Perry County health director defends reduced HFI budget as council presses for proof ambulance spending meets prevention rules

Tara Lucas, Perry County health department director, told the county council on the department’s 2026 budget that a requested $11.59 carryover was intended to convert a 2025 stipend into salary and that the department had not asked for broader salary increases. "We are not asked to do any less on this budget. Everything is the same," Lucas said.

Lucas said the department drafted the smaller 2026 HFI budget after discussing 2025 carryover and regional guidance so essential programs could continue into 2026–27 "with the massive funding cuts." She described line-item reductions (office supplies, school-liaison supplies) while preserving core services such as prenatal vitamins, epinephrine and safe-sleep materials. On prenatal vitamins she said a bottle typically costs about $5–$7 and is distributed to uninsured pregnant clients who receive testing and referrals at the health office.

The largest point of contention was whether HFI money can legally or practically be used to fund EMS-related purchases such as an ambulance lease or capital equipment. A council member pointed to a $30,000 ambulance lease line and questioned whether the county could justify that as a preventative core service under Health First Indiana rules. Lucas responded that state guidance allows counties to choose a core service and must document how funds are used. "You have to pick the core service and you open it up, it will show you the key performance indicators," she said, urging the council to review Health First Indiana KPIs.

Health-board leadership pressed the council to provide the documentation tying EMS spending to prevention. The health board president said the board will require justification before endorsing related expenditures and instructed the council to supply evidence the ambulance or EMS activity would meet the chosen preventative core service's KPIs. At one point the exchange grew tense; the board president told a council member, "Justify it. Provide the documentation."

Council members and health staff suggested concrete preventative activities that could link EMS use to prevention: community fall-risk education conducted with EMS, event staffing and public education, home checks after births, rapid-response cardiac tools (AEDs) for prevention of death, and targeted outreach that reduces hospitalization. Lucas said staff would compile examples and documentation and circulate them to the council by email.

Action and next steps: Lucas agreed to rework the HFI budget to show a 10% ambulance/EMS allocation (the council’s target) and to send detailed documentation tying any EMS spending to specific preventative core services and KPIs. The council did not adopt or reject the health budget at the listening session; staff were asked to provide the requested justification and revised budget language for the next meeting.