Manassas questions doubled cost, need for proposed county health department

A plan to create a local health department was met with critical reception at a Manassas City Council meeting.

Prince William County leaders want to replace the county’s Health District Office, operated by the state government, with a health department under its control. The new health office would provide services for county residents, and for those who live in the independent cities of Manassas and Manassas Park.

Under the plan, the county would take over five existing health district offices and all its services, from immunizations to women’s health assistance. The county health department could be operational by July 1, 2023, a year later than anticipated, with a $12.3 million budget.

Acting Prince William County Executive Elijah Johnson paid a visit to the Manassas City Council on Monday, April 18, to discuss the transition and to tout the benefits of a county takeover of the local healthcare office. “The state is not funding the Health District at its full capacity,” said Johnson. “It has been understaffed and underfunded.”

The transition would give local government departments like housing assistance and planning and zoning “a seat at the table” when it comes to helping the county reach its health goals, while at the same time provide affordable housing and create walkable communities, explained Johnson. Currently, these local government offices have “advisory roles at best” when it comes to healthcare input, said Johnson.

A transition to local control would also benefit as existing state healthcare employees become county workers and get a bump in pay and benefits in what the county calls “pay equity.”

The call for a health department takeover came during the pandemic. County leaders grew frustrated when they asked for specific coronavirus infection rates in particular county zip codes. During the early days of the vaccine rollout, they couldn’t get a straight answer when they asked whey fewer minorities were choosing to not to get the jab.

According to Johnson, when it came to opening mass coronavirus vaccination clinics at a former Gander Mountain store in Woodbridge and a clinic at Manassas Mall, the county had to step in and expedite lease negotiations to open the vaccination sites. According to Johnson, opening the locations would have taken months, not weeks, if left up to the state’s slower procurement processes.

When Prince William leaders learned neighboring Loudoun County was vying to create a local health department similar to Fairfax County, they sprang into action. Margaret Franklin, who represents Woodbridge on the Board of County Supervisors, pushed state legislators in 2021 to allow Prince William to piggyback on the Loudoun County legislation allowing the county to start its health department.

Currently, the state healthcare office serves Prince William County and the independent cities of Manassas and Manassas Park. For the county’s plan for a local health department to work, it needs the cities on board with the program.

“This is just me talking, but if all three jurisdictions don’t come together, this will not happen,” Johnson told elected leaders in Manassas.

According to initial budget estimates, Manassas and Manassas Park residents would need to pay double what they currently pay the state to operate the existing health district office. Manassas’ annual payment for local health services would double to $492,000, while Manassas Park, at $198,000 a year, would pay $123,000 more each year.

Prince William County, the largest of the three jurisdictions, would bear 89% of the cost at $5.5 million a year, while an estimated $6 million in state funding, grants, and fees would be used to fund the remainder of the department’s budget.

According to Johnson, the county’s health department would provide the same level of service from the same offices, at least for the first few years of operation, despite the increased cost.

“I don’t understand the advantage,” said Manassas City Councilwoman Theresa Ellis. “I get that the new department will be more locally controlled, but [the increase in funding] is a huge jump for services that we don’t get to control.”

There is one public health office in Manassas, at 9301 Lee Avenue, next to the county courthouse. City leaders say residents should expect more if the city were to join the county’s health department.

“To double what we’re paying into the health department, for people who live here and want better access, it would be irresponsible not to provide [more services],” said Manassas Vice Mayor Pamela Sebesky.

Sebesky said more county than city residents would benefit from the local health department, similar to a “shared services” agreement the city has with the county to provide library access. Before a new branch library opened inside a Manassas shopping center in 2021, most patrons at Central Library, located just outside the city, were county residents.

Councilwoman Lynn Forkell Greene asked Johnson to estimate the number of city residents who would use the local health department. Johnson did not have the information.

About half of the proposed health department’s budget will come from state funding and grants. If those funding sources run out and costs rise, the jurisdictions would be left to fill in the gaps.

“Yes, it’s costing us more money to do this,” said Johnson. “The overhead cost the state is covering right now will be passed down to the local health department, so we’re not going to get any savings by doing this.”

Johnson encouraged city leaders to continue its talks with the county about the new health department. Johnson said he’s hopeful the county will to reach an agreement with Manassas and Manassas Park by August.