CHARLESTON, W.Va. -- In the wake of the Putnam County Health Department's financial woes, Kanawha health officials say many Putnam County residents are visiting the Kanawha-Charleston Health Department for clinical services.It's not clear if the Putnam County Health Department is no longer offering those services, said Dr. Rahul Gupta, executive director of the Kanawha-Charleston Health Department.Gupta told the Kanawha-Charleston Board of Health on Thursday that there's been a spike in the number of people seeking clinical services at the Kanawha agency. "We are seeing much more people coming from that side of the state," Gupta said. He added that in a given year, his health department treats people from all over the state and from many different states.Joel McKinney, who has been administrator for the Putnam County Health Department since February, recently applied for $186,000 from the local board of health emergency fund through the state Department of Health and Human Resources.The Putnam health department owes money for rent, vaccine costs, attorney fees, federal and state taxes and to the state Office of Technology. Legal fees stemming from a wrongful termination lawsuit caused the debt, officials say.Each year the state withholds 2 percent of each local health department's state funding, Gupta said. That withheld money makes up the emergency funds. If the emergency funds are not used, each health department gets that money back, he said."The point is we are aware also through public reports that they have applied for $186,000 or something in public funding so obviously we're not going to get our 2 percent back," Gupta said.Kanawha-Charleston's portion of the emergency funds has been in the range of $30,000 for the past several years, said Lolita Kirk, director of administrative services for the health department.Kirk said she's reached out to Putnam County health officials, but hasn't heard back.Among Kanawha County health officials' concerns are whether they should count on having to offer more school vaccines and flu vaccines if Putnam County will not offer them, Gupta said."Flu vaccine orders usually go well ahead of six months in advance so we need to know," he said. "There's a lot of planning that goes into place for clinical services."Also at the meeting, Gupta told the health board the department will have $31,000 less funding for the 2014 fiscal year, which begins in July, because of a change in the formula the state uses to allocate money to local health departments.The health department's divisions have been restructured recently, Gupta told the health board.The department's former Health Promotion division will be encompassed by a new division called Prevention and Wellness, Gupta said.The new division will also include chronic disease management, aging, and worksite health."It aligns much better with the future of health reform and the way the Affordable Care Act is structured," Gupta said.It will also help the department apply for funding through the ACA, he said.Sara Fitzwater, a new employee, is the acting director of the Prevention and Wellness division as well as the Community Transformation Grant program, Gupta said. The department may hire more people in the future for that division.The department has also hired Thomas Sims as performance management coordinator, Gupta said. Sims' job will be to help the department through the process of becoming nationally accredited by the Public Health Accreditation Board. Accreditation is so far optional for local health departments."Most mandatory things start out voluntary," Gupta said.Becoming accredited will cost about $27,000 in fees, Sims told the board.In other business, the health board approved the department's budget for the 2014 fiscal year. That budget includes 2 percent across the board raises for full-time employees. Reach Lori Kersey at email@example.com or 304-348-1240.