Health isn't expendable


What compromises will the Franklin County Health Department be forced to make because of the 12 furlough days its employees face in the upcoming fiscal year? Fewer inspections of the restaurants most of us patronize, or of swimming pools and the hospital? Or will the department have to cut back on cancer screenings and infectious disease monitoring? Twice the number of furlough days most state workers had to endure last year is bound to have an impact, although Director Paula Alexander promises to uphold quality of the agency’s services.
Fiscal Court, which has largely escaped the budgetary strife that’s roiled the City Commission lately, got the news about the furloughs at Friday’s meeting. Director Paula Alexander told magistrates the health department is in for a rough stretch, receiving 20 percent less funding from state government than last year. The furloughs and other cost-cutting measures are expected to cut the deficit more than half. One part-time employee is to be laid off and two full-timers will be reduced to part-time status.
At least, she said, the department should be able to avoid mass layoffs.
Health department funding comes from state, local and federal sources. But its workers won’t share in the $500 pay raise the county recently granted to staff, because they’re not part of the county workforce. The Franklin County Board of Health oversees department operations and draws part of its income from a special tax. When the “health tax” came up for voter approval 40 years ago, it was soundly defeated at the polls. ButMagistrate Jill Robinson says today’s tax seems to enjoy good public support.
Still, Alexander indicated she was reluctant to consider increasing the rate to offset the loss of state funds this year. School boards and local government boards for the most part have reluctantly settled for lower property tax rates than they otherwise might have, recognizing that taxpayers are suffering from the persistent economic downturn.
The local health department is not alone in facing difficulties. The Lexington Herald-Leader reported Monday that while total funding statewide is little changed, some agencies are winners while  others are losers because of changes in the allocation formula. Counties like Franklin and Anderson find themselves in a bind familiar to many individuals – those not poor enough to qualify for big government aid and not affluent enough to cover health care costs out of their own pockets. In addition, state government’s move to solve its Medicaid budget problem by shifting to managed care has curtailed reimbursements.
Further complicating the situation, the furlough order comes at a time when the local department must cope with growing demand for its services. Clinic appointments are up and the staff of school nurses, recently expanded, will have to participate in the furloughs. The chief administrator is looking for ways to make the cutbacks less burdensome – perhaps scheduling the off days on Fridays. And she holds out hope that the number of furlough days can be decreased. That’s an iffy proposition.
Few services are more vital to the community than public health. With Alexander pledging her department will meet its obligations regardless of the hardships, other levels of government should be no less determined to get their priorities straight.

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