With his budget pared by the state fiscal crisis, Carroll County Deputy Health Officer Larry Leitch is saying that county property owners may discover they have no place to complain about rats and trash in their neighborhood and drug addicts may end up with no place to go for residential treatment.
Health departments throughout metropolitan Baltimore face a loss of funds as the state Department of Health and Mental Hygiene cuts $61 million and as many as 700 jobs statewide.
In Carroll County, which will lose $1.6 million in state aid, Leitch plans to terminate 93 people -- 50 full-timers, 35 on contract, seven temporary employees and one consultant. The health agency currently employs 370 full- and part-time people.
The full-time employees could be laid off by mid-January, Leitch said, but the contractual workers will lose their contracts and their jobs as of today.
Leitch expects that the county, too, will pare some of the $1.9 million it contributes to his overall budget of about $10 million.
The state's plan to reduce its share of a state-county funding formula for health care leaves local officials pondering ways to make up for the loss of state money. Local governments must decide whether to lower their funding levels by the same proportion, keep them at the same dollar amount, or spend more.
Local officials also face the effects of statewide cuts in specific programs, such as drug-treatment centers.
The centers were among services targeted in an early version of the state's sweeping budget cuts, but some may be spared as a result of the budget-cutting revision signed into law last Friday.
State Health and Mental Hygiene Secretary Nelson J. Sabatini said the governments will be updated after the state Board of Public Works approves the overall $61 million cut tomorrow. .
Sabatini said drug addicts from treatment centers that are eliminated may be referred to those that are still open. But the referred clients are likely to join a lengthening waiting list. "There were not enough slots to meet the need even before the cut," Sabatini said.
In Carroll County, Leitch said, three in-patient programs -- providing detoxification, rehabilitation and long-term care -- are expected to close by the end of November. Out-patient services in Westminster are to continue operating under a 20 percent budget cut.
PTC Leitch said his agency also will lose the following programs: noise-control monitoring, school health nurse visits, dental health services, visiting nurses to people confined at home with chronic illnesses, investigations of sexually transmitted diseases, advice to poor women on their health, lead abatement and weed control.
People who relied on weed control personnel to mow an overgrown adjoining property will just have to "slug it out in the neighborhoods," Leitch said.
Several other services, such as restaurant inspections, air-quality monitoring and youth camp certifications, will be reduced, he said.
In Howard County, officials say state cuts will force them to scrap plans for a halfway house for recovering addicts.
Nancy Weber, an assistant to the health officer, said further cuts could come. "The bottom line is, we don't know," she said. "We're in a holding pattern."
The Anne Arundel County Health Department is still figuring out how to compensate for a $1.2 million loss from the state, including $260,000 slated for mental health services, said agency spokeswoman Evelyn Stein.
In the meantime, the Health Department is asking county residents who can afford it to pay $5 for flu shots that are ordinarily free, Stein said. Her agency also plans to close four community health centers, she said, but there are no plans for staff layoffs. Stein said that staff from the centers will be dispersed among the 10 remaining health centers Jan. 1. The change is expected to save about $40,000.
Even before the state budget crisis, the county had planned to close the centers in Davidsonville, South Shore, Churchton, and Meade Village because of declining population, Stein said. "The current budget crisis just moved us to act a little quicker than expected."
County officials are still thinking about how to make up the rest of the cut, Stein said. "Not all the details are locked in. We still have more than a million dollars in cuts."
Baltimore health officials have drafted three plans to deal with a $6 million budget cut. The plans, which have not been made public, are now before Mayor Kurt Schmoke.
On its face, the budget cut would mean the end of the city's schoolnursing program and restaurant inspections, among other things. But Schmoke has declared the nurses a priority and may find money elsewhere in the city budget to save the jobs of 57 nurses and their support staff as well as the inspectors.
Clinton R. Coleman, Schmoke's press secretary, said the mayor probably would not make a final decision on what programs will be cut before next week.