By Chris Taylor
http://stream.publicbroadcasting.net/production/mp3/wkms/local-wkms-910853.mp3
Mayfield, KY – On the heels of layoffs and budget cuts last year, the Purchase Area Health Department is losing one of its biggest members. Graves County is opting out of the region effective this week. Chris Taylor takes us on a tour to the Graves County outfit and finds out how their withdrawal will affect the remaining membership and those who rely on it.
For three years now, the Graves County Health Department has been occupying and renovating the former Mayfield Elementary School. The 40,000 square foot building makes Graves' department one of the largest in the area and serves as part health clinic, part community center. Director Noel Coplen gives a tour of the facility beginning in the gym, which is now used as an employee exercise space and where nurses administer flu shots at yearly public clinics.
Coplen-- We've just been tickled to death with it. We have more room than we would have ever imagined and got a really good deal on it and just been fixing up as time and money would allow.
A spacious waiting area sits beneath a wall mural of a jungle scene, just down a short stoop of stairs away from the lobby. The area is what used to be a library. Coplen now stands in front of a clinic room decorated with flowers. He says health department staff see anywhere from 30 to 70 people are seen daily in the uniquely decorated rooms, which have been converted from classroom space. New floors and drop ceilings go a long way to make the older building feel modern and Coplen says he strives for efficiency, even reusing the old library's card catalogue as storage drawers in the lab. As unique as this health department is, it's little wonder Graves County has decided to go solo, dropping out of regional district oversight.
Coplen-- It's about helping people and what our board and our staff here want to do is to take those same taxpayer funds and address some needs that are unique for Graves County. And in doing that, as opposed to doing the cookie cutter approach, our efficiencies with those funds should increase. Then we should be able to help more people.
Already, Coplen is creating two new positions at the clinic, something he says wouldn't have been possible without independence. But while the local outfit here hopes to help more people, the move could affect service for a greater number throughout the region. Purchase District Health Department Public Health Director Charlie Ross says the foremost immediate impact of Graves County seceding from the regional district will be financial. State statutes require the district to reimburse Graves with a portion of the funds it has contributed over nearly three decades.
Ross-- We're still in the process right now trying to negotiate that because there's a number of different factors that are involved in an operation of this size as far as equipment and supplies, but eventually we will make a payment. It means some loss of revenue for our agency for this next fiscal year.
Ross estimates that figure to be somewhere in the ballpark of a half-million dollars. That's a one-time payment that should only affect next year's budget.
Ross-- The expenses that were related to us managing that department: the salaries, the benefits, the overhead, all those things that go into running the operation will go away. That local assessment support will also go away, but those things will come near balancing each other out.
Health department budgets come from a combination of local, state and federal revenue streams. But, Ross estimates Graves' local assessment was one of the top breadwinners for the district next to McCracken and Calloway. He says Graves' absence will affect the region's overall service.
Ross-- In many cases, the pie has just been split a different way. So, many of the programs will carry on somewhat at the same level from the past. The one that we are taking the hardest look at right now is our home health program.
The home health program sends nurses and therapists to homebound patient's residences throughout the Commonwealth. Ross says it's an increasingly costly program.
Ross-- All health departments around the state are having to take a very hard look at what services that they're providing, what are the core mandated services, and what can they afford to provide beyond that.
The Graves pullout comes after a strained fiscal year for the district that saw several layoffs, attrition and various cuts. As Graves County is no longer required to support the home health program, residents using the service will, for now, still be served by the district. This may be disconcerting for officials in member counties, whose joint funds wind up servicing those apart from the district. Ross says it's only logical Graves' recent independence may bring some to take another look at their participation.
Ross-- The challenge for us now as a district is to prove them that what their monies that are being use right now are being used effectively. That they're getting a good return on their investment for the dollars that they've spent.
Despite continuing financial hardships, it's not all doomed fiscal prophecies for the district. Ross hopes to find funding from the national Health Reform Act.
Ross-- Which is kind of coming out in just very small bits and pieces right now, but there may actually be some funding to help support health promotion programs and that's very much within the realm of what we do.
Ross says it's unclear what the ultimate effect of Graves' departure on the group will be. Back in Graves County, Director Noel Coplen says despite the county's secession from the Purchase District Health Department, they won't limit their patient pool.
Coplen-- The health of Graves County is not limited to the political borders and we see folks from other counties. Whether it's a matter of convenience or a matter of their personal privacy. We never turn away people and we don't plan on doing that in the future.
As the possibility of future cuts may threaten regional care as a whole, Coplen expects Graves' independence will be a success and plans to further expand the department's role in the community.