Board, health department iron out issues

Tim Darnell, director of the Mississippi Department of Health, and Peter Oppedisano, regional administrator of the Northern Public Health Region, visited the Marshall County Board of Supervisors recently to do some tough talking of cutbacks on services.

Marshall County has an annual investment in keeping the county Health Department open. The Health Department on the clinical side had to cut back to three days a week because people were receiving services elsewhere.

Supervisors had said that since the health department had cut back its hours in Marshall County, they wanted to know why they should not cut back the mills in the budget which raises about $166,000 a year.

Darnell said the state had cut back its funding. He said in an examination of the way certain services are delivered and the way they were delivered about seven years ago, the health department found that clinical services such as family planning and immunizations usage had declined from 80 percent to 30 percent. There was a decreased case load at the clinic.

Service demand at the health department (which was reimbursed by Medicaid) went down, causing a decrease in the number of staff members needed.

“With a decrease in reimbursement funds, we looked at our operations and decreased positions,” Darnell said.

The department laid off 150 employees.

Darnell said the Health Department decided it could see the remaining clients in three days in Holly Springs.

Employees also collect data on the incidence of diseases such as tuberculosis and sexually transmitted diseases on days the office is not seeing patients.

But the Marshall County Health Department added another day in September and October, and will keep an eye on patient flow.

Darnell said patient use at the clinic has recently increased.

Supervisor Ronnie Joe Bennett said the state cut services back but the Marshall County taxpayers are still paying the same fee annually – $175,000.

Darnell said those dollars are a vital part of the operating revenue of the clinic and services in Marshall County.

Supervisor George Zinn III questioned other changes at the health department such as well water testing and inspections of restaurants.

“It appears some other things got caught up in it,” he said.

Darnell said those services are separated out now and are not a part of the local clinic. They have been centralized. He said there are wait times sometimes but the department is about to get things worked out in delivering inspections which used to be under a health officer.

Bennett asked why supervisors were not informed the clinic is now open four days a week.

“Why were we not informed about the reorganization?” he asked.

Darnell said the county should have received written letters about the changes.

Supervisor Keith Taylor said the board found out about the letters after the fact. He asked whether any of the county money was going to fund the state Health Department’s operations.

Darnell said revenue went down at the state level because the money from Medicaid decreased. So the department was reorganized from nine districts to three regions to cut upper level costs but not at the county level, he said.

“The state cut their funding, so why couldn’t we cut some?” asked Bennett. “It seems that we were cut out of the discussions to start with.”

Taylor said the county could have cut its $175,000 pro rata to cover the loss of two days service.

Darnell said the state tried to reduce administrative overhead by shutting down six district offices.

And with the decrease in use of children’s health serves, family planning, and immunizations, the department cut the revenue that went with the decrease in patient flow, he said.

“Not every county’s patient load went down,” Darnell said.

Peter Oppedisano, regional administrator for the northern district, explained that 49 percent of the state monies were cut which resulted in a proportional cut across the 30 counties in his district. The cuts were not specific to any county but distributed across all counties.

Supervisor Charles Terry asked Oppedisano if Medicaid funds were reduced. And the county did not know the local office had gone back to four days, he said.

Oppedisano said the health department sees its relationship with counties as partnerships.

Zinn asked whether the waste water and restaurant inspections are being done by independent contractors.

“A year or two ago, they centralized it from Jackson,” Oppedisano said. “They don’t report to me.

“We are open Tuesdays through Fridays this month (in Holly Springs). During the closed days, employees are working on venereal disease cases, and so forth.”

A check with the local health department staff indicated Fridays are dedicated to WIC clients.

Darnell sent a letter of appreciation to the board of supervisors October 16, acknowledging the helpfulness of the discussion in clearing up misunderstandings.