County health departments in West Virginia face growing financial strain as a result of significant declines in federal, state and local government funding. At the same time, demographic and socioeconomic changes have increased the need for the critical services these agencies provide.

What’s the answer? Well, it may be that these agencies can do more collectively than they can do individually.

A study by West Virginia University’s Bureau of Business and Economic Research in the College of Business and Economics indicates that consolidated health departments like that in the Mid-Ohio Valley or Charleston areas may not only save significant money, but may also better serve their constituents. The study, “Briefing on Local Health Department Consolidation Potential in West Virginia,” was requested and funded by the West Virginia Department of Health and Human Resources, Bureau for Public Health, Center for Local Health, and looks at a proposal to group the state’s local health departments into a nine-region system.

A focus of the study is to provide a review of the methodology and identify other benefits, costs, national-level trends and other prospective issues that should be examined for a statewide local health department consolidation plan. Drema Mace, Ph.D., Executive Director of the Mid-Ohio Valley Health Department, proposed the plan by which West Virginia would operate nine district health departments.

“When we look at prior research, it suggests that many costs associated with the services that are delivered by local governments – including the provision of public health – can be decreased by providing them to a larger or more densely-concentrated population,” said Brian Lego, BBER research assistant professor. “As a result, state officials in West Virginia have started to look at the efficiency of consolidating county-based local health departments into a multi-county regional model that combines resources and certain key activities into a centralized location, yet maintains some local provision of services.”

The Mid-Ohio Valley Health Department, based in Parkersburg, is a consolidation of resources for six counties, while the Putnam County Health Department has an operations contract that combines the agency with the Kanawha-Charleston Health Department.

“Many local health departments in the state generate limited amounts of revenue and face high costs for the services they provide due to a variety of human and physical capital resource limitations,” Lego said. “In addition, they face the difficulty of servicing counties with small, declining or widely dispersed population bases, and that is a hardship.”

John Deskins, director of the BBER, participated in a news briefing on Tuesday afternoon (Feb. 2) hosted by the DHHR and talked about the study’s findings. He said it is likely that many of West Virginia’s local health departments currently have unrealized revenue potential. “There is evidence to suggest that larger and more efficient health departments can enhance service provision and, ultimately, generate significantly more revenue.”

The study reads, “Ultimately, these consolidated health departments create the potential for lowering system-wide expenditures by eliminating overlapping administrative functions and administrative costs, and could also generate additional revenue as areas that once lacked the ability to provide certain services to residents could now do so thanks to the availability of sufficient staff and resources.”

The Mid-Ohio Valley Health Department serves communities in Calhoun, Pleasants, Ritchie, Roane, Wirt and Wood counties. After years of financial woes, Putnam County’s state-allotted funds were redirected to the Kanawha-Charleston Health Department starting in July 2013. Putnam initiated a contract with its neighbors in Charleston after it incurred an estimated $400,000 in debt. That debt was erased last year.

The study provided conclusions that included, “Additional research should be conducted so as to gain a more comprehensive accounting of all the possible quantifiable benefits and costs that occur as a result of consolidating LHDs into multi-county entities. We also find that further investigation is necessary to determine the proper geographic design by which county LHDs are consolidated by examining transportation issues, demographic and socioeconomic variables, as well as the overall financial and organizational health of county LHDs.” The study also concludes that further research is necessary to determine the impacts of health department consolidation in states that are predominantly rural.

The full report is available in PDF format at For further information about the WVU College of Business and Economics, follow B&E on Twitter at @wvucobe or visit



CONTACT: Patrick Gregg, WVU College of Business and Economics
304.293.5131 or

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