Uncertainty about the future of public health in Greene County seems to be ending.
Becky Wolf, RN, director of Greene County public health, presented her budget request for Fiscal Year 2019 (beginning July 1) to the county supervisors at their Dec. 11 meeting. The request is for $300,000, which is more than the request for the current year but much less than what was projected for FY19 a year ago.
The county has contracted with the medical for the provision of public health services for many years. The relationship moved along quietly until a year ago when medical center CEO Carl Behne and Wolf presented the public health request last December.
At that time, Behne told the supervisors that the medical center had been subsidizing public health and proposed a three-year funding plan that would have the county paying the full cost of public health by FY20.
The county had paid $150,000 in prior years. Behne proposed a payment of $275,000 in FY 18, $437,000 in FY19, and $614,000 in FY20.
The county increased its payment to $200,000 for the current year, and several discussions were held between the supervisors, the medical center administration and trustees, and the board of health.
Supervisor Dawn Rudolph, a member of the board of health, researched what would be involved in a county-run public health department. Guthrie County has a county-based public health department and Rudolph provided information from Jotham Arber, director of public health there. Heather Bombei, a regional community health consultant with the Iowa Department of Public Health met with the supervisors in April.
A point of contention between the supervisors and the medical center was the indirect costs included in the total cost of public health. Also, the supervisors pointed out that the county was at its maximum property tax levy while the medical center is not. Behne admitted that it was a question of “right pocket, left pocket,” since ultimately the money being discussed was all taxpayers’ money.
During her budget presentation Monday, Wolf said she cut the budget for the current year by $75,000 to reflect the county’s allocation. She did that by reducing staff hours, and said most staff was agreeable to that.
She said providing vaccines is growing. Board chair John Muir said that during the discussions this past year, he learned that being able to purchase vaccines with the group purchasing price the medical center gets is a benefit of the relationship. If public health were county-based, the cost of vaccines would by 40 percent more.
Wolf told the supervisors that on the revenue side, public health is able to claim more grant funds for emergency preparedness. She said she anticipates a decrease in state funding for public health because of budget cuts to the Iowa Department of Public Health.
The medical center does not plan salary increases for employees.
“I don’t think it ever felt adversarial,” Muir said about the discussions this past year. “We both stated our positions and then tried to figure out how we could do what we could do that was best for the community and best for public health.”
“I felt much more at ease and confident after our last meeting,” Rudolph said. Muir added, “I felt like we would all be able to work together to get where we wanted to be.”
