IN YOUR CORNER

We have had a bit of confusion in trying to track monies collected

for use by the Hospital Review Board. In Chapter 32 of the Martin County

Code, Article II, "the board of county commissioners of Martin County is

authorized and directed to levy a tax of not less than one-fourth mill

nor more than two (2) mills per annum on the assessed valuation of all

taxable real and personal property in the county for the purpose of

providing funds for the payment of hospitalization of indigent

residents". This goes on to mandate the creation of our Hospital Review

Board, and states that "the excess remaining unexpended in the fund at

the end of the budget year shall be paid into the general fund".

The Social Services Division of the Martin County Community

Services Department oversees this task, as well as other state and

federal health service mandates handed down to our county over the

years. Overall, county social medical expenditures in FY 1999/00 were

$4.3 million.

In FY 1999/00, the one quarter mill generated $2,180,920 for

indigent care. The Hospital Review Board expended $1,460,701 for

indigent medical expenses, leaving the balance of $702,219 to be

deposited into the General Fund in accordance with Chapter 32 of the

Martin County Code. While this one quarter mill more than takes care of

our indigent hospitalization claims, the county spends an additional

$2,042,535 on the medical expenses of the poor and needy in our county

from the General Fund. The above costs cover Martin County residents

only, and these applicants are meticulously screened for proof of

residence. The county also spends approximately $800,000 for Martin

County prisoners.

The Martin County budget document does not show this one-quarter

mill tax as a Revenue Source for the Social Services Division. Instead,

it is listed under a Line Item Summation generally referred to as Other

Grants and Aids.

We have requested that the county government use a more

straight-forward approach in reporting these revenues and expenditures

and look forward to working with the county towards that goal. Although

we may not wish to go so far as Palm Beach County which has created a

Health Care District whose independent board manages its health care

costs, a better approach is needed.

***

During 1999, the Martin County Taxpayer Association selected four

county procedures for review. They were Capital Expenditure Request

Justification, Real Estate Acquisition Procedure, Exit Review Process

(better understanding our personnel attrition), and the Process to

Justify New Hires. Some progress was made in the first three tasks, but

the justification of new hires is still a work in process. This is a

complicated procedure, with no quick fixes.

Recently, it was reported that a commissioner-elect requested the

county hold the line on filling selected job openings until their need

can be supported by a thorough review process, and a good place to start

may well be some of the unfilled openings in the Growth Management

Department, which has tripled in size in the past decade. There are many

in our county who say that the layers of bureaucracy which have been

added to county government have slowed many of our processes at great

cost without increasing the quality of the output. Proving the need for additional technical,

clerical and administrative personnel is a very difficult task, as opposed to

measuring labor needs using standards of output. We have witnessed

examples where the addition of new job duties triggered a requisition

for more personnel rather than a thorough review of existing talent and

personnel to absorb or share the new tasks. We would rather see a more objective justification

process. We feel the review process that was proposed is a

strengthening of county policies which results in a higher level of

confidence in subsequent hiring decisions. This would alleviate the need

to question each decision and/or micromanage the hiring process.

Our organization is dedicated to helping in any way we can to

effect a lean and efficient county government and the optimal use of

taxpayer dollars; therefore, this column should be construed as an offer

of help.

***

Over the next several columns, we intend to reflect on the fiscal

changes in our county over the past ten years. We will show our growth

as reflected in the assessed property values, millage rates, number of

employees, variety of services, and so forth for the county government

and the school district from 1990 through the fiscal year of 1999/00.