TOLEDO – Upon entering the Tama County Public Health (TCPH) building for the joint Board of Supervisors and Board of Health work session last Monday (March 17), it was impossible to miss the many hearts festooned around the office with numbers written in the center, each heart representing a client TCPH has served since 2020.

The number in the center of the heart stood for how many months they were patients. The largest number represented a patient who received TCPH services for 204 months.

This meeting came as rumors had been spreading that TCPH was shutting down, which officials refuted as false gossip. The department will remain open, but budget cuts are likely as the Board of Supervisors seeks to reduce overall general fund expenditures by nearly $950,000.

Nothing regarding the public health budget is final, but during this work session, possible numbers were mentioned. Public Health Assistant Director and CFO Lori Johnson stated in the meeting that they were asked to cut $372,881.50 from general basic fund dollars. Johnson went on to state that between positions remaining unfilled, one employee resigning, and reducing the budget line by line, they proposed cutting $336,067; factoring in FICA, IPERS and health insurance, the total would come to $445,714.

Much of the meeting was made up of discussion and comment. Several speakers shared testimony regarding the good work TCPH does in the community and how much their services are needed in the county.

Board of Supervisors Chairman Mark Doland handed out a packet of information that he had compiled, which included a map from the Iowa Hospital Association that showed Tama County is one of only a handful of counties without a hospital. A chart compiled from information in the ISAC county manual compared Tama County’s population and number of public health full-time and part-time employees to seven other counties.

According to the chart, Tama County has a population of 16,613, and public health has 13 full-time employees and two part-time employees. Crawford County, the closest county in population on the supplied chart, has a population of 15,781. Crawford’s Public Health has 21 full-time employees and 10 part-time. Crawford also has a hospital, but Tama County does not.

Other information in Doland’s supplied packet included a map from an Iowa Department of Public Health 2023 survey showing the counties that did and did not have county-supplied home health services. Also from that survey was a chart showing what positions full-time public health employees occupied, registered nurses were at the top.

“In my own opinion, the rest of the board has to determine whether, because there’s some real, you know, staunch, does this change their mind at all. I think I did my due diligence, I did a lot of research, I put this report together over the weekend to try to sway their opinions. I was okay with leaving it at 20 percent. They came in at 18. I think that’s pretty close,” Doland said. “For every five percent that we don’t cut, it costs us $75,000 and we’re trying to at least break even, and we need $150,000 to break even so I think that we could find that (in) other places, particularly in the rural services. If we can pay some of this bill out of rural services, that will free up our general fund which will allow us to keep them funded at the level that they need to be.”