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These programs are relatively small in terms of staff; the <br />functions are housed at 555 Cedar Street. <br />The merger of these programs would involve shifting the tax base <br />from a City -wide base to a County -wide base. <br />4. Merge the City's Epidemiology and disease investigation functions <br />into a County -wide Public Health Department. <br />This recommendation should be closely tied to the merger of the <br />City /County Environmental Health Divisions. The merger of <br />epidemiology and disease investigation functions would involve a <br />sizable move of services. Constraints again center around <br />personnel issues. <br />5. Delivery of Clinic Services. <br />Clinic Services includes AIDS testing, Sexually Transmitted <br />Disease Clinic, Family Planning, Colposcopy Testing, Refugee <br />Health, Dental Health, Immunications, Laboratory Services, Breast <br />Cancer Screening and Treatment, Tuberculosis and Communicalbe <br />Disease Control, Lead Poisoning Intervention for Children, <br />Nutrition Services and Women, Infant and Children Program. These <br />functions are funded primarily with grants to the City. These <br />functions could be moved to the County or remain in the City with <br />the County contracting with the City for specialized services. <br />Under the latter option, city staff could then chose to remain <br />with City employment under contract with the County or move over <br />to County payroll. <br />6. Other Implementation Issues. <br />There are two implementation issues related to revenues for a <br />merged department, these issues are <br />o Tax Levy Funds. Ramsey County would need the authority to <br />raise the necessary tax levy funds to replace the levy <br />supported services in the City. Levy limits are supposed to <br />end in 1995 which would deal with the issue if implemented as <br />planned. However, if levy limits are retained, the County <br />would need to get a special exemption from the levy limit for <br />a period of 5 to 7 years for merger related activities. <br />Community Health Services Subsidy. This subsidy comes to the <br />County and is currently passed through to the City. A <br />mechanism for transferring the CHS subsidy should be <br />developed early in the implementation process. <br />3 <br />Page 22 <br />