The public health district is getting more money from each of its three member counties in the upcoming budget, but is losing a large, one-time funding source.
The ensuing belt-tightening, including the loss of a temporary office worker along with other cuts, will not affect the current hours of the health district’s walk-in clinic, the service it is best known for.
Walk-in clinic hours — when people do not need an appointment to receive services — will continue to be offered Wednesday through Friday, 8:30 a.m. to noon and 1 to 5 p.m. Staffers try as best they can to accommodate those who show up on Mondays and Tuesdays in need of birth control, said district Director Teri Thalhofer.
The walk-in clinic is available for immunizations, birth control and treatments for sexually transmitted infections.
The health district had to cut back its previously five-days-per-week walk-in clinic hours two years ago when its budget was cut by Wasco County, but it received a reprieve last year when it got a one-time $90,000 payment from a local regional coordinated care organization.
While the three member counties of the health district — Wasco, Sherman and Gilliam — each increased their contribution over last year by 5 percent — or 4.8 percent in Wasco County’s case, other funding streams have reduced, leaving the health district with $118,000 less in 2017-18 than in 2016-17.
Eliminated from the budget that takes effect July 1 will be a temporary office specialist, which cost $36,745. Reductions will also occur in the hours of the county health officer, down $15,191, and reduced hours for an accounting clerk, down $10,134.
Overall, the health district is down the equivalent of one full-time person, with the loss of .8 FTE from the front office and .2 FTE for the health officer. The health officer position was reduced when a grant focusing on reducing obesity ended.
Staff will again not get any cost of living increases, making it the third time in five years no such increase was given. A salary survey found health district salaries are an average of 13.4 percent below market.
The FTE of the district will drop from 25.1 to 24.1 at the new fiscal year.
The reduction in funding is “disappointing,” Thalhofer said. “It makes retaining and hiring staff difficult when we know that we’re so far below the market rates. Staff haven’t received raises. They don’t get training. It makes it difficult.”
She said it could make the district’s response to health outbreaks more difficult. “We respond to any sort of illness outbreak that occurs, and most of them the public never hears about. We respond to food borne outbreaks in assisted living facilities, nursing facilities, camps, those sorts of things. We respond to environmental events, so we responded to the Mosier train [derailment in June 2016] because there were hazards in the air and water there.”
The district is even doing planning right now for the solar eclipse in August, which is expected to draw many thousands of people to Oregon. “What will the impacts be? There may not be enough water, there may not be enough sanitation. We’ll be working with our medical partners to see what sort of responses we need to have in place and what sort of capacity we have.”
The district has also cut $20,000 from its vehicle replacement reserve, will now only do required/reimbursed training, cutting $9,250, and will not replace any computers this year, cutting $8,000 from that line item. It is also cutting the office supplies line item by $4,650.
Sherman and Gilliam counties are giving $107,157 and $108,768, respectively, while Wasco County’s contribution in the upcoming budget is $356,000.
That is up from $340,000 the previous year, and $314,000 the year before, but still below the $376,000 given in the 2014-15 fiscal year.
Thalhofer said the public can expect longer wait times because of cuts to the front office staff.
The health district has a complex array of funding sources, and one of those sources is actually increasing, allowing the district to do more home visiting of pregnant women.
“The funding mechanism changed Jan. 1 so we’re ramping up to that now and we hired more staff last year because we have a prive community grant that allowed us to hire an additional community health worker to support that program,” she said.
The program serves pregnant women and children. It serves kids from birth to five and kids with special needs up to 21.
In the past, the health district was expected to use mostly nurses, but now community health workers can provide services as well.
Clients will have a nurse case manager, but community health workers can do some of the home visiting as well, she said.