New York's proposed budget for the coming fiscal year includes several public health policy changes that health officials support, Paul Pettit, director of Health Services for Genesee County, told the Human Services Committee during a department review Monday.
But the changes don't necessarily come with flexible or increased funding to help pay for the programs.
This could create new unfunded mandates for the county.
Providers for the Early Intervention Program haven't received a raise in 20 years and the governor's budget includes a 5-percent increase in the reimbursement rate but the burden for the additional expense will fall largely on the county.
"Providers have been loaded with additional administrative responsibility without additional resources and funding resulting in a continued exodus of providers, creating waiting lists, especially in rural areas like Genesee County," Pettit said.
The state is also looking at changes in residential lead monitoring programs. Currently, pediatricians able to conduct blood test for lead poisoning rates -- though not all pediatricians provide this service and not all parents take advantage of the service -- and those results are reported to a state database. County officials are then able to identify children with higher levels of lead in their system. A five-part level leads to a health worker contacting the family to provide education and information on best practices to avoid lead poisoning.
Action to remediate exposure to lead isn't required for the property owner -- whether the family is renting or owns the home -- unless a level of 15 mg/dL is detected.
The state is proposing lowering the rate -- thereby prompting more costly intervention -- to 5 mg/dL. This would mean an additional 50 to 60 inspections each year for the county with no additional funds from the state to cover the costs.
The Preschool Supportive Health Program remains the department's most expensive locally supported program, Pettit said. The state has been slow to provide mandate relief. There is a shortage of providers and reimbursement rates set by the state are not competitive.
"This shortage creates a waiting list for children who have been identified as needing our providers," Pettit said.
There needs to be changes in the program, Pettit said.
The state's county health directors continue to work with the governor's office on these and other issues, Pettit said, in an attempt to bridge the gap between mandates and funding.
