MISSISSIPPI (WDAM) - The Mississippi State Department of Health is considering reducing the number of public health districts and stopping some programs to cope with less state funding for the next fiscal year.
Liz Sharlot, Director of Communications for the Mississippi State Department of Health (MSDH), said the department's reorganization proposal would reduce the current nine districts to three with the state divided into northern, central and southern regions.
"Each of those areas would have about 33 percent of the population, and what that does there is reduces administrative costs," she said. "We no longer have nine district administrators. We now have three. We won't need all of the district health offices now. We'll only need three, so things like that where we can reduce that administrative cost without having any impact on the field is what we're looking at."
Last year, Sharlot said MSDH combined departments departments within it's central office, like the Office of Health Disparity Elimination and the Office for Policy and Evaluation, to also reduce administrative costs and help the department operate more efficiently.
"We really want more of the impact to be on the administrative end," she said. "We need to look at ourselves more as a business model, learn to operate leaner, more efficiently and effectively, while assuring core public health services."
Sharlot said MSDH started fiscal year 2017 with $36 million from the state to run the agency and pay employee salaries, but budget cuts throughout the year reduced that to $31 million. For 2018, the state budgeted $24.6 million for the department.
"It's a 32 percent decrease in state funds, however it could have been a much worse scenario," Sharlot said. "We're very grateful to the legislators who worked with us, so that we could assure core public health services. So certainly a cut, and one that will mean we need reorganize, but not as bad as it could be."
The department started evaluating programs last year that were seeing fewer patients, and closed nine county health departments, including one in Jasper County, to reduce costs. Sharlot said the department doesn't plan to close any health departments in this reorganization, but said some services, like childhood immunizations and the Early and Periodic Screening, Diagnosis and Treatment Program, could be stopped.
"The Affordable Care Act allowed them to have a medical home, which is a good thing, but it kind of means we need to reevaluate what we're spending money on and doing because people are going elsewhere for the services," Sharlot said. "The services are assured in other places, and people aren't coming to us for it anymore. We continue to lose revenue, so we are studying those numbers as well."
Sharlot said from 2009 to 2015 county health departments saw a 54 percent decrease in patients coming in for childhood immunizations. The Early and Periodic Screening, Diagnosis and Treatment Program saw a 47 percent decline over the same period.
"The numbers drive a lot of the decision," Sharlot said.
She said the same reasoning applied when the department saw a 47 percent decline in maternity patients fro 2009 to 2015 and stopped enrolling new patients in early 2016.
WDAM 7 News asked on Facebook for viewer opinions about the proposed program cuts.
"Hardly anyone uses the health dept for vaccines anymore," Nicole Lott wrote. "They are given by the child's primary doctor at well check ups. Why continue to fund the program when that money can be used elsewhere? By having the vaccines done by the child's doctor, this also ensures that the child is getting regular checks so problems won't be missed/overlooked by only seeing a nurse for vaccines at the health dept."
Kathi Selman agreed, saying, "Vaccines are given at well baby check ups even if the child is on Medicaid (chips) or private insurance. Like the previous poster said it's a great way of ensuring regular check ups and a child being followed by a regular provider. Vaccines are vital but I know no one in my area that uses the health department for vaccines. With the rising cost of vaccines, the cost doesn't outweigh the benefits, so if you have a program not being used to its full potential why not use funds where they are necessary?"
Wayne Garner disagreed, saying cutting the childhood immunization program puts lower income children, and subsequently the general population, at higher risk for diseases.
"While there are people that CAN afford primary care doctors there are still a number of people that cannot afford the shots and are going to procrastinate until they actually have to have them at age 7 entering kindergarten," he wrote. "That puts a large population of kids at risk from infancy until age 7 with no vaccinations. My opinion is that there will be a rising amount of children deaths/sickness in the coming years."
Sharlot said the agency's job is to promote and protect the health of all Mississippians by assuring core public health services.
"If you're going to operate like a business model, you can't keep putting money in where you're losing revenue, and the truth is, our clients are finding other places to go for these services" Sharlot said. "We would not stop any service without being assured that people could get those services elsewhere."
Sharlot also said job cuts are inevitable, but doesn't yet know how many positions could be eliminated.
Sharlot said any reorganization must be approved by the state personnel board, so none of these decisions are final. She hopes to have a plan in place by June 30 before the 2018 fiscal year starts on July 1.