Fifteen percent of the Osceola County Health Department’s workforce was laid off Tuesday after the agency announced earlier this month it is seeing an increase in patients and a decrease in funding.  

Employees in clerical, environmental health and other non-clerical positions, 37 workers in total, were terminated from salaried and hourly positions after the state agency ran out of money. Services, such as maternity, will see cutbacks and consolidations in the coming month.

“Our expenses have quickly outgrown our revenue and as a result, we have greatly reduced our non-staff expenses over the past few years,” Belinda Johnson-Cornett, department administrator, said. “Unfortunately, in an effort to right-size our organization and to operate within our budget, at this time we had to reduce our staff expense.”

The layoffs will have an “immediate” impact, Johnson-Cornett said, particularly in clinical services, as the public may see an increase in wait times at the clinics as well as more difficulty getting appointments.

At its April 4 meeting, Osceola County commissioners heard that funding shortfalls would force the Health Department to both cut and consolidate services while the need for such services is increasing.

Johnson-Cornett provided a report to the commission outlining how Health Department services are used and what challenges lie ahead.

Johnson-Cornett said the Health Department is seeing more patients who are uninsured or who pay on a sliding scale, which results in less revenue. More than $1.5 million was spent on uninsured residents seeking care and services in 2010.

She also said there have been steep state budget cuts since 2008 with more impending cuts coming and there has been less federal grant funding available.

The pharmacy at the department’s Stadium Place facility is closing Friday, in part, due to the agency ending pharmacist Jessica Warthen’s contract early “in an effort to decrease our expenses and save more staff positions from being eliminated,” Johnson-Cornett said.

“The pharmacy is definitely closing as we can no longer afford to keep it,” Johnson-Cornett said, adding the pharmacy’s expenses for 2010 were nearly $400,000. “We are currently working on a short-term contract with another pharmacist who can assist us in transitioning.”

The hope is to keep the pharmacy open long enough to help patients find a new location to fill their prescriptions. Camille Bissainthe, public relations director for the department, said medications for the 2,500 prescriptions a month now being filled would no longer be purchased.

The department’s pharmacy offers reduced prices on medications based on a federal guidelines and that the pricing will be continued at the private pharmacy, according to Johnson-Cornett.

The pharmacy space will be used for the maternity department, she added.

This will likely improve care for Jasmine Ruiz, who moved to Kissimmee last week from New York City and is seven months pregnant. Ruiz’s stepmother, Sylvia Torres, brought her to the Health Department’s main campus Wednesday to inquire about prenatal care.

Although Ruiz was on Medicaid in New York, due to differing regulations between the states, Ruiz was unable to transfer her insurance and is currently without health care. Torres was told the Health Department was free for uninsured residents, however, staff informed her rates had recently gone up. Ruiz paid $19 for a urine test to prove she was expecting.

“It’s not a good thing for anyone in the long run,” Torres said about the cutbacks and cost increases.

Johnson-Cornett told commissioners that the last service to be cut would be primary care, an area of great need.

For 2009-10, according to the report, the Health Department saw 39,516 patients for 109,006 adult, child, maternity and dental care visits.  

Johnson-Cornett offered a number of statistics to commissioners to demonstrate the county’s status as a medically under-served area and under-served population, especially in primary care:

• The county in 2010 was 43rd out of 67 counties for morbidity factors (the lower the number, the better overall health) and 50th out of 67 counties for access to health care.

• The county in 2009 had 66 primary care doctors per 100,000 population and in 2010 had 64 primary care doctors for that same population, one-third of what is needed.

Commissioner Frank Attkisson asked Johnson-Cornett about the primary care issue.

“Are we profitable for primary care physicians?” Attkisson asked.

Johnson-Cornett said not having enough primary care doctors or not being able to keep them in the county once they are here is something that requires discussion with the medical community.