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Public health director asks for targeted increases as Medicaid and EMR costs shift
Summary
Public health and home health budgets were presented with a $20,000 increase to Medicare supplies, a new $10,000 tobacco grant (with $5,000 non-wage expense), and higher revenue expectations for private-pay nursing; officials debated how cost-of-living raises and step/performance increases should be reflected in departmental totals.
Speaker 2, identified in the transcript only by speaker number, walked supervisors through public health and home health budgets and the reasoning behind several line-item changes. She said she increased the Medicare supplies line by $20,000 (from $80,000 to $100,000) to cover therapy and Medicare supplies and noted that EMR and information-tech costs are trending upward each year.
Speaker 2 introduced a new tobacco grant worth $10,000 and explained that approximately half of that ($5,000) would be salary and the remainder would be spent on eligible supplies and programming; staff will spend the grant and receive reimbursement. "It's a $10,000 grant...half of that would really go towards salary," Speaker 2 said.
Supervisors and department heads engaged at length about wages: whether cost-of-living increases should be pre-included in departmental budgets and how step or performance raises are tracked. Speaker 2 said the department had already included roughly $8,500 in step/performance increases in the wages line and that any approved cost-of-living increase would be added on top. "The step increase is already included in there," she said, and asked for guidance on whether to build cost-of-living raises into the base submitted to the auditor.
Other revenue adjustments noted included modest increases for community education, immunization insurance revenue, Medicaid therapy, and private-pay nursing, which the director said can fluctuate substantially with single patients starting or stopping service. Supervisors asked for clearer spreadsheets breaking out step increases and performance raises so the board can see what portion of a wages number is base pay versus step/performance adjustments.
