Knox County health commissioner warns of Medicaid shortfall, reports flu and Lyme trends

Zach Green, health commissioner at Knox Public Health, told the Knox County Board of Commissioners on March 5 that the department is navigating an $800,000 shortfall in its 2025 budget and continuing disease‑surveillance work for influenza and Lyme disease.

Green opened his quarterly update by describing recent public‑health planning meetings and a new focus on artificial intelligence. "AI is valuable," he said, but cautioned it can produce false affirmation and urged local policies and education for K–12 use. "You take a tool, you can use it for bad or for worse," Green said, arguing for standard operating procedures and school guidance.

On influenza, Green said the 2025–26 season had produced 201 cumulative cases through epidemiological week eight and 19 hospitalizations "thus far." He noted that influenza A has persisted longer than usual this season and that the expected late‑season rise in influenza B had not materialized. "It is the season so nothing surprising there," he said, while urging continued monitoring.

Green also reported Lyme disease figures: 12 confirmed cases year‑to‑date as of January and 195 confirmed cases across Knox County in 2025, which he said represents a 57% increase from 2020. He described the health department's tick‑identification service and said the department cannot test ticks for infection but can advise residents and primary‑care clinicians on follow‑up. "If it is a blacklegged deer tick we always recommend following up with primary care," Green said.

Turning to finances, Green said the department recorded an $800,000 shortfall in its 2025 annual report, attributing most of the gap to lower Medicaid reimbursement after the unwinding of eligibility. He said the department is pursuing higher wraparound reimbursement through contractors and is managing overhead carefully. "When you start looking at substantial hits to your budget ... it's not 'we just won't do that program' — it's [that] we're cutting staff members," he said, emphasizing the potential operational impacts of reduced revenue.

Green closed by urging residents to continue seeking care and by noting navigation resources: "If you are on Medicaid and services, our doors are still — you got private insurance, we'll still take you, no questions asked. Uninsured, underinsured, maybe you just lost your Medicaid coverage, we'll work with you. We'll still be able to see you. We have patient care navigator that can work and try to get you reenrolled with Ohio Department of Medicaid." He reiterated the department's emphasis on access despite budget pressure.

The board did not take a formal vote on budget actions during the March 5 meeting; Green and commissioners said they would continue monitoring revenue and service levels and coordinate on next steps.