COMMENTARY
Preserving health services Cost must be reduced BY DONALD R. MAY, MD Efforts have been ongoing to preserve
necessary public health care services in Lubbock by restructur- ing the Lubbock Health Department.
The City of Lubbock has made diligent efforts to best use
existing funds to prepare for additional state and federal fund- ing cuts. The intent has been to reduce the duplication of pub- lic health services in Lubbock, to move out of a deteriorating building and into newer and less costly facilities, and to ensure that the health department will continue to exist and provide the highest quality level of services. The immense cost pressures of
providing public health services, indigent health care, and other health services have impacted all communities and states. Most communities have severely de- creased the size of their health departments over the past three years. “Local health departments have been operating on leaner bud- gets and fewer staff since 2008,” said NACCHO Executive Director Robert M. Pestronk. “Fewer staff means a loss of key protections for you and me. But with the loss also comes resourcefulness and innovating ways to make the most of the staff and funding that remain.”
and other public health and indigent care services will quickly decrease, with much of the funding soon disappearing. The federal government intends to shift increasing amounts of the cost of Medicare, Medicaid, other indigent health care, and public health services to the states and communities. State and local governments cannot afford to pick up the additional expenses. The only way city and county govern- ments can support additional costs is to raise property tax rates, which has been a goal of the “politically correct.”
“Local health
departments have been operating on leaner budgets and fewer staff since 2008.”
Donald R. May, MD
Federal Medicaid, Medicare, health in- surance, and other health care mandates have greatly increased the cost of health care to states and communities. With the advent of Obamacare, massive additional amounts of federal health care dollars will go to pay the salaries of multiple layers of bureaucracies, leaving ever less money for health care services. Federal and state grants for immuniza- tions, sexually transmitted disease clinics,
The Lubbock experience Lubbock and other cities cut costs by consolidating duplicated ser- vices and contracting services to qualified health care providers. In Lubbock, we have the Lubbock Community Health Center, the Larry Combest Center, the De- partment of State Health Services (DSHS), and major hospitals and health care centers that provide immunizations and other clinical services.
The Lubbock Health Depart-
ment resides in a remodeled 80-year-old building that needs about $1.5 million in renovations
to keep it functional for the health department clinics, labora- tories, and offices. The Lubbock City Council and city manager suggested relocating the health department offices, laborato- ries, and clinics to other facilities and closing the building now housing the health department. Clinical services, including the immunization and sexually transmitted disease clinics, were to remain under the control of the Lubbock Health Department and were to be contracted to other health care providers in locations readily accessible to the public.
This announcement drew some confusion and public con-
cern. Due to the concern, Steven Presley, PhD, chair of the Lubbock Board of Health, appointed me to chair a committee
February 2012 TEXAS MEDICINE 47
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