As the Union County Health Department plans its budget for the future, officials are working to balance the increasing needs of a growing community with staffing and programming levels it can currently maintain.
“Right now, we’re at the limit of what we can reasonably take on,” said Union County Health Commissioner Jason Orcena.
The Board unanimously approved its 2024 budget during a special meeting this week, including $6,913,074 in appropriations – a 0.84% decrease from 2023.
The vast majority of UCHD’s expenses are dedicated to personnel costs, with approximately 46% toward salaries and 22% for benefits. Operational costs comprise 28% of the budget and the remaining amount goes toward capital expenses.
Revenue is expected to increase 1.1% from 2023, up to $6,228,601.
Just under 45% of UCHD’s revenue is generated by its two levies, a 0.5 mill levy that will continue collection through 2032 and a 0.9 mill levy (a 0.75 mill renewal with a 0.15 mill increase) that collects through 2029. About 29% comes from grants.
The remainder is generated by permits, licenses and fees, at 19%, followed by contracts and reimbursements.
At the direction of the board, the health department abides by a policy of maintaining 50% of its costs in its cash balances year-to-year.
UCHD Fiscal Officer Amy Hamilton described this year’s budget as “relatively flat” compared to last year’s.
“It’s pretty much business as usual with this budget,” Orcena agreed.
However, he said public health officials are keeping a close eye on UCHD’s staffing levels as the department works through an “in between place with the growth of the community.”
As the county’s population increases, Orcena said the health department is working to build the infrastructure needed to expand its programs accordingly.
He has said in previous board meetings that health departments that serve communities with populations between 50,000 and 100,000 commonly juggle providing services with the budget available.
At this point, he said UCHD is “not getting our highest efficiency because we just aren’t big enough yet.”
He emphasized that he feels the health department’s employees are doing “really great” work through their programs in the community and would not advocate for a reduction in staff.
Still, he said he does not feel UCHD could take on more staff members at this point, noting that he is “a little uncomfortable” with the current staffing level.
Orcena explained that adding employees adds risk to the health department’s operations because many of those positions are grant dependent.
Hamilton noted that UCHD’s grant funding is complex in that “few programs are covered 100%” by the grants intended to fund them.
Orcena added that many grants are funded on a multi-year cycle. So, even if much of the program is funded initially, “by the end it doesn’t cover” the full cost.
Hamilton said many grants also dictate that the amount awarded must be spent during that year, so the health department cannot carryover funding to balance out the costs in later years of the program.
Beyond that, the grants are largely deliverable-based, meaning that UCHD has to finance the programs using money generated from its levies, then be reimbursed when certain deliverables are completed.
Orcena detailed a situation that occurred in 2023 in which the federal and state requirements of a grant changed, so, at no fault of the health department, it did not receive funding and a staff member’s programming was without the grant stream for four months.
UCHD was able to absorb the cost in this scenario, but Orcena said he would not want to risk needing to cut staff members if something similar arose in the future.
Moving forward, Orcena encouraged the board to “watch the number of programs and staffing levels” the health department is taking on.
“If we have a vacancy, we’ve always asked, ‘Do we need to fill it?’ and that’s never more true than it is today,” he said.