The Board of Health has approved the 2020 budget for the Union County Health Department (UCHD).
During a special meeting Wednesday, the Board of Health approved appropriations for 11 different funds, totaling approximately $5.88 million.
Fiscal Officer Amy Hamilton said the 2020 revenues will increase by $267,688, when compared to expected revenues for 2019. This excludes the receipt of $500,000 in bond proceeds that were received in 2019 for the renovation.
The majority of UCHD’s funding comes from tax dollars generated by two levies.
A 0.5 tax levy will continue through 2021, with collection through 2022. Hamilton said it is expected to generate approximately $664,000 in 2020.
Additionally, in November 2018 voters approved at 0.75 renewal levy with a 0.15 increase that will begin collection in fiscal year 2020. Hamilton said, because of the increase, it is expected to generate approximately $1.376 million next year.
In total, she said levy dollars account for 47% of UCHD’s revenue.
The next largest chunk, at 24% of revenue, comes from grant funding.
However, Hamilton noted a major change in how Ohio Department of Health funding will be received. In 2020, there will no longer be prefunding, as all grants will be on a “deliverables-based model.”
For that reason, she said the Board of Health will often need to work with levy funds before being reimbursed when deliverables are complete.
Another 21% of revenue will be generated by licensing, permits and fees.
Hamilton noted that the 2020 budget includes $180,000 in collections for the 2020-2024 permit cycle. The fee is $10 per year for a 5-year permit, so this revenue will not be collected again until that time expires.
Total appropriations are expected to decrease by 4.88%, or nearly $290,000. This accounts for a 7.5% decrease in operational costs, as well as a 2.83% increase in personnel expenses. The personnel expenses account for moving one part-time position to full-time, along with sick day and vacation buyouts.
Costs associated with staffing make up the majority of appropriations, Hamilton said, as salaries account for 44% and benefits 20%.
Health Commissioner Jason Orcena said salary and benefit appropriations could be affiliated with why an analysis has shown that UCHD clinics “continue to underperform” financially.
Orcena and Hamilton explained that expenditures for clinics regularly exceed the revenue they generate.
Since UCHD is a public health entity, Orcena said “the expectation of earning 100% is probably unrealistic,” but he said the fact that some clinics do not generate half of what they cost is concerning.
Orcena said this is likely caused by organizational issues with staffing, as the number of individuals receiving clinic services does not indicate a problem.
He said most hospitals and public health agencies have physicians assistants to complete many clinical tasks, but UCHD has only one nursing employee who is not a Registered Nurse (RN) or hold a Bachelor of Science in Nursing (BSN). Orcena explained that these positions are much more expensive to employ.
Moving forward, he said the Board will need to have discussions regarding how staffing is structured in order to make clinics more financially efficient.
In other business, the Board:
– Approved the purchase of a copier, not to exceed $9,500.
– Approved an increase of $25,000 for renovation change orders, along with $65,000 for new carpeting and painting.
– Approved the purchase of conference room tables and chairs as well as two cubicles, not to exceed $30,000.
– Approved security card door readers and installation, not to exceed $11,000.
– Approved a resolution to increase the cost of living allowance by 1.5% across all three pay schedules.