As part of a state effort to transform public health in Kentucky and make it more cost efficient – especially in light of pension costs that are expected to rise dramatically next year – the Whitley County Health Department is looking at what programs and services aren’t essential, what might no longer be needed, and things that are losing money and can be cut. It is also trying to identify what services to keep.
A very partial list of both started to emerge during Monday night’s quarterly meeting of the Whitley County Board of Health.
Whitley County Public Health Director Marcy Rein noted during the meeting that most of the services offered by the health department are required unless the Kentucky General Assembly makes changes to the law, such as not requiring some environmental inspections.
She did identify a few items that the health department will likely to cut, such as most family planning practices with the exception of handing out condoms, which the health department gets for free.
Rein said that the health department is planning to cut well child exams and newborn screenings unless there is strong opposition to discontinuing those programs.
“We got through the beginning of the school year to make sure everybody had their needs met,” Rein noted.
The health department does plan to continue pregnancy testing, which Rein noted is a good feeder for the agency’s HANDS (Health Access Nurturing Development Services) program.
The health department plans to continue its home health program. The health department will continue handing out Give Me a Reason drug testing kits that parents can pick-up for free. These kits are provided for free by Operation UNITE, and it costs the health department little to do this.
In June, Kentucky Public Health Commissioner Dr. Jeffrey Howard told the Whitley County Board of Health, which oversees the Whitley County Health Department, that the state planned to transform the way local health departments operate with the goal of stretching their available dollars and targeting the most pressing health needs in the county they serve.
Four core programs that health departments will continue to provide are HANDS, WIC (Women, Infants, Children), harm reduction initiatives and substance use disorder service, he told the board.
Local health departments will also be required to keep offering services required by law, but will be able to decide what other services and programs to discontinue and which to keep through a community health assessment.
These proposals will then be presented to a public health advisory council for approval.
Rein told the Board of Health Monday that plans are being put into place to make this transformation plan law when the General Assembly convenes in January.
A pension reform bill passed during a special legislative session earlier this year gives health departments and other quasi governmental entities, such as community mental health centers, rape crisis programs, and regional universities, the option to opt out of the state pension system, but the agencies would have to pay to do so.
Rein added that health departments have until Dec. 30 to request a cost estimate on what it would cost them to get out of the state pension system. The cost for this evaluation is $1,500. Should a health department decided to cease participation in the state retirement system, it will need to provide the state with notice between April 1 – April 30.
The effective date to leave the state pension system would be June 30.
In addition, during Monday’s meeting, Rein also gave the board an update on the harm reduction program, which is also known as the needle exchange program, where drug users can exchange used hypodermic needles for new clean needles instead.
The goal of the program is to reduce the transmission of diseases, such as HIV and Hepatitis C, which can easily take place when drug users share needles. Statistics show six intravenous drug users typically share one needle.
Since the last board of health meeting in June, the health department has conducted 13 harm reduction clinics with 428 total participants and 58 new participants.
The program disposed of 11,317 used needles and gave out 11,964 clean needles.
“Those numbers will never be equal because the first time you come to the clinic, we don’t make you give needles back. We are always going to give more than we take,” Rein said.
During the clinics, the health department gave out 28 Hepatitis A vaccinations, performed 13 HIV and Hepatitis C tests, and gave out 132 Naloxone kits.