Commissioners Handbook Chapter 47: Alcohol, Drug Addiction

Commissioners Handbook

County Commissioners Association of Ohio

209 East State Street, Columbus, OH 43215-4309

Phone: 614-221-5627

Fax: 614-221-6986

www.ccao.org

Chapter 47: Alcohol, Drug Addiction & Mental

Health Services

Last Updated: December 2023

1 Introduction

Ohio’s Alcohol, Drug Addiction, and Mental Health (ADAMH) Boards are statutorily

empowered under Chapter 340 of the Revised Code to plan, develop, fund, administer

and evaluate their local systems of mental health and addiction services. Ohio’s 50

ADAMH Boards, covering all 88 counties, provide community members with access to a

statutorily deﬁned continuum of care that includes prevention, treatment and recovery

supports.

Each ADAMH Board is governed by a robust and diverse group of volunteer community

members that understand their unique communities and the intricacies of their service

districts. Local citizen leaders are best positioned to assess local needs, determine

local priorities, create local plans, and make local decisions.

An ADAMH Board’s service district can be comprised of a single county or multiple coun-

ties. There are currently 31 single county boards and 19 joint-county boards. ADAMH

Boards are independent political subdivisions. Per numerous Ohio Attorney General

Opinions, neither single-county nor joint-county ADAMH Boards are considered to be

county ofﬁces or boards and are not subject to supervisory control by boards of county

commissioners. A map of ADAMH districts is included at the end of this chapter.

Previously, ADAMH boards were local community mental health boards. In the late

1980s, the state of Ohio added a requirement for local communities to also have alcohol

and drug addiction services boards. At that time, the ten largest communities in Ohio

had a choice to combine these two boards, or create separate boards. Since then, all

boards have combined and are now joint ADAMH Boards. Additionally, in the late 1980s,

if a county had a population of larger than 40,000, it was permitted to be a single county

board. Any counties under a population of 40,000 had to work with other counties to

create a joint district. This process is largely how the 31 single county boards and 19

Commissioners Handbook Chapter 47: Alcohol, Drug Addiction & Mental Health Services

joint-county boards were formed. It is important to note that Chapter 340 is silent on

the creation of future joint-county ADAMH Boards.

2 Board Membership and Appointment (R.C. 340.02)

The governing boards of ADAMH districts may be comprised of 9, 12, 14, 15, or 18

members. A change in board size may not occur more frequently than once every

four calendar years. To change the size of an existing governing board, the board(s) of

county commissioners must send a representative to a meeting of the governing board

to solicit feedback on the change and must consider the feedback received.

If the commissioners decide to proceed with a change after considering the feedback

received, the board(s) of county commissioners must adopt a resolution specifying the

selected board size and notify the Ohio Department of Mental Health and Addiction Ser-

vices (OhioMHAS) of the size that has been selected in order to implement the change.

In a joint-county district, the decision among the boards of county commissioners must

be unanimous. When a board size decreases, the reduction in board members must be

implemented by not ﬁlling vacancies as they occur.

2.1 Appointments

Two-thirds of governing board members must be appointed by the boards of county

commissioners and one-third by OhioMHAS.

In a joint-county ADAMH Board district, the board of county commissioners of each

participating county must appoint governing board members in as nearly as possible

the same proportion as that county’s population bears to the total population of the

district, with at least one member appointed from each participating county.

2.2 Terms of Ofﬁce

Each member is appointed for a term of four years, commencing the ﬁrst day of July,

except that one-third of initial appointments to a newly established Board must be

staggered among the members as equally as possible with terms of two years, three

years, and four years.

Governing board members may not serve for more than two consecutive four-year

terms under the same appointing authority. A member may serve for three consecutive

terms under the same appointing authority only if one of the terms is for less than two

years. A member who has served two consecutive four-year terms or three consecutive

terms totaling less than ten years is eligible for reappointment by the same appointing

authority one year following the end of the second or third term, respectively (R.C.

340.02).

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2.2.1 Removal and Vacancies

Any governing board member may be removed from ofﬁce by the appointing authority

at will after being informed in writing and afforded an opportunity for a hearing.

When a vacancy occurs, appointments for the expired or unexpired term must be made

in the same manner as the original appointment. The Board must notify the appointing

authority of any vacancy by certiﬁed mail and the appointing authority must ﬁll the

vacancy within sixty days following that notice.

2.3 Board Composition

The Ohio Department of Mental Health and Addiction services (OhioMHAS) must ensure

that, of those members appointed to a governing board, there is at least one person

that ﬁlls each of the following categories: a person who has received or is receiving

mental health services; a parent or other relative of such a person; a person who has

received or is receiving addiction services; a parent or other relative of such a person; a

clinician with experience in the delivery of mental health services; and a clinician with

experience in the delivery of addiction services. A single governing board member who

meets both qualiﬁcations may fulﬁll both clinician requirements.

If a governing board size provides for fewer than six appointments by OhioMHAS, the

board(s) of county commissioners also will be responsible for ensuring these appoint-

ments are made.

All governing board members must be residents of the service district in which they

serve and the membership must, as nearly as possible, reﬂect the composition of the

population of the service district as to race and sex. Half of the members must be

interested in mental health services and half must be interested in alcohol, drug, or

gambling addiction services.

2.4 Prohibited Conﬂicts of Interest

R.C. 340.02 prohibits governing board members and employees from engaging in the

following dual roles to avoid conﬂicts of interest:

•

Governing board members and employees of a Board are prohibited from serving

as a member of the governing board of any provider with which the Board has

entered into a contract for the provision of services or facilities.

•

Governing board members are prohibited from being an employee of any provider

with which the Board has entered into a contract for the provision of services or

facilities.

•

Employees of a Board also cannot be employed by a provider with which the Board

has entered into a contract for the provision of services or facilities unless the

Board and provider both agree in writing.

Commissioners Handbook Chapter 47: Alcohol, Drug Addiction & Mental Health Services

•

Governing board members and employees of Boards are prohibited from having a

spouse, child, parent, brother, sister, grandchild, stepparent, stepchild, stepbrother,

stepsister, father-in-law, mother-in law, son-in-law, daughter-in-law, brother-in-law

or sister-in-law that serves as a member of the governing board of any provider

with which the Board has entered into a contract for the provision of services or

facilities.

•

Governing board members and employees of Boards are prohibited from having a

spouse, child, parent, brother, sister, grandchild, stepparent, stepchild, stepbrother,

stepsister, father-in-law, mother-in law, son-in-law, daughter-in-law, brother-in-law

or sister-in-law that serves or that serves as a County Commissioner in any of the

counties in the Board’s service district.

2.5 Training Requirement

Governing board members are required to attend at least one in-service training session

each year that is provided or approved by OhioMHAS.

2.6 Current Members List

R.C. 340.08 requires ADAMH Boards to annually, and upon any change in membership,

submit to OhioMHAS a list of all current members of their governing boards, including

the appointing authority for each member, and the member’s speciﬁc qualiﬁcation for

appointment, if applicable.

3 Executive Director (R.C. 340.04 and 340.041)

The governing board of each ADAMH district is responsible for employing and setting

the compensation of an executive director that is a qualiﬁed mental health or addiction

services professional with experience in administration or a professional administrator

with experience in mental health services or addiction services.

The executive director is in the unclassiﬁed civil service but may only be removed by

majority vote of the full membership, for cause, upon written charges and after an

opportunity for a hearing before the board has been afforded upon request.

R.C. 340.041 lists speciﬁc powers and duties of the executive directors of ADAMH

Boards. One duty is to hire and remove employees and to ﬁx their compensation within

the limits of the salary schedules and positions approved by the governing board.

In addition to the speciﬁc authority of an executive director described in R.C. 340.041,

the governing board is authorized to prescribe the director’s duties and to delegate

the authority for the executive director to act in its behalf in the performance of its

administrative duties.

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4 Duties of the ADAMH Board

R.C. 340.03(B) requires ADAMH Boards to establish rules, operating procedures, stan-

dards, and bylaws, and perform such other duties as may be necessary or proper to carry

out the purposes of Chapter 340. Several of these purposes are discussed below.

4.1 Community Planning (R.C. 340.03)

ADAMH Boards are required to submit a community plan to OhioMHAS outlining the

local plans for the provision of alcohol, drug addiction, and mental health services and

supports within their service districts. During this planning period, Boards orchestrate

a process to solicit feedback from consumers, family members, community members,

and other constituents.

4.2 Community-Based Continuum of Care (R.C. 340.032 and

340.033)

ADAMH Boards are charged with ensuring that a community-based continuum of

care, inclusive of prevention, intervention, crisis, treatment, and recovery services and

supports for both mental illness and addiction, as outlined in R.C. 340.032, is available

and accessible for citizens of their Board area.

4.3 Contracts for Services and Supports (R.C. 340.036)

Local ADAMH Boards do not deliver direct services. They contract with a network of

private providers to deliver services across the continuum. It is the responsibility of

the Board to ensure the complete continuum of care is available as each provider may

not deliver every service. R.C. 340.036 contains the requirements for ADAMH Board

contracts with community addiction and mental health service providers.

4.4 Civil Commitments and Emergency Hospitalizations

Both Chapter 340 and Chapter 5122 (Hospitalization of Mentally Ill) of the Revised Code

contain various requirements for ADAMH Boards related to emergency hospitalizations

and civil commitments. Both statutes provide for persons found to be persons with

a mental illness subject to court order to be committed to ADAMH Boards or to the

contract service providers designated by ADAMH Boards. Both statutes also require

ADAMH Boards, or their designated contract service providers, to review afﬁdavits of

mental illness ﬁled with probate courts to assist the courts in determining whether the

person named in the afﬁdavit is a person with a mental illness subject to court order

and whether alternatives to hospitalization are available and appropriate.

ADAMH Boards also are required to contract with attorneys to present the case at civil

commitment hearings demonstrating that the respondent is a person with a mental

illness subject to court order. In addition, ADAMH Boards are authorized to appoint

Commissioners Handbook Chapter 47: Alcohol, Drug Addiction & Mental Health Services

health ofﬁcers that are authorized under R.C. 5122.10 to pink slip persons that are

believed to meet the criteria for emergency hospitalization.

5 Role of Boards of County Commissioners

In addition to appointing board members as previously described, the boards of county

commissioners have other statutory roles related to ADAMH Boards:

•

ADAMH Boards are required by R.C. 340.03(A)(9) to submit an annual report of the

addiction services, mental health services, and recovery supports made available

by the Board, including a ﬁscal accounting to OhioMHAS and to the board(s) of

county commissioners of the county or counties served by the Board.

•

Upon receipt of a request from an ADAMH Board, R.C. 340.07 authorizes a board

of county commissioners in the Board’s service district to appropriate money to

the ADAMH Board for the operation, lease, acquisition, construction, renovation,

and maintenance of community addiction services providers, community mental

health services providers, and facilities in accordance with the Board’s OhioMHAS-

approved budget.

•

R.C. 340.03(A)(1)(b) requires that ADAMH Boards, when setting priorities for the

operation of addiction services, consult with the boards of county commissioners

in their service districts regarding referrals for services made by a public children

services agency (PCSA) for children, or the parents, guardians and custodians of

those children, that have been identiﬁed by a PCSA as being at imminent risk of

abuse or neglected because of an addiction of a parent, guardian or custodian.

6 Required County Representation

ADAMH Boards are required under R.C. 340.30 to administer a county hub program

to combat opioid addiction in each of the counties in their respective service districts.

There are various other bodies established throughout the Ohio Revised Code that

permit or require ADAMH Board representation, including :

• Local Corrections Planning Boards (R.C. 5149.34)

• Child Fatality Review Boards (R.C. 307.621)

• County Family and Children First Councils (R.C. 121.37)

• Child Abuse and Neglect Prevention Advisory Boards (R.C. 3109.172)

• County Family Services Planning Committee (R.C. 329.06)

• Suicide Fatality Review Committees (R.C. 307.642)

• Drug Overdose Fatality Review Committees (R.C. 307.632)

Commissioners Handbook Chapter 47: Alcohol, Drug Addiction & Mental Health Services

7 Auditor and Fiscal Ofﬁcer

R.C. 340.10 designates the county auditor in a Board’s service district as the auditor

and ﬁscal ofﬁcer of a Board. For joint-county ADAMH Board districts, the creation

agreement between the member counties designates a county treasurer to serve as

custodian of the Board’s funds; the auditor of that county serves as the auditor and

ﬁscal ofﬁcer of the joint Board.

The auditor must submit to the Board a detailed monthly statement of all receipts,

disbursements, and ending balances for the community addiction and mental health

services funds.

R.C. 340.04 provides the Executive Directors of ADAMH Boards with the authority to

authorize the county auditor, or in a joint-county district the county auditor designated

as the auditor for the district, to issue warrants for the payment of board obligations

approved by the board, provided that all payments from funds distributed to the board

by OhioMHAS are in accordance with the budget submitted pursuant to R.C. 340.08,

as approved by OhioMHAS.

8 Funding for ADAMH Boards

Funding received by ADAMH Boards for addiction services, mental health services, and

recovery supports comes from a variety of sources including federal awards, General

Assembly appropriations, levy revenue where applicable, and grants received from both

public and private sources. The boards county commissioners in an ADAMH Board’s

service district may also appropriate money to Boards.

OhioMHAS is required under R.C. 340.09 to allocate to ADAMH Boards funding appro-

priated by the general assembly for the operation of ADAMH Boards and provision of

certain support functions, community-based continuum of care-related activities and

the provision of the addiction services, mental health services, and recovery supports in-

cluded in each ADAMH Board’s OhioMHAS-approved list of services and supports.

R.C. 340.10 speciﬁes that state funds allocated for the support of an ADAMH Board are

to be paid to the county treasurer or, in a joint-county district, to the treasurer of that

county designated in the agreement as custodian of the funds for addiction services,

mental health services, and recovery supports and authorizes the treasurer to make

payments from such funds on order of the county auditor and on recommendation of

the ADAMH Board, or when authorized by the board, the Executive Director.

R.C. 340.07 authorizes the board(s) of county commissioners in an ADAMH Board’s

service district, upon receipt of a resolution from the ADAMH Board so requesting,

to appropriate money to the ADAMH Board for the operation, lease, acquisition, con-

struction, renovation, and maintenance of community addiction services providers,

community mental health services providers, and facilities in accordance with the bud-

get required by section R.C. 340.08 and approved by OhioMHAS pursuant to section

R.C. 5119.22. R.C. 340.011 speciﬁes, however, that nothing in Chapters 340, 5119, or

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5122 of the Revised Code is to be construed as requiring a board of county commis-

sioners to provide resources beyond the total amount set forth in an ADAMH Board’s

OhioMHAS-approved budget and list of services and supports.

8.1 Property Tax Levies for ADAMH Services

A board of county commissioners may seek a levy pursuant to R.C. 5705.221 for the

beneﬁt of a single county ADAMH Board. The statutory purpose of a levy sought under

this section is “the operation of mental health and alcohol and drug addiction programs

and for the acquisition, construction, renovation, ﬁnancing, maintenance, and operation

of such facilities.” The levy may be for a period of up to ten years.

A joint-county ADAMH Board, as both a “taxing authority” and a “subdivision,” may seek

a levy on its own behalf under R.C. 5705.19(A) for the purpose of “current operating

expenses” of the Board. Levies sought under this section may be for a period of up to

ﬁve years.

A board of county commissioners also may seek a levy pursuant to R.C. 5705.221 for

that county’s contribution to the joint-county ADAMH Board. The purpose of a levy

sought under this section is “the operation of mental health and alcohol and drug addic-

tion programs and for the acquisition, construction, renovation, ﬁnancing, maintenance,

and operation of such facilities” and the levy may be for a period of up to ten years.

Either a joint-county ADAMH Board, or a board of county commissioners, may seek a

tax levy under R.C. 5705.191 to supplement the general fund for the purpose of making

appropriations for human or social services for a period of up to ten years.

8.2 Unique Levy Authority

Under R.C. 9.03(C), ADAMH Boards are exempt from the prohibition on political subdi-

visions using public funds to communicate or distribute information that supports the

passage of a levy. The Boards are also exempt under R.C. 9.03(D) from the prohibition

against conducting transactions of public funds to the beneﬁt of a political action com-

mittee. This unique authority is a result of R.C. 340.03(A)(7) which requires Boards to

“Recruit and promote local ﬁnancial support...from private and public sources.”

This provision is the basis of an Ohio Elections Commission Opinion (2019ELC-01)

stating that an ADAMH Board is “not required to create a political action committee

(PAC) to receive money that will be utilized to promote the passage of its tax levy since

ADAMHB’s have the unique authority under Ohio law to raise and expend funds to sup-

port their own levies pursuant to the provisions of Ohio Revised Code (RC) 340.03(A)(7),

read in concert with RC 9.03(C), and are not, therefore, a PAC pursuant to the provisions

of RC 3517.01.” The Opinion further states that if an ADAMH Board does not form a

PAC, it is not required to ﬁle campaign ﬁnance reports.

Lastly, Ohio Attorney General opinions have held that the R.C. 340.03(A)(7) requirement

also authorizes ADAMH Boards to promote their levies and to expend public funds and

staff time to do so.

Commissioners Handbook Chapter 47: Alcohol, Drug Addiction & Mental Health Services

8.3 Capital Improvements Account / Reserve Balance (R.C.

5705.221)

Pursuant to R.C. 5705.221(C), upon receipt of a resolution from an ADAMH Board, the

county auditor who is the ﬁscal ofﬁcer of an ADAMH Board, must establish for the

ADAMH Board a capital improvements account or a reserve balance account, or both,

as speciﬁed in the resolution. The capital improvements account is a contingency fund

for the necessary acquisition, replacement, renovation, or construction of facilities and

movable and ﬁxed equipment. Upon the request of the board, funds not needed to

pay for current expenses may be appropriated to the capital improvements account, in

amounts such that the account does not exceed 25% of the replacement value of all

capital facilities and equipment currently used by the board for programs and services.

Other funds which are available for current capital expenses from federal, state, or local

sources may also be appropriated to this account.

The reserve balance account is to contain funds that are not needed to pay for current

operating expenses and not deposited in the capital improvements account but that will

be needed to pay for operating expenses in the future. Upon the request of an ADAMH

Board, such funds must be appropriated to the reserve balance account. Payments

from the capital improvements account and the reserve balance account must be made

by the county treasurer who is the custodian of funds for the district upon warrants

issued by the county auditor who is the ﬁscal ofﬁcer of the district pursuant to orders

of the ADAMH Board.

9 Withdrawing from Joint County Districts (R.C.

340.01(B))

The board of county commissioners of a county that is part of a joint-county ADAMH

Board may submit a resolution requesting withdrawal from the district along with a

comprehensive plan that complies with rules adopted by the Director of OhioMHAS

under R.C. 5119.22. The plan must include proposed bylaws for the new board; proposed

list of board members proposed list of services to be made available including inpatient,

outpatient, prevention, and housing; provision for employment of an executive director;

and plan for ensuring no disruption in services and equitable adjustment and division of

all services, assets, property, debts and obligations of the joint-county ADAMH Board.

The resolution and comprehensive plan must be submitted to the joint-county ADAMH

Board, the boards of county commissioners of each county in the district, and the

Director of OhioMHAS.

The Director of OhioMHAS is required to approve the plan within one (1) year after the

resolution to withdraw was approved by the board of county commissioners. With-

drawal requires the consent of the Director and cannot take effect earlier than one (1)

year after submission of the resolution unless all of the participating counties agree to

an earlier withdrawal. Any county withdrawing from a joint-county district will continue

to have levied against its tax list and duplicate any tax levied by the district during the

Commissioners Handbook Chapter 47: Alcohol, Drug Addiction & Mental Health Services

period in which the county was a member of the district, until such time as the levy

expires or is renewed or replaced.

This Chapter provides an overview of ADAMH Boards and their statutory responsibili-

ties. For more detailed information, please see the Auditor of State’s Behavioral Health

Handbook located on the “Publications” page of the Auditor’s website.

10 Acknowledgment

The County Commissioners Association of Ohio expresses its gratitude to the Ohio

Association of County Behavioral Health Authorities (OACBHA) who prepared this

chapter of the handbook.

Contact Information

Please contact the following Policy Team staff member with any questions:

Rachel Massoud Reedy, Outreach & Member Engagement Manager

rreedy@ccao.org, 614-220-7996