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Consolidations coming to county health departments

By MARY SELL, Alabama Daily News

The Alabama Department of Public Health plans to consolidate some services and staffing at county health departments.

The changes will be implemented around Jan. 1, State Health Officer Scott Harris told Alabama Daily News. Funding changes at the state and local level are at least part of the reason for the scale back. County specific plans have not been finalized.

“We will see some counties that may not have every service every day,” Harris said. Local offices will be open for birth certificates and other documents, but a nurse may not be on staff every day, he said.

A handful of counties have multiple health department facilities.

“We’ve talked to them about closing a redundant site,” he said.

Harris said ADHP officials are talking to lawmakers about potential changes in their districts.

Meanwhile, Harris said he plans to ask in the 2020 legislative session for additional funding for county departments. 

Alabama Daily News has previously reported that ADPH is looking for ways to save money after losing about $21 million in revenue this year that it previously received from Alabama Medicaid to manage the care of some Medicaid recipients.

Sen. Larry Stutts, R-Tuscumbia, is a medical doctor and on the Senate’s health care and General Fund budget committees. He said he wasn’t yet aware of health department changes, but is supportive of cost savings.

“I haven’t heard about it but I think it’s probably a good idea,” he said. “I applaud ideas to be more efficient.”

About future budget requests, Stutts said he wants to support the services the department provides, “but I also support efforts to make it more efficient.” 

Harris said that in recent year’s financial support from county and municipal governments has dropped from about $10 million a year to about $5 million.

“We’ve had a significant loss of county and city funding in recent years,” Harris said. There are several counties that have cut us out completely.

“…They’ve got their own local issues.” 

In 2019, ADPH had total appropriations of $799.4 million, about $113 million of that being state dollars. Most of the funding is federal. Its total funding has trended down slightly in recent years, from $816 in 2015.

Harris said the changes have been years in the making. Coosa County closed its health department to the public a few years ago. Various health inspections are handled by staff from other counties.

“We provide services in every county and always intend to do that,” Harris said.

Family planning, including birth control, is the largest clinical service county office’s offer, Harris said. Others include sexually transmitted disease treatments and some cancer screenings.  

“We’re the only provider in some of these areas … we’re certainly the only provider who can see people regardless of ability to pay,” he said.

Sen. Jim McClendon, R-Springville, is the Senate Health Care Committee chairman. He said some senators want a detailed account of what primary health care, including pediatricians and family doctors, is available in each county.

“In some of them, we’re probably going to find out that there’s not much,” he said. “…We’ve got to find out what we’ve got out there.”

Harris said the department is considering the state’s lowest-income and underserved areas, including the Black Belt, as it makes changes.

“We intend to be there,” he said.

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