After exploring a different route, county supervisors now appreciate more than ever their partnership with the Greene County Medical Center to provide public health services.

Public health services to remain at medical center


A year ago, county supervisors reacted to a funding request from Greene County Public Health like a kid getting a diphtheria shot.

This year, they put on a brave face and even watched the needle go in.

Supervisors were unfazed at Monday’s request by the Greene County Medical Center to boost public health funding for fiscal-year 2019 by another $100,000.

While supervisors took no action Monday, board chairman John Muir doesn’t see any problems with the medical center’s request of $300,000 to operate a public health department on the county’s behalf.

“We’re going to get our money’s worth and come closer to carrying our load to what it’s costing them,” Muir said.

Muir chalked it up to a series of meetings over the past year that better educated supervisors on the actual costs of a public health department to the medical center, which was reeling from delayed or denied reimbursements from Iowa’s recently privatized Medicaid system.
Medical center CEO Carl Behne this week said they’re pleased with the supervisors’ willingness to increase funding and that they appreciate the partnership.

Behne, too, said he feels supervisors’ “understanding for the work public health does, the resources needed and the overall efficiencies the medical center creates grows more and more each day.”

“They have a lot to take in and understand across the county,” he said, “so it is our job to help educate them better throughout the year.”

When the medical center last year requested $275,000 to operate public health in fiscal-year 2018 — a jump of $125,000 from the year before — supervisors experienced sticker shock.

When the medical center floated a three-year plan that would see the county by fiscal-year 2020 picking up the entire, $614,000 cost of public health, supervisors essentially went into cardiac arrest, vowing to explore alternatives and questioning the medical center’s tab.

Supervisors agreed to fund public health at a cost of $200,000 for the current fiscal-year that began July 1.

The county budgeted $150,000 for public health in fiscal-year 2017.

“The plan for now is to take one year at a time and continuously review our expenses, services and access to revenue,” Behne said. “We will more than likely look at additional increases, but what those numbers look like is to be determined.”

Behne previously told The Jefferson Herald the hospital “just can’t sustain footing the entire bill.” He said public health expenses by fiscal-year 2020 were estimated to top $985,000.

Muir said supervisors were unaware public health was such a drag on the medical center’s bottom line.

“We didn’t want to be a burden to them,” he said.

By state law, the county must provide some level of public health services. In Greene County, those services have been offered since 1984 through a partnership with the local hospital.

“One way or another,” Muir said, “there’s going to be a cost incurred with public health.”

Muir said the hospital’s buying power for drugs and supplies makes the continued partnership especially attractive.

“You’re talking $50,000 in extra cost that would be to us,” he said.

Muir also said that public health staff — who are medical center employees — would become the county’s responsibility alone if not for the partnership.

Muir said the current public health department does an “excellent job.”

“What we have now ... they fill a lot of needs,” he said.

He said he’s comfortable funding public health at the full $300,000.

“We ended up where we needed it to be,” Muir said, “to be fair from both sides.”

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