Lewis and Clark County Health Department faces budget cuts, service reductions

The Lewis and Clark County Department of Public Health plans to cut positions and reduce services as the county works to balance its budget. 

County commissioners last fall directed the health department to cut about $400,000 for the upcoming year’s budget. The plan includes eliminating six staff and administrative positions and cutting back on immunization and health inspection services.

“We are looking at a pretty significant budget shortfall with ongoing increases in fixed expenses in particular due to inflation. So rent, IT, personnel, those expenses are growing faster than our revenue is growing for the health department,” Lewis and Clark County Public Health Officer Drenda Niemann said during a November city commission administrative meeting.

Immunization and vaccines the department usually provides may be limited to individuals who don’t have health insurance, and department officials are encouraging the public to see their primary health care providers to provide these services.

Health inspections of restaurants, group homes, daycares, pools and spas are also at risk of being affected by budget cuts. The county typically conducts multiple health inspections at such businesses throughout the year, although the state requires only one annual inspection. 

However, without adequate staffing, the department cannot meet those needs, and the public could be more susceptible to things like foodborne illnesses as a result, Niemann told Montana Free Press in an email. 

Besides job losses and service cutbacks, city and county officials are concerned about maintaining a balanced budget. During a city-county commission joint work session in December, Niemann addressed a question on what efforts could be made to lessen the impact of the cutbacks. 

“We know that expenses will continue to rise,” Niemann said. “We know that revenues won’t rise at the same level that our expenses are, so we really need to be thinking beyond just fiscal year ‘25 into the future on how we’re able to maintain operations at a high quality and the operations that are absolutely necessary to protect public health and still meet budget demands. I don’t think the work is done.”

The plan to balance the budget for the fiscal year 2025, which begins this July 1, also calls for the reorganization of the health department by moving its environmental health division out of its current location in the City-County Building to the Murray Building where the rest of the health department is housed. Renting the city-county space costs the county about $46,000 annually.

Lewis and Clark County utilized CARES Act funding to supplement the budget after the health department spent its cash reserves during the pandemic. Now the county is asking the budget to be balanced without any additional funds, Niemann said during the initial city commissioner’s administrative meeting in November. 

The public health department’s total budget for the 2024 fiscal year is about $6.2 million, according to the county’s report, with 26% coming from tax revenue and 46% from grants, but it has had difficulty keeping up with inflation and the increased cost of operations, Niemann said.

The budget plan includes expense-reducing strategies as well as revenue-making strategies, including charging increased fees to businesses that require inspections. According to Lewis and Clark County Commission Chair Andy Hunthausen, the fees the county currently charges for inspections fall far short of the $300,000 needed to operate the program.

 The budget plan for the health department will be presented to the county board of health next month. The county commission is expected to take up the issue in the spring. 

This story was updated on Jan. 25, 2024, to correct the spelling of Drenda Niemann.

In-depth, independent reporting on the stories impacting your community from reporters who know your town.