Portage County health department representatives asked the Portage County Board of Commissioners on Monday to formally designate the department as the county’s tuberculosis control unit and to set aside roughly $10,000 in county funds to cover immediate, nonreimbursable TB costs.

A Portage County health district representative told commissioners the county is responsible under Ohio law for funding “TB prevention, control, and treatment within the county,” citing Ohio Revised Code 339.73, and said the department has functioned as the local control unit since the 1980s but lacks a current MOU or contract. Becky Bridal, director of nursing programs for the Portage County Health Department, described TB as “a class B illness” with epidemic potential and explained the department’s role in case finding, treatment coordination and daily observed therapy.

The department outlined how it manages cases: local detection is reported through the Ohio Disease Reporting System; public-health staff find providers, assist with insurance enrollment and medication costs, and provide direct observed therapy so patients complete a six- to nine-month antibiotic regimen. Bridal said national estimates and guidance from the National TB Controllers Association put average public cost per TB case at about $20,000–$25,000 annually when housing, hospitalizations and other complications are included. Locally, the health department said it spent about $1,600 on one recent case before that patient obtained insurance.

Health officials described the reimbursement process: the department documents all eligible expenditures, submits an invoice to the state once a TB case is closed, and the state determines what is reimbursable; any state award would flow back to the county as a subaward. Bridal and the health district representative also said housing placed for TB patients (for example, hotel stays while infectious) would likely not be reimbursed by the state and would create an immediate local cost. Commissioners were told hotel costs could be about $1,000 a month per person if housing is required for isolation.

Commissioners did not take a formal vote on the request at the meeting. Several commissioners expressed informal support for creating a small county reserve—one commissioner suggested $5,000 and another said $10,000 would give “some wiggle room” if an outbreak required urgent housing or other nonreimbursable expenses. Commissioners asked the health department to provide copies of the older 1980s-era resolutions and to follow up with the county prosecutor’s office to determine whether a resolution, MOU or contract is most appropriate.

The health department said Portage County has had two confirmed TB cases this year; it reported 0–2 cases annually from 2020–2024 and one to two cases per year in some earlier years. Health officials said they are coordinating with regional partners, including a TB clinic in Mahoning County, and with state TB controllers to document costs and seek reimbursement when eligible.

Commissioners requested follow-up documentation and a draft agreement for legal review; no formal commitment of county funds was recorded during the meeting.