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Crowd cheers vote to retain county health department
McCOOK, Nebraska -- At the conclusion of a meeting which felt more like a made-for-TV melodrama than a McCook public hearing, more than 90 area residents burst into applause and cheers Tuesday evening as Red Willow County Commissioners decided on a split vote to continue operating the county health department. The emotional reaction from attendees followed more than one and a half hours of testimony from supporters of the county health department, ranging from those who relied heavily on the services of the department, to local pharmacists, health care providers from other entities and local school representatives.
Commissioners Vesta Dack and Steve Downer were quiet for much of the meeting, with Commissioner Earl McNutt faced with the majority of direct questions from those who hoped to keep the health department open. Dack vocalized her support for the county run health department prior to the vote but it was unclear where Commissioner Downer sat on the issue until the final vote.
When asked where he stood on the topic by attendees just prior to the final vote, Commissioner Downer would offer no hints other than to say he and his family had utilized the county health department for years and he was ready for a motion. Commissioner Dack subsequently obliged Downer by moving to keep the health department open and the pair ultimately outnumbered Commissioner McNutt on a 2-1 vote, leading to the dramatic conclusion.
The testimony began with comments from one of the original founders of the Red Willow County Health Department, former County Commissioner Eldon Moore. Moore said government couldn't be everything to everybody and he didn't envy the decision commissioners were faced with. Moore said he had been commissioner for 32 years and the county health department budget was a "bone of contention annually."
Moore said he equated the situation to taxpayers being double-dipped by paying for city and county law enforcement. He also said the biggest argument against the health department was that it was servicing residents outside of the county and not assessing them for it.
Moore said he had mixed feelings himself about the topic but his vote would likely go to close to the health department, telling commissioners, "right or wrong, I won't hold it against you either way."
Local farmer Kevin Potthoff spoke next and began with an apology to Moore, "I'm sorry you started such a successful program," he said. Potthoff said his biggest concern was that "Southwest [Nebraska Public Health Department] can't tell us what services they will guarantee." Potthoff said the trust and compassion that Red Willow County Health Department operated with would not be duplicated by Southwest, "not right away, if ever."
Potthoff said taxpayers would not be seeing a rebate on taxes if the health department closed and said there was plenty of opportunity to increase service fees to reduce expenses.
"We have an efficient, quality health department, lets keep it," said Potthoff, who was met with the first of many rounds of applause from the near 100 county heath department supporters in attendance.
The wife of a man with type-two diabetes agreed with Potthoff, she testified that local podiatrists charged $105 for her husband to have his toenails trimmed, an amount they could not afford. The same service is provided by the Red Willow County Health Department for $15. The woman said there was plenty of room to raise the amount the county charged and still remain affordable to their patients.
Richard Klug said his wife was a nurse at the county health department and he had reviewed the department budget with the McCook Clinic office manager, Brian Rokusek. Klug said they had determined that after factoring in revenue the health department brought in and savings from not refilling the director position, as well as making improvements to their billing procedures, the budget could be reduced to somewhere between $100k to $130k. Klug said that was a minimal amount when compared to the $1.2 million county budget.
Rokusek reiterated Klug's statement and said the health department expense amounted to $8 to $10 per county resident annually, a very reasonable amount he believed when compared to the health service the department provided.
"Every one dollar spent on immunizations saves $120 in healthcare expenses," said Rokusek, adding that we needed both health departments.
"We believe in taking care of people, we're not concerned where they come from," Rokusek said, adding that in the healthcare business a lot of what was done didn't make financial sense. Rokusek said it was a cheap program and local control would be lost if it were closed.
Nancy Morris said she was a social worker and she wanted to speak on behalf of the many under and uninsured county residents. Morris said a lot of people utilizing the county health department could not afford the services anywhere else. "If you could say that Southwest will pick up these services I would be for it, but you are not saying that," said Morris.
Morris said concerns had been raised with expenses of the new county jail hurting the county budget, "we have not even seen ground break and we're talking about services being cut already."
Shirley Perez said commissioners had backed the construction of a new jail and provided financial support for Hillcrest, the county owned nursing home that has experienced financial problems in recent years, but nothing was said then about having to close the county health department. Perez said she believed commissioners were wise enough to find a solution to the problem and resented comments that supporters of the county health department were uneducated on the topic, adding that she had spent 30 years in the healthcare business and had a business degree as well.
Perez said she felt like commissioners were acting like parents to the county residents, "and you bought yourself a non-refundable ticket to a place you could not afford to go."
Another county health department supporter questioned why county employees were not required to pay a portion of their own healthcare, as nearly every other entity does, saying it could save the county hundreds of thousands of dollars each year. Others praised the local work of the county health department, citing examples of the previous director maintaining a local list of homebound elderly citizens, that was said to be of particular use during heat emergencies.
"Red Willow County Health Department is our neighbor," said Community Service Coordinator Barb Ostrum.
A former school nurse of 27 years said she would not have been able to obtain immunizations for her students without the county health department. "Thank you for the 27 years you helped me out. Please commissioners lets have a county health department," she said.
The Heritage Senior Center director, Sue Chipman, said Commissioner McNutt commented recently that he didn't want to pay the expense of another county employee's benefits, pertaining to replacing the recently retired director of the county health department. Chipman questioned how many county employees and accompanying benefit expenses would the new jail be adding, saying that one for the county health department shouldn't break the budget.
Chipman said the people of Red Willow County will lose services, services that have been available for years and that cannot be found anywhere else. Chipman specifically mentioned foot and blood pressure clinics that she said Southwest Nebraska Health Department had told her would not be provided.
Chipman added she was speaking as a citizen of McCook and not a representative of the city owned senior center.
County health department employee Terri Stevens said they had collected 823 names on their petition and had a third party confirm the signatures after Commissioner McNutt made comments on the radio that the petition contained duplicate names. Stevens said four names were duplicated of the more than 800 signatures, not the 25 McNutt had said on the radio.
Several others asked commissioners to take a step back and review the scenario, consider the public opinion received on the matter and look for a solution in the future that didn't require the loss of services.
Commissioner McNutt responded to a question that any savings from the closure would likely be absorbed in the budget to offset increases. McNutt said budget cuts were worked on all the time by commissioners and were similar to the animal trapping services that had been cut recently. McNutt said he believed the scenario was a matter of poor communication and that Southwest could provide the majority of the services.
The Superintendent for Southwest Public Schools equated the scenario to the 1988 presidential election. Clayton Waddle said commissioners seemed out of touch with what regular folks wanted, similar to what he believed led to a Clinton victory over Bush.
Waddle said 71 percent of Southwest Public School kids took advantage of the Red Willow County Health Department, "you're not taking into consideration health care for these kids."
Local business owner Linda Taylor said if it was a vote of the people that created the health department why not consider a vote before closing it.
A local pharmacist said the reminder program pertaining to when children's immunizations were due, provided by the county health department, was very valuable to working parents and not an area of expertise for Southwest Nebraska Public Health Department. Others praised the overall efficiency of the county health department and said it was a great asset to the community.
Just prior to closing the public hearing Commissioner McNutt was asked if he himself was a county employee. McNutt responded that he was, but offered no further response when the citizen asked why his department's budget wasn't being cut.
Prior to the vote Commissioner McNutt said he believed there had been a "lack of education and information representing Southwest," and added that he had sat on the Southwest board for 10 years and was part of the group of commissioners that started the Red Willow County Health Department. McNutt said Southwest was in the process of taking over 90 percent of the county provided services.
Commissioner McNutt subsequently faced criticism from attendees wanting to know why, if there was a lack of education, Southwest Nebraska Public Health Department had not spoke during the public hearing. McNutt responded that he had asked them not to attend the meeting, saying "it's not there meeting."
Another citizen asked McNutt, if he had sat on the Southwest board for so long, why he wasn't able to be more specific with what services they wouldn't be able to provide.
Commissioner McNutt said the decision was a no-brainer to him, he believed the county could get the services they provided now, for free.
Commissioner Dack responded that she had been vocal in her support of the Red Willow County Health Department and didn't believe the services could be picked up that easily. Her subsequent motion to keep the county health department opened was seconded by Commissioner Downer, who had maintained a poker face throughout the public hearing and refrained from giving hints as to where he stood on the issue.
Downer's vote in support of Dack and keeping the county health department open was met with a roar of cheers and applause from the near 100 in attendance, who subsequently lined up to thank the two commissioners for their decision.