|TASK FORCE WORKS TO FIX PUBLIC HEALTH|
|April 26, 2002 11:00 pm|
By BILL LUNDQUIST
GOLD BEACH The new Public Health Task Force was given six months to put the Curry County Public Health Department's house in financial order, but it hopes to do most of that work in six weeks.
Five of the task force members met Thursday, organized, delegated assignments, and began to work to make the department self-sufficient.
The sixth member, Curry County Commissioner Marlyn Schafer, was out due to surgery.
Dr. Bill Swartz is chairing the task force. The former medical administrator said the goal is to turn the department from a cost center into a revenue center.
He said its spending authority will come not from an amount determined by the commissioners, but from its own revenue.
The department will receive no support from the county's general fund.
"Don't take on more work than you have the money to pay for," said Swartz to Public Health Director Barbara Floyd.
She said that would be a new way of thinking. Floyd said she had spent 13 years thinking in terms of how to provide more and better services to the public.
Swartz and Floyd also differed on how much to pay for the indirect services provided to the department by the county.
Swartz said the county foots overhead costs like office space and furniture. It also provides indirect services like computer maintenance and legal counsel.
Swartz said businesses have to pay such costs, and some of the grant funds the department receives from the state could be used to do so.
Floyd's philosophy was that everything from the state should be used to provide services for the public. She said it wasn't fair to single one department out to pay those costs.
Swartz said it wasn't necessary to agree on every detail of the department's new financial plan yet.
He said he would e-mail updated versions of the plan to task force members every 48 hours for the next four to six weeks.
After that, he said, the task force should be able to ease off and turn over some of its duties to the existing Public Health Advisory Board.
Within six months, said Swartz, they should be able to leave a smooth-running financial machine in Floyd's hands.
Floyd said she appreciated the help, would look at all the recommendations of the task force, and probably end up adopting most or all of them.
As the department head, however, she said she would have to make the ultimate decisions.
For now, work was divided up among the members of the task force.
Swartz said Schafer was missed because he needed her information on indirect costs, reserves, starting cash flow, and the commissioners' expectations.
For this year, said Floyd, the commissioners gave the departments back what had gone to new, indirect charges.
That amounted to an $8,000 gain for the Public Health Department, enough to cover the $6,000 needed for a computer billing program to bring in more revenue.
Swartz warned her there would be indirect charges next year. He said her department would also need to save $65,000 to $75,000 for a cash carry-over for next year.
Curry County Budget Committee member Linda Brown said she thought public health would be getting $50,000 from the general fund to get started.
Swartz said that was to pay unemployment costs for anticipated layoffs and hourly cuts.
Task Force member Diane Pace said even the county borrows some of its cash carry-over from its road department. She said public health might be able to do the same.
Task Force member Dale Thomas, another retired medical administrator, said the task force and commissioners need to establish parameters so they can measure the department's financial progress.
Swartz said, "What we are trying to do is say we are on target, that the audited report in September 2003 will say there has been no general fund contribution.
"We will be able to track expenses well, but what are the revenue numbers we will match against expenses?"
To that end, said Swartz, he devised a monthly at-a-glance tool so Floyd can plug in a few numbers and come up with revenue figures.
"Your job," he told Thomas and Brown, "is to show that tool is accurate."
Thomas said he also wanted to establish benchmarks that could be measured Sept. 15 and Dec. 15.
Swartz said the tool would become more accurate month by month as he could calculate what the true average bill is for each type of client.
Swartz said the task force should also look at the department's billing practices. He said it needs a double-billing system to make sure bills were sent out.
Pace said the new computer billing system would provide that information. She said the department should not wait until July 1 to switch over to it.
Swartz said the department needs to look at how it is getting bills to its billing company in Texas. It also needs to look at exactly what the biller does and can do.
Swartz was also concerned that there would be a dip in receivables while switching to the new system.
While Thomas and Brown are measuring finances, said Swartz, he, Pace and Floyd would work on the clinical part: changing office hours and appointment schedules, and publicizing changes to the public and clinics.
Floyd said the first change would come in two weeks in Port Orford. She said the employee there needs a full-time position and is going to work for Curry General Hospital.
Pace said seniority is important in county employment. "Are we decreasing hours for someone who is new and very good," she asked.
"That's exactly what happened in Port Orford," said Floyd.
She said the county must give employees 14 days notice before it lays them off or cuts their hours.
The task force members agreed the department's new hours should go into effect May 28.
Floyd said she wants to talk first with the affected employees before mentioning any names in a public meeting.
She said she would work with County Counsel Jerry Herbage and Payroll Officer Julie Swift to get the official letters out to the affected employees by May 10.
Task force members also discussed transportation problems for clients who may now have to travel out of their own towns to access public health services on certain days.
Brown suggested working with Curry Public Transit. Floyd said her budget contained no money to pay for bus tokens.
Swartz said it would require a new way of thinking. He said if the department needed to provide a 50-cent bus token so someone could come in for a family planning visit that would generate $100, then the department should give out tokens.
To be more user-friendly, said Swartz, the department had to look at language, transportation and child-care barriers standing between it and its clients.
Floyd said she would talk with the Oregon Department of Human Services about paying for tokens.
Brown said she would check about the Retired Senior Volunteer Program helping with transportation.
Task force members also discussed strengthening relationships with other county and state agencies so they always referred clients to each other. They might also be able to share a few costs.
The task force will meet again at 10:15 a.m. May 7 in the commissioners' hearing room in the courthouse annex.