Adair County supervisors discuss turning public health duties over to Guthrie County; hiring deferred

Adair County supervisors discussed a proposal May 27 to transition county public health duties to a Guthrie County–led arrangement while keeping local home health services in place.

Jotham Arber, identified in the record as Guthrie/Adair County Environmental/Public Health Director, told the board he has worked with the hospital on a step-by-step plan that would designate Guthrie County as the district’s lead agency. Arber said the proposal is expected to be submitted to the state in July. Under the model he described, Guthrie County would oversee claims and billing; grants currently held by the hospital would transfer to public health and be subcontracted through Guthrie County; and insurance, Medicaid and Medicare would be billed first for home health services with county funds covering gaps.

The Board of Public Health has approved entering a 28E agreement with Guthrie County for a one-year contract, Catherine Olesen said, adding the arrangement is intended to preserve a local presence, allow local staffing and protect continuity for grants and programs. Arber said the proposal would use one-year contracts with six-month assessments to allow flexibility if regionalization or state funding circumstances change.

Supervisor Wedemeyer voiced concern about a permanent location for Public Health and said the department needs a central “home” if services are to be sustained locally. Hoadley and Walker asked questions about staffing and facility options; Hoadley noted there may be available space at the Fontanelle clinic. Arber said current staffing would meet minimum requirements during the transition and emphasized maintaining immunization clinics, outreach services, home visits and local points of contact while long-term office needs are evaluated.

Arber recommended waiting until later in the year before hiring a county public health director; supervisors agreed to delay hiring until after the county has more information from the state, with November or December cited as a possible hiring window. No formal board vote to effect structural change was recorded in the meeting minutes; the discussion centered on the proposed plan, the Board of Public Health’s 28E action, and next steps.

The next procedural step the board recorded was a planned submittal of the proposal to the state in July and further supervisory discussion once state funding and district arrangements are clarified.