Nearly half the members of Carroll County Association for Retarded Citizens' residential program rely on the county Health Department's neurological clinic to treat seizures or other neurological problems.
But the clinic is scheduled to close. It will be just one of the services lost or reduced by Dec. 31 as Carroll's Health Department absorbs a $659,000 cut in state contributions to its $7.5 million budget.
"We are certainly disappointed, and it will have a great impact. It's been a much-needed service used by our clients," said Timothy J. Atkinson, executive director of CCARC.
Mr. Atkinson said 12 of the 28 residential program clients and several of the 80 day-program clients attend the clinic.
He said the staff is looking for alternative sources of service, but what the solution will be, "at this point, I just don't know."
Health Department officials determined the cuts on the basis of "What are the most important programs we have to keep for the benefit of the community?" said Larry L. Leitch, deputy health officer.
Plans call for eliminating six nursing bureau services and reducing hours in walk-in and immunization clinics.
Six nursing employees face layoffs at the end of December.
In the Environmental Health Bureau, seven services are targeted for elimination and two for cutbacks. Eight employees have received notices that they will be laid off. These programs will remain intact if the county commissioners agree to increase some fees and charge for some services that now are offered free.
The health clinics are being phased out as the physicians work with patients to find alternative care, Mr. Leitch said. For example, in the audiology clinic, where individuals can obtain hearing tests and be fitted for hearing aids, the staff will complete services to the 50 to 60 persons now enrolled, but will not accept new clients, Mr. Leitch said.
Nursing services scheduled to end include: fluoride rinses for children whose drinking water source is not fluoridated; an ear, nose and throat clinic where youngsters are checked for ear infections, deviated septums, nasal polyps and throat tumors; and a personal care program to help disabled persons live at home rather than enter nursing homes.
The state Board of Public Works authorized the diversion of several million dollars from drug and alcohol programs to the personal care program early this month, but Mr. Leitch said he does not know how much Carroll County will receive.
Vision and hearing screenings in schools are to end under Health Department auspices. But an education official has said that the county school system is under a state mandate to provide the services.
In the area of environmental health, the department will no longer issue open burning permits or respond to complaints.
Sanitarians issue 400 to 500 open burning permits a year after checking each site for health or safety hazards.
"We wouldn't issue permits for any sites we haven't visited, so any open burning [in the future] would have to take place without a permit," said Charles L. Zeleski, assistant director of environmental health.
Mr. Zeleski estimated that sanitarians respond to an average of one complaint about burning a week during working hours and about 20 a year during off hours.
Complaints usually concern smoke blowing from an open fire into a neighbor's house, someone burning without a permit or someone adding a prohibited substance such as plastic or old tires to the fire, he said.
The frequency of food service inspections will be reduced, but Mr. Zeleski said details have not been worked out. For example, the bureau may continue to inspect restaurants three times a year and reduce the frequency of inspections of businesses that sell only prepackaged foods, he said.
The Environmental Health Bureau will stop testing private wells for contamination, leaving it to homeowners to contract with private labs for the service. It will eliminate quarterly tests of food service facilities served by wells.
The bureau also will stop investigations of well contamination unless the contamination shows fecal coliform bacteria, an indicator of disease-causing bacteria, and officials will reduce inspections of public swimming pools.
Tenants who complain that roaches are sharing their apartments will no longer be able to call a Health Department inspector. The department also will stop checking mobile home parks for health problems.
Builders outside public water-service areas still will be required to pump new wells to determine if the wells' capacities meet state standards, but sanitarians will no longer observe the tests.
"I guess we'll have to take someone's word for it. We won't be there," Mr. Leitch said.
The walk-in clinics where individuals can obtain pregnancy testing, blood pressure screening, referrals and tuberculosis testing will be cut from 45 to 36 hours a week, Mr. Leitch said.