By David R. King
Doña Ana County Manager
In recent days, Doña Ana County has come under fire from a few residents and politicians over a proposed amended ordinance. The criticism, while undoubtedly well-meaning, has been unnecessarily alarmist in nature. Instead of criticizing, these people should make a good faith effort to understand the proposal by which a small portion (approximately one-sixteenth of 1 percent) of gross receipts taxes currently earmarked exclusively for health services will instead be channeled toward the county’s General Fund, where it can be applied to a wide variety of programs, including preventive health services.
The county’s commitment to health-care funding remains resolute under this plan. A minimum of $1 million generated by sales taxes will continue to be earmarked solely for indigent health services, in complete and total compliance with state law. Revenues above that level can be used at the discretion of the county commission for other purposes, although much of the $650,000 we estimate to be affected will still go toward health costs.
Of the $650,000 affected under the current budget proposal, $400,000 will be used to offset rising employee health-insurance premiums. Without this allocation, many county employees would be forced to drop insurance for themselves and their families, thereby placing an additional burden on indigent health service providers in the county. Clearly, to allow such a thing to happen would be irresponsible and inconsistent with our obligation as an employer to make affordable health insurance available to our employees and their families.
Far from adversely affecting the county’s ability to serve the health-care needs of our residents, the current budget nearly triples health-related spending in any budget year prior to 2000 (see graph).
During the preparation of the 2001-2002 county budget, each one of the county’s 27 departments was mandated to cut back spending levels by up to 7 percent from last year’s levels. There is simply no merit to the argument that “the county is really trying to go into reserves for health-care needs and is unwilling to cut back elsewhere,” as was stated in a recent letter signed by a number of political leaders. Further, the county currently maintains a reserve fund of $4.7 million in its health-care coffers.
It is possible that $700,000 of the reserves will be spent to implement a county-wide coordinated health-care delivery system as recommended by the Doña Ana County Health Council. Assuming this proposal is adopted by the Board of County Commissioners, it will be a one-time investment designed to dramatically reduce costs and improve health services county-wide.
Health-care funding by the county has increased each year for the past three years, and no agency that has historically been funded has had its funding cancelled in the next budget cycle. In fact, the 2001-2002 budget contemplates health-related spending at a record level of $14.1 million. Further, agencies that want more funding than has been allocated have been invited to make their case(s) before the County Commission, with the promise that all requests will be seriously considered and, in cases where it is warranted, more funding will be made available.
Some critics of the budget have implied – wrongly – that the commission has subverted the intent of the Legislature by redirecting a small portion of sales-tax receipts to the General Fund. The truth of the matter, however, is that the county has, in the past, directed significantly more revenue toward health care than has been legally required and has, in many instances, committed substantial resources from other areas to health costs associated with indigent and inmate care.
Our critics are well-meaning people and elected officials who have, unfortunately, not taken a realistic look at the facts of the matter. Those facts support the management and elected officials who formulated the budget proposal that has been put forward. The underlying truth is that Doña Ana County is – and has been – a leader in the management of indigent health care and low-income health services for the residents who live here. We have been – and continue to be – forward-looking, and we are using our budget to meet many needs across a wide range of services in the most expedient and efficient manner possible.
Our books are open, and we welcome informed dialogue. We believe that reasonable people who study the budget will agree that the county’s proposal makes sense, and that it does nothing to compromise health care in Doña Ana County. Actually, health care is enhanced. The numbers just don’t lie.