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Budget Committee Examines Health Department Programs

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Budget Committee Examines Health Department Programs

Tuesday, October 12, 2010
Much of the focus was on the Health Department, as Legislators acting as an Expanded Budget Committee neared the end of the presentation phase of 2011 budget review--'much of that discussion concerning the future of the certified home health agency (or CHHA) operated by the Health Department.

The tentative budget prepared by County Administrator Joe Mareane calls for a nearly $200,000 target reduction, which would eliminate local dollar support for the home health agency by mid-year--'reductions to be achieved either through internal cost savings or revenue increases or, if that does not prove feasible, through transfer to a qualified not-for-profit provider to provide the community service. Reductions in state aid have increased the County's cost from $270,000 last year to $400,000 this year. The tentative budget also would allocate $25,000 in one-time rollover funding to evaluate CHHA processes and fiscal practices, a study Interim director Brenda Grinnell Crosby agreed is "absolutely essential" and must begin as soon as possible, even before the 2011 budget is passed.

But department officials urged legislators to think long and hard about the effects of potentially giving up the home health agency down the road, Patient Services Director Sigrid Connors saying that the County-run CHHA serves everyone without regard for ability to pay, including patients with complex and high-level needs who might not be served by a not-for-profit agency in a home setting And she suggested the potential loss of 15 home care positions, including 11 experienced nurses with specialized medical-surgical skills, would disrupt continuity of care and decrease the department's surge capacity to respond to critical events in other parts of the department. Connors said the CHHA has achieved very high patient satisfaction ratings, which compare favorably with other public home health agencies in New York State. Administrator Joe Mareane said the budget proposal takes a careful, deliberative approach, supporting half-year funding and setting aside nearly $200,000 of one-time funds in contingency, in case extra time is needed to determine the proper course of action.

Asked by legislators how the department would rank funding for the home health agency compared to requested over target support for several positions, Grinnell Crosby said that is not a proper comparison for the department to make--'that all positions requested are important. Among positions recommended for over target spending in the tentative budget: a Community Health Nurse for the Early Intervention program, a Team Leader in Community Health Services, and a Public Health Sanitarian in Environmental Health. Department administrators urged the positions be maintained, since they are needed to handle caseloads and to provide mandated services. A half-time administrative assistant position, requested to be funded on a one-time basis through rollover, was not recommended as part of the tentative budget.

Among other budgets reviewed, the administrator's budget recommends about $100,000 in over target spending to maintain staff hours at the Board of Elections (cited as important to core governance), but it does not recommend $10,000 in requested one time funding to support potential 2011 primary expense. The administrator notes any such expense, if it becomes necessary, should be requested from the contingent fund.

For Assigned Counsel, about $19,000 in over target spending is recommended to maintain hours for the program coordinator and clerical support, but the tentative budget reduces by half, to $100,000, the target increase the office requested to handle anticipated high profile cases next year, with a contingent fund request recommended if expenses turn out to exceed that.

The Expanded Budget Committee will review the Department of Social Services budget on Thursday, October 14, beginning at 5:30 p.m. On Monday, October 18, Legislators will begin recommending changes to the Tentative Budget prepared by County Administrator Joe Mareane. Any changes the committee recommends will still need approval of the Legislature to become final.