The March 5 Marion County Board of Health meeting welcomed two new members, Rebecca McKay and Karen Goff. The inaugural session of the board for the duo was filled with issues raised by Marion County Supervisor Craig Agan.
One of the first issues was in regard to the board’s budget. Through discussion at the health board meeting, it was learned that the original budget proposed by Director Kim Dorn asked for $422,000 for Public Health. The supervisors, according to Agan, asked her to reduce that request by $20,000. Additionally, the supervisors asked her to cut $12,000 from the Environmental Health portion of the budget.
Dorn said she could not find $12,000 to cut from Environmental Health without it affecting staff. The department, which began in 2008 with one staff member, has three today. Agan was concerned about the department’s growth. Environmental Health, according to Dorn and Environmental Health Director Cory Frank, has taken on inspection duties that were once the responsibility of the State. All three employees are full-time, and the reduction would have made one of them part time.
Environmental Health was founded with one staff member, Frank. Frank said the addition of the first employee was due to increased duties for the office. This employee was working for the Auditor’s Office, then split time with Environmental Health as work with the auditor decreased. She officially transferred later. The third employee was added to guarantee services as the state became less dependable.
Factored into Public Health’s budget request was a 2 percent wage increase for employees. The department had originally sought 3 percent, but the supervisors have asked every department keep pay increases to 2 percent or below.
Those on the County payroll are also being asked to contribute a portion of the cost of individual health insurance policies, whereas no contribution was sought in years past. Those on family plans will continue to contribute to those costs.
Dorn repeatedly asked Agan for a final number the supervisors intended to provide Public Health and she would work from there. Agan said he thought it was clear the number was $402,000, when the supervisors asked for the $20,000 cut to her original proposal.
She proposed cuts, totaling around $13,000. Reductions proposed included immunizations, CPR supplies, AED supplies, office equipment, health supplies and telephone lines.
Health Board Chair Pati Van Zante was concerned about proposing cuts to essential services Public Health exists to provide.
“There’s no way we want to cut core services,” Agan said. Cuts are expected to get worse as key funding sources – the state and federal governments – may be forced to reduce their expenses.
Dorn said she went through the budget, program by program. Some grants are factored into the costs of core services.
Even with grants and other funding sources, Agan researched the historical requests for Marion County funds by Public Health since fiscal year 2007-08. That year, the request was $319,000, but came down to $202,578 in 2008-09 and $126,522 in 2009-10. Dorn explained that, during those years, Public Health was receiving extra federal funding to fight H1N1 and not as much money was needed from the County. The request went up to $301,861 in 2010-11 and to $408,501. Increases, according to Dorn, were due to fewer federal funds flowing in, as well as the purchase of the new building.
Issues about administering WIC
On a separate agenda item, the Health Board was asked to approve applications for continued WIC (Women, Infants, Children) and tobacco prevention programs. Marion County administers WIC for multiple counties, and according to staff members, WIC does not use Marion County funds. However, Agan was concerned that Marion County was leaving itself open to liability and utilizing Marion County money to help residents from beyond the county lines.
“We’re losing money somewhere,” Agan said. He is also concerned about depending on grants and other outside sources, as they may go away. Few counties in Iowa administer the WIC program, he added.
Agan provided the Health Board a map from the Iowa Department of Public Health website, which displays all of the WIC agencies in Iowa. Many of them have general names to cover multiple counties, such as “Hawkeye Area” and “Mid Iowa.” Counties with their names on the program include Marion, Johnson, Pottawattamie, Scott and Webster.
Goff works for Broadlawns Hospital, which used to administer WIC services. She was working with the WIC program in Marion County, before the state mandated that Marion County join with others for the program. Broadlawns used to administer the services for Polk, Warren and Marion, but according to Goff, Polk asked to drop Warren and Marion. Marion County was asked by the state to administer the service for Lucas and Monroe counties. Most counties can’t afford to administer the program, and the state cannot afford to pay for 99 administrators. Marion County does not have the population to stand alone in administering the WIC program. To receive WIC funding, Marion County has to assist other counties, and Public Health is currently in the third year of a five-year agreement.
Public Health employee Diane Ellis told Agan that WIC clients who come to Marion County for services compliment the department for the job they do.
“I think it’s administered well here,” Ellis said. “Don’t fix it if it’s not broken.”
IT contract issue
A contract was up for an agreement between Public Health and an information technology provider, which also raised issue with Agan. Agan believes the $32,000 cost for the agreement was too much for one department, and he did not want the department to enter into a long-term agreement, as the supervisors hope to have an IT audit performed to try to improve this in all areas.
“This seems like a really high cost for information technology,” Agan said. “I think this is the most expensive contract in the county.”
Dorn said the department wanted a written contract, due to privacy concerns associated with much of its files and paperwork. Dorn will be allowed to sign the contract, which includes a way out if changes are made to IT services for Marion County.
Agan had requested a joint meeting between the Board of Health and the supervisors. This is tentatively set for March 19 at 8:15 a.m., with an alternate date of April 2. This meeting will be open to the public and held at the Public Health building.