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HomeMy WebLinkAbout1976-036• RESOLUTION NO. 76-36 WIiEREAS, the Florida Public Health Service has, by law, 9M beenlaced under the p jurisdiction and control of the Department of Health and Rehabilitative Services; and WHEREAS, a review of the costs for past operations of the County Health Departments, as compared to the operations of the various other departments under the direction of HRS, indicates that the Health Departments are providing a much more efficient and economical operation; and WHEREAS, as pointed out in Schedule "A", attached hereto, any reorganization of the Department of Health could result in less services to the citizens of Florida at a much greater cost to the taxpayers. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA, as follows: (1) That the Florida Legislature is urgently requested to support Representative Earl Dixon's Bill to establish a separate Department of Health, with a Division of Public Health, to coordinate the over- all activities of the various County Health Departments. (2) That the State Association of County Commissioners and the Boards of County Commissioners of the Counties of Florida are urged to actively support this request. This Resolution shall become effective as of the 19th day of May , 1976. BOARD OF COUNTY COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA n . By Willard W. Siebe t, Jr.,Acb Xilman Attest: Ralph Harr ].s''', Q dtk s • r COUNTY HEALTH DEPARTMENT INTEGRITY The Florida public health system can be likened to a confederation of units, known as County Health Departments, all having similar and different character- istics in their health services programs and funding sources. These programs and the funding are governed by many state laws and regulations that require ® oversight of the entire system to be centralized at the state level. In addition, each is governed by county laws, ordinances and regulations, which in many cases contain safeguards for the public health over and above those required by the state. This system has existed since 1931 under a partner- ship arrangement between the state and the counties in the basic law known as Florida Statutes, Chapter 154. This system has worked exceedingly well. In fact, in the fiscal year ended June 30, 1973, the DHRS Division of Health (which included the County Health Departments) delivered 7,211,200 direct services to Florida citizens with 2,628 personnel, out of total services of 8,335,274, and total personnel of 32,863 for the entire Department of Health and Rehabilitative Services. To state it another way, 88 of the personnel delivered 86.5% of the total HRS services in FY 73. Nowhere in government can one find a better value per dollar expended than in public health, be it a federal, state, county, or provately contributed dollar. Conversely, the rest of DHRS delivered only 13.58 of total services with 928 of total personnel. Nowhere can you find a poorer value per dollar expended. As stated previously, the CND's are similar, yet the whole system is flexible. It provides for differences in public health programs offered in the various counties due to local geography, population, custons, funding. Coastal counties are involved in shellfish programs while interior counties are not. Some CHD's are intimately involved with their county governing authorities while others are not. A few even have their own laboratories. Others have extensive environmental health programs. Yet all are involved in statewide programs such as tuberculosis and venereal disease control. The funding, administration and professional direction of CHD's is a complex and intricately balanced process. It calls for local day-to-day and on -the - spot guidance and decision making. In addition to local direction, and the state -level coordination of statewide health programs, it calls for overall coordination and evaluatiion of funds, budgets, and personnel at the state level. It calls for a single agency that can provide overall, equitable allocation of state funds to the CND's; that can provide direct, fast reaction and turnaround time between the CHD's, the state comptroller and the division of personnel, or any other agency whose rules and regulations affect the daily operations of the CHD's. The shorter, the more direct this coordinative line can be, then the more efficiently and quickly can the CHD's respond to local health needs. This coordinative state agency that can deal directly with the CND's and with other agencies is needed regardless of the fact that the state contribution annually to the total CHD funds is as low as 28% in some cases. The funding and administration of the CHD is a very complex process that is, unfortunately understood by comparatively few persons outside of the public health professionals. The operation of a County Health Department is not something that can be learned vicariously. It is something that must be experienced! The large daily voulme of services delivered, the sources of funds and the management of those funds requires very fast reaction time on the part of the CHD's and the coordinative agencies upon whom they must depend. Some CND's may have as many as ten or more "operating budgets" and some of these may be incorporated in the CHU Trust Fund Budget. Some have general fund budgets supplied by their county governments in addition to funds from ad valorem taxes. In addition, the counties have many millions of dollars invested in the public health facilities and equipment used by the CND's. The interrelationships between programs and between budgets often result in a management process akin to that of a finely woven fabric. Any reorganization, which could ultimately result in less services to Florida citizens at a much greater cost to the taxpayers, should be closely observed and carefully evaluated. A system that calls for CHD personnel actions, payrolls, travel vouchers, physician vouchers, vender invoices, etc., to be processed through the HRS maze of district, secretariat, central personnel, consultants, analysts, specialists, health program office, etc., before they can ever get out of HRS to the division of personnel, the comptroller, or wherever else they go, to say nothing of the return trip to the CHD's destroys the fast reaction time so vital to the daily operations of the 4D CND's and cannot even begin to match the efficiency of the Bureau of Local Health Services of the old Division of Health. Such a bureaucratic process can only lead ultimately to disastrous public health epidemic in the State of Florida. 40 What is needed in Florida is embodied in Rep. Dixon's bill to establish a separate Department of Health, with a Division of Public Health to coordinate the overall activities of the various County Health Departments. It would i continue the state and county partnership under FS 154. It would maintain the local integrity of the County Health Departments and allow them to deliver maximum services at lowest cost per dollar expended.