Many health departments across the Commonwealth are in danger of closing down by the end of the year due to ballooning pension burdens, but Oldham County is not facing immediate danger, according to local health officials.
Teresa Gamsky, the county health department’s director of public health, told the Oldham County Fiscal Court June 18 that the Kentucky Department for Public Health is in “crisis mode.”
During the meeting, Magistrate Albert Harrison asked Gamsky about the challenges many health departments are facing and asked Gamsky if Oldham County was at risk of losing its department.
“Not at this point,” Gamsky said in response. “We’re doing all the cost-cutting measures and savings that we can going forward as we have been for several years.”
These cost cutting measures largely include cutting back on personnel. Gamsky said in the field of public health, the biggest asset and largest expense is personnel.
She said the department is now sharing some of their personnel with other departments and they have two positions, dietician and epidemiologist, that they’re contracting with the North Central District Health Department, which serves neighboring Henry, Shelby, Spencer and Trimble counties.
Gamsky also said the department is currently not hiring for any vacant positions.
In addition to cutting back on personnel, she said the department will begin scaling down programs either this year or next year.
These programs include the Kentucky Women’s Cancer Screening and the Family Planning program, which is a federal program.
The cost cutting comes as a response to increased pension obligations health departments are scheduled to begin making come July 1.
Pension obligations are slated to increase to almost 84 percent, up from almost 50 percent, for county health departments, which for Oldham County means paying almost $366,500 for those retirement obligations.
“For the first time in our existence, our fringe benefits are at a higher cost than our personal cost,” Gamsky said. “In order to accommodate for that increased expense, we have gone through several different measures to stay within our budget.”
According to the Kentucky Department of Public Health, 42 county health departments will close in the next year, and 22 more will close the following year if no relief is granted to departments for pension contributions.
Some of the health departments in danger of shutting by the year’s end include Anderson, Greenup, Knox and Magoffin counties, according to an analysis by the Kentucky Local Health Department.
That same analysis says the Oldham County Health Department has an estimated 29.4 months of solvency, or about two and a half years. Solvency is often used as a measure of an organization’s long-run financial health.
Gov. Matt Bevin has proposed a pension plan that would give relief to Kentucky’s regional universities and “quasi-public” agencies, such as local health departments. Bevin, however, vetoed a bill that would have offered similar relief in April.
The Courier Journal reported that Bevin’s administration believes it has the necessary votes to pass his pension plan in a special legislative session. Officials also told the Courier it was unlikely a special session would occur before July 1.
Aside from cost cutting, Gamsky also said the structure of the health department, and departments around the state likewise, will be changing.
The new structure focuses on four core areas of public health: foundational public health, Women’s, Infants and Children nutrition program (WIC), Health Access Nurturing Development Services (HANDS) and harm reduction and substance-use disorder programs, including syringe exchanges.
“Our foundational services are expected to be funded within 1.8 cents of our taxing district revenue and we’re very encouraged that we’re able to compensate for that,” Gamsky said.
The new structure comes from Dr. Jeffrey Howard, the state health commissioner. His plan calls for departments to scale back their services and only be required to provide the core public health services.
Fiscal court approved the county’s public health taxing district budget, which Gamsky had presented at the meeting, and did not increase the tax rate of 2.5 cents per $100, which helps fund the county health department.
Fiscal court raised this tax rate two years ago. No discussion was held about potentially raising the tax again.
For the upcoming fiscal year, the health department is projected to have almost $2,684,000 in revenue and pay nearly $2,680,000 in expenses.