“The Affordable Care Act will have an impact on health departments. It is going to put a whole lot more people out there on the street on health insurance” of one kind or another, Dr. Rice Leach, head of the Lexington-Fayette County Health Department, told Cox.
“I think how health departments are impacted is going to look a little different depending on what part of the state they’re in,” Rice said. “The United States has passed a law that creates an entitlement for 30 or 40 million people, and here in Lexington, for 10,000 or 20,000 more people to have health insurance. Now, who is going to take care of them?”
If the private sector can’t handle the increased patient load, Leach said, the stress goes onto the health departments, meaning they may be expected to provide a broad “continuum” of care for acute medical needs, including doctors and laboratory services. Leach said he hopes other systems will step up to provide care so health departments can continue to focus on preventative services.
Many factors determine what health departments can and can’t do as well as their ability to generate dollars. Leach called the services mandates by state and federal governments as “mission critical activities,” which include preventive health, communicable disease control, public health education, emergency response, sanitary code and restaurant inspection and public health policy, writes Cox.
Despite the challenging economic environment created by budget cuts and managed-care non-payment issues, Kentucky health departments are trying to stay focused on their big-picture mission. Some departments are writing grants and others, like the Lincoln Trail District Health Department, has sent nurses into school systems in attempt to increase revenue through expanded clinical services, Cox reports.