By Scotta Callister
Blue Mountain Eagle
CANYON CITY – Faced with continuing revenue worries, the board of Community Counseling Solutions has voted to give the county health department back to Grant County to run.
Kimberly Lindsay, executive director of Heppner-based CCS, told the Grant County Court last week the nonprofit continues to see revenues lag at the public health clinic.
She said the situation continues despite “a lot of efforts to address the budget issues, and a certain amount of sweat and tears … Including the $80,000 the county generously provided, there is still a deficit – a significant deficit.”
Briefing the Court at its Feb. 19 meeting, Lindsay said it was a hard decision for the board.
Asked by County Judge Scott Myers how soon CCS wants to make the change, Lindsay said the cleanest break would be to have the transition at the end of the fiscal year, June 30. The CCS board said it would give 90 days notice in writing next month.
County Court members hope to come up with a way to keep CCS on board, however.
Commissioner Boyd Britton said he had talked to the chairman of the CCS board, and “the door is not closed.”
He said the health department has been “trending down,” and the board wants to see that trend stop.
He said the Court can go back to the board with a counterproposal.
According to information from the Oregon Health Authority, most counties provide some general fund money to run their health departments; Grant County is among the few that do not.
Myers said he wanted more information on that trend and how others counties are handling their public health services. The Court plans to discuss the situation more at a future meeting, but has not set a date.
The county began contracting with CCS to run the health department in 2012, basing that decision on a successful partnership at the mental health department. Last week’s notice from the board affects only the public health duties, not the counseling and mental health services.
County and CCS officials have pegged the department’s difficulties in part to reduced state funds and loss of some grants. But they say a key factor was the loss of Tim Neilson, the family nurse practitioner who died unexpectedly in September 2012. That left a period of several months when the department had no physician, and many patients shifted to other providers for primary care.
CCS brought in Karen Triplett, a family nurse practitioner who formerly worked for the county, in January 2013 to fill the void, and she has been working to rebuild the practice.
In August 2013, the County Court decided to take $80,000 from contingency to carry the department through tough times.
Lindsay said the agency continues to seek new grant and revenue opportunities.
However, at the board’s direction, CCS has been absorbing the administrative costs, which means the nonprofit’s other programs must cover that expense, she said. She also said the health department still does not have the 90-day reserves recommended for operation.
She said she presented other options to her board, including proposals to cut primary care or do an across the board FTE reduction. However, the board voted to begin the process to return the department to the county.
Court members, discussing what services are mandated, balked at the idea of cutting primary care.
“If we lose primary care, we’re going to lose the health department,” said Commissioner Chris Labhart.
Britton said he believes primary care, which is the department’s main source of revenue, is rebounding thanks to Triplett.
Sally Bartlett, the county’s economic development coordinator, said the death of a doctor can decimate a practice, and that’s why it could take more time for the health department to recover.
She said the Court also needs to consider how the county would manage the department, if CCS gives it back.
“I don’t think, in the past, the county has ever been prepared to administer a health department,” she said. “We didn’t have the knowledge base and we didn’t have anyone suitable or experienced for that job.”
She and others said CCS has provided that experience and made improvements in both patient care and business practices at the agency.
Lindsay said the nonprofit has straightened out some billing issues, bolstered policies and procedures, improved staff training and other aspects.
“I’m very proud of what CCS has accomplished, with the county’s support, at the Health Department,” she said.
Lindsay Madden, who works for CCS, said the agency has a strong team and a strong program now, but that might not be the case without the administrative abilities provided by Lindsay and CCS.
Adding to the concerns, CCS officials said Triplett would not be interested in continuing in her position if it reverts to the county.