After a two-week delay because of a $670,000 gap in two spending proposals, the Lexington-Fayette County Board of Health approved a $28 million budget Monday.
Earlier, the budget process also had to deal with a $2.1 million deficit. That resulted in 23 employees losing their jobs at the health department and 19 positions being eliminated at the Primary Care Center.
There had been a discrepancy between budgets put forth by Dr. Rice Leach, the health commissioner, and William North, executive director of the Primary Care Center. To close the gap, Leach froze a number of positions to save $370,000. North cut rent, temporary staff and janitorial service and repairs to save $300,000.
The care center serves 17,000 people a year, many of them low-income.
Cuts in state Medicaid funding and an increase in expenses, such as the amount of money the department must pay into the state retirement system, have contributed to the deficit and the cuts, Leach said.
In addition to laying off employees, the health department already had announced that it is cutting services, including a program that provides health care to refugees, and reducing the scope of mosquito spraying in the county.
The health department announced last month that it no longer would fund the Bluegrass-Aspendale Teen Center and the Center for Creative Living, a day program for elderly patients.
The budget woes come at the end of a difficult fiscal year.
The health department is the focus of an investigation by the state Office of the Inspector General and the Kentucky Board of Pharmacy. State Auditor Crit Luallen is examining the department's finances at Leach's request. A federal review concerning an $11.7 million grant to build a new clinic raised questions about how tax dollars are allocated to the department's Primary Care Center. The health department has received about $37 million in property tax money since the city began collecting the tax specifically for the health department in 2005.