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Health Department collaboration creates savings

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An investigation into the steps that caused the Putnam Health Department to fall into financial crisis is moving forward, but lawmakers heard from Dr. Rahul Gupta, Kanawha-Charleston Health Department Executive Director, during an interim committee meeting Sept. 24 about the successes seen in the two departments' collaboration.

"They were spending way more than they were incurring, and because of that, because of overhead, with a lot of the expenditures, they couldn't keep up and the services were going down," Gupta explained. "So our job was supposed to increase the services, but at the same time, reduce the overhead."

When legislators pressed Gupta about the issues in Putnam County that occurred before the July collaboration with the Kanawha-Charleston Health Department, he told them there is a degree of investigation, so he was limited in what he could say.

"I'm no accountant, … but there were problems that should have been looked at three years ago," Gupta said.

He told lawmakers he began hearing about issues in Putnam County in early June, so his department reached out and began to develop a contract of services. Kanawha County began offering the services July 1, and Gupta touted the strategies utilized in the collaboration along with the results.

He said there had been a net increase in public health services of 283 percent for Putnam County residents, and the net projected decrease in the annual budget is 41 percent, or $515,036. He estimated the savings at $9 per person in Putnam County.

He said that from January to June of 2013, the Putnam Health Department had conducted 10 restaurant inspections. Since July 1, with one sanitarian from Kanawha County, 50 food inspections had taken place in Putnam County.

"This was a crisis situation, so the results are not typical," he said. "But it shows an example of how when things are done in a more efficient manor, there are benefits to be had."

Gupta said inventory and overhead costs were reduced, resource management was improved and they worked on business-to-business communications as part of the quality improvement process utilized in Putnam County to streamline operations.

When Sen. Mike Hall, R-Putnam, asked Gupta about health department funding, Gupta explained that roughly 50 percent of county health department funding comes from state aid, but it's a complex formula.

Gupta said he would not play the "blame game," to pinpoint what went wrong in Putnam County, but reminded lawmakers that the field of health care is currently being overhauled.

"The externalities are changing, and boards are becoming accredited; there is money tied to accreditation," Gupta said. "There is an opportunity to leverage federal dollars if we have our act together, and right now we don't."

Hall said there were three groups of people who, in theory, should have had some oversight over the Putnam Health Department: the Putnam County Commission, the state board of health and the local board of health.

He said the state indicated it had tried to communicate with the county. The commission members thought the board of health had everything under control.

"You normally trust that people will do what they're supposed to do," Hall said. "I'm interested to see how this happened with two or three groups that had some degree of oversight. … I also would not be so unkind as to say they weren't following normal protocol."