Toe River Health District: Fact vs. Fiction

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What do we all want in Mitchell County? Do we want tourism? A strong economy? Do we want businesses to move here and bring jobs? Do we want quality, affordable housing? Do we want healthy residents with adequate resources to live a good life? I believe we all want those things for the good of everyone in Mitchell County. 

Your health department is a significant part of that goal. The Mitchell County Health Department has been part of a three-county district with Avery and Yancey counties since 1980. The health department has 14 employees who are dedicated to providing excellent healthcare, health education, family support services and environmental health services. Although most of the time the public doesn’t know it, your health department touches every person in this county, whether it’s providing medical care, health education or inspecting the restaurants in which you eat.  

The Wednesday, May 29, article in the Mitchell News-Journal had some inaccuracies I’d like to address.  

Claim: Toe River Health District, or TRHD, requested $462,000 from Mitchell County for the fiscal year 2019-20.

Fact: TRHD requested $434,910 plus $17,269, which will give an average 3 percent pay increase for Mitchell County Health Department employees, for a total request of $452,179.

Claim: The budget request is a 30 percent increase.

Fact: This is the first year the commissioners have seen the actual cost of the Mitchell County Health Department. Before 2018, TRHD had one budget with the three counties combined. It was impossible to know what an individual county’s budget was. The budget requests were based on a formula using each county’s population, but those requests were never accurate. 

In spring of 2018, the county manager from each county, along with the commissioners who represent each of the counties on our board of health, met and decided our finance officer needed to develop a separate budget for each county, and that is what the commissioners see now. I would argue these budgets are much lower than they would have been in prior years. Since 2016, we have cut or lowered many of our expenses. We have moved our administration offices, changed various contracts for services to cheaper companies and we’ve left positions vacant. 

Claim: The increase in requested funding comes with no increase in services offered. 

Fact: The services offered at all three county health departments are virtually identical. TRHD is increasing services by increasing our primary care services, providing Commercial Driver’s License physicals, providing Commercial Driver’s license drug tests (coming soon), providing Medicine Assisted Treatment (coming soon), providing pre-employment drug screens and we’re starting a mobile clinic in all three counties. 

Avery County has given us a retired transportation van we are making into a mobile clinic, and we have requested from Mitchell and Yancey counties to provide us retired transportation vans so we can start service in those counties as well.  

Claim: It doesn’t make a difference for Mitchell County to take its budget allocation out of its portion of the reserves from the sale of Home Health.

Fact: This will make a difference. Mitchell County’s share of the reserve is currently $712,945.  

The request for the current year (2018-19) was $319,554, but the commissioners cut that amount by $59,023 so the actual budget for the current year is $260,531, which will result in a deficit for this current year. Potentially they could spend all of their $712,945 reserve by June 30, 2020. Our concern is by spending all of their reserves there won’t be any funding in case of a rainy day. 

Claim: All three counties should pay the same share each year and should receive consistent services across the board.

Fact: Yancey County’s budget request this year was $504,832, and Avery’s was $460,565 compared to Mitchell’s $452,179. Services are the same except Yancey has School Health Centers that stay within their funding, and Yancey and Mitchell have Healthy Families, which also stay within their funding. 

We have heard the complaint that Mitchell County has paid more than its fair share over the years. Since the TRHD was formed 39 years ago, Avery County has allocated $6,738,421; Yancey $6,619,378; and Mitchell has allocated $6,395,172.

Claim: When everyone comes to the table, we’ll talk.

Fact: We would love to have a meeting to talk. 

Claim: Mitchell County taxpayers shouldn’t have to suffer.

Fact: Mitchell County is investigating the option of taking the Mitchell County Health Department out of the TRHD. This has severe consequences for the people of Mitchell County. 

There are services only a Public Health Department can provide by state law. If Mitchell County is absorbed by another health district that doesn’t share county borders, services will decrease. 

If the Mitchell County Board of Commissioners manages the health district, they will need to make arrangements for a health director or consolidate the health department with other county services under one director. 

The district model makes sense from economic and service delivery standpoints. The district model affords administrative costs to be divided between the counties involved, which lowers the cost for individual counties. 

The district model allows the health departments to run with a lower number of staff since staff can be moved from county to county as needed and in an emergency (communicable disease outbreak or natural disaster) staff from all counties can provide extra manpower and support. 

Mitchell County Health Department provided the following services for residents in 2018: medical services for approximately 2,000 residents who visited the health department more than 3,000 times, investigated 133 communicable diseases, 577 immunizations, 1,603 WIC visits, and our nurses and environmental health staff investigated 17 animal bites environmental health had 1,272 activities in its onsite program performed 372 well-water activities, 116 water samples were taken for the public to make sure their water is safe, and 385 food and lodging activities took place.  

We provide health education and other services at all schools in Mitchell County along with various health fairs, business health fairs and other events. 

We love our county, we’re dedicated to serving all residents of Mitchell County and we want to continue doing so. 

Please don’t hesitate to call or email if you have questions.

Diane Creek is Director of the Toe River Health District. She can be reached by calling 828-688-2371 or by email at  

The MItchell News

Mailing Address: PO Box 339 
Spruce Pine, NC 28777 
Phone: 828-765-7169
Fax: 828-765-1616