) STOKES COUNTY GOVERNMENT
COUNTY OF STOKES ) DANBURY, NORTH CAROLINA
) JUNE 4, 2003
Meeting Highlights
NORTHWESTERN REGIONAL LIBRARIES
The Board of Commissioners of the County of Stokes, State of
North Carolina, met in recessed session (recessed from
the June 3, 2003 meeting) in the Council Chambers of the
Administrative Building, located in Danbury, North Carolina,
on Wednesday, June 4, 2003, at 6:00 pm with the following
members present:
Chairman
Sandy McHugh
Vice-Chairman
John Turpin
Commissioner
Howard Mabe
Commissioner
Leon Inman
Commissioner
Joe Turpin
Darlene
Bullins, Clerk to the Board
Chairman McHugh called the meeting to order.
Dr. Ron Carroll, Stokes County School Superintendent
delivered the invocation.
Chairman McHugh opened the meeting by inviting the citizens
in attendance to join the Board with the Pledge of Allegiance.
My comments tonight will be
restricted to the recommended budget for the Health Department in Danbury. Our other primary budget components, Home
Health and the King Clinic consume no local dollars and had relatively minor
changes to their respective budgets so they are not an issue.
The focus of my comments tonight
will be on the recommended funding level for local appropriations for the
Health Department budget because there are important implications for the
future of the Health Department and the County.
·
The Health Department requested
$443,000 in local funding for the 2003-2004 fiscal year. The recommended amount for local funding is
approximately $178,000. This reduction
represents a 60% decrease in local funding.
Local dollars have generally comprised about 29% of our total budget so
every local dollar lost equates to at least two additional dollars being lost
from other revenue streams. In some
cases, the decreased amount of local dollars will jeopardize entire allotments
of funding.
·
The strategy utilized in the
budget cutting process was to eliminate expenditures that were paid in whole or
in part by non-local funds and then reflect that full cost cutting in local
appropriations. A prime example is
Medical Supplies. That line does not have
local funding in it. It was decreased
by $28,000 and then that reduction was reflected by diminishing local
appropriations $28,000.
Another
example would be full-time and part-time salaries. The total salary base for these two categories was reduced by
approximately $202,000 and then again, local appropriations were reduced by the
same amount. Local funding only
supported $54,000 of those salaries.
·
Please consider the actual
funding level vs. the amount listed as being recommended for local appropriations
($178,000). Home Health returned
approximately $85,000 in revenues to the County for the 2001-2002 fiscal
year. We are on track to earn that much
or more this fiscal year. In the past,
the Health Department had been able to negotiate having some of those funds
returned for specific public health needs.
We didn’t get a dime from the revenues for the 2001-2002 fiscal year and
we don’t expect a dime this year. If you
subtract those revenues from the local appropriations for the Health Center, your
actual local funding for all public health needs in this County is
$93,000. $93,000 for every man, woman
and child in this County – 45,000 people.
·
The NC Department of Health and
Human Services/Division of Public Health expects a certain level of local
funding for Women and Children’s Health (WCH) programs. They use a baseline index for those local
contributions based on 1985. Our MOE
(Maintenance of Effort) amount for Stokes County is approximately $70,000. If we can not demonstrate that level of
investment for those local health programs, all DPH (Division of Public Health)
funding may be withdrawn. The total
amount of funding we receive from DPH exceeds $380,000.
Please
consider this commitment in addition to mandated services and mandated personnel.
·
The budget document lists a
specific prohibition on purchasing medical supplies for the Family Planning
program. It is not the Commissioner’s
role to dictate the utilization of non-local funds for the Health Department. The Board of Health is statutorily
referenced as the policy making entity for the Health Department and they
continue to endorse the continuation of the Family Planning program as it is
currently structured. Interference with
their desires directly usurps their authority for Health Department policy.
·
Please refer to North Carolina
General Statute 130A-9 and then to the various mandated services listed in the
North Carolina Administrative Code. The
statute and the associated rules clearly outline Communicable Disease (including
certain obligations with Immunizations), Environmental Health and Vital Records
as the responsibility of the County Health Department. In addition to these mandated services, 15A
NCAC 25 .0301 stipulates a minimum standard for Health Department staffing
which includes a full-time health director, a full-time public health nurse, a
full-time registered sanitarian and a full-time secretary. It is my opinion that the proposed amount of
local funding ($178,000) will not meet the County’s minimum obligations under
these rules.
Local
dollars in last year’s program budget for:
Communicable
Disease - $ 40,588
Environmental
Health - $153,595
$194,183 Total
This
doesn’t include costs associated with Vital Records, Immunizations, Maintenance
of Effort and mandated staffing.
If local appropriations for the
Health Department remain at the $178,000 level, I would have to pursue major
alterations to Environmental Health staffing levels to more equitably
distribute local dollars among all public health programs and even then I don’t
think we could accomplish all mandated responsibilities.
If it is the Commissioner’s
desire to sustain local funding support for Environmental Health and local
appropriations stay at $178,000 – the Health Department for all intents and
purposes is closed. The budget document
currently being shared with the public does not reflect our ability to maintain
programs and staffing based on a local appropriation amount of $178,000. I can not magically fill a $265,000
reduction in local funds by “moving money around”. It is my estimation that our shared responsibilities for public
health will require baseline funding of $300,000. Remember that Environmental Health consumes $150,000 so I’m
asking for that same amount to support all other public health programs. Also remember that a request for $300,000
only entails actual funding of $215,000.
$215,000 represents 1.4% of ad valorem taxes collected last year – less
than 2 cents on the tax dollar for every service and program administered by
the Health Department.
Please give every consideration
to my comments. I understand the
obligations Commissioners feel toward being fiscally responsible, but we have
developed too much “tunnel vision” regarding this goal. The proposed budget may solve one singular
problem, but will do so by creating many others. That’s not the kind of trade off that our citizens expect. The County Commissioners are treating
Departments the same way that the Governor treated municipalities. The budget crisis for the entire County
should not be balanced on the back of departmental budgets. We didn’t get into this situation in one year
and we aren’t going to get out of it in one year. There has to be room for compromise and negotiation regarding
local funding support.
Thank you for your time.
Regards,
Steven E. Smith, MPA
Health Director – Stokes County
FY ’02-’03 (Current Fiscal Year):
We requested $1,562,434 for
salaries
We were approved $1,553,772 for
salaries (county dollars were $756,756)
We requested $1,471,148 which is
$82,624 less than the amount we were approved for this year (county dollars
will be $562,468; this amount is less than last year’s amount due to so many
experienced staff leaving for other jobs. New staff have come in at the minimum
amount of pay)
Savings from last year are $ 756,756
- 562,468
$194,288
(All County Dollars)
(Due to reduction-in-force,
savings were actually much greater)
Due to the Federal Government assuming a greater portion of the
Medicaid costs, Stokes County will see a reduction of the Medicaid costs of
approximately 8% in COUNTY DOLLARS. This translates to approximately $160,000
in COUNTY DOLLARS that will be saved!!
Total savings
$194,288
160,000
$354,288
To fund our total request of 55.5
workers, DSS only needs $193,000 additional COUNTY DOLLARS. We currently have
38 workers (17.5 staff are needed)
Please consider the budget
package that the DSS Board approved and that I feel will adequately serve the
needs of the citizens of Stokes County. Anything less will seriously compromise
our ability to provide adequate services and may place children and the elderly
at risk of harm.
Thank you in advance for your
consideration.
Jan Spencer, Interim Director
There being no further business
to come before the Board, Vice Chairman John
Turpin move to recess until Thursday, June 5, 2003 at 6:00pm.
Commissioner Mabe seconded and
the motion carried unanimously.
_________________________
_____________________________
Darlene
Bullins Sandy
McHugh
Clerk
to the Board Chairman