Knoxville — The Marion County Board of Supervisors held a budget meeting with the Marion County Public Health Department this afternoon, which prompted one supervisor to ask several questions of how the department does business. 

Supervisor Craig Agan raised questions about the salary of Public Health Director Kim Dorn. Dorn's salary, presently at $68,761 for this fiscal year, has increased by $20,000 in the past three years. 

Her salary receives preliminary approval from the Board of Health. The supervisors also approved her salary last year. 

"We don't have anybody in the county with raises like that," Agan said. "It seems excessive to me." 

Pat Stockton, a member of the Board of Health, explained that his board surveyed the salaries of the health department's positions. The Marion County salaries were compared to those of employees in similar roles in other counties around the state. 

"(Dorn) was way out of market on her salary," Stockton said. Dorn's salary was "substantially under" the pay of public health directors in the state. Stockton said the Board of Health did not consider the pay of other Marion County employees, just statewide figures for Public Health positions. Since the survey was completed, the Board of Health has taken action to bring Dorn's salary in line with others in her field. Thus, the $20,000 pay increase in three years. 

Dorn added that the salary figures were taken from information provided by Iowa Workforce Development. IWD indicated that Marion County salaries should fall within the 25-75th percentile in the state. 

Agan was also concerned about the fact that Dorn is not a registered nurse. He asked if others in her position usually are.

"They're not all registered nurses," Dorn said. She added that, in some large counties, Public Health Directors come from more of a business background. 

The salary discussion was fueled, in part, by a disparity in pay raises for the 2011-12 fiscal year between Public Health employees and others on Marion County's payroll. The Board of Health approved a budget last year that included a 2 percent raise for all employees. According to Stockton, this was done in anticipation that the supervisors would give the rest of the County's employees a 2 percent raise. However, the supervisors provided a $400 per employee raise, rather than a percentage. 

"It was not at all intended to be sneaking around," Stockton said. For the next budget year, which was the purpose of the meeting, Public Health based its proposal on providing no pay increases for employees. The overall budget increase proposed by Public Health is $21,872. 

MCPH serves as a pass-through entity

Concern was also raised about reducing employees inside Public Health and protecting Marion County taxpayers. 

Marion County Public Health (MCPH) administers different federal programs aimed to help local residents. These include Women, Infants and Children (WIC), as well as Maternal Child Health (MCH). The role of MCPH is that of a "pass-through" organization, which means it is a medium through which money comes in from the federal government and distributed to others. 

In addition to that, MCPH is also a "hub" for WIC, and administers funds for five counties. Agan is concerned that Marion County taxpayers may be paying for WIC expenses incurred by other counties. Dorn said that is not happening. 

"I looked at some of the bills," Agan said. "They were all over the place. It looks like we're exposing ourselves in an unnecessary way." 

Dorn said the role of MCPH is to ensure that the federal money is being spent, according to the rules of the federal program. Before any federal money is paid, through MCPH, it must be approved at the state level. Board Chairman Sam Nichols agreed, that the only liability befalling Marion County would be if the bills are not paid, or if MCPH pays a claim without submitting it for approval from the state. 

"It's all flow-through," Dorn said. Agan continued to raise concern about the documentation of expenditures, and asked if there are any programs that concern Dorn. Dorn admitted that she has concerns about the process for MCH. 

"We need to make some changes to that program," Dorn said. She encouraged Agan, if he had other concerns would like to know more about the process MCPH follows when handling federal money, he was welcome to come to the office and observe. 

"I was out, but I didn't see anything," Agan said. He added that he just wanted to be sure that Marion County taxpayers were not paying for expenses incurred by other counties. 

Other concerns raised

Supervisor Jim Kingery expressed his concern about the department's proposed budget ($20,000) for office equipment and furniture. 

"I don't want to spend a bunch of money on furniture," Kingery said. Dorn told him that $12,000 of that figure was just to cover the expense of the department's copy machine. 

MCPH moved into a new building last year. Dorn said that despite the move, not much new furniture was purchased.

"We don't have a lot of new desks," Dorn said. 

"The bottom line, there has been huge expenditures," Agan said. "It just really looks extravagent." 

He added that he was concerned about the amount of money budgeted for information technology expenses. According to Dorn, this is due, in part, to the completion of the Emergency Operation Center at the new MCPH building. Grants were received for this, and the grants are nearing their expiration date. Dorn said it would be terrible to lose funding and not have the equipment necessary to serve the people of Marion County. 

"I think we really need to sort out our wants and needs," Agan said. Agan was also concerned about the department's dependence upon grants, which is still taxpayer money. Dorn and Nichols both indicated that while that is true, if Marion County does not utilize the grant money, other counties will. They would rather see Marion County residents receive the benefits. 

Meetings Tuesday

The Marion County Board of Health is scheduled to meet at 7 a.m. Tuesday. The supervisors will meet at 10 a.m. Discussion of the MCPH budget is expected to continue at the supervisors' meeting. 

We'll follow up and have more information in the Feb. 24 Journal-Express.