acquisitions of property, plant, and equipment when paid. The accompanying financial statements do not report these items as assets.

H. Intergovernmental Revenues

Intergovernmental revenues, such as entitlements and grants awarded on a non-reimbursable basis are recorded when received in accordance with the District’s cash basis method of accounting.

I. Accumulated Leave

In certain circumstances, such as upon leaving employment, employees are entitled to cash payments for unused leave. The District’s personnel policy is available upon request for the restrictions for unused leave. The financial statements do not include a liability for unpaid leave.



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2. BUDGETARY ACTIVITY

Budgetary activity for the year ending 2019 follows:

2019 Budgeted vs. Actual Receipts

Fund Type Budgeted Receipts

Actual Receipts

Variance

General $3,321,032 $3,346,148 $25,116 Special Revenue 4,087,457 3,920,654 (166,803)

Total $7,408,489 $7,266,802 ($141,687)

2019 Budgeted vs. Budgetary Basis Expenditures

Fund Type Appropriation

Authority Budgetary

Expenditure

Variance

General $3,251,400 $3,202,385 $49,015 Special Revenue 4,162,472 3,952,244 210,228

Total $7,413,872 $7,154,629 $259,243 3. PROPERTY TAX

The County Commissioners serve as a special taxing authority to levy a special levy outside the property tax ten-mil limitation to enable the District with sufficient funds to provide health programs and maintain general operations. The County Commissioners place a countywide (excluding the City of New Carlisle) levy of 1.0 mils on the 2001 ballot and obtained voter approval by the electors of the County. The District continued to pass replacement levies since 2001 noting the most recent five year replacement levy approved was in calendar year 2016 which represents real estate collections for calendar year 2018 through 2022.

Real property taxes become a lien on January 1 preceding the October 1 date for which the tax rates are adopted. The State District of Tax Equalization adjusts these rates for inflation. Property taxes are also reduced for applicable homestead and rollback deductions. The financial statements include homestead and rollback amounts the State pays as Intergovernmental Receipts. Payments are due to the County by December 31. If the property owner elects to pay semiannually, the first half is due December 31. The second half payment is due the following June 20.

The County is responsible for assessing property, and for billing, collecting, and distributing all property taxes on behalf of the District.

4. RETIREMENT SYSTEMS

The District’s employees belong to the Ohio Public Employees Retirement System (OPERS). OPERS is a cost-sharing, multiple-employer plan. The Ohio Revised Code prescribes this plan’s benefits, which include postretirement healthcare and survivor and disability benefits. The Ohio Revised Code also prescribes contribution rates. For 2019, all employees with the exception of the Health Commissioner, contributed 10% of their gross salaries and the District contributed an amount equaling 14%. Regarding the Health Commissioner, the District contributes 24% of the Health Commissioner’s gross salary to OPERS, which is considered the Health Commissioner’s required 10% plus the District’s required contribution of 14%. The District has paid all contributions required through December 31, 2019.



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5. POSTEMPLOYMENT BENEFITS

OPERS offers a cost-sharing, multiple-employer defined benefit postemployment plan, that includes multiple health care plans including medical coverage, prescription drug coverage, deposits to a Health Reimbursement Arrangement, and Medicare Part B premium reimbursements, to qualifying benefit recipients. The portion of employer contributions allocated to health care for members in the traditional pension plan and combined plan was 0 percent during calendar year 2019. The portion of employer contributions allocated to health care for members in the member-directed plan was 4.0 percent during calendar year 2019.

6. CONTRACTUAL OBLIGATIONS

The District entered into agreements for the purpose of rental space for operations of the Women, Infants and Children (WIC) and Early Childhood (EC) programs, rental space (Sunset Ave) for all Nursing Services, and also eight vehicles to be used for District operations.

Rental space for the WIC/EC programs is for a period of ten years with a base rent of $4,160.42 per month. Rental space for Sunset Ave is a period of 2 years with a base rent of $400 per month. The eight vehicles are for a period of 36 months commencing August 2019 and continue to August 2022 with base rent ranging from $244.50 to $324.25 per month. At the time of expiration a decision will be made regarding the future of the vehicles.

7. RISK MANAGEMENT

A. Risk Pool Membership

The District is exposed to various risks of property and casualty losses, and injuries to employees. The District insures against injuries to employees through the Ohio Bureau of Worker’s Compensation.

The District belongs to the Public Entities Pool of Ohio (PEP), a risk-sharing pool available to Ohio local governments. PEP provides property and casualty coverage for its members. York Risk Pooling Services, Inc. (formerly known as American Risk Pooling Consultants, Inc.), functions as the administrator of PEP and provides underwriting, claims, loss control, risk management, and reinsurance services for PEP. PEP is a member of the American Public Entity Excess Pool (APEEP), which is also administered by ARPCO. Member governments pay annual contributions to fund PEP. PEP pays judgments, settlements and other expenses resulting from covered claims that exceed the members’ deductibles.

Casualty and Property Coverage APEEP provides PEP with an excess risk-sharing program. Under this arrangement, PEP retains insured risks up to an amount specified in the contracts. At December 31, 2018, PEP retained $350,000 for casualty claims and $100,000 for property claims.

The aforementioned casualty and property reinsurance agreement does not discharge PEP’s primary liability for claims payments on covered losses. Claims exceeding coverage limits are the obligation of the respective government.



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7. RISK MANAGEMENT (Continued)

Financial Position PEP’s financial statements (audited by other auditor’s) conform with generally accepted accounting principles, and reported the following assets, liabilities and net positions at December 31, 2018 (the latest information available):

2018

Assets $49,921,998

Liabilities ($14,676,199)

Net Position $35,245,799

At December 31, 2018 the liabilities above include approximately $13 million of estimated incurred claims payable. The assets above also include approximately $11.3 million of unpaid claims to be billed. The Pool’s Member ship increased to 538 members in 2018. These amounts will be included in future contributions from members when the related claims are due for payment.

Based on discussions with PEP, the expected rates PEP charges to compute member contributions, which are used to pay claims as they become due, are not expected to change significantly from those used to determine the historical contributions detailed below. By contract, the annual liability of each member is limited to the amount of financial contributions required to be made to PEP for each year of membership.

2019 Contributions to PEP

$47,650

After one year of membership, a member may withdraw on the anniversary of the date of joining PEP, if the member notifies PEP in writing 60 days prior to the anniversary date. Upon withdrawal, members are eligible for a full or partial refund of their capital contributions, minus the subsequent year’s contribution. Withdrawing members have no other future obligation to PEP. Also upon withdrawal, payments for all casualty claims and claim expenses become the sole responsibility of the withdrawing member, regardless of whether a claim occurred or was reported prior to the withdrawal.

B. County Commissioner Association of Ohio Workers’ Compensation Group Rating Plan

For 2019, through Clark County serving as the District’s fiscal agent, the District participated in the County/Commissioners Association of Ohio Workers’ Compensation Group Rating Plan (“the GRP”), an insurance purchasing pool. The intent of the GRP is to achieve a reduced premium for the District by virtue of its grouping with other participants in the GRP. The workers’ compensation experience of the participants is calculated as one experience and a common premium rate is applied to all participants in the Plan. Each participant pays it workers’ compensation premium to the State based on the rate for the Plan rather than the individual rate.



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7. RISK MANAGEMENT (Continued)

The GRP then calculates the total savings which accrued to the Plan through its formation. This savings is then compared to the overall savings percentage of the Plan. The Plan’s executive committee then collects rate contributions from, or pays rate equalization rebates to the various participants. Participation in the plan is limited to counties than can meet the Plans’ selection criteria.

C. Employee Medical Benefits

The District participated in a health insurance plan through UMR in 2019 available for all full-time employees. The fully insured plan includes health, mental health, and prescription benefits. The cost of the program for 2019 was $898,389 compared to 2018 of $880,952, and 2017 of $931,790. The District also participates in a group dental plan with Superior Dental. The total cost for the program in 2019 was $12,936 compared to 2018 $11,770, and 2017 $12,135. This indicates an increase between 2018 and 2019 and was attributed to more employees accepting coverage and insurance rates increasing.

8. CONTINGENT LIABILITIES

Amounts grantor agencies pay to the District are subject to audit and adjustment by the grantor, principally the federal government. The grantor may require refunding any disallowed costs. Management cannot presently determine amounts grantors may disallow. However, based on prior experience, management believes any refunds would be immaterial.

9. INTERFUND TRANSACTIONS

Interfund transfers for the year ended December 31, 2019, were as follows:

Transfers from the General Fund to Special Revenue Funds: $173,000

Transfers represent the allocation of unrestricted receipts collected in the General Fund to finance various programs accounted for in other funds in accordance with budgetary authorizations.

Interfund advances for the year ended December 31, 2019 were as follows:

Advances from the General Fund to the Special Revenue Fund: $38,000

Advances from the Special Revenue Fund to the General Fund : $35,000

Advances represent the allocation of unrestricted receipts to finance a program that had not received the total grant funds awarded as of December 31, 2019, or return advances from those programs to the General Fund.

10. SUBSEQUENT EVENTS

The United States and the State of Ohio declared a state of emergency in March 2020 due to the COVID-19 pandemic. The financial impact of COVID-19 and the ensuing emergency measures will impact subsequent periods of the District. In addition, the impact on the District’s future operating costs, revenues, and any recovery from emergency funding, either federal or state, cannot be estimated.

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Federal Grantor/Pass Through Grantor Pass Through CFDAProgram Title Entity Number Number ExpendituresU.S. Department of AgriculturePassed through the Ohio Department of Health:Special Supplemental Nutritions Program for Women, Infants, & Children 01210011WA0619 10.557 684,815$

01210011WA0720 10.557 89,432 Total U.S. Department of Agriculture 774,247

U.S. Department of Health and Human Services Passed through the Ohio Department of Health:

Immunization Cooperative Agreements 01210012GV0119 93.268 47,836 Immunization Cooperative Agreements 01210012GV0220 93.268 48,024

95,860

Maternal and Child Health Services Block Grant to the States 01210011MB0119 93.994 99,834 Maternal and Child Health Services Block Grant to the States 01210011MB0220 93.994 28,782 Maternal and Child Health Services Block Grant to the States 01210011RH0420 93.994 9,839 Maternal and Child Health Services Block Grant to the States 01210011MP0420 93.994 17,300

Total Maternal and Child Health Services Block Grant to the States 155,755

Hospital Preparedness Program and Public Health Emergency Preparedness 01210012PH1019 93.074 78,195 Public Health Emergency Preparedness 01210012PH1120 93.069 24,993

Maternal, Infant and Early Childhood Home Visiting Grant Cluster: Maternal, Infant and Early Childhood Home Visiting Grant Program 01210011MH0319 93.870 336,362 Maternal, Infant and Early Childhood Home Visiting Grant Program 01210011MH0420 93.870 106,318 Total Maternal, Infant and Early Childhood Home Visiting Grant Cluster 442,680

Preventative Health & Health Services Block Grant 01210014CC0418 93.758 50,569 Preventative Health Services_Sexually Transmitted Diseases Control Grants 01210014CC0519 93.977 41,158 National State Based Tobacco Control Programs 01210014TU0420 93.305 12,000

Family Planning - Services 01210011RH0420 93.217 53,761

Total U.S. Department of Health and Human Services 954,971

U.S.Department of Transportation

Passed through Ohio Department of Public Safety:

Highway Safety Cluster: State and Community Highway Safety SC-2019-Clark County Combined Hea-00052 20.600 31,474 State and Community Highway Safety SC-2020-Clark County Combined Hea-00021 20.600 12,021

Total U.S.Department of Transportation National Highway Traffic Safety Administration 43,495

Total Expenditures of Federal Awards 1,772,713$

See accompanying notes to the Schedule of Expenditures of Federal Awards.


SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS FOR THE YEAR ENDED DECEMBER 31, 2019


NOTES TO THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS 2 CFR 200.510(b)(6)

FOR THE YEAR ENDED DECEMBER 31, 2019

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NOTE A – BASIS OF PRESENTATION

The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal award activity of the Combined Health District, Clark County (the District’s) under programs of the federal government for the year ended December 31, 2019. The information on this Schedule is prepared in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the District, it is not intended to and does not present the cash basis financial position or changes in fund balance of the District.

NOTE B – SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Expenditures reported on the Schedule are reported on the cash basis of accounting. Such expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, wherein certain types of expenditures may or may not be allowable or may be limited as to reimbursement. The District has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance.

NOTE C - MATCHING REQUIREMENTS

Certain Federal programs require the District to contribute non-Federal funds (matching funds) to support the Federally-funded programs. The District has met its matching requirements. The Schedule does not include the expenditure of non-Federal matching funds.

NOTE D - COMMINGLING

The District has several funds which receive and expend federal and local funds to meet specific program requirements. It is assumed that federal dollars are expended first.

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INDEPENDENT AUDITOR’S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS

REQUIRED BY GOVERNMENT AUDITING STANDARDS

Combined Health District Clark County 529 East Home Road Springfield, Ohio 45503 To the Members of the Board: We have audited in accordance with auditing standards generally accepted in the United States and the Comptroller General of the United States’ Government Auditing Standards, the financial statement of the cash balances, receipts, and disbursements by fund type of the Clark County Combined Health District,(the District) as of and for the year ended December 31, 2019, and the related notes to the financial statement and have issued our report thereon dated July 30, 2020 wherein we noted the District followed financial reporting provisions Ohio Revised Code Section 117.38 and Ohio Administrative Code Section 117-2-03(D) permit. We also noted the financial impact of COVID-19 and the ensuing emergency measures will impact subsequent periods of the District as disclosed in Note 10.

Internal Control Over Financial Reporting As part of our financial statement audit, we considered the District’s internal control over financial reporting (internal control) to determine the audit procedures appropriate in the circumstances to the extent necessary to support our opinions on the financial statement, but not to the extent necessary to opine on the effectiveness of the District’s internal control. Accordingly, we have not opined on it. A deficiency in internal control exists when the design or operation of a control does not allow management or employees, when performing their assigned functions, to prevent, or detect and timely correct misstatements. A material weakness is a deficiency, or combination of internal control deficiencies resulting in a reasonable possibility that internal control will not prevent or detect and timely correct a material misstatement of the District’s financial statement. A significant deficiency is a deficiency, or a combination of deficiencies, in internal control that is less severe than a material weakness, yet important enough to merit attention by those charged with governance. Our consideration of internal control was for the limited purpose described in the first paragraph of this section and was not designed to identify all internal control deficiencies that might be material weaknesses or significant deficiencies. Given these limitations, we did not identify any deficiencies in internal control that we consider material weaknesses. However, unidentified material weaknesses may exist.

Combined Health District Clark County Independent Auditor’s Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Required by Government Auditing Standards Page 2

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Compliance and Other Matters

As part of reasonably assuring whether the District’s financial statements are free of material misstatement, we tested its compliance with certain provisions of laws, regulations, contracts, and grant agreements, noncompliance with which could directly and materially affect the determination of financial statement amounts. However, opining on compliance with those provisions was not an objective of our audit and accordingly, we do not express an opinion. The results of our tests disclosed no instances of noncompliance or other matters we must report under Government Auditing Standards. Purpose of this Report

This report only describes the scope of our internal control and compliance testing and our testing results, and does not opine on the effectiveness of the District’s internal control or on compliance. This report is an integral part of an audit performed under Government Auditing Standards in considering the District’s internal control and compliance. Accordingly, this report is not suitable for any other purpose.

July 30, 2020 Newark, Ohio

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INDEPENDENT AUDITOR’S REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO THE MAJOR FEDERAL PROGRAM AND ON INTERNAL CONTROL

OVER COMPLIANCE REQUIRED BY THE UNIFORM GUIDANCE

Combined Health District Clark County 529 East Home Road Springfield, Ohio 45503

To the Members of the Board:

Report on Compliance for the Major Federal Program

We have audited the Clark County Combined Health District’s (the District) compliance with the applicable requirements described in the U.S. Office of Management and Budget (OMB) Compliance Supplement that could directly and materially affect the Clark County Combined Health District’s major federal program for the year ended December 31, 2019. The Summary of Auditor’s Results in the accompanying schedule of findings identifies the District’s major federal program.

Management’s Responsibility

The District’s Management is responsible for complying with federal statutes, regulations, and the terms and conditions of its federal awards applicable to its federal programs.

Auditor’s Responsibility

Our responsibility is to opine on the District’s compliance for the District’s major federal program based on our audit of the applicable compliance requirements referred to above. Our compliance audit followed auditing standards generally accepted in the United States of America; the standards for financial audits included in the Comptroller General of the United States’ Government Auditing Standards; and the audit requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). These standards and the Uniform Guidance require us to plan and perform the audit to reasonably assure whether noncompliance with the applicable compliance requirements referred to above that could directly and materially affect a major federal program occurred. An audit includes examining, on a test basis, evidence about the District’s compliance with those requirements and performing such other procedures as we considered necessary in the circumstances.

We believe our audit provides a reasonable basis for our compliance opinion on the District’s major program. However, our audit does not provide a legal determination of the District’s compliance.

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Combined Health District Clark County Independent Auditor’s Report on Compliance With Requirements Applicable to the Major Federal Program and On Internal Control Over Compliance Required by the Uniform Guidance Page 2

Opinion on the Major Federal Program

In our opinion, Clark County Combined Health District complied, in all material respects with the compliance requirements referred to above that could directly and materially affect its major federal program for the year ended December 31, 2019.

Report on Internal Control Over Compliance

The District’s management is responsible for establishing and maintaining effective internal control over compliance with the applicable compliance requirements referred to above. In planning and performing our compliance audit, we considered the District’s internal control over compliance with the applicable requirements that could directly and materially affect a major federal program, to determine our auditing procedures appropriate for opining on each major federal program’s compliance and to test and report on internal control over compliance in accordance with the Uniform Guidance, but not to the extent needed to opine on the effectiveness of internal control over compliance. Accordingly, we have not opined on the effectiveness of the District’s internal control over compliance.

A deficiency in internal control over compliance exists when the design or operation of a control over compliance does not allow management or employees, when performing their assigned functions, to prevent, or to timely detect and correct, noncompliance with a federal program’s applicable compliance requirement. A material weakness in internal control over compliance is a deficiency, or combination of deficiencies, in internal control over compliance, such that there is a reasonable possibility that material noncompliance with a federal program compliance requirement will not be prevented, or timely detected and corrected. A significant deficiency in internal control over compliance is a deficiency, or a combination of deficiencies, in internal control over compliance with federal program’s applicable compliance requirement that is less severe than a material weakness in internal control over compliance, yet important enough to merit attention by those charged with governance.

Our consideration of internal control over compliance was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control over compliance that might be material weaknesses or significant deficiencies. We did not identify any deficiencies in internal control over compliance that we consider to be material weaknesses. However, material weaknesses may exist that have not been identified.

This report only describes the scope of our internal control over compliance tests and the results of this testing based on Uniform Guidance requirements. Accordingly, this report is not suitable for any other purpose.

July 30, 2020 Newark, Ohio

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SCHEDULE OF FINDINGS 2 CFR § 200.515

DECEMBER 31, 2019

1. SUMMARY OF AUDITOR’S RESULTS

(d)(1)(i) Type of Financial Statement Opinion GAAP – Adverse Regulatory – Unmodified

(d)(1)(ii) Were there any material weaknesses in internal control reported at the financial statement level (GAGAS)?

No

(d)(1)(ii) Were there any significant deficiencies in internal control reported at the financial statement level (GAGAS)?

No

(d)(1)(iii) Was there any reported material noncompliance at the financial statement level (GAGAS)?

No

(d)(1)(iv) Were there any material weaknesses in internal control reported for major federal programs?

No

(d)(1)(iv) Were there any significant deficiencies in internal control reported for major federal programs?

No

(d)(1)(v) Type of Major Programs’ Compliance Opinion

Unmodified

(d)(1)(vi) Are there any reportable findings under 2 CFR § 200.516(a)? No

(d)(1)(vii) Major Programs (list): Special Supplemental Nutrition Program for Women, Infants, & Children/C.F.D.A. 10.557

(d)(1)(viii) Dollar Threshold: Type A\B Programs Type A: > $750,000 Type B: all others

(d)(1)(ix) Low Risk Auditee under 2 CFR §200.520? No

2. FINDINGS RELATED TO THE FINANCIAL STATEMENTSREQUIRED TO BE REPORTED IN ACCORDANCE WITH GAGAS

None.

3. FINDINGS FOR FEDERAL AWARDS

None.

88 East Broad Street, Columbus, Ohio 43215 Phone: 614-466-4514 or 800-282-0370

This report is a matter of public record and is available online at

www.ohioauditor.gov

CLARK COUNTY COMBINED HEALTH DISTRICT

CLARK COUNTY

AUDITOR OF STATE OF OHIO CERTIFICATION

This is a true and correct copy of the report, which is required to be filed pursuant to Section 117.26, Revised Code, and which is filed in the Office of the Ohio Auditor of State in Columbus, Ohio.

Certified for Release 9/29/2020

* = funds that were changed

8201 - General Fund

ESTIMATED REVENUES 3,706,258

SALARIES & BENEFITS 2,151,671

OTHER EXPENSES 1,554,587

TOTAL - GENERAL FUND 7,412,516

8202 - FOOD SERVICE

ESTIMATED REVENUES 230,000

SALARIES & BENEFITS 189,000

OTHER EXPENSES 38,500

TOTAL - FOOD SERVICE 457,500

8203 - SOLID WASTE




TOTAL - SOLID WASTE 270,000

8204 - RECREATION PARKS AND CAMP




TOTAL - RECREATION PARKS AND CAMP 6,789

8205- WATER




TOTAL - WATER 239,000

Clark County Combined Health District

2020 Amended Budget

8206 - POOLS




TOTAL - POOLS 33,947

8207 - MOSQUITO




TOTAL - MOSQUITO 39,740

8208 - MAC


SALARIES & BENEFITS -


TOTAL - MAC 276,800

8209 - HIV



OTHER EXPENSES -

TOTAL - HIV 88,544

8211- DRUG OVERDOSE




TOTAL - DRUG OVERDOSE 230,000

8212 - HMG




TOTAL - HMG 868,135

8213 - CRIBS FOR KIDS




TOTAL - CRIBS FOR KIDS 163,422

8214 - GET VACCINATED




TOTAL - GET VACCINATED 159,881

8217 - PLUMBING




TOTAL - PLUMBING 253,965

8220 - WIC




TOTAL - WIC 1,577,722

8223 - COVID-19




TOTAL - COVID-19 648,465

8224 - MOMS & BABIES FIRST




TOTAL - MOMS & BABIES FIRST 260,000

8225 - WATER POLUTION CONTROL




TOTAL - WATER POLUTION CONTROL 370,000

8226 - MOMS QUIT FOR TWO




TOTAL - MOMS QUIT FOR TWO 121,595

8227 - SAFE COMMUNITIES




TOTAL - SAFE COMMUNITIES 142,296

8228 - TOBACCO




TOTAL - TOBACCO 161,638

8229 -CONTINGENCY

ESTIMATED REVENUES -


OTHER EXPENSES -

TOTAL - CONTINGENCY -

8233 -LICE




TOTAL - LICE 73,867

8237 - PHEP




TOTAL - PHEP 413,382

8238 - SW NON DISTRICT




TOTAL - SW NON DISTRICT 8,145

8239 - SICK LEAVE PAYOUT



OTHER EXPENSES -

TOTAL - SICK LEAVE PAYOUT 20,000

8240 - ENVIRONMENTAL SERVICES




TOTAL - ENVIRONMENTAL SERVICES 188,320

8244 - CARE RESOURCE COORDINATION*

ESTIMATED REVENUES 116,197 NEW GRANT



TOTAL - ENVIRONMENTAL SERVICES 232,394

8246 - CD&D




TOTAL - CD&D 138,508

8248 - SEWAGE




TOTAL - SEWAGE 233,654

8252 - CONTACT TRACING




TOTAL - SEWAGE 1,070,332

8257 - MIECHV




TOTAL - MIECHV 891,956

8259 - MOTORCYCLE




TOTAL -MOTORCYCLE 102,857

8260 - CHC




TOTAL - CHC 196,414

8261 - RHW




TOTAL - RHW 1,201,766

8262 - MCH




TOTAL - MCH 167,782

TOTAL REVENUES 9,478,071

TOTAL SALARIES & BENEFITS 5,775,720

OTHER EXPENSES 3,468,749

2020 2020

CURRENT AMENDED

GL NUMBER DESCRIPTION BUDGET BUDGET

ESTIMATED REVENUE - CARE RESOURCE COORDINATION

8244-810-421000 INTERGOVERNMENTAL - 116,197

8244-810-520000 ADVANCES IN - -

TOTAL ESTIMATED REVENUES - 116,197

APPROPRIATIONS

8244-810-702000 SALARIES - EMPLOYEES - 50,000

8244-810-711000 PERS - 7,000

8244-810-712000 WORKERS COMPENSATION - 1,000

8244-810-714000 MEDICARE - 725

8244-810-715000 DENTAL INSURANCE - 220

8244-810-716000 LIFE INSURANCE - 50

8244-810-717000 HEALTH INSURANCE - 21,005

8244-810-721000 OFFICE SUPPLIES - 18,197

8244-810-746000 RENTS & LEASES - 10,000

8244-810-746200 UTILITIES - 8,000

8244-810-80000 ADVANCES OUT - -

TOTAL APPROPRIATIONS - 116,197

NET OF REVENUES/APPROPRIATIONS - FUND 8244 - -

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