Health department hopes to reset county relationship
ADA — (TNS) — Oklahoma State Department of Health Interim Commissioner Tom Bates told Pontotoc County commissioners Monday that he wanted to “reset” the agency’s relationship with the county.
Bates met with the commissioners Monday to answer their questions and speak to longstanding concerns over the state’s management of the Pontotoc County Health Department. The most recent issue of concern has been a series of invoices presented to commissioners by OSDH Regional Director D’Elbie Walker, in which the agency has asked the county to increase its share of funding for payroll expenses at the local health department, despite staff vacancies and reduced levels of service to county residents.
“I think to sum it up, we feel like — I don’t understand how we could pay more for less on that,” District 3 Commissioner Justin Roberts told Bates.
Bates said he understood the commissioner’s concerns and began his remarks by reminding them this was the start of only his sixth week as interim commissioner of health.
“As you know, back in October there was a lot of things that came to light about the Health Department’s fiscal situation, and as a result of that there were — we had about 230 exit the agency by resignation, and on top of that we had another 190 employees exit by a reduction of workforce, so well over 400 employees,” Bates said. “I would say three-fourths of those were in our county health departments.”
Pontotoc County was affected by the resignations and the workforce reduction.
“The situation here in Pontotoc County, specifically in the notes that I’ve been provided, was that prior to that you guys had 20 (staff positions), and now you’re down to eight, with four vacancies,” Bates said.
County officials told the interim commissioner the few health workers who were regularly able to make the trip to Ada from the Pittsburg County Health Department to fill in often arrived well after the doors were open, causing substantial service delays.
Bates said he understood the frustration.
“I’m not here today to try to justify or explain past decisions that were made,” Bates said. “I’m here today to try to help everybody move forward and see what we need to do. But, a lot of those positions that were cut were in counties that had ample millage dollars to have paid for some of those positions, had they chosen to.”
Bates told commissioners that the agency was facing a situation where several counties were so “severely understaffed” that “core public health services are at risk,” and that he was still trying to determine the depth and magnitude of what the agency was facing.
“As we do our budget planning, I have committed to the legislative leadership and the governor … to find out what the minimum amount of state-appropriated dollars (necessary will be) to carry out our core public health functions — meaning, control of infectious disease, maintenance of all these inspections we have to do, particularly with regard to our restaurants and hospitals and nursing homes,” Bates said. “We’re, frankly, behind — the agency as a whole. Its resources are not aligned right now to their core functions. That’s what we’re trying to do.”
Bates told commissioners there will need to be a discussion about counties who have millages in place using at least a portion of those funds to offset the cost of providing health services to their residents.
“As we try to ascertain what that amount of state-appropriated dollars is, we have to look at everything,” Bates said. “I have asked, in those counties where we feel that we are critically understaffed and we (begin) trying to get people back on staff that can carry out those core missions, if counties have the millage in reserve and want to do that, you can do that. So, that gets to the question of why we’re asking you to do more for less.”
The “less” Bates and commissioners refer to is the amount of money the state of Oklahoma spends to operate county health departments, with the counties themselves making up the difference between what it costs to provide services and what the state is willing to pay. It is that difference, Bates said, that may have to change.
“What I have here is that the total projected annual payroll if we had 11 positions filled (in Pontotoc County) would be $690,000,” Bates said. “In the past, (the state) has asked (the county) for $300,000 of that to come from millage, but you’re getting a (federal) reimbursement off of that of $226,000. If you go up to the $373,000 the regional director suggested, the (federal) reimbursement would actually go up to $265,000, because some of those positions would be partially covered by federal (funds).”