97-005
Health district per diem
Cite as 1997 Ohio Op. Att'y Gen. No. 97-005
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1997 Opinions
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OPINION NO. 97-005
Syllabus:
1.
A person who serves as a member of a board of health of a general health
district is a public officer for purposes of the prohibition in Ohio Const.
art. II, §20 against ill-term changes in compensation. (1979 Op. Att'y Gen.
No. 79-102, approved and followed.)
2.
Payments made to a member of a board of health of a general health district
pursuant to R.C. 3709.02 are within the purview of the prohibition in Ohio
Const. art. II, §20 against in-term changes in compensation. (1979 Op.
Att'y Gen. No. 79-102, approved and followed.)
3.
The amendments to R.C. 3709.02 enacted by the General Assembly in Am.
Sub. H.B. 117, 121st Gen. A. (1995) (eff., in part, Sept. 29, 1995) affect
the payments received by members of a board of health of a general health
district under that section and constitute a change in compensation for
purposes of the prohibition in Ohio Const. art. II, §20 against in-term
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changes in compensation. Therefore, a person serving as a member of a
board of health of a general health district on the effective date of those
amendments may not be paid in the manner specified by those amendments.
To: Charles E. Coulson, Lake County Prosecuting Attorney, Painesville, Ohio
By: Betty D. Montgomery, Attorney General, January 8, 1997
You have requested an opinion regarding the eligibility of members of a board of health
of a general health district to be paid in accordance with certain amendments to RC. 3709.02.
Your question is prompted by the prohibition in Ohio Const. art. II, §20 against in-term changes
in the compensation of public officers and the conclusions in 1979 Op. Att'y Gen. No. 79-102
regarding the application of that prohibition to members of a board of health of a general health
district. In the light of that prohibition and its interpretation in Op. No. 79-102, you wish to
know whether members of a board of health of a general health district who held their positions
on the effective date of those amendments may be paid in the manner specified by those
amendments.
R.C. 3709.02 provides for the appointment and payment of members of a board of health
of a general health district. See R.C. 3709.02(A)-(C).1 In Am. Sub. H.B. 117, 121st Gen. A.
(1995) (eff., in part, Sept. 29, 1995), the General Assembly amended R.C. 3709.02 for the
purpose, inter alia, of modifying the formula for calculating the amount to be paid each member
of a board of health for the member's attendance at meetings of the board. Am. Sub. H.B. 117
also modified the criteria for calculating the amounts to be received by a member of a board of
health for expenses incurred by the member for travel to and from meetings of the board and
certain conferences.
In this instance you have asked about the eligibility of members of a board of health of a
general health district to be paid in accordance with the amendments to RC. 3709.02 as set forth
in Am. Sub. H.B. 117. Specifically, your question concerns members of a board of health
serving in their positions on September 29, 1995, which is the date upon which those amendments
became effective.
Let us first review the matters addressed in Op. No. 79-102. Section 20 of article II of
the Ohio Constitution prohibits in-term changes in the compensation of public officers in the
following manner: "The general assembly, in cases not provided for in this constitution, shall fix
the term of office and the compensation of all officers; but no change therein shall affect the salary
RC. 3709.03 grants a general health district advisory council the authority to appoint the
members ofthe board of health ofa general health district. See generally 1995 Op. Att'y Gen. No.
95-030. However, R.C. 3709.03 also provides that if the district advisory council fails to meet or
appoint a member of the board of health as required thereunder or by R.C. 3709.02, the Director of
Health, with the consent of the Public Health Council, "may appoint the member." See Am. Sub.
H.B. 355, 121st Gen. A. (1996) (eff. April 2, 1996). See also R.C. 3709.04 (if in any general health
district the district advisory council fails to meet or to select a board of health, the Director of Health
may, with the consent of the Public Health Council, "appoint a board of health for such district
which shall have and exercise all powers conferred on a board of health of a I!eneral health district")'
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of any officer during his existing term, unless the office be abolished." In Op. No. 79-102 the
Attorney General was asked whether members of a board of health of a general health district are
public officers for pUrpOSes of the foregoing constitutional prohibition. The question was
prompted by legislation enacted by the General Assembly for the purpose of alTlending R.C.
3709.02 to read, in pertinent part, as follows:
Each member of the board shall be paid twenty dollars a day and mileage
at the rate of fifteen cents a mile to and from the place of meeting to cover the
actual and necessary expenses inCurred during his attendance at any meeting of the
board and not exceeding five meetings of board committees in anyone year.
See 1977-1978 Ohio Laws,Part II, 3701 (H.B. 1009, eff. March 8, 1979). Prior to. this
amendment, RC. 3709.02 had provided, in pertinent part, as follows:
Each member of the board shall be paid six dollars a day and mileage at the
rate of eight cents a mile to and from the place of meeting to cover the actual and
necessary expenses incurred during his attendance upon any meeting of the board
not exceeding twelve meetings in anyone year.
See 1967-1968 Ohio Laws. Parts I & II. 1211.2245 (Am. S.B. 257, eff. Nov. 24, 1967).
In response the Attorney General advised that members of a board of health of a general
health district are public officers for purposes of the prohibition in Ohio Const. art. II, §20, and
therefore such board members "may not receive an increase in compensation during their existing
terms of office." Op. No. 79-102 (syllabus, paragraph one). In arriving at this conclusion the
Attorney General determined that members of aboard of health hold a public office as defmed by
the Ohio courts, and thus are public officers. Op. No. 79-102 at 2-314. In support of that
determination the opinion relied upon the decisions of the Ohio Supreme Court in State ex rei.
Gordon v. Zangerle, 136 Ohio St. 371,381,26 N.E.2d 190, 196 (1940), and State ex rei. Landis
v. Board o/Comm'rs ofButler County, 95 Ohio St. 157, 159, 115 N.E. 919,919 (1917). Those
decisions set forth and approved the common law criteria for determining whether a particular
position is a public office rather than a position of employment.
The Attorney General then considered whether payments to a member of a board of health
under RC. 3709.02 were within the purview of Ohio Const. 8rt. II, §20, and, if so, whether the
amendments to RC. 3709.02 in H.B. 1009 effected an increase in those payments that could not
take effect during a board member's existing term of office. Op. No. 79-102 answered each of
those inquiries in the affirmative.
Regarding the scope of the constitutional prohibition, Op. No. 79-102 explained that the
Ohio Supreme Court has read the prohibition broadly, such that it applies to various types of
payments made to and received by public officers. In that regard Op. No. 79-102 cited the
decisions of the court in State ex rei. Artmayer v. Bd. ojTrustees, 43 Ohio St. 2d 62, 330 N.E.2d
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684 (1975), and State ex reI. Parsons v. Ferguson, 46 Ohio St. 2d 389,348 N.E.2d 692 (1976)..
. In State ex rei. Artmayer v. Bd. of Trustees the court. held that the terms "salary" and
"compensation," as used in Ohio Const. art. II, §20, are synonymous. In so holding the court
expressly overruled its earlier decisions in Thompson v. Phillips, 12 .Ohio St. 617 (1861), and
Gobrecht v. Cincinnati, 51 Ohio St. 68, 36 N.E. 7.82 (1894), which had held to the contrary. See
also State ex rei. DeChant v. Keiser, 133 Ohio St. 429, 14 N.E.2d 350 (1938) (rejecting the
argument that the words "compensation'" and "salary" as used in Ohio Const. art. II, §20 are not
synonymous); Slate ex rei. v. Raine, 49 Ohio St. 580,31 N.B. 741 (1892) (syllabus) ("[a] statute,
whatever terms it may employ, the only effect of which is to increase the salary attached to a
public office, contravenes [Ohio Const. art. II, §20], in so far as it may affect the salary of an
incumbent of the office during the term' he was serving when the statute was enacted"); cf State
ex rei. Boyd v. Tracy, 128 Ohio St. 242, 253, 190 N.E. 463, 468 (1934) (considering a similar
prohibition in Ohio Const. art. 1I,§31 applicable to members of the General Assembly, and
expressing the view that the terms "salary" and "compensation" "do not mean a thing when cases
of this character' are being considered, the whole question being, 'Can the number of dollars
payable to an incumbent of a public office be increased by the enactment of a statute during his
term of office?"').
In State ex rei. Parsons v. Ferguson the court further determined that the term
"compensation," as used in Ohio Const. art. II, §20, encompasses fringe benefits extended to a
.public officer, including premium payments tnade to secure.health insurance for the public officer:
Fringe benefits, such as',the payments made here, are valuable perquisites
of an office, and are as much a p~rt of the compensations of office as a weekly pay
check. It is obv~ous that an office holder is benefitted [sic] and enriched by having
his insurance bill paid'out of public funds, just as he would be if the payment were
made directly to him, and only then transmitted to the insurance company.
46 Ohio St. 2d at 391, 348 N.E.2d at 694. Accordingly, such payments for fringe benefits "may
not constitute 'salary,' in the strictest sense of that word, but they are compensation." [d.
Applying the statements of the Ohio Supreme Court in State ex rei. Artmayer v. Bd. of
Trustees and State ex rei. Parsons v. Ferguson, Op. No. 79-102 determined that the types of
payments made to a member of aboard of health under R.C. 3709.02 are subject to the strictures
of Ohio Const. art. II, §20. Op. No. 79-102 further-determined that the legislation in question
affected those payments in a manner that was prohibited by those strictures, and thus advised that
such changes could not be implemented during a board member's existing term of office.
Op. No. 79-102 is correct in its conclusion that a member of a board of health of a general
health district is a public officer for purposes of Ohio Const. art. II, §20. In particular, Op. No.
79-102 accurately assessed the nature of the duties, powers, and responsibilities conferred upon
the members of a board of health by the statutory provisions that appear in R.C. Chapter 3709,
and appropriately drew therefrom the inference that such board members, in the course of
fulfilling their statutory responsibilities, exercise continuing and independent governmental
functions. See also 1995 Op. Att'y Gen. No. 95-030 at 2-150 (reviewing the general powers and
duties conferred upon a board of health of a general health district by the provisions of R.C.
Chapters 3707 and 3709). It is apparent, in other words, that the powers thus conferred upon the
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members of a board of health of a general health district "constitute apart of the sovereignty of
the state. II State ex rei. Landis v. Board of Comm 'r$ of Butler County, 95 Ohio St. at 160,115
N.E. at 920. See also State ex rei. Milburn v.Pethtel, 153 Ohio St. 1; 90 N.E.2d 686 (1950)
(citing with approval State ex rei; Landis v; Board o!Comm'rs of Butler County); Scofield v.
Strain~ 142 Ohio St. 290,,51 N.E.2d 1012 (1943) (same); 1985 Op. Att'y Gen. No. 85-036at 2
127; 1971 Op. Att'y Gen. No.71-071 at 2-242 and 2-243j 1963 Op. Att'y Gen. No. 3548,p. 58,
at 61 ("[t]he requisite elements of public office are: (1) the incumbent must exercise certain
independent public duties; a part of the sovereignty of the state;' (2) such exercise by the
incumbent must be by virtue of his election or appointment to the office; (3) in the exercise of the
duties so imposed, he can not be subject to the direction and control 'of asuperior officer"). It
follows, therefore, that a member of a board of health ofa general health district is a public
officer for purposes of Ohio Const. art. II, §20.
We also agree with the detennination in Op. No. 79-102 that paYluents made to a member
of a board of health of a general health district pursuant to R.C. 3709.02 are subject to the
prohibition in Ohio Const. art. II, §20 against in-term changes in compensation. In reaching that
conclusion Op. No. 79-102 correctly interpreted and applied the statements of the Ohio Supreme
Court regarding the categories of payments that are within the purview of' the constitutional
provision.2 This means that changes enacted by the General Assembly that affect payments made
pursuant to R.C. 3709.02, whether by' way,of increase or decrease, may not be implemented and
applied to a member of a board of health during the member's existing term of office. See, e.g.,
1993 Op. Att'y Gen. No. 93-045 (syllabus, paragraph one) (where a board of county
2
In 1985 Op. Att'y Gen. No. 85-036 the Attorney General approved the conclusion thus
reached in 1979 Op. Att'y Gen. No. 79-102, and reiterated at2-127 and 2-128 that Ohio Const. art.
II, §20 covers both salary and expenses paid to a public officer:
It is by now well established that art. II, §20 prohibits a public officer from
receiving, during his term, not only an increase in his fixed salary, but also an
increase in the amount allowed him for the expenses he incurs in performing his
official duties. In State ex reI. v.Raine, 49 Ohio St. 580, 31 N.E. 741 (1892), the
court addressed the issue whether incumbent county commissioners could receive the
benefit of a newly enacted statutory provision allowing commissioners one thousand
dollars per year for expenses incurred in the discharge of their duties. The court
concluded that the allowance constituted salary for purposes of Ohio Const. art. II,
§20 and thus could not be paid to a commissioner who held his office when the
provision was enacted. In State ex rei. Boyd v. Tracy, 128 Ohio St. 242, 190 N.E.
463 (1934), the court discussed the application of Ohio Const. art. II, §31,which
prohibits members of the General Assembly from receiving in-term increases in
compensation, to a statute which granted legislators a sum sufficient to pay expenses,
but which was not to exceed four dollars per day for room and board. The court
concluded that such reimbursement for expenses was compensation which could not
be paid to incumbent legislators. Stat~ ex rei. Harbage v. Ferguson, 68 Ohio App.
189,36 N.E.2d 500 (Franklin C;:ounty 1941), appeal dismissed, 138 Ohio St. 617, 37
N.E.2d 544 (1941), although not specifically dealing' with in-term increases,
concluded that reimbursement for a legislator'S travel expenses constitutes part of his
compensation for purposes of art. II, §31.
'
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commissioners decreases the percentage of the premium paid by the county on behalf of county
officers and employees for insurance coverage provided under R. C. 305.171, without any change
in the amount of coverage thus provided, such a decrease constitutes a change in salary for
purposes of Ohio Const. art. n, §20, and may not be applied to a county officer during the term
of office the officer was serving at the time such decrease became effective); 1992 Op. Att'y Gen.
No. 92-031 at 2-120 (Ohio Gonst. art. II, §20 "prohibits any change, whether an increase or
decrease, in an officer's salary during his term"); 1945 Op. Att'y Gen. No. 387, p. 473 (when
the General Assembly, pursuant to Ohio Const. . art. II, §20, has fixed the compensation orany
officer, whether by way of salary or fees or both, any change in such compensation effected by
the enactment, amendment, or repeal of any law, shall not operate to increase or decrease the
compensation of such officer during his existing term, unless the office be abolished).
The remaining task is to determine whether the amendments to R.C. 3709.02 enacted by
Am. Sub. H.B. 117, 121st Gen.A. (1995) (eff., in part, Sept. 29, 1995) have affected the
payments that may be made to members of a board of health of a general health district under that
section. This requires a comparison of R.C. 3709.02, as amended by Am. Sub. H.B. 117 in
1995, with the version of that statute that was enacted by the General Assembly in Am. S.B. 297
in 1992. See 1991-1992 Ohio Laws, Part I. 1741 (Am. S.B. 297, eff. April 16. 1993).
As enacted by Am. S.B. 297, R.C. 3709.02 provided the following with regard to
payments to be made to each member of a board of health of a general health district for mileage
and the actual and necessary expenses incurred by the member in attending meetings of the board
and its committees:
Each member ofthe board may be paid a sum not to exceed eighty dollars
a day and mileage to and from the place of meeting at the rate established by the
director of budget and management pursuant to section 126.31 of the Revised Code
to cover the actual and necessary expenses incurred during his attendance at any
meeting of the board and not exceeding five meetings of board committees in any
one year. 3 (Footnote added.)
As amended by Am. Sub. H.B. 117, R.C. 3709.02 states, in pertinent part, as follows:
(B) Each member of the board shall be paid a sum not to exceed eighty
dollars a day for the member's attendance at each meeting of the board. No
member shall receive compensation for attendance at more than eighteen meetings
in any year.
(C) Each member of the board shall receive travel expenses at rates
established by the director of budget and management pursuant to section 126.31
of the Revised Code to cover the actual and necessary travel expenses incurred for
In 1994 Op. Att'y Gen. No. 94-023 (syllabus), the Attorney General advised that R.C.
3709.02, as enacted by 1991-1992 Ohio Laws, Part 1,1741 (Am. S.B..297, eff. April 16, 1993),
entitled a member of a board ofhealth of a general health district to be paid "for mileage travelled
to and from each meeting listed in that statute at the rate established by the Director of Budget and
Management in 3 Ohio Admin. Code 126-1-02(C)," and, in addition, "an amount not to exceed
eighty dollars per day for those necessary expenses that the member actually incurs in attending such
meeting."
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travel to and from meetings that take place outside the county in which the member
resides, except that any member may receive travel expenses for registration for
any conference that takes place inside the county in which the member resides. 4
(Footnote added.)
Am. Sub. H.B. 117 has separated the provisions ofRC. 3709.02 into five divisions. That
legislation has also made several substantive revisions with respect to the· matters addressed in
those divisions. Division (B) of R.C. 3709.02 provides that each member of a board of health
of a general health district shall be paid a sum not to exceed eighty dollars a day for the member's
attendance at each meeting of the board, and also provides that no member shall receive
compensation for attendance at more than eighteen meetings in any year. Division (C) of RC.
3709.02 provides that each member of the board shall receive travel expenses at rates established
by the Director of Budget and Management pursuant to RC. 126.31 to cover the actual and
necessary travel expenses incurred for travel to and from meetings that take place outside the
county in which the member resides. R.C. 3709.02(C) also provides that any member of a board
of health may receive travel expenses for registration for any conference that takes place inside
the county in which the member resides.
In section 1 of Am. Sub. H.B. 355, 121st Gen. A. (1996) (eff. Apri12, 1996), the General
Assembly has since amended R.C. 3709.02 to read, in pertinent part, as follows:
Each member of the board may be paid a sum not to exceed eighty dollars a
day and mileage to and from the place of meeting at the rate established by the
director of budget and management pursuant to section 126.31 of the Revised Code
to cover the actual and necessary expenses incurred during attendance at any meeting
of the board and not exceeding five meetings of board committees in anyone yew.
Section 2 of Am. Sub. H.B. 355 also states that existing section 3709.02, inter alia, is "hereby
repealed."
It is apparent that Am. Sub. H.B. 355 did not take into account the amendments to R.C.
3709.02 enacted earlier in Am. Sub. H.B. 117. In such a situation R.C. 1.52(B) provides the
following rule of construction:
If amendments to the same statute are enacted at the same or different
sessions of the legislature, one amendment without reference to another, the
amendments are to be harmonized, if possible, so that effect may be given to each.
If the amendments are substantively irreconcilable, the latest in date of enactment
prevails. The fact that a later amendment restates language deleted by an earlier
amendment, or fails to include language inserted by an earlier amendment, does not
of itself make the amendments irreconcilable. Amendments are irreconcilable only
when changes made by each cannot reasonably be put into simultaneous operation.
It is unclear whether the amendments to R.C. 3709.02 enacted in Am. Sub. H.B. 117 and Am. Sub.
H.B. 355 are substantively irreconcilable, or whether those amendments can be harmonized and
reasonably put into simultaneous operation.
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Am. Sub. H.B. 117 has thus limited the number of meetings of a board of health of a
general health district for which a board member may be paid a sum not exceeding eighty dollars
a day for his attendance; the limitation is eighteen meetings in any year. The prior version of
RC. 3709.02 imposed no limitation on the number of board meetings for which a member could
be paid, yet limited to five per year the number of board committee meetings for which a member
could be paid. In another departure from the prior law, Am. Sub. H.B. 117 has also eliminated
,the authorization to pay each member of a board of health a sum not exceeding eighty dollars a
day for the member's attendance at no more than five board committee meetings in,any one year.
Moreover, Am. Sub. H.B. 117 no longer limits these payments to only those amounts that cover
the actual and necessary expenses incurred during the member's attendance at board meetings.
See note three, supra.
Regarding travel expenses, Am. Sub. H.B. 117 limits payment to the actual and necessary
travel expenses that are incurred by a board member for travel to and from board meetings that
take place (Jutside the county in which the member resides, with the exception that a member may
receive travel expenses for registration for any conference that takes place inside the county in
which the member resides. Previously, RC. 3709.02 made no mention of the location of
meetings of a board of health for purposes of paying mileage reimbursement to a member who
travelled to and from those meetings, nor did the statute authorize the payment of mileage for
travel expenses incurred by a member fof, registration for any conference held within the county
in which the member resides.
Accordingly, the amendments thus enacted by the General Assembly in Am. Sub. H.B.
117 affect the payments received by a member of a board of health of a general health district
under RC. 3709.02 and constitute a change in compensation for purposes of the prohibition in
Ohio Canst. art. II, §20 against in-term changes in compensation. In Am. Sub. H.B 117 the
,General Assembly has substantially revised the statutory scheme pursuant to which members of
a board of health are paid in connection with their attendance at meetings of the board.
Am. Sub. H.B. 117 has omitted from RC. 3709.02 the requirement that a sum not
exceeding eighty dollars a day is to be paid to a board member for the member's "actual and
necessary expenses" incurred during the member's attendance at meetings of a board of health.
This means that a board member's receipt of a sum not exceeding eighty dollars a day during the
member's attendance at meetings of the board no longer must correspond to a specific amount of
expenses actually and necessarily incurred by the member during that attendance. 5 The likely
effect of this change, therefore, is to increase the amount that a member of a board of health may
receive for the member's attendance at meetings of the board.
Assume, for example, that a board member actually incurred forty dollars in necessary
expenses during his attendance at a meeting of the board of health. Under the prior version of
In other words, under R.C. 3709.02(8), the amounts paid to a member ofa board of health
for attending meetings of the board more nearly approximate compensation for services rendered
rather than reimbursement for expenses incurred, and indeed the statute expressly designates these
amounts as "compensation."
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RC. 3709.02, this member would be entitled to be paid no more than forty dollars because that
is the amount of expenses he actually and necessaiily incurred during his attendance at the board
meeting. Under the current version of R.C. 3709.02, however, this same board member is
eligible to receive a sum not exceeding eighty dollars for the member's attendance at the board
meeting, notwithstanding that the board member actually incurred only forty dollars in necessary
expenses. This represents an increase in the, amount for which the board member is eligible to
be paid under RC. 3709.02(B).
Conversely, RC. 3709.02(B) now limits to eighteen per year the number of meetings of
a board of health for which a member shall be paid for his attendance. Insofar as the prior version
of R.C. 3709.02 imposed no limitation upon the number of board meetings for which a member
could be paid in any year, this new limitation could decrease the aggregate amount of payments
received by a member of a board of health'for,the member's attendance at meetings of the board.
Similarly, the elimination of the authoriZation to pay, a 'member of a board of health for the
member's attendance at no more than five board committee meetings in anyone year could result
in a decrease in the aggregate amount of payments made to a board member.
Finally, Am. Sub. H.B. 117 limits payment of a board member's travel expenses to only
those meetings of a board of health that occur outside the county in which the member resides.
In addition, Am. Sub. H.B. 117 now authorizes payment of a board member's travel expenses for
registration for any conference that takes place inside the county in which the member resides. 6
The prior version of RC. 3709.02 provided no such authorization. It would appear that in most
circumstances, the effect of these changes will be to decrease the aggregate amount of payments
made to a member of a board of health for the member's travel expenses.
The amendments to R.C. 3709.02 enacted by the General Assembly in Am. Sub. H.B.
117, therefore, affect the payments received by members of a board of health of a general health
district under that section and constitute a'change in compensation for purposes of the prohibition
in Ohio Const. art. II, §20 against in~term changes in compensation. Therefore, a person serving
as a member of aboard of health of a general health district on the effective date of those
amendments may not be paid in the manner specified by those amendments.
It is, therefore, my opinion, and you are advised that:
1.
A person who serves as a member of a board of health of a general health
district is a public officer for purposes of the prohibition in Ohio Const.
R.C. 3709.02(C) states that each member of a board of health of a general health district
"may receive travel expenses for registration for any conference that takes place inside the county
in which the member resides." (Emphasis added.) The statute makes no mention, however, ofa
member:s travel expenses for attendance at any such conference. In that respect, therefore, the
statute i'g ambiguous.
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art. II, §20 against in-term changes in compensation. (1979 Op. Att'y Gen.
No. 79-102, approved and followed.)
2.
Payments made to a member of a board of health of a general health district
pursuant to R.C. 3709.02 are within the purview of the prohibition in Ohio
Const. art. II, §20 agai~st in-term changes in compensation. (1979 Op.
Att'y Gen. No. 79-102, approved and followed.)
3.
The amendments to R.C. 3709.02 enacted by the General Assembly in Am.
Sub. H.B. 117, 121st Gen. A. (1995) (eff., in part, Sept. 29, 1995) affect
the payments received by members of a board of health of ageneral health
district under that section and constitute a change in compensation for
purposes of the prohibition in Ohio, Const. art. II, §20 against in-term
changes in compensation. Therefore, a person serving as a member of a
board of health of a general health district on the effective date of those
amendments may not be paid in the manner specified by those amendments.