Crook County commissioners on Oct. 14 reviewed a draft description of core services for the county health department and discussed how those services are funded and reported to state authorities.

Katie Khan, Crook County health and human services director, told commissioners the department’s work centers on three broad service groups: health protection and response (including communicable disease surveillance and environmental health inspections), clinical access (vaccines, family planning and screening) and family health services (perinatal support, nurse home visiting and early childhood prevention). "The work of public health safeguards our community, largely through preventative measures," Khan said.

The discussion focused on statutory mandates versus discretionary services and how programs are sustained financially. Will (staff member) and other county staff walked the board through a summary table in the meeting packet that links core-service areas to program-level funding sources and to any applicable statutory or rule-based requirements communicated to the county.

Why it matters: The exercise is part of a countywide effort to create consistent, written core-service descriptions for each department to guide budgeting and policy questions. Commissioners asked for clarity about which services the county must provide under state law, which are funded by grants or billing revenue, and how residents interact with the health department’s referral and reporting networks.

Most mandated items are tied to state reporting and plan requirements. Khan said communicable disease reporting is required of medical providers and local health departments, and the county submits an annual plan to the Oregon Health Authority describing local public-health activities. "Communicable disease is a state mandate, for both public health and for medical providers to report certain communicable diseases," Khan said. Khan also identified immunization assurance and certain family-planning duties as state-mandated "as funds are available."

Commissioners pressed staff on practical questions about service access and oversight. In response, Khan described three common pathways for communicable-disease reporting used locally: secure electronic health-record messages (the county and several local medical providers use the same system), phone or fax reports, and monthly clinical coordination meetings that include local providers such as Mosaic Medical. "We have monthly clinic meetings with each of the providers ... to follow up on referral pathways," Khan said. She described contract oversight for school-based health centers and community mental-health providers and said those contracts include routine touchpoints and monitoring.

Commissioners also discussed funding mechanics. County staff said the health department’s budget includes intergovernmental transfers (grants) and a general fund transfer; the packet cited approximately $2.178 million in intergovernmental transfers and a $577,000 general-fund transfer to the health department for the current budget year. Staff cautioned that many programs listed as discretionary are nevertheless grant-funded or supported by billing revenue, foundations or other external sources. "Even though something may be discretionary, ... it doesn't necessarily mean the county suddenly has funds to expand another priority service," a staff member said.

Board members asked how discretionary services would be affected if grant or billing revenue stopped. Khan said programs supported solely by outside funds would not continue without that funding: "If we have no funding for those programs, they wouldn't exist," she said, noting that WIC and nurse-home-visiting programs currently have federal funds and billing revenue and are not funded from the county general fund.

Commissioners also queried performance metrics and sources. Khan said the department tracks indicators such as immunization coverage (Khan cited a 2023 figure of 72.7% of 2‑year‑olds vaccinated in the county, with a local target of 75%), emergency-department visits for heat-related illness (12 patients in 2023), and fatal overdose and suicide follow-up because those events carry risks of contagion.

Discussion versus decision: The meeting established only informational direction and requests for follow-up. Staff offered to provide additional performance metrics or deeper program-level details on request; the board did not take formal action beyond the routine adjournment motion at the end of the meeting.

Looking ahead: Staff said they will refine the written core-services descriptions and can return with supplemental data or contract-level information if commissioners request it. Khan invited commissioners to submit topics or metrics they want included in a future packet. "We measure things up and down, left and right, so I'm happy to provide that information," Khan said.