Bill: Put health departments under county control
PANAMA CITY — A bill in the Florida House has county officials across the state, including Bay County, trying to figure out what their role in public health would be if health departments are brought under local control.
The bill by Rep. Matt Hudson, R-Naples, would restructure and significantly limit the scope of the state Department of Health. The bill passed the House’s Health and Human Services Quality Subcommittee on Monday, but it was met with skepticism by Gov. Rick Scott during a press conference Tuesday, when he said didn’t see any immediate benefit to the plan in terms of reduced costs or increased services.
The bill’s next committee stop is in appropriations, but a vote hasn’t been scheduled.
County health departments, the “implementation arm” of the state health system, have three missions: infectious disease prevention and control, basic family health care services and environmental health services. Programs currently are funded directly by the state and supplemented with federal and local funds. Hudson’s proposal would funnel health department funding through county governments by providing population-based block grants that could be distributed at the direction of commissioners.
The Florida Association of Counties has expressed concerns about the bill, but County Manager Ed Smith said he’s not sure how Bay County Commissioners would react to the changes and he’s not even sure what the administration’s recommendation would be at this point.
Local governments taking on new responsibilities — with assurances from the state that they would be funded — is a delicate issue, Smith said.
“Any time the state says the check is in the mail, there’s a possibility for a funded mandate to become an unfunded mandate,” he said.
An analysis by the Health and Human Services’ staff notes there could be a cost to counties because of increased health insurance and retirement costs for health department employees that would transition from state to local employment. County health departments currently employ 12,000 people statewide.
On the other hand, county commissioners look favorably on local control, Smith added.
To this point, Smith said Bay County’s relationship with the health department has been one of “arm’s length” cooperation. The county owns and maintains the health department facilities and funds them with 0.115 mills of tax revenue, or about $1 million annually. The county also teamed up with the health department to open a children’s dental clinic last year.
Since the Department of Health was created in 1996, its budget has doubled, according to the committee staff analysis.
This fiscal year, the Bay County Health Department has an $11 million budget, of which about $2.5 million comes from the state. About 37 percent of the budget is dedicated to family health services. Since the spring of 2011 the health department’s ER diversion clinic has served 2,085 patients and the day clinics have served about 11,700 patients, according to information provided by health department spokeswoman Julia Ruschmann.
SETTING IT STRAIGHT
The original version of this article incorrectly reported the date of some Bay County Health Department data, and mischaracterized the position of the Florida Association of Counties regarding the bill.
