DeKALB – It could not be solved with a 25 percent reduction in workforce.
It could not be solved with a $600,000 cut in spending. The DeKalb County Health Department’s budget continues to run larger deficits despite extreme measures taken by Jane Lux, public health administrator, and her department is facing another difficult year in 2013.
The Board of Health recently approved the department’s budget for 2013, which is projected to run a $340,500 deficit with $5.2 million in expenses against $4.9 million in revenue. The health department’s fiscal year runs from January to December, but budgets are approved in July.
Lux said painful staff and program cuts have taken place since 2010, when the department first experienced deficits, and the troubling financial trend has worsened. She said the drastic revenue decreases at the federal and state level, partly from health care reform, are crippling smaller health care operations such as the county’s.
“We’re swimming against a hurricane of revenue decline,” Lux said. “There are external forces out there right now we are really struggling against.”
Since 2010, the department’s overall budget has shrunk by $700,000, or 12 percent. There has been a 14 percent decrease in property tax revenue and a 26 percent decrease in Home Care Program revenue, the latter because of cuts in Medicare compensation and what Lux called an oversupply of providers.
At the same time, federal policies are encouraging consolidation and integration in the health care industry, and larger home care providers have entered the market and made it nearly impossible for the county to compete, Lux said. Service fees make up 51 percent of the health department’s budget and 66 percent of them are from the health care program.
But the health care program has been losing money the past few years and is expected to run a $284,000 deficit in 2013. The Board of Health’s policy is for the home care program to be self supporting, which it had been until 2010.
The reality of the continuing deficits has brought up the possibility of the most extreme cut yet – the entire home care program.
Lux said there have been discussions about KishHealth System starting a home care program and if it does, the county’s program would voluntarily close. She said health systems are large enough to handle the costs that have come with the reforms and it is becoming increasingly difficult for smaller agencies, such as the county’s, to offer the amount of programs it once did.
She said the staff is understandably anxious about the fate of the home care program, which likely will be decided within the year.
“It’s not anyone’s fault ... we have cut our expenditures by a lot and I think we have done well,” Lux said. “People like our home care program and our home care staff.”