|CITIZENS QUESTION HEALTH DECISION|
|April 04, 2002 11:00 pm|
By BILL LUNDQUIST
GOLD BEACH Several citizens commented on the proposed closure of the Curry County Public Health Department at Tuesdays commissioners workshop with state officials.
County Commissioner Rachelle Schaaf reminded speakers that the quality of services provided by the Public Health Department was not in question.
She said the proposal to have the state take over public health services was made strictly for financial reasons.
Schaaf gave each citizen two minutes to speak.
Mary Corey, of Port Orford, asked Tom Engle, from the Oregon Department of Human Services, if the state would do a study to determine what services to provide in Curry County. She asked who would pay for such a study, and who would carry it out.
Engle said the state would conduct no formal study.
He said the Human Services office in Portland would look at programs and contact people in Curry County. Then it would look for vendors to provide services.
Corey said, It sounds like the big issue is the financial cost and the cost of local control.
Curry County Human Services Director Deb Wilson spoke in support of Public Health Director Barbara Floyd. Wilson said she could find herself in the same position as Floyd.
Barbara is on the right track about being given time to restructure, said Wilson, like the commissioners did with us.
She asked Engle if the state would have a local health advisory board if it took over public health services for Curry County.
Engle said an advisory board is not mentioned in the statute allowing the county to give its public health authority back to the state. He said he wouldnt necessarily rule out an advisory board, however.
Floyd said even the county is not mandated to have an advisory board, though it does have one.
Wilson asked if state money would go to the county or the district if the county gave its public health authority to the health district.
Engle said in the three counties that have made districts the public health authority, state money goes directly to those districts.
Linda Morgan, the school nurse for Brookings-Harbor School District 17-C, said she was concerned about not having a public health office in Brookings.
She said of the 2,000 children in the district, 75 percent get their shots at the countys health department office in Brookings. She said half of the students in the district qualify for free or reduced meals at school.
Dr. Bill Swartz, of Gold Beach, said he spent 25 years in San Diego County as a provider and administrator of health services.
He said he viewed public health as a safety net made up of small, interconnected pieces.
Those little pieces are more responsive on a local level, he said.
He said public health could be done at the state level, but with consequences.
We can do it better locally than you can from a distance with the same dollars, said Swartz.
He said the countys health department could look into outsourcing some services.
With clever planning, and close monitoring, the program could be run within its allotted budget, he said.
Swartz asked Engle if the state would help advise the county on what other counties had done to organize their health departments. Engle said yes.
Commissioner candidate Olive Wooldridge asked what would happen to the responsibility of the health department to keep vital statistics.
Engle said the Human Services office in Portland would have to come up with a plan for that.
Wooldridge wondered if taxes would be raised within the health district if it became the public health authority, and if taxpayers outside that district would also be charged.
Engle said Columbia County contracts with its local health district to serve the 30,000 people in the county. He said the district does not use its own money to do so.
Schaaf asked if the state might consider a hybrid health authority with a local advisory board that would work with the state.
Engle said he didnt know. He said the state will need local advice on what to do with the $50,000 to $60,000 in federal bioterrorism money Curry County will be receiving.
Commissioner Marlyn Schafer asked if the state could contract with the countys Emergency Services Department to provide services with that money.
Engle said those funds would be for the health component of the federal Homeland Security program.
He said the county would receive enough money to hire one full-time employee to work on system development and communicable disease requirements.
Commissioner Lucie La Bont said, Well receive additional money but with additional mandates. Well have to hire another person.
Part of our concern is the state needs to better fund the programs we have to fund out of the general fund.
La Bont said tax revenues are down because timber counties are not allowed to cut timber.
Tell the federal government these people dont have any money to do this at all, she said.
Engle said that is why the federal government is sending the money. He said it wants to rebuild the public health infrastructure to better fight communicable diseases.
He said that infrastructure would help the county fight all communicable diseases, not just those that might be spread by bioterrorism.
Barbara Kemp, a member of the countys Health Advisory Board, said she would like to retain local control of public health.
She said the commissioners had heard from many people that local control is the best way to go. She asked what procedure or plan the county would use to do that.
Schafer said the balanced budget, without the public health department, would be presented to the full budget committee April 15.
She said if a majority of the commissioners and lay members on that committee want to keep the health department, they will have to look at other ways to balance the budget.
Id heard the decision hasnt been made, said Kemp.
Schafer said the decision to present a balanced budget by returning the health department to the state had been made by the commissioners in their budget workshops. She said the official budget hearings beginning April 15 will be public hearings.
Schaaf asked if the commissioners wanted to give Floyd direction to develop a proposed budget for her department that includes no money from the county general fund.
Schafer said Floyd would also have to include unemployment for the employees she would have to lay off. She said Floyd should consider the buildings the county is planning to vacate.
La Bont said she would talk with the health district about using their buildings in the North and South county.
Henry Lustig, from Ophir, was unable to attend Tuesdays meeting, but sent the commissioners some comments by e-mail.
The Public Health Department has woefully neglected to meet its goals without increasingly draining county resources, he said, bringing us to the brink of bankruptcy. The state falls increasingly short in funding its mandated services.
He commended the commissioners for looking ahead, correctly analyzing the problem and offering a viable solution.
Transferring overseeing responsibility to Curry General Hospital is flawed, said Lustig. This body never met a business budget for profit either.
With their track record, they cannot be expected to run public health with any more efficiency and be taxpayer-friendly.
Lustig was also against a tax levy to support public health. The Curry taxpayers must not be asked to support what the state inadequately funds. You were on the right track in your original analysis of the situation.
I urge you to go ahead with your proposal to the budget committee and return public health to its rightful owners in Salem, he said.