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PUBLIC HEALTH DEPARTMENT CONSOLIDATION <br />ANALYSIS OF FINANCIAL AND SERVICE IMPACTS <br />RECOMMENDATION OF THE RCLGSSC <br />Total consolidation, under County authority, of the Ramsey County and <br />St. Paul Public Health Departments, with transfer of St. Paul Housing <br />Services to another St. Paul department. <br />PUBLIC HEALTH ASSUMPTIONS OF THE STAFF SUBCOMMITTEE <br />1. Housing and animal control functions shall remain with the <br />municipalities. <br />PROPOSED DESIGN OF A CONSOLIDATED PUBLIC HEALTH DEPARTMENT <br />This proposal for a phased -in merger of the Ramsey County Public <br />Health Department and the St. Paul Division of Public Health was <br />developed in response to the RCLGSSC's above recommendation. <br />With a total consolidation of the City and County public health <br />functions, the Ramsey County Board of Commissioners would serve as the <br />Board of Health for the County. <br />First, staff recommend that a single work group be established to <br />implement a merger. The County would form a work group of County and <br />City staff with the authority and purpose of defining and implementing <br />the administrative and programmatic steps necessary to develop a <br />merged Public Health Department. The work group could address the <br />merger of specific program and service functions in a number of ways. <br />One proposed approach is presented below. <br />1 Combine Community Clinic Funding and Contract Administration. <br />Currently, the City and the County contract with eight <br />neighborhood clinics in St. Paul in order to subsidize the cost of <br />medical and dental care for uninsured and underinsured residents. <br />Combining Community Clinic funding and contract-administration <br />would shift about $500,000 of general funds levied from St. Paul's <br />tax base to a County -wide tax base. One of the community clinics, <br />American Indian Health Care Association, also receives a grant <br />from the State of Minnesota through the City of St. Paul for <br />outreach services to Native Americans. <br />This could be done with no impact on personnel. This is an <br />administrative function, therefore, impact on staffing levels <br />should not be an issue. This should lead to simpler contracting <br />and reporting requirements for the community clinics. <br />This recommendation was proposed by the City in the 1989 health <br />merger report. <br />Page 20 <br />1 <br />