Health Department changes

By Milam County Judge David Barkemeyer

Acting in our capacity as the governing body of the Milam County Health Department, the Commissioner’s Court met in its regular quarterly meeting this past week with Marybeth Saxton, interim director, and other members of the health department to review the quarterly financial statements and other business issues of the department.
This department, like all other county departments, is faced with dealing with a reduced 2016 budget and in general with helping the county cope with the financial uncertainty that we’re facing in the months ahead.
Commissioner’s Court voted to approve a fee increase starting Jan. 1, 2016 for various services provided by the health department. One of these fee increases relates to septic inspections and permits for conventional systems for residential and commercial properties. This permit fee will increase from $210 to $310 plus $100 for the design review for a total fee of $410. Currently the contract inspector that the county employs to do the inspections charges $400 and we pay TCEQ a $10 fee for each inspection, so we are simply passing our cost of the inspection on to the homeowner rather than having the taxpayers of Milam County subsidize this activity as has been occurring. We think this is a reasonable step in our efforts to control costs.
We also increased fees paid for certain vaccines, injections, and tests done by the Health Department by those that can afford to pay. If an individual needs a vaccine or STD tests and is indigent or otherwise cannot pay for various reasons, we will provide the service free of charge. But again, we’re trying to bring in more revenue where possible.
Another program that we voted to discontinue is the well child program which we were told is no longer being administered by public health departments in other counties. Private physicians and clinics that contract for Medicaid clients are required to administer the program. Public Health Departments may administer the program and be paid, but are not required to do so. We will continue to provide vaccines for those Medicaid clients, but they must now see their assigned medical provider to obtain well child checkups and services.
Last year our health department collected about $11,000 in well child fees and was on track to collect about $17,000 this year while paying a nurse $45,000 in base salary to administer the program along with certain other duties. So while it’s a convenience for those that use the program, it is not cost effective for the county. With the elimination of this program along with the use of contracted services to help administer vaccines in the county’s immunization programs, we will be able to eliminate one of two full time RN positions.
The health department will be contacting their existing clients as well as local Medicaid providers to inform them that the department is no longer providing this service. These clients will be told to contact their assigned Medicaid provider for future well child visits and not wait until the last minute to get necessary checkups since wait times will be longer in most cases. And their providers will have to get acclimated to the fact that they must accommodate Medicaid patients for well child services similar to what has taken place in most other counties.
I know that these actions are causing inconvenience for many of you, and I apologize. Call me the bad guy, but I’m determined that the county must be diligent in reducing costs in the face of the financial uncertainty caused by the Luminant lawsuit over their property valuation. We must act now, we can’t wait because even more will need to be done for the county to remain solvent in the months ahead.