Utah County health chief warns inflation, staffing and shrinking fund balance threaten services

Eric Edwards, executive director of the Utah County Health Department, told the County Commission on June 28 that the department must plan beyond one-year budgets to keep up with rapid population growth, inflation and statutory duties.

"We're all feeling the inflationary impacts of what's going on right now," Edwards said during a detailed briefing on the department's revenue structure, staffing and program obligations. He said the department is working to develop 3-, 5- and 10-year budgets to inform capital projects and staffing needs and to avoid repeating year-to-year shortfalls.

Edwards outlined drivers of higher costs including salary and benefit pressures, supply-chain constraints for medical and environmental testing supplies, and rising mileage and vehicle-replacement needs. He also noted that many grants are earmarked for specific programs and cannot be repurposed for core statutory responsibilities. "One clear-cut reason is simply ... grants are earmarked for one specific thing," he said.

The presentation showed that the department is budgeting to use a substantial portion of its fund balance in 2022. Commissioners and staff agreed the department's numbers indicate about $7.2 million of 2022 operating costs are covered from fund balance, leaving limited cushion. Edwards warned that relying on one-time fund balance for ongoing operations is not sustainable and could force difficult choices about which statutory duties to prioritise if no stable, ongoing revenue source is found.

Edwards described several near-term actions: using newly available state minimum performance dollars to hire environmental health staff required by statute, pursuing a possible Northwest facility or lease to reduce travel for WIC and other services, developing in-house IT and informatics solutions to replace costlier third-party systems, and scheduling a July 13 work session on an innovative approach to mosquito abatement and other cost-saving measures.

Commissioners asked for the Health Department slides and for an overlay comparing population growth with health department funding. Edwards said he would provide the slides and population projections and agreed to prepare an overlay comparing population and past funding trends.

Edwards also stressed workforce risks: several divisions, notably health promotion, have experienced unusually high turnover and the department anticipates further pressure if market wage adjustments elsewhere continue. He said a conservative 5.5% wage increase was being used as a working assumption while the county completes its market survey.

The presentation and discussion concluded with a request for continued budget dialogue and for commissioners to consider stable funding options so the department can meet statutory responsibilities and plan strategically.

The county asked for the presentation slides to be circulated to commissioners.